Health Insurance: USA vs France

I came to Paris, in 2014, for one year. My intention was to better my french then to return to Oakland, go to baseball games and continue learning civics. It didn’t happen that way. Within six months, I knew I wanted to stay; one year was not enough. Not only was Paris beautiful, inspiring and exhilarating, I’d never lived in a city before. Cities, I learned, pulse with life. In Paris, no matter the time of day or night, life was happening. People were out on the street, having a drink in cafes, walking for pleasure or transportation, going to a myriad of events available every evening. For me, it was intoxicating. I loved it.

Then we had an election in the US. I found it hard to be there but not be living there. All my friends were in various stages of depression. At the time, no one thought it could get as bad as it has, that democracy is actually at stake. Some friends are inured. It’s impossible to watch from over here in France and not be shocked and outraged. The US, always somewhat imperialist, is now cruel and verging on terrorism. That is as extreme as I’m willing to state. In the back of my mind was always the question ‘What would it take to move here, to cut ties to California?’ Two things always jumped up. The first was health insurance. The second was home ownership. The wisdom says don’t sell your home in California unless you are 100% sure you never want to move back. I couldn’t afford my own home if I had to buy it.

Health Insurance: I’m 72 years old. I have Medicare and also a secondary insurance. Until recently I didn’t know if I was eligible to get French insurance. The french system may be the envy of the world. It is a single payer plan. A citizen gets a social security number and then applies for the Carte Vitale. With the carte vitale, every time one goes to the doctor, any kind of doctor, at the end of the visit, you hand your card to the doctor. Then you pay your co-pay. The doctor is paid the rest by the government. Some of my friends have a secondary insurance, which is not expensive in US terms, so as to cover any unforeseen problems. And french medicine is NOT expensive compared to the US. When I had my right hip replaced in February of 2017, I received a statement telling me how much the operation, lead-up appointments and post-op appts cost and what percentage of that Medicare paid. The grand total was $65,000. For the sake of personal information, I googled the price of hip replacement in Paris and the average cost was $8,000-$10,000. Same operation, same skill set, same medicine. It’s one thing to know that there is something very wrong with the American system, it’s another to have the numbers. I once ran out of an over-the-counter stomach aid while in Oakland. It had to be prescribed and my co-payment was higher than I paid over the counter here in Paris.

For five of the six years that I have been in Paris, not knowing what to do about health insurance has kept me from committing to moving here. Last fall, I learned that Macron had decreed that anyone who has lived here more than three months is eligible to apply for french health insurance. As with many things that require dealing with the french administration, I felt paralyzed to take action. Friends offered to help. One sent me the web address to get more info. Another actually translated into English what I needed to do and what I needed to produce, document wise, to get my social security #. Then I finally found someone who would go with me to the office. I needed my hand held. We set up a date and ….. the office had moved two years before. There was no longer an office in my arrondissement. My friend is married to a frenchman who writes beautiful french just the way administrators like. He wrote a letter to be signed by me applying for both the number and the Carte Vitale. Yesterday morning, I sent it registered mail. So now I wait.

https://www.expatica.com/fr/healthcare/healthcare-basics/guide-to-health-insurance-in-france-108848

This is not a political post. All the above raises all sorts of questions (that most of us already know the answers to) about why certain American politicians don’t want to make insurance affordable to 50% of the country. That’s not my fight this week. My fight is to grow old with insurance and the best quality of life I can have. I think the quality of my life is far better here in France. I would like to take the actions necessary to commit to living here. I may not hear anything for a year