Roman fell badly on his arm a little over a week ago (the kids were wrestling, again). He cried on and off that night, but he was pretty jolly the next day so we went ahead with a trip to Paris on the Sunday (some great parenting there…)
By that night Roman was still dangling the hurt arm like a scarecrow, so on Monday we decided that I’d take him to the Emergency Room/ urgences / A&E.
We got to the hospital at 12.30pm, and finally saw a doctor after six hours. Almost eight hours later, we left the hospital to head home.
It was not an impressive showing of the French healthcare system.
The waiting room was crammed with people (at least for trauma, there was no separate area for kids). At first all the seats were taken, so we sat on the floor. It was dusty, and I kicked away some lumps of mud that people had walked in. We kept wriggling back against the wall as ambulance crews rolled moaning patients past us on stretchers, since the pedestrian door doubled up as the ambulance unloading bay.
We found seats shortly afterwards and read some of our library books, but as Gaston got more tired he started throwing himself on the floor and yelling. Thankfully he fell asleep on me for about an hour. After the first four hours, I got out the Amazon Fire tablet for Roman to play games.
It was past normal dinnertime, but the hospital shop was a short walk away. I didn’t dare leave in case we were called. Fortunately a very kind French lady lady who’d been waiting with her husband since 8am that morning (she told me that he needed a specialist doctor) fetched us some bags of chips. She refused to take any money from me.
No one else seemed particularly surprised at waiting for so long – or at the dirtiness of the waiting room. When I took the kids to the bathroom, I saw that someone had thrown a blood-soaked bandage in the open-topped garbage can. (It was still there three hours later, half-covered by the paper towels).
I asked a father waiting with his daughter (suspected broken arm), whether the timing was normal. He shrugged: “When more serious cases arrive, they are seen first.”
The lady next to us said it was an “old hospital”, which didn’t really explain the apparent doctor shortage or the grime. “It’s best to always call an ambulance”, she added. “Anyone that comes in by ambulance is seen straight away.”
The doctor was very pleasant, although he seemed tired. Roman had his arm x-rayed, and we waited again for some time, now in a strange room that had half a cocktail sausage on the floor, and a tiny bathroom with no sink.
The verdict: Roman has a growth plate fracture at his elbow. The doctor wrote the diagnosis down for me: “Decollation Epiphysaire Salter 1”, which I had to look up on the internet back at home.
I asked for the bill at the reception desk: the total out-of-pocket cost for the visit – doctor consultation, the x-ray and the cast/bandaging – was 75 Euros ($88).
The downside: a very long wait and a nasty waiting room. The upside: it was dramatically cheaper than the US.
Was our experience typical for France? I don’t know.
The French healthcare system has a good reputation. Back in 2000, the World Health Organization rated France’s healthcare as the best in the world (it was the only time they made a ranking, which was based on life expectancy, access, out-of-pocket cost, satisfaction, and so on).
France has universal healthcare, mostly paid for by a public healthcare insurance scheme. Most of the direct costs to the consumer (about 70% of bills) are covered by the state through social security contributions taken from workers’ salaries (about 6/7%).
The majority of people pay for “top-up” private insurance to make up the difference (apparently 10 Euros/month covers most medical costs, and about 100 Euros/month buys a high end plan). Long term illness is fully covered by the state.
The French government fixes the fees for most services – for example, 23 Euros for a doctor appointment, 25 Euros for a specialist. (At some point a compulsory fee of 2 Euros was introduced for an ambulance journey, in order to encourage responsible use…)
Everyone has the option of going private, for doctor or hospital visits, but the charges are higher.
I’m presenting our experience here not as some comprehensive critique or commentary (of course, it’s based on one hospital), but because it strikes me as interesting.
(I’d add that we’ve seen the local GP here twice, and both times he refused to charge us the 23 Euros fee…adding that to the sweet lady who fetched us food at the hospital, we have been the beneficiaries of some lovely kindness).
Anyway, Roman has been excited about his plaster ‘power-arm’. He doesn’t seem to be suffering too badly, at least so far. It took all of one day for him to start wrestling and beating his brothers with his one good arm.