en-fr  What a French Doctor’s Office Taught Me About Health Care Medium
Ce qu’un cabinet de médecin français m'a appris sur les soins de santé.

J'ai déménagé en Europe parce que je ne pouvais pas me permettre d'être un patient atteint de cancer en Amérique. Je préférerais avoir pu rester à la maison.

De Erica Rex, The New York Times, 2 janvier 2019.

TOURS, France — Une douzaine d’entre nous sont assis dans la salle d’attente du chirurgien orthopédiste. Nous sommes ici pour les suivis. Certains, comme moi, ont eu des oignons enlevés. D'autres ont eu des hanches ou des genoux remplacés. La plupart sont des femmes âgées.

Les exemplaires de Paris Match et du Monde sur la table ont au moins six mois. La seule œuvre d’art est une reproduction encadrée de « Champs de coquelicot près d’Argenteuil » de Claude Monet. Comme je n’ai plus que deux semaines de chirurgie et que je ne peux plus conduire, je suis venu en taxi. Le tarif a été souscrit par le système français de sécurité sociale, connu sous le nom de La Sécu, qui fournit également une assurance maladie à tous les résidents.

La femme assise en face de moi me dit qu’elle a eu sa deuxième opération d'oignons. Son médecin, un grand chirurgien orthopédiste, facture plus que la compensation normale de Sécu, comme le font de nombreux spécialistes. La plupart des Français souscrivent une assurance complémentaire pour couvrir les frais non pris en charge par la Sécu. En tant que résident et contribuable français, j'en ai un aussi.

Une autre femme se remet d'un remplacement de la hanche. Les discussions médicales sont courantes dans les salles d’attente en France. Si l’attente est longue, tout le monde finit par tout savoir sur les plaintes des autres.

Pour mes amis américains, cette attitude désinvolte semble stupide, voire risquée. Mais en France, la confidentialité des informations médicales n’est pas pertinente. Personne ne perdra son emploi à cause d'une longue convalescence. Il est impossible que des conditions préexistantes rendent l'assurance inabordable. Les personnes sans emploi continuent de recevoir un traitement. D'énormes factures médicales ne réduisent pas les citoyens ordinaires à la terreur existentielle.

L'absence de malaise face aux soins de santé modifie la texture de l'expérience française. Nous nous sentons bien dans les salles d'attente.

Une femme dans la soixantaine avancée est assise à côté de moi. Elle bouge et semble au bord des larmes. Elle se penche et demande à voix basse combien de temps s'est écoulé depuis ma chirurgie. Elle porte des bottes orthopédiques, mais contrairement au reste d’entre nous, dames des oignons, elle utilise toujours des béquilles. Elle me dit qu'elle a subi une opération il y a quatre semaines et pense que quelque chose ne va pas.

La femme en face de moi se penche en avant.

« Que s'est-il passé ? » Ma voisine décrit une « sensation de craquement » — le sentiment que les os de son pied se tordent lorsqu'elle prend du poids.

Trois autres femmes la rassurent : Le craquement des os est normal. Ces os ont dû être brisés et réalignés pour remodeler son pied.

Oui, mais le kinésithérapeute lui a dit que le médecin avait bâclé quelque chose. Maintenant, elle a peur. Le thérapeute avait complètement tort, lui disons-nous. Elle semble soulagée, mais s'inquiète à nouveau lorsqu'elle réalise qu'elle aurait dû reprendre les séances de physiothérapie il y a un mois.

Le médecin apparaît et appelle le nom de la femme. Même les grands orthopédistes n’ont pas d’aide infirmière dans leurs bureaux. Le médecin change son propre papier de table d'examination.. Son personnel se compose de deux employés de bureau coléreux qui prennent des rendez-vous, prennent des paiements et distribuent des ordonnances.

La femme prend ses béquilles. Il lève les mains en question. Les béquilles ? Encore ? Elle retient les larmes. Nous la rassurons, ça ira. Elle boite après lui dans la salle d'examen en tirant les béquilles dans une main.

Je suis un européen accidentel. J'ai développé un cancer du sein en 2009. En l'absence de couverture médicale continue aux États-Unis et dans le besoin désespéré, j'ai déménagé en Grande-Bretagne. Sous le parrainage d'une connaissance, on m'a accordé un « congé de séjour indéfini » et j'ai reçu des soins par l'intermédiaire du service national de santé. Quand je suis arrivé en France il y a quatre ans, le système français a rapidement pris le relais pour me couvrir.

