It is not good to be sick anywhere, let alone in the United States. Not surprisingly, health is one of the main causes of indebtedness in the country of Uncle Sam. For French expatriates, the pill is usually difficult to swallow.

Hanna * (the name has been changed), 28 years old, became aware of this when she was diagnosed with a 6cm ovarian cyst three years ago. Until then, she had no American mutual. "In general, I take advantage of my annual stay in France to see the gynecologist, the dermatologist and the ophthalmologist. In case of emergency, I go to urgent care", Emergency care structure. In the summer of 2016, when she returned to France, her gynecologist found this cystic anomaly.

She must then perform a new ultrasound two months later, to check if the cyst continues to grow. But it was much more complicated in Los Angeles where she lives the rest of the year. "JI had to go to the urgent care where I paid almost $ 200 for a prescription, then $ 90 for the ultrasound. I had to go back for the interpretation … Instead of a single gynecologist, I had to deal with the administration, the people from the laboratories, the doctors, it took weeks"She recalls.

While his American doctor recommends him to "Monitor the evolution of the cyst", His Parisian gynecologist offers him"another readingAnd offers him to make an appointment with a surgeon. She chooses this second option for a comfort issue. By inquiring about the price of this service in France and the United States, Hanna decides without any hesitation to take her plane tickets – 800 dollars. She is covered by social security but does not have a mutual. "In Los Angeles, the price of the operation ranged between $ 5,000 and $ 40,000, and without spending the night there. "

In addition to the financial aspect, she preferred to be operated in France "where there is a real follow-up". If the prices had been the same, she would undoubtedly have made the same decision. "I have often heard that care is dehumanized in the United States, especially when you do not have a mutual, advance Hanna. In France, the surgeon gave me advice, it reassured me especially since it was my first operation under anesthesia."

If Marianne had an experience different from that of Hanna, she joined him on this point. This American naturalized septuagenarian lives six months of the year in the Bay Area and six others in the Grenoble area. In 2017, when she feels weak for several months, we end up discovering a very rare type of lymphoma. "I saw many doctors in the United States and France before my cancer was detected. All were convinced that there was something abnormal due to the yellowish color of my complexion, but nobody saw anything until I consulted a French physiotherapist for sciatica ". While feeling his body, he noticed that his spleen was extremely swollen and asked him to make specific and complete examinations. "In a system like the United States, we do not do this because it costs too much. That's why I stayed in the dark a moment. "

At the end of the results, Marianne was quickly taken care of by the doctors of the University Hospital of Grenoble. They offer him a light treatment based on chemo and immunotherapy for six months. Two years later, she feels truly lucky and grateful for the interest of her medical team. "If I could redo it, I would. After each immunotherapy treatment, I was asked to stay put to be sure I was not reacting. It would never have been the case here. The faster you are sent home, the better, advance the American. It was like that once a week for six months. They came to see me in my room, just to ask me how I was going. I did not expect that."Beyond that, she appreciates the fact that everything has been simplified for her: no unnecessary paperwork, no insurance contract issue, no caregivers ("providers") …

Asked about this phenomenon of medical exodus, Catherine Collins, French doctor settled in the United States for twenty years, considers that "it is a false problem". If the financial aspect can be considered as a valid argument for returning to Europe, it depends on each and every insurance. This professional defends access to care on American soil. "As a doctor for Air France and KLM, I had a patient who had neurological problems. I managed to show him an ENT the same day and an MRI the next day. By contacting his doctor, he told me that outpatient (treatment of a patient without hospitalization, ndr) in France, it would never have been faster. When you have the right team and good knowledge of the network, access to care is very fast. "

In general, she admits that French and Americans do not have the same approach to health. "Health in the United States is highly regulated and organized, it makes our work easier, but it can dehumanize it. I can understand that some people compare the medical to a business. This is not the case in France where relational premium as well as case by case. Here, we follow guidelines accepted by all. You will very rarely see people coming for a consultation the first day of a cold."

Joanna Valdant (San Francisco) and Sandra Cazenave (Los Angeles)


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