Must-Read: The French Way of Cancer Treatment (Vs. U.S.)

[Hissyspit]

http://gregmitchellwriter.blogspot.com/2014/02/health-care-with-heart-france-vs-usa.html

Health Care With Heart: France vs. USA

Greg Mitchell

Today's must-read, via Reuters: Anya Schiffrin's account of the cancer care her father--renowned editor and writer Andre Schiffrin, who died last December--received in France. Anyone enmeshed in the U.S. healthcare system will weep with longing for the humane and thoughtful way the French receive healthcare. Imagine this: quiet waiting rooms with no billing departments. Contrasting the ordeal of getting care in New York with their experience in Paris, she writes:

Every time I sit on hold now with the billing department of my New York doctors and insurance company, I think back to all the things French healthcare got right. The simplicity of that system meant that all our energy could be spent on one thing: caring for my father.

http://blogs.reuters.com/anya-schiffrin/2014/02/12/the-french-way-of-cancer-treatment

The French way of cancer treatment

By Anya Schiffrin FEBRUARY 12, 2014

- snip -

My parents were pleasantly surprised by his new routine. In New York, my father, my mother and I would go to Sloan Kettering every Tuesday around 9:30 a.m. and wind up spending the entire day. They’d take my dad’s blood and we’d wait for the results. The doctor always ran late. We never knew how long it would take before my dad’s name would be called, so we’d sit in the waiting room and, well, wait. Around 1 p.m. or 2 p.m. my dad would usually tell me and my mom to go get lunch. (He never seemed to be hungry.) But we were always afraid of having his name called while we were out. So we’d rush across the street, get takeout and come back to the waiting room.

We’d bring books to read. I’d use the Wi-Fi and eat the graham crackers that MSK thoughtfully left out near the coffee maker. We’d talk to each other and to the other patients and families waiting there. Eventually, we’d see the doctor for a few minutes and my dad would get his chemo. Then, after fighting New York crowds for a cab at rush hour, as my dad stood on the corner of Lexington Avenue feeling woozy, we’d get home by about 5:30 p.m.

So imagine my surprise when my parents reported from Paris that their chemo visits couldn’t be more different. A nurse would come to the house two days before my dad’s treatment day to take his blood. When my dad appeared at the hospital, they were ready for him. The room was a little worn and there was often someone else in the next bed but, most important, there was no waiting. Total time at the Paris hospital each week: 90 minutes.

There were other nice surprises. When my dad needed to see specialists, for example, instead of trekking around the city for appointments, he would stay in one room at Cochin Hospital, a public hospital in the 14th arrondissement where he received his weekly chemo. The specialists would all come to him. The team approach meant the nutritionist, oncologist, general practitioner and pharmacist spoke to each other and coordinated his care. As my dad said, “It turns out there are solutions for the all the things we put up with in New York and accept as normal.”

MORE


FYI:

As an anti-Communist socialist, Schiffrin opposed both the Soviet invasion of Hungary and the U.S. war in Vietnam. He was one of the founders of the organization that became Students for a Democratic Society.[2] In 1968, he signed the “Writers and Editors War Tax Protest” pledge, vowing to refuse tax payments in protest against the Vietnam War.[3]

Schiffrin's daughter Anya is married to the economist and Nobel Prize winner Joseph Stiglitz. His daughter Natalia is married to international lawyer Philippe Sands.

[dixiegrrrrl]

1. Huge amounts of disgust and envy are roiling in me after reading this.

Wonder how long France can hold on to its sane approaches to medical care..
and food.

[lark]

18. I spent several months in France a few years ago.

The country is so sane, it's just amazing. There is very little auto traffic in the cities, busses and trains are everywhere and are cheap and on time. You'd be amazed at the noise pollution we take for granted from cars. It was so loud by comparison when we came back. The cities don't straggle on forever, they are densely populated and the land around is empty and natural. The food, wine, parks, museums, wineries are amazing, especially the wine and wineries, lol. I really love the Alsatian whites (Pinot Gris, Gerwurztraminer, Reisling's). In fact, I loved them so much I still purchase them from a good local wine store, but of course at a MUCH higher price. People just seem to really love life there. Another thing I loved, you could tell time by the church bells. We lived one block down from La Cathedral de Notre Dame au Strausbourg and their bells were so beautiful. Every night during the summer there was a really cool laser show on the front of the cathedral done to Beatles, and some french songs - wow! But our house sitting days ended and we had to return to reality and our jobs back here in the states. Sux! I would love it if our country were half so sane and good for the working class.

