en-de  What a French Doctor’s Office Taught Me About Health Care Medium
Was eine französische Arztpraxis mir über das Gesundheitswesen beigebracht hat.

Ich zog nach Europa, weil ich es mir nicht leisten konnte, in Amerika Krebspatient zu sein. Ich wäre lieber zu Hause geblieben.

Von Erica Rex, The New York Times, 2. Januar 2019

TOURS, Frankreich - Ein Dutzend von uns sitzen erwartungsvoll im Wartezimmer des Orthopäden. Wir sind wegen der Nachuntersuchungen hier. Einige, wie ich, wurden von entzündeten Fußballen befreit. Andere haben Hüften oder Knie ersetzt bekommen. Die meisten sind ältere Frauen.

Die auf dem Tisch liegenden Kopien von Paris Match und Le Monde sind mindestens sechs Monate alt. Das einzige Kunstwerk ist ein gerahmter Druck von Claude Monets "Mohnfelder bei Argenteuil". Da ich nur zwei Wochen von der Operation entfernt bin und nicht fahren kann, kam ich mit dem Taxi. Der Fahrpreis wurde vom französischen Sozialsystem übernommen, umgangssprachlich als la Sécu bekannt, welches auch die Krankenversicherung aller Anwohner gewährleistet.

Die Frau, die mir gegenüber sitzt, erzählt mir, dass sie wegen ihrer zweiten Hallux vagus operation hier ist. Ihr Arzt, ein erstklassiger orthopädischer Chirug, berechnet, wie so viele Spezialisten, mehr als die normale Sécu Vergütung. Die meisten Franzosen erwerben einen Zusatzversicherungsplan zur Deckung von Kosten, die nicht von la Sécu übernommen werden. Als französischer Einwohner und Steuerzahler habe ich auch einen.

Eine andere Frau erholt sich von ihrer Hüftoperation. Gespräche über medizinische Behandlungen sind normal in französischen Wartezimmern. Wenn die Wartezeit lang ist, erfährt jeder alles über die Beschwerden des anderen.

Meinen Freunden in den Vereinigten Staaten erscheint diese lässige Haltung unklug, ja sogar riskant. Aber in Frankreich ist medizinische Privatsphäre irrelevant. Niemand wird ihren Job wegen einer längeren Konvaleszenz verlieren. Es besteht keine Möglichkeit, dass bereits bestehende Erkrankungen die Versicherung unerschwinglich werden lassen. Arbeitslose erhalten weiterhin eine Behandlung. Riesige Ärzterechnungen bringen normale Bürger nicht in den Zustand existenzbedrohender Ängste.

Das Fehlen von Besorgnis über die Gesundheitsversorgung verändert die Struktur der französischen Erfahrung. Wir machen es uns in den Wartezimmern gemütlich.

Eine Frau in ihren späten 60ern sitzt neben mir. Sie zappelt herum und scheint den Tränen nahe zu sein. Sie lehnt sich zu mir hinüber und fragt mit leiser Stimme, wie lange es seit meiner Operation her ist. Sie trägt den orthopädischen Stiefel, aber im Gegensatz zu den anderen Ballenladys benutzt sie immer noch Krücken. Sie sagt mir, dass ihre Operation vor vier Wochen war, und sie glaubt, dass etwas nicht stimmt.

Die Frau mir gegenüber beugt sich nach vorne.

"Was ist passiert?" Meine Nachbarin beschreibt ein "Gefühl des Knirschens" - das Gefühl, dass die Knochen in ihrem Fuß knirschen, wenn sie ihn belastet.

Drei andere Frauen beruhigen sie: Das Knirschen der Knochen ist normal. Diese Knochen mussten gebrochen und neu angeordnet werden, um ihren Fuß neu zu gestalten.

Ja, aber der Physiotherapeut sagte ihr, dass der Arzt bei etwas Mist gebaut hat. Jetzt hat sie Angst. Der Therapeut lag völlig falsch, sagen wir ihr. Sie scheint erleichtert zu sein, wird aber wieder besorgt, als sie merkt, dass sie vor einem Monat mit der Physiotherapie hätte beginnen sollen.

