So I am back living in the US. I haven’t been able to write in my blog since I moved from France, as I have been pretty busy starting a new life from scratch: getting a place to live, my driver license, etc. This is in addition to starting my new work, since doing my work in Paris and doing it in Sunnyvale has been a different experience.
I had not lived in the US for years, and I lived on the East coast before now being around San Francisco, so after 4 years in France,
I have experienced a pretty big culture shock.
Anyway, out of the hundreds of things I’d love to have time to write about, one of the experiences that has surprized me the most is the
health care system.
While at MIT, I was going to the MIT hospital. It was pretty easy: you need an appointment? You call the hospital, and you have it.
It’s a little bit like France: you are insured via the national social security system, and usually an extra private insurance that your employer gives you. If you need to see a doctor, you call to make an appointment, show up, and you’re done. You may even just show up and this is it. No need to fill in tons of forms, or anything: you go, pay about $20 (19 of which are reimbursed to you automatically a few days later), and say bye to the doctor.
My experience here is slightly different. It goes like this:
- Choose your health insurance among the ones your company provides: there are tons of variables. Good luck to you.
- Pick a primary care physician (PCP) on the insurance Web site; they have a nice database of doctors to make it easy for you.
- Receive your health insurance card with your choice of PCP marked as invalid.
- Pick another PCP from the database.
- Receive a new card, showing the right doctor this time.
- Try to make an appointment with the PCP you just chose, and be told that this doctor cannot be chosen as a PCP.
- Curse your insurance database, and pick another PCP.
- Try to make an appointment with this new one, and be told that this doctor does not accept new patients.
- Curse the insurance database again; go through the database and call each doctor to check whether he or she accepts new patiens to confirm that the database is correct; find out that it’s often wrong.
- Finally find a PCP which accepts new patients and choose him.
- Try to make an appointment, and be told that the next available appointment is in two months, but that you can call first thing in the morning to make an appointment later that day
- Call a few days later first thing in the morning, and be told that the doctor that accepted new patients a few days ago just decided not to anymore
- Lose patience on the phone; result: finally find a PCP which accepts new patients, and can see you soon.
- Make an appointment right away, before the doctor changes his mind
All I can say is that I don’t understand how the US can have such a screwed up health care system. In the same vain, going to the pharmacy for a tiny bit of cream, you can hear the lady at the counter telling you: “It’s going to be $220; oh, I’m sorry, you have insurance, that’s the price without insurance.” In France, things are actually a little screwed up, as you don’t even need to pay, most of the time, to get medications at the pharmacy. The result is that people do not realize that medications cost money, though in France a tiny bit of cream costs more around $10 than $220.
After 4 years in France, health had just become something that one does not worry about, which is the way it should be. But going back to the US, I was just reminded that it’s not the case everywhere in the world, and that staying in good health is a real privilege even in certain developed countries.