[pangaia]

20. I would venture to say that it was in Paris that your were living in reality.

I have always loved that city more, I think, than any other.

[lark]

22. We spent a week in Paris, OMG what an amazing place.

We lived in Strasbourg (sorry, always have trouble with the spelling) the rest with some short trips to other cities in the region as well as Germany.

[Bluenorthwest]

2. In the US currently, mediocrity is seen as a virtue, if not a holy sacrament

America is proud to be incompetent.

[chervilant]

43. Incompetent, mediocre,

AND wilfully ignorant.

The rampant anti-intellectualism is appalling.

[El_Johns]

3. One of my bigger beefs with the US health care system is the way my elderly relatives were forced to

drive hours in all different directions to get treatment, or have someone drive them -- to this hospital, to that clinic, etc etc etc.

It didn't use to be like that.

[dickthegrouch]

4. I sprained my ankle in Paris a few years ago

I was seen in an emergency room the next day since my ankle had blown up like a balloon overnight. X-Rays, bandages, pain killers, crutches and a follow-up care recommendation. 3 hours tops. The best bit was the bill: the equivalent of $48.00.

I've spent 10 times that getting acute diarrhea treated in the US.

I was on vacation and they couldn't have been nicer about it (I do speak French fluently, which helped a bit, although I couldn't remember the word for ankle at the time (La Chenille), not that it mattered; it was obvious why I was visiting a doctor).

I did get another bill for $54.00 a few weeks later at home in the US. They agreed to waive it over the phone since it was from the Obstetrics Dept, which I clearly never went anywhere near . It would probably have taken an act of congress to get that bill waived here.

[sabrina 1]

5. Lol, 'It would probably have taken an act of Congress to get that bill waived here'.

That is so true. But it did make me laugh. Americans are now so accustomed to being treated as commodities rather than human beings, they have accepted it, some even defend it. Sort of like abused families who know no other norm.

We have been well trained to take our place in the corporate pyramid, way, way down at the bottom.

[Enthusiast]

37. Sort of like Stockholm Syndrome.

[Frutuoso]

15. What a difference

La cheVille. good story, though when I tell similar stories, people call me a liar.

[cui bono]

34. Good thing you didn't tell one now or I would've had to call you one.

I kid, I kid...

Welcome to DU!

[Surya Gayatri]

29. LOL! Quite understandably, Dick, you have confused

"chenille" (caterpillar worm) and "cheville" (ankle). I love the image of a caterpillar ankle!

And yes, the French National Health System, or SECU, is second to none. It's one of the real benefits of residing in France.

It has its weak points, of course, but I thank heaven for it every time I go to the doctor or hospital.

My recent knee replacement surgery and month of rehab in a clinic was 100% taken in charge by the SECU.

[MADem]

49. Ah, good--I was beginning to think I'd gone a bit nuts...

I am lousy at French but I didn't think that word was right!

If you are of a certain age, you can remember your mother/grandmother wearing a "chenille" robe or "chenille" bedspreads that you weren't supposed to muss up!

[cui bono]

35. My brother got smashed in the mouth with a beer bottle in Denmark

when he was visiting there. They did all his temp dental care for free. He got permanent caps when he got back here.

[skydive forever]

