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[Ed. Note: This letter was taken from the dailykos.com blog from a writer living in Paris. All spellings are just as they are spelled in the "non-American" version, e.g., "specialised" as opposed to our spelling of "specialized."]
Fri Apr 20, 2007 at 11:15:40 AM CDT
As the next exam for my son gets near (next week), I though I'd provide a short summary of my family's dealings with a socialist, centralised, single-payer healthcare system.
As a reminder, my (then 4 years old) son was diagnosed 2 and a half years ago with a brain tumor. He underwent surgery, then chemiotherapy for a year and a half. Early last year, he appeared to have been cured, but the tumor reappeared last autumn, and he underwent radiotherapy this winter. Next week we'll know how that is working.
In the meantime, as a consequence of surgery, he is handicapped and only very partial use of one arm.
He was first diagnosed by our pediatrician, a private sector doctor, who sent us to the (public) specialised pediatric hospital in Paris for additional exams. We did a scan and a MRI the same day, and that brought the diagnosis we know. He was hospitalised the same day, with surgery immediately scheduled for two days later. At that point, we only had to provide our social security number.
Surgery - an act that the doctor that performed it (one of the world's top specialists in his field) told us he would not have done it five years before - actually took place the next week, because emergency cases came up in the meantime. After a few days at the hospital, we went home. At that point, we had spent no money, and done little more than filling up a simple form with name and social security number.
Meetings with the doctor in charge of his long term treatment, and with a specialised re-education hospital, were immediately set up, and chemiotherapy and physical therapy were scheduled for the next full year.
Physical therapy included a few hours each day in a specialised hospital, with a varied team of specialists (kinesitherapy, ergotherapy, phychologist, orthophonist) and, had we needed it, schooling. As we lived not too far away, we tried to keep our son at his pre-school for half the day, and at the hospital the other half. Again, apart from filling up a few forms, we had nothing to do.
My wife pretty much stopped working to take my son to the hospital every day (either for reeducation or treatment) - and was allocated a stipend by the government as caregiver, for a full year (equal to just under the minimum wage). Had we needed it, transport by ambulance would have been taken care of, free of charge for us (as it were, car commutes to the hospital could also be reimbursed).
During the chemiotherapy, if he had any side effects (his immune system being weakened, any normal children's disease basically required him to be hospitalised to be given full anti-biotic treatment), we'd call up the hospital and just come around. Either of us could spend the night with him as needed. We never spent a dime.
After a year at the specialised hospital, ongoing re-education was moved to another institution specialised in home and school interventions. In practice, a full team of 5 doctors or specialists come to see him over the week, either at home or at school, to continue his treatment (such follow up, possibly less intense than at the beginning, will be needed until he reaches his adult size). Of course, they manufacture braces and other specialised equipment for him and provide it free of charge to us.
Check up exams take place every 3 months, with all the appropriate exams (usually including a MRI), and we've never had to wait for the appointments. Again, no cost for us, no funds to be fronted.
When he relapsed, our doctors considered all available options. In the end, the most promising technology was in another Paris hospital. Such technology, linked to nuclear research, exists only in 3 places in the world, one in Boston and one in Switzerland, so the French system itself was able to provide a cutting edge option. But had we needed to go to Germany, the UK or even the USA for treatment because that's where the best hope was, the costs of that would have been covered too by French social security.
Now that our son is in first grade, he has the right to special help for handicapped children at school (a fairly recent law), and he now benefits from part time help - a person who is around about 20 hours per week to help him do his work and catch up when he is absent for his therapy. This is paid by the city of Paris and the ministry of education.
Oh, and as he is officially handicapped, I recently discovered that we actually benefit from an additional tax break (in France, the taxes you pay are roughly divided by the number of people in the family; the handicap counts as
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