Dann taucht der Arzt auf und ruft die Frau auf. Selbst Orthopäden, die so berühmt wie ein Rockstar sind, haben hier keine Krankenschwestern, die ihnen in ihren Praxen helfen. Der Arzt wechselt sein eigenes Untersuchungspapier. Sein Personal besteht aus zwei schlecht gelaunten Büroangestellten, die Termine vereinbaren, Zahlungen entgegennehmen und Rezepte ausstellen.

Die Frau nimmt ihre Krücken. Er hebt fragend seine Hände. Die Krücken? Immer noch? Sie kämpft gegen die Tränen. Wir versichern ihr, dass es in Ordnung gehen wird. Sie humpelt ihm in den Untersuchungsraum nach und schleppt die Krücken in einer Hand.

Ich bin eine zufällige Europäerin. Ich habe 2009 Brustkrebs bekommen. Ohne eine kontinuierliche medizinische Versorgung in den Vereinigten Staaten und wegen des dringenden Bedarfs zog ich nach Großbritannien. Under the sponsorship of an acquaintance, I was granted “indefinite leave to remain” and received care through the National Health Service. Als ich vor vier Jahren nach Frankreich zog, übernahm das französische System schnell meine Absicherung.

It has taken me nine years to grow accustomed to the idea that my health care won’t suddenly evaporate at the whim of a new government. Ärzte fragen oft, wie ich in Europa gelandet bin. Wenn ich es ihnen erzähle, schütteln sie den Kopf. Amerikanische Werte sind gestört, sagen sie.

Sometimes I encounter Americans for whom visiting France is like a trip to Disneyland, only with foie gras, and they’ll ask about medical care.

One such visitor, on learning I have a “carte vitale,” a social security card, asked, “How did you score that?” as if health insurance was like box seats at a Yankees-Red Sox game.

I don’t live in the promotional brochure version of France those Americans are touring. France for me was not a vacation selection. Moving to Europe was a choice weighed against other, grimmer options for health care, which included the strong possibility of being bankrupted by cancer treatment and winding up at the mercy of New York State’s welfare system.

In France I can rest assured I will not be refused care for any treatable condition, including a painful bunion — or yes, even a recurrence of breast cancer. All the same, I’d rather have been able to get coverage without emigrating.

Too many Americans do not realize how much better off they would be if they felt safer about access to medical care. Imagine what might happen if everyone felt safe — safe enough to talk about ailments in waiting rooms.

Erica Rex is working on a book about the use of psychoactive drugs to treat depression and PTSD.