6. Just yesterday I sent this leter to the editor in our local paper

Joan, 58 years old, (not her real name), worked at Harris for over 25 years. Then she worked at Walgreens Pharmacy for about 12 years, rising up to Assistant Manager. During this time she also took care of her disabled husband, who died about 5 years ago. Problem is, her health has never been that great, mostly genetic (heart disease and lung issues, and, BTW a non smoker), something she had no control over. Well, her health took a turn for the worse, and she had to leave her job. Eventually went on disability, and pretty much became a homebody. No money for anything else but food and rent. Because of the dreaded Obamacare she would qualify for Medicaid, but because Gov. Scott turned down the expansion of that, she didn't qualify for Medicaid. So she waited the required 2 years to qualify for Medicare. Well, almost, she didn't quite make it. Yeah, she ended up at Holmes Hospital, very, very, sick. Now, 2 months shy of being eligible for Medicare (you have to be disabled for 2 years before Medicare kicks in), she is in a really bad place. Really sick. Shands, a hospital that has the ability to help her, wont take her without insurance, and there are no other good options. To those of you that hate Obama and anything that has his name attached to it, I would really like you to look her son (John) in the eyes, and say, well, whatever you want to say. This is a perfect example of someone doing all the right things in life, and getting totally screwed by the "system". Oh, and all the time she should be worried about her health, she's actually more worried about the money aspect of it. This is America? Really? You're proud of this? As Alan Grayson said about the republican health care plan; "If you get sick, die quickly". To my republican friends, how do you sleep at night? This could be your mother, or sister, how do you do it? Please tell me, because I'm only 4 years younger than her, with lots of bad family history heath wise, and I'm really curious how you can be this way to your fellow Americans. Please, explain it to me.

[Autumn]

7. The system here sucks.

rec

[Egalitarian Thug]

8. The only people that love the American system are those that haven't had to fight

the American system while fighting for their lives at the same time.

Fucking barbaric.

[jsr]

17. The only people who love our system are the 1% and their profiteering helpers.

[Egalitarian Thug]

54. Exactly. +1

[Swede Atlanta]

9. I am so tired of the right wing claiming we have a fabulous health care system......

If you measure it in terms of the ability to keep someone alive on medicine and machines the longest (assuming you are independently wealthy or have good insurance) then they might be right.

But by all other measures we are far down on the list in terms of things like infant mortality, longevity, healthy outcomes, cost, relative satisfaction with the health care system, etc.

No doubt we have some of the best physicians and best equipped medical centers in the world. But that doesn't mean we have the best health care system.

[Dustlawyer]

25. +1 Well and truly said! What I will never understand how so many can be brainwashed into such

heartlessness. There are a certain percentage out their that truly don't care, but many I have noticed are otherwise nice caring people. Fox News and right wing-nut radio are psychologically designed to make white people afraid and angry. Pretty much have them believe what they want them to believe and how they feel about it. It is all so negative I will never understand how people could watch it, but then again, I can't stand my kids music and they love it.

[KoKo]

10. Big Kick and Recommend!

[DFW]

11. We're in Germany--great if you're German, expensive if you're not (though less than the US)

Thirteen years ago, my wife was diagnosed with cancer. There was one operation in January. Then one in May which required serious intervention, removal of lymph nodes and a month's recovery time in the hospital.

Then she needed six weeks of heavy chemo, a brief pause, then six weeks of daily radiation (weekends off). When that was done, she was sent (not mandatory) to a rehab spa in the Black Forest. In Germany, they have cancer rehab spas all around the country, all attuned to a particular kind of cancer, so that the clinic can concentrate their expertise. Her clinic specialized in breast and thyroid cancer rehab, so most of the patients were women. She had her own room, and the rehab consisted of aquatic training, organized hikes through the woods, massages, and various other kinds of therapy. Spouses/partners were allowed to visit on the last weekend of the month's stay. The rehab is considered an integral part of cancer treatment in Germany, and most patients take it. It is completely covered, right down to the train trip from wherever you are in Germany down to the Black Forest, where the rehab spa is.

The cost to us: nothing. From start to finish: nothing. She is a German citizen who was working in Germany for a German employer, so that mattered.

I have had several operations while I was here, but before I was a full-time resident. Even as a full-time resident now, it doesn't matter. I work for an American employer, and even though I now pay German taxes (right around 50%, all included), I get zero health insurance here. I have to pay up front and hope our US insurer reimburses me (usually they fight tooth and nail not to, even though my treatment here cost about a third of what it would have cost in the USA).

One weird thing I found out: US hospitals will issue huge inflated bills, and then reduce them by about a third--ONLY for an insurance company. My three day at a Dallas hospital in 2011 was billed at $36,000, reduced to $26000--for the insurance company. A similar 3 day hospital stay, with complicated operation etc etc, cost me 9000 euros. An acquaintance from Venezuela told me that her mother, visiting from Venezuela, had a heart attack while in the USA. The bill for her mom's ten day stay was $75,000. The woman, who was well off, said she couldn't handle that much, but instead of referring the case to Venezuelan insurance, which she said was useless for a US bill, she offered to settle the bill with the hospital for %50,000, which she did have. The hospital told her that they would be happy to do that for an insurance company, but not for an individual. Go figure THAT one out.

