Archive for March, 2011

It Is So Good It Makes You Sick! . . . Or Really the Other Way Around.

15 March 2011 1 comment

As the health care reform continues in the States, there is always some pointing across the pond.  France’s health system has always been a gem in the eyes of the World Health Organization.  Other countries have examined just how the French do it as well as big names in documentary film as Michael Moore.

I may have loathed in earlier posts at the process of getting my social security number but now that I have it, it is fair game with the Mediterranean germs.  Round 1 was just recently.

Sunday evening I enjoy the company of close colleagues and some good home-cooked ethnic food.  After the wine bottles were finished and the karaoke machine showed signs of boredom off-pitch voices, we said our au revoirs and bisous.  Unfortunately for me the night continued a little further.  I realized tout de suite that the food I had eaten was laying heavy in my stomach.  There were some new dishes for my digestive tract to assess.  I didn’t really pay it much mind as I thought after a good night’s sleep I should be ready the next Monday morning for another work week.   Unfortunately I woke up a couple times in the night by my stomach and felt compelled to eat something and drink some water.  Then my alarm was going off.  To my surprise my stomach still weighed heavy and as I was getting ready for work, there were clear signs the situation was getting worse.  I had a full fledge gastro.

After leaving a message with my manager that I was not going to make it in the office, I began to assess the situation.  It is company policy (not a French state thing) at Amadeus to still get a certificate from a doctor when you call out sick for one day.  If you don’t, then that day will be docked out of your personal time and not counted on payroll as sick leave.

I am very happy with the doctor I have found in Nice and established a good relationship. I only have one negative feedback to his practice, he is always closed on a Monday.  So I am calculating in my bed how I should handle the situation.  A friend generously sent me a SMS of the address of his doctor to go for an appointment.  As you can imagine, I wasn’t really in the mood to leave home, hop a city bus, wait in a lobby to see a doctor just to really obtain a piece of paper.  Then I remembered about the medecins domicile, or the doctors that make house calls.  Yep, they still do exist . . . at least in this country.  I called the 800 number and a pleasant woman answered the line.  I explain my situation in French and asked for a doctor to come see me.  I apologize for my mauvais French and that I am an American.  She asked where I was from in the States and I promptly replied Philadelphie.  Immediately she switches to impeccable English and proudly states she is German.  “I heard there is a big German community in Philadelphia!”  I bend over to rest my head on my kitchen counter and force a smile to confirm her sudden revelation.  I’m struggling at that very moment to understand what that has to do with the fire that is going on in my stomach.  She finally concludes that it will be a few hours before a doctor can arrive at my address.  I said that is fine and hung up the phone.  I figured I would rather spend those few hours resting on my couch, in my sweats instead of having to get fully dressed and finding a new doctor . . . out there.

I then grabbed a piece of paper and wrote in French what has happened in the last 24 hours in reference to my health.  I had low expectations that someone with good English would arrive and my French writing skills are better, particularly since I wasn’t at a 100%.  I figured it would be better if they read my story instead of me doing charades and not pronouncing my “a”s hard enough.  So my one page journal entry, my Carte Vitale and my insurance card awaited their knight in shining armor du jour.

Take your pick . . .

Take your pick . . .

Time passes. A young doctor rang my intercom to be buzzed into the building.  I welcome him into my apartment when he gets off the elevator and to my relief, he spoke very good English.  He quickly reads my love letter to him and asks me a few more questions.  He did a brief physical exam of my abdomen on my couch.  Of course he confirmed what I already knew that I have a gastro.  Well he decides to give me an arrêt de travail (stop of work) that lasts for three days.  He made it clear I should stay home longer than just one day.  So here is where company policy ends and the national law begins.  Doctors do carry the power here to determine the health of the worker.  Once an arrêt de travail is issued, a company in France must obey it.  The doctor says I stay home for three days, then my employer must acknowledge it.  If the arrêt de travail is compromised, then the employer could be fined.

I witnessed shortly after I started at Amadeus a colleague having an arrêt de travail for four days actually show up for work on that fourth day.  The managers were upset that she came to work in spite the fact that she felt all better and wanted to come into work.  (yes, read that sentence again)  The company could be liable if the unions ever hear of such a compromise of contract.  Not to mention, the State kicks in a bit on the payroll when an employee is out sick.

All said and done, my doctor gives me my prescriptions and the paperwork I must turn into my employer.  It is true, the French love their drugs as he gave me four different varieties.  One for the virus itself, one if diarrhea continues, one for stomach pain / bloating and one for a fever (just in case) even though I didn’t have one.  Two of the four prescriptions require that you put the pill under your tongue and let it dissolve for quicker absorption.

So here is the punchline, how much do think this whole experience just costed me?  Only 46 Euros! Most of you probably have that amount in cash in your pocket now.  That 46 is without any insurance discount rates – it is the full price! I quickly wrote him a check and off he went.  Of course I will get my 46 Euros back once I turn in the paperwork at work to be mailed to the State for reimbursement.  So in the end, the visit will not cost me a centime.

(A regular doctor’s visit at his office will only cost you 22.50 Euros.)

As a sidebar, the State will not pick-up the full tab.  The magic number here is 70, as in 70%.  The State covers 70% of your medical bills including doctor visits, hospital stays and prescriptions.  The remaining 30% is up to you to cover.  In France there still is a concept of health insurance that you need to buy called a mutuelle.  They pick up the remaining 30% of your bill.  Amadeus includes a mutuelle for all full-time employees.  No co-pays.  No direct contributions.  It is a done deal.  No worries.

For some, a state system doctor is not their taste and prefer a private one.  That is still possible here in France and there are plenty of private doctors to choose from.  Just be aware of that your reimbursement from the State goes down to only 50% for certain out-of-network of providers and even lower to a measly 30% for a doctor that wants nothing to do with the State.  Still not bad for a fringe benefit of being a citizen.

Still thinking there is a catch? Well there is one minor one.  You do need to mail a copy of your arrêt de travail within 48 hours that it is written.  So yes, you need to muster up the energy to make it to the mailbox.  Still, nothing to really complain about.

In closing, I was conversing with my new friend Clara, a French school teacher, where we do a 50/50 exchange of French and English.  The shared experience of an arrêt de travail had come up in our recent discussion. She asked “What would you call it in English?” I looked at her and said, “It doesn’t exist in the States, there isn’t a translation for it.”  After a pause she concluded “I’ve thought about moving to the States to work but it is because things like that, I don’t.

Categories: Everyday Life