https://www.nytimes.com/2019/01/02/opinion/france-united-states-universal-health-care.html
unit 1
What a French Doctor’s Office Taught Me About Health Care.
1 Translations, 0 Upvotes, Last Activity 2 weeks ago
unit 2
I moved to Europe because I couldn’t afford to be a cancer patient in America.
1 Translations, 0 Upvotes, Last Activity 2 weeks ago
unit 3
I’d rather have been able to stay home.
1 Translations, 0 Upvotes, Last Activity 2 weeks ago
unit 4
By Erica Rex, The New York Times, January 2, 2019.
1 Translations, 0 Upvotes, Last Activity 2 weeks ago
unit 6
We’re here for follow-ups.
1 Translations, 0 Upvotes, Last Activity 2 weeks ago
unit 7
Some, like me, have had bunions removed.
1 Translations, 0 Upvotes, Last Activity 2 weeks ago
unit 8
Others have had hips or knees replaced.
1 Translations, 0 Upvotes, Last Activity 2 weeks ago
unit 9
Most are older women.
1 Translations, 0 Upvotes, Last Activity 2 weeks ago
unit 10
The copies of Paris Match and Le Monde on the table are at least six months old.
1 Translations, 0 Upvotes, Last Activity 2 weeks ago
unit 13
The woman seated opposite me tells me she’s on her second bunion surgery.
1 Translations, 0 Upvotes, Last Activity 2 weeks ago
unit 15
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As a French resident and taxpayer, I have one too.
1 Translations, 1 Upvotes, Last Activity 1 week, 2 days ago
unit 17
Another woman is recovering from a hip replacement.
1 Translations, 2 Upvotes, Last Activity 1 week, 2 days ago
unit 18
Medical chat is common in French waiting rooms.
1 Translations, 1 Upvotes, Last Activity 1 week, 2 days ago
unit 19
If the wait is long, everyone comes to know everything about one another’s complaints.
1 Translations, 1 Upvotes, Last Activity 1 week, 2 days ago
unit 20
To my friends in the United States, this casual attitude seems foolish, even risky.
1 Translations, 1 Upvotes, Last Activity 1 week, 2 days ago
unit 21
But in France, medical privacy is irrelevant.
1 Translations, 2 Upvotes, Last Activity 1 week, 2 days ago
unit 22
No one will lose her job because of a lengthy convalescence.
1 Translations, 2 Upvotes, Last Activity 1 week, 2 days ago
unit 23
There is no possibility that pre-existing conditions will make insurance unaffordable.
1 Translations, 1 Upvotes, Last Activity 1 week, 2 days ago
unit 24
Unemployed people still receive treatment.
1 Translations, 1 Upvotes, Last Activity 1 week, 2 days ago
unit 25
Huge medical bills do not reduce ordinary citizens to a state of existential terror.
1 Translations, 2 Upvotes, Last Activity 1 week, 2 days ago
unit 26
The absence of unease over health care alters the texture of French experience.
1 Translations, 1 Upvotes, Last Activity 1 week, 2 days ago
unit 27
We get cozy in waiting rooms.
1 Translations, 1 Upvotes, Last Activity 1 week, 2 days ago
unit 28
A woman in her late 60s sits next to me.
1 Translations, 2 Upvotes, Last Activity 1 week, 2 days ago
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She fidgets and appears close to tears.
1 Translations, 1 Upvotes, Last Activity 1 week, 2 days ago
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She leans over and asks in a low voice how long it has been since my surgery.
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She tells me she had surgery four weeks ago and believes something is wrong.
1 Translations, 2 Upvotes, Last Activity 6 days, 23 hours ago
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The woman across from me leans forward.
1 Translations, 2 Upvotes, Last Activity 6 days, 23 hours ago
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“Que s'est-il passé?” What happened?
1 Translations, 0 Upvotes, Last Activity 6 days, 23 hours ago
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Three other women reassure her: The bone crunching is normal.
1 Translations, 2 Upvotes, Last Activity 6 days, 23 hours ago
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Those bones had to be broken and realigned to reshape her foot.
1 Translations, 2 Upvotes, Last Activity 6 days, 23 hours ago
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Yes, but the physical therapist told her that the doctor had botched something.
1 Translations, 1 Upvotes, Last Activity 1 week, 2 days ago
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Now she’s frightened.
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The therapist was completely wrong, we tell her.
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Then the doctor appears and calls the woman’s name.
1 Translations, 2 Upvotes, Last Activity 6 days, 23 hours ago
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Even rock-star orthopedists here don’t have nurses helping them in their offices.
1 Translations, 2 Upvotes, Last Activity 6 days, 23 hours ago
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The doctor changes his own examining table paper.
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The woman picks up her crutches.
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He raises his hands in question.
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The crutches?
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Still?
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She fights back tears.
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We reassure her it will be fine.
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She limps after him into the examining room, dragging the crutches in one hand.
1 Translations, 0 Upvotes, Last Activity 6 days, 23 hours ago
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I am an accidental European.
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I developed breast cancer in 2009.
1 Translations, 0 Upvotes, Last Activity 6 days, 23 hours ago
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When I moved to France four years ago, the French system quickly took over covering me.
1 Translations, 0 Upvotes, Last Activity 6 days, 16 hours ago
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Doctors here often ask how I landed in Europe.
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When I tell them, they shake their heads.
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American values are deranged, they say.
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lollo1a 10177  commented on  unit 39  6 days, 17 hours ago
Maria-Helene 14564  translated  unit 49  6 days, 23 hours ago
lollo1a 10177  commented on  unit 25  1 week, 6 days ago
lollo1a 10177  commented on  unit 17  1 week, 6 days ago

What a French Doctor’s Office Taught Me About Health Care.

I moved to Europe because I couldn’t afford to be a cancer patient in America. I’d rather have been able to stay home.

By Erica Rex, The New York Times, January 2, 2019.