In July, 2012, when I had the opportunity to spend an hour with Barack Obama, he mentioned that he would like to trim the budget deficit in part by eliminating excessive health care costs. I told him to please not the difference in what the hospitals in Germany and Dallas charged for similar stays and treatment. He took note of it, and had one of his White House guys get in touch with me afterward about it. At least they took note of it, but I don't see any well-publicized attempt to rein in the inflated billing hospitals charge in the USA. Maybe it's beyond the scope of the Federal Government to do so, who knows. Certainly it would take an act of Congress to change things dramatically, but dramatic change is what is needed.

Had it come entirely out of my pocket, my wife's cancer treatment would probably have bankrupted me in the States, and she wouldn't have had the wonderful rehab spa after her chemo because such a thing (as far as we could tell) does not exist in the USA as a standard part of cancer treatment. As it is, she bounced back from the torturous operations, chemo and radiation, and we have enjoyed 13 cancer-free years in the meantime. Surely the German treatment wasn't any more thorough than the same treatment would have been in the USA, but it WAS well-organized, and the peace of mind that it would not by any kind of financial burden was of incalculable value. In a country with resources such as ours, that shouldn't even be a question. If a country like France, with an economy that has been driven off a cliff by its current government, can provide universal health care for all its citizens, of better quality, and at a cost half what it is in the U.S., then something is very wrong with this picture.

[kristopher]

12. I had a similar experience except it was Japan vs US

I don't want to rehash the details, but within one year I was primary care giver as my wife went through a terminal illness in Japan, and then for my brother for the last few months of his life in the US. This was in 1988 and the perception I had was identical to that expressed in the OP.

If only people really understood how badly the profit motive has corrupted our medical system...

[Fred Sanders]

13. Someone I know in Thailand had severe gastro pains, got a blood test, full doctor consult and

medication for a blood infection - $30.

At a first rate hospital, 10 minutes waiting, in and out in 3 hours, with an Australian trained physician - America has got it totally wrong from ANY other way; profitizing health care as an industry is the root of the problem.

[BlueMTexpat]

36. A close friend who is now a retiree

covered under UN health insurance, which has global coverage, books complete annual physical checkups and tests for himself and his wife in Thailand. He is a medical doctor himself and happened to be returning from a TDY in the Philippines when he fell seriously ill, which, fortunately for him, happened right before his stopover in Thailand. He spent a couple days in emergency care there and says that the treatment and attention that he received there, including the facilities themselves, were the best that he has received/seen anywhere in the world.

This is from someone who has traveled extensively, knows and worked with health authorities, professionals and facilities everywhere on the globe during the course of his career (in health). He gives France high marks too, although he ranks Thailand first.

Although I worked extensively with international organizations myself, I committed the unfortunate oversight of working under different health care programs, which means that I missed being vested in the UN or another IO program by just a hair. If only ....

Now, of course, since I am >65, I have Medicare coverage when I am in the US (premiums are deducted from my SS payments). I do love Medicare, and will literally rend asunder any politician stupid enough to try to hurt that program for anyone. But since I still spend the greater part of the year in Switzerland, I also have to purchase private health insurance here, with a global coverage feature since it is so easy to travel from one country to another in Europe. Fortunately, the costs are not prohibitive, but I still try to have most medical work done in the US, where my residence is in a comparatively "good" state (MD).

I totally concur with your statement about profitizing health care as the root of the problem in the US.

[Fred Sanders]

44. Thank you for the reply. The astounding ignorance of the masses of America of what is avaiable in

terms of medical care and general life well, arts, culture, family life, standards of living and happiness outside its own small borders and small thinking is a truly sad state of affairs.

[Lydia Leftcoast]

14. Many years ago, Business Week, of all things, carried an article about an American businessman

who had been transferred to France. While living there, he was diagnosed with cancer.

He said that his treatment was excellent and compassionate, and when he was in remission, he received a bill written in bureaucratic French (he knew some French, but not bureaucratic language). He had no idea what the bill was for, but it was so small (less than $100) that he paid it without hesitation.