Il m'a fallu neuf ans pour m'habituer à l'idée que mes soins de santé ne s'évanouiront pas subitement à la merci d'un nouveau gouvernement. Les médecins ici demandent souvent comment j'ai atterri en Europe. Quand je leur dis, ils secouent la tête. Les valeurs américaines sont dérangées, disent-ils.

Parfois, je rencontre des Américains pour qui visiter la France est comme un voyage à Disneyland, uniquement avec du foie gras, et ils poseront des questions sur les soins médicaux.

Un de ces visiteurs, apprenant que j’ai une « carte vitale », une carte de sécurité sociale, a demandé : « Comment as-tu marqué cela ? », comme si l’assurance maladie ressemblait à une place réservée dans un match Yankees-Red Sox.

Je ne vis pas dans la version France de la brochure promotionnelle de ces Américains en tournée. La France pour moi n'était pas une sélection de vacances. Déménager en Europe était un choix qui pesait contre d’autres options plus sombres pour les soins de santé, qui comprenaient la forte possibilité de faillite par le traitement du cancer et finir à la merci du système de protection sociale de l’État de New York.

En France, je peux être assuré qu'on ne me refusera pas des soins pour toute affection traitable, y compris un oignon douloureux — ou même une récidive du cancer du sein. Néanmoins, je préférerais pouvoir obtenir une couverture sans émigrer.

Trop d'Américains ne réalisent pas à quel point ils seraient mieux s'ils se sentaient plus en sécurité face à l'accès aux soins médicaux. Imaginez ce qui pourrait arriver si tout le monde se sentait en sécurité — suffisamment en sécurité pour parler de maux dans les salles d'attente.

Erica Rex prépare un livre sur l'utilisation de drogues psychoactives pour traiter la dépression et le SSPT.

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.
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unit 2
I moved to Europe because I couldn’t afford to be a cancer patient in America.
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I’d rather have been able to stay home.
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By Erica Rex, The New York Times, January 2, 2019.
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unit 6
We’re here for follow-ups.
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Some, like me, have had bunions removed.
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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.
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The woman seated opposite me tells me she’s on her second bunion surgery.
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As a French resident and taxpayer, I have one too.
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Another woman is recovering from a hip replacement.
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Medical chat is common in French waiting rooms.
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If the wait is long, everyone comes to know everything about one another’s complaints.
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To my friends in the United States, this casual attitude seems foolish, even risky.
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But in France, medical privacy is irrelevant.
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No one will lose her job because of a lengthy convalescence.
1 Translations, 0 Upvotes, Last Activity 1 week, 6 days ago
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There is no possibility that pre-existing conditions will make insurance unaffordable.
1 Translations, 0 Upvotes, Last Activity 1 week, 6 days ago
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Unemployed people still receive treatment.
1 Translations, 0 Upvotes, Last Activity 1 week, 6 days ago
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Huge medical bills do not reduce ordinary citizens to a state of existential terror.
1 Translations, 0 Upvotes, Last Activity 1 week, 6 days ago
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The absence of unease over health care alters the texture of French experience.
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We get cozy in waiting rooms.
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A woman in her late 60s sits next to me.
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She fidgets and appears close to tears.
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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.
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The woman across from me leans forward.
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“Que s'est-il passé?” What happened?
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Three other women reassure her: The bone crunching is normal.
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Those bones had to be broken and realigned to reshape her foot.
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Yes, but the physical therapist told her that the doctor had botched something.
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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.
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Even rock-star orthopedists here don’t have nurses helping them in their offices.
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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.
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I am an accidental European.
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I developed breast cancer in 2009.
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When I moved to France four years ago, the French system quickly took over covering me.
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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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I don’t live in the promotional brochure version of France those Americans are touring.
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France for me was not a vacation selection.
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All the same, I’d rather have been able to get coverage without emigrating.
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Erica Rex is working on a book about the use of psychoactive drugs to treat depression and PTSD.
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https://www.nytimes.com/2019/01/02/opinion/france-united-states-universal-health-care.html
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markvanroode 7072  translated  unit 49  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