TOURS, France — A dozen of us sit expectantly in the orthopedic surgeon’s waiting room. We’re here for follow-ups. Some, like me, have had bunions removed. Others have had hips or knees replaced. Most are older women.

The copies of Paris Match and Le Monde on the table are at least six months old. The only artwork is a framed print of Claude Monet’s “Poppy Fields Near Argenteuil.” Since I’m only two weeks out from surgery and can’t drive, I came by taxi. The fare was underwritten by the French social security system, known familiarly as la Sécu, which also provides health insurance for all residents.

The woman seated opposite me tells me she’s on her second bunion surgery. Her doctor, a top orthopedic surgeon, charges more than the normal Sécu compensation, as do many specialists. Most French people purchase a supplementary insurance plan to cover costs not picked up by la Sécu. As a French resident and taxpayer, I have one too.

Another woman is recovering from a hip replacement. Medical chat is common in French waiting rooms. If the wait is long, everyone comes to know everything about one another’s complaints.

To my friends in the United States, this casual attitude seems foolish, even risky. But in France, medical privacy is irrelevant. No one will lose her job because of a lengthy convalescence. There is no possibility that pre-existing conditions will make insurance unaffordable. Unemployed people still receive treatment. Huge medical bills do not reduce ordinary citizens to a state of existential terror.

The absence of unease over health care alters the texture of French experience. We get cozy in waiting rooms.

A woman in her late 60s sits next to me. She fidgets and appears close to tears. She leans over and asks in a low voice how long it has been since my surgery. She’s wearing the orthopedic boot, but unlike the rest of us bunion ladies, she’s still using crutches. She tells me she had surgery four weeks ago and believes something is wrong.

The woman across from me leans forward.

“Que s'est-il passé?” What happened? My neighbor describes a “sensation de craquement” — the feeling that the bones in her foot are crunching when she puts weight on it.

Three other women reassure her: The bone crunching is normal. Those bones had to be broken and realigned to reshape her foot.

Yes, but the physical therapist told her that the doctor had botched something. Now she’s frightened. The therapist was completely wrong, we tell her. She seems relieved, but grows worried again when she realizes she should have restarted physical therapy sessions a month ago.

Then the doctor appears and calls the woman’s name. Even rock-star orthopedists here don’t have nurses helping them in their offices. The doctor changes his own examining table paper. His staff consists of two foul-tempered office assistants who make appointments, take payments and hand out prescriptions.

The woman picks up her crutches. He raises his hands in question. The crutches? Still? She fights back tears. We reassure her it will be fine. She limps after him into the examining room, dragging the crutches in one hand.

I am an accidental European. I developed breast cancer in 2009. With no continuing medical coverage in the United States, and in desperate need of it, I moved to Britain. Under the sponsorship of an acquaintance, I was granted “indefinite leave to remain” and received care through the National Health Service. When I moved to France four years ago, the French system quickly took over covering me.

It has taken me nine years to grow accustomed to the idea that my health care won’t suddenly evaporate at the whim of a new government. Doctors here often ask how I landed in Europe. When I tell them, they shake their heads. American values are deranged, they say.

Sometimes I encounter Americans for whom visiting France is like a trip to Disneyland, only with foie gras, and they’ll ask about medical care.

One such visitor, on learning I have a “carte vitale,” a social security card, asked, “How did you score that?” as if health insurance was like box seats at a Yankees-Red Sox game.

I don’t live in the promotional brochure version of France those Americans are touring. France for me was not a vacation selection. Moving to Europe was a choice weighed against other, grimmer options for health care, which included the strong possibility of being bankrupted by cancer treatment and winding up at the mercy of New York State’s welfare system.

In France I can rest assured I will not be refused care for any treatable condition, including a painful bunion — or yes, even a recurrence of breast cancer. All the same, I’d rather have been able to get coverage without emigrating.

Too many Americans do not realize how much better off they would be if they felt safer about access to medical care. Imagine what might happen if everyone felt safe — safe enough to talk about ailments in waiting rooms.

Erica Rex is working on a book about the use of psychoactive drugs to treat depression and PTSD.

https://www.nytimes.com/2019/01/02/opinion/france-united-states-universal-health-care.html