[jsr]

16. Yes, this is a must read.

[Mass]

19. When I moved to the States from France, I could not figure out why people were

so much afraid of the "Socialist welfare" we have in Europe. I could choose my doctor freely in France while I have to look into a list of accredited doctors there (and this is not ACA that brought there, though it did not get rid of it).

I could go to any other doctors if I wanted a second opinion without having to ask permission.

Only a few interventions had to be waived and most of them were waived without problems.

Many chronical conditions had no copays.

But the clearest aspect is that you were free, something that is still not the case here even with ACA (though it may be with Medicare).


I will always remember my husband's fear when my son was hospitalized in ICU when he was born. He was there for a month, and the better he was getting, the more I was seeing my husband worry for the cost. We ended up paying absolutely nothing, because for a long term hospitalization, there is no copay, but as I did not yet know the American system, I could not understand why he was so frightened.

[busterbrown]

21. Exactly what right winger industrialist fear most..

This type of system..

Thanks for the post Hissyspit..

[RC]

23. At one time I was dating a Canadian, living in Winnipeg.

One night she was home in bed sleeping and had a bronchitis attack. She could barely breathe. She called a friend, who came over and took her to the emergency room. They treated her right away, then admitted her to the hospital, where she spent 3 days recovering. Her total bill for the whole event was $10 Canadian, co-pay for some antibiotics.
That was it. No forms for her to fill out, no paper work, no credit cards, no insurance claims. All she did was present a card with a Canadian health care number in it. And she was billed later for the $10 co-pay. None of this pay now or get refused service.

How many thousands of dollars would that have cost someone in this country, even with insurance. The bills and notices of insurances coverage and the rest of the bullshit that goes on getting medical help in this country.

[Brickbat]

24. Yeah, but what if someone gets it who doesn't deserve it? What if someone doesn't get a job just so

they can sit around and get a chemo treatment that doesn't make you feel like a criminal for wanting to feel better?

[jsr]

40. Plus, they're gonna die anyway.

The money should go to corporate tax cuts.

[riderinthestorm]

26. K&R. Its not just NY. My husband had the exact same situation in Chicago for his treatment

We can and should be doing so much better....

Its such a shame the Rethugs have poisoned the well for the next generation about what health care SHOULD be with their hideous slanders about "socialized medicine".

[DesertFlower]

27. my friend lost her battle with cancer last year.

she was in chicago and was treated at the best hospital (northwest -- if i remember right). the first 4 months she stayed in the hospital for chemo -- the 2nd round almost killed her -- she wound up in ICU and they were talking to her husband about ending her suffering. she did recover from that. to make a long story short for 3 years it was back and forth to the hospital which was a long drive for different treatments. it was always a whole day affair. most times she fell asleep on the way home in the car.

she also had a bone marrow transplant. she came down with "graft host disease".

she suffered terribly. when she was first diagnosed they told her the odds were not in her favor. it was the chemo or hospice. i would have chosen hospice.

[Hoyt]

28. Excellent article. It's not just cancer. Ever been to a dialysis clinic? That's 3 days a week.

[slipslidingaway]

30. I understand the comparisons between systems but ...

having spent many hours/weeks and ultimately months at MSK I feel this article is a bit one-sided. He received one cycle of chemo at Sloan and then left for Paris, maybe that week was hard, it could not have been anything else!!!

We almost Always having blood test results (through the patient portal) before being called in to see the doctor. We were just there just last Friday and yes you cannot wait to see the numbers! But they are very good and quick with the results. Many times we have spent days there, usually multiple appointments/complications, but also have been in and out of Sloan in a couple of hours.

Could we do things better in the US, Sure we can!!!

My daughter is in her third year of residency and mentions that some docs (specifically an oncologist) wants to extend life when they should let the person go. That always makes for an interesting and sometimes quiet dinner discussion after my husband's diagnosis and bone marrow transplant over three years ago.

Just wanted to weigh in as someone who has been to MSK several times and finds the staff excellent and thankful that Sloan happened to be in our network of providers when our family needed care. We met several people at Hope Lodge in NYC who were did not have that choice.

We received some frills at our area hospital (local Ivy league hospital) but when push comes to shove we'll head to NYC where they have more experience with blood cancers.


'When my father, the editor and writer Andre Schiffrin, was diagnosed with stage four pancreatic cancer last spring, my family assumed we would care for him in New York. But my parents always spent part of each year in Paris, where my father was born, and soon after he began palliative chemotherapy at Memorial Sloan Kettering my father announced he wanted to stick to his normal schedule — and spend the summer in France.

...But my dad got what he wanted, as usual. After just one cycle of chemo in New York, my parents flew to Paris, to stay in their apartment there. The first heathcare steps were reassuring: my parents found an English-speaking pancreatic cancer specialist and my dad resumed his weekly gemcitabine infusions..."

[BlancheSplanchnik]

31. just about ready to weep in frustration here. My god, this is one sick society…...

and repukes want to keep it this way.

read that, trolls. Read that and tell me you didn't have a little spark of clarity there, for just a moment. Before you shut down the brain, closed the curtains, turned off the lights and went back to blind rage-angry-screaming mode.

[MannyGoldstein]

32. Oh sure, but we can't afford such deluxe health care.

Spending 10% of GDP on health care instead of 17% would break Americans.

Regards,

TWM

[Jesus Malverde]

33. Great read thanks!..nt

[Enthusiast]

38. K&R! This post should have hundreds of recommendations!

The only reason we can't have a similar system is because the political system no longer represents the needs of the citizens. Now politicians cater only to the wishes of the greedy corporations.

Even the ACA preserves the strictly parasitic insurance industry. Obviously we could do much better.

[llmart]

41. "The only reason we can't have a similar system is.........."

Well, that and we have to spend trillions on wars and the DOD.

Our priorities in this country are so screwed up.

[Enthusiast]

42. Yes, Our priorities are screwed up. With single payer money wouldn't be as much of a factor.

Based on what we see in Europe, it would cost about one half the current screwed up system.

And those trillions on wars were for unnecessary, counterproductive wars of choice. And that is something that the media is forbidden from pointing out. Freedom? I don't think so.

[emsimon33]

39. Cancer in the U.S. ís big business

It is all about the money and not about the patient. I know this first hand because both parents died of rare cancers.

[Overseas]

45. K&R. Great article. Such a beautiful compassionate approach to care. Not for profit.

So very sad that medical care is such a big profit center in the USA.

I foolishly hoped that after the devastating Bush economic crash, more of my Democrats would push for single payer (Medicare Part E for Everyone) to give people some relief when we were devastated by our financial losses.

But didn't realize the serious impact the media consolidation decades ago would have had, so most of our fellow citizens would never know what other countries get for their tax dollars. The corporate media gave them primarily more propaganda about how terrible socialized healthcare was, enabling our legislators to yank single payer off the table, as though being "bipartisan" was more important than the suffering of their constituents being evicted from their homes and bankrupted paying for medical care.

At least ACA is a start.

[colsohlibgal]

46. Ah Sanity!

If I were a 20 something right now I might well look to moving there. They get so much of it right, Paris is alluring and much of the countryside is beautiful.

It recalls the lunacy of " freedom fries" because France wouldn't go along with Dubya's plan to bomb, to "shock and awe" Iraq, a war that was against a country that had absolutely nothing to do with 9/11. All because he thought he had a mandate - he who had unquestionably lost the popular vote and was in reality installed by a Supreme Court coup. This chapter of our history will not be judged kindly down the road.

There is nothing wrong with democratic socialism, it works for the 98/99%. Once in operation it would never be legitimately voted out - what's not to like unless you want to accrue 800 million. That why the aristocracy, the ultra wealthy, will spend billions to make sure it never happens, why the thought of it scares them silly.

[dotymed]

47. I am sorry about you losing your Father.

did he live in America? I guess that he did because I cannot imagine anyone traveling here for medical treatment.
Condolences..

[senseandsensibility]

48. All I can do is kick this and rec it, too, of course

I am too depressed and beaten down to respond because this is such a never-ending, horrible, serious problem.

[bbgrunt]

50. the for profit system here is an abomination. k and r

[wheniwasincongress]

51. America is the greatest country in the world

echoes loudly in my head when I read and see things like this... We can say without sarcasm that "America is like no other country"

[think]

52. K&R /NT

[liberal_at_heart]

53. My daughter is fascintated with France. She is even in her 4th year of learning french.

Even though I would miss her terribly, for her sake I hope she ends up living in France.