Monday, October 26, 2009

What Paris taught me about American health care

Earlier this month my family traveled to Paris together. It was the first time I had been there in thirteen years. So last time I was a newlywed, and this time I saw the city through the eyes of a Mom of a ten-year old. I am sharing this not as a travelogue, but because the experience of spending time in a country that has universal health care really struck me at this moment as we, here in the United States, are debating the future of our current flawed health care system.

Today as the Senate is taking action on their bill, I want to tell you what I learned on my recent trip, but first I want to mention that today I heard a fantastic interview on The Story With Dick Gordon [listen through their website or by iTunes podcast] about a French woman who lived in America for many years, and became an American citizen. She was married to a doctor and and worked as an administrator in his medical practice, but even so they could not afford health insurance for themselves or their employees. So when she became seriously ill, she ended up returning to France for hospitalization and stabilization. Then she came back to America, and was able to get insurance and continued her treatment here. She sees the good in the American system but also the gaping holes in coverage that can leave people untreated, which she says just would not happen in France.

On our recent trip to Paris, I was immediately struck by how family-friendly the city seemed. Our first full day there we happened upon a massive Family Sport Fun Fair, designed to promote healthy living. It was a huge festival taking place in the field next to the Eiffel Tower. The FREE festival featured dozens of activities, from a little Circus School, to boxing lessons from the police, to Aikido demonstrations, a rock climbing wall, badminton courts, wheelchair sports for all to try, and a cool obstacle course. There was even a scuba-diving tank trucked in, which you had to see to believe.

We passed on the scuba diving lessons but did just about everything else we could fit in. I was really proud of Mojo Girl as she scaled the rock-climbing wall and careened down on the huge zip line attached to the top. Here she was in a brand-new city, and she doesn't speak French, so it took all the courage she had to try out these adventurous activities. (At the rock climbing wall we waited in line for an hour and saw about 50 kids do it ahead of us, so we helped translate the instructions for her as we all observed.)

Being in Paris and doing family activities for a whole week I really felt that there is a French esprit de corps that we are lacking here, at least in American suburbia. I don't know if I am capturing the exact term the French would use, and if anyone can direct me to a more accurate term I am all ears. But I felt like the Parisians are really used to being together, in public. Instead of being in a car, for the whole week we walked, or took the Metro subway or bus. The city is crowded and we were surrounded by lots of other people the whole time. But with the exception of one jam-packed subway ride with suitcases, it wasn't uncomfortable. People didn't feel like "strangers," they felt like people. They were generally not overtly friendly but they were not intimidating either, and any time we needed assistance we were able to find it.

So when it came to Parisian kids, I got the sense that they are used to crowds. Take a look at the playground on a Wednesday afternoon when there was no school:

That is public spirit!

We spent a lot of time on the playground (roughly one park visit for every musuem or church visit) and it really and truly struck me to the the core of my heart as I looked at the diverse, playful crowd: every one of these kids has health care. And it felt different. It didn't feel like us versus them, my group versus your group, rich versus poor. It was just KIDS at the park and they all had health care.

American kids deserve no less and we need to keep pushing our leaders as they take tentative steps in the direction of providing options that will make health care for all a possibility.

How to get there is still a matter of great debate and one piece of good news is that there is more than one way to do it! I recommend the Fresh Air interview with author T. R. Reid talking about different health care strategies around the globe, also detailed in his book The Healing of America, and the Frontline special Sick Around the World.

We HAVE to figure out a better way to provide health care in the United States and ensure that everybody has basic coverage. I am afraid that our great American Individualism has become our great flaw: we assume that what we have do it here is the BEST when it's not necessarily so. When it comes to health care and related social/family issues like maternity leave, we can no longer afford to stick out like a sore thumb as the big, rich industrialized nation that has failed to provide the basic protection that we need.

Do you have experience with health care around the world that allows you to see the American system in a different light? Please tell us about it in the comment section.

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Anonymous Sasha Bakaric said...

Hi Amy!
I believe that what is happening in the USA now is a very healthy debate and that it will bring us one step closer to what other developed countries already have - a sense of security in terms of health care, education and basic human rights. Comparing my experiences from Croatia and Denmark I have to say that some health care aspects are better here than there - nicely done waiting rooms, fully equipped delivery rooms and examination rooms. On the other hand you can only stay in that nice delivery room max of 36 hours and you see your doctor for max of 7 minutes. The most important difference is general sense of fear of not only diseases and health conditions (normal) but also fear of potential health conditions severely influencing your life both financially and in many other ways. The women who was on The Story today was our first door neighbor until she got sick, left for France and their house was foreclosed. I felt so sad and almost sick today to hear Ann's story. Part of my sadness was due to the fact that we we not aware of things she and her family were going through. How is that possible?!

9:31 PM  
Blogger Maya Frost said...

Great post, Amy. I agree with everything you said here.

Illness and injury should never lead to personal financial disaster. Those who are suffering from illness and injury should never be refused medical treatment. It's that simple.

And you are dead-on in your assessment of how France (and other countries) have a much more family-friendly approach in general. We've found this to be true in the three countries we've lived in: Japan, Mexico and Argentina.

And as a small-town girl and suburban mom now living in Buenos Aires, a metropolitan area with 14 million people, I agree with your assessment of the "people-ness" and friendliness of living in close proximity and taking public transportation. Rather than living in our cars, the way we did in the suburbs raising four daughters, we walk or take public transportation everywhere. We haven't owned a car in five years and hope we never own one again!

And while in the U.S. we suspect that anyone who is out at midnight is up to no good, Latin cultures embrace late nights and it's normal to see entire families out in the plazas and on the streets together at midnight. People are not inherently scary, but in the U.S. I feel that we are inherently SCARED. That makes me sad. Some of the most amazing experiences of my life--and my daughters' lives--have occurred in crowds of thousands of people with no car "protecting" us from the outside world.

As an expat, I know many, many people who truly appreciate the quality of medical care they receive abroad. Yes, the waiting rooms aren't as fancy and the clinics may not be as fully supplied. but the staff is friendly, caring and well-trained and no patient is rushed or pushed on to the next staff member without having their questions answered in a kind and thoughtful way. There's a sense humanity in the care that tends to be missing in our rush-rush healthcare culture.

It's that same sense of humanity that I experience daily as I walk around the city here, watch people greeting each other with a kiss and taking the time to admire a baby or pet a dog or help an old person rather than rushing on to their next task.

I know that there are plenty of these moments happening all over the U.S. but they are not as visible when we're in a car and not as likely to occur when people are stressed.

I love the US, but I am grateful that I've had a chance to see how others live, love and care for those who need medical attention.

One of the problems with our healthcare system is how we educate our doctors. Other countries do it differently. To see my post on this topic, visit:

7:48 AM  
Blogger Michael Tiemann said...

Just to add to what Maya Frost said ("And while in the U.S. we suspect that anyone who is out at midnight is up to no good, Latin cultures embrace late nights and it's normal to see entire families out in the plazas and on the streets together at midnight."), in northern Europe, there is also much less fear of the night.

When returning from a restaurant in Osnabrück, I noticed that all the streetlights went out just past midnight. In a few seconds my eyes adjusted, and I was amazed at being able to see clearly the stars above, and to be able to continue to navigate to my hotel without the glaring lights above. Never did I feel either danger or that I was myself being seen as a dangerous element.

Another story from our honeymoon concerns Norway. Of course we were there during the time of the midnight sun, yet how amazing it was to meet people at 1am who, like us, were just out for a stroll, with nothing but a glowing light from the South. Earlier in the day we had seen a six year old leading two younger children across streets in the village. I can only imagine what such a display of young independence would lead to for the parents of those children in 21st century America!

Seeing so much peace and freedom outside the US makes me wonder why we cling so strongly to our well-armed, individualistic myths that seem to create only violence, fear, and loneliness.

8:52 AM  
Blogger Melissa said...

When I lived in Japan, as a tourist/student, two decades ago, I required medical care twice during my stay. Both times my Japanese neighbors took me to their doctors, and those doctors provided me with care as if I was covered by Japan's national healthcare system. (While I had American health insurance, both practitioners determined it would be easier for them to charge me the Japanese co-pay than for either of us to have to navigate the American health insurance system.) One of the docs, a dentist, provided me with a root canal and fillings that dentists here in the states later declared to be among the best work they'd ever seen. I've often wondered how my U.S.-based doctors would react to my arriving at their office with a person from another country in need of medical care. -- Melissa

P.S. My husband and I are thinking of taking our son, who will be 12, to Paris next year for our 20th wedding anniversary. (His younger sisters will have to wait their turns.) A large part of my wanting to make the journey is so he can experience, for a few days, life in a livable, family-friendly city--away from the suburban sprawl he routinely sees here in the U.S. It's one of the reasons I routinely take my kids back to our hometown in New Jersey (Westfield). I want them to know that places exist where people walk to school, work, parks, shops, etc.

4:37 PM  
Blogger ErinOrtlund said...

I do. My husband did his doctorate in Scotland. This ended up being a very family-friendly choice for us. I was able to work part-time, before and after my daughter's birth. It's not necessary for someone to work full-time for benefits in a universal healthcare system. I also got a 6 month paid maternity leave, and very generous vacation time for a part-time job. My job was actually a job share--most every woman in my childbirth classes went back to work after their maternity leaves, all on reduced schedules, in a wide variety of professions.

Second child born in Canada. There's a bit of a doctor shortage here, but then I live in a rural area, so I'm not sure it's because it's Canada.

Medical care was great in both countries. In Scotland, midwives and health visitor come visit new moms at home for 10 days. They even readmitted me to the hospital for intense help with breastfeeding. Maybe if I'd ever had a baby in America, I would be disgruntled about one aspect of my care, I don't know. Neither system is perfect but I prefer a universal system because I know I won't be turned away and won't ever face medical bankruptcy.

8:48 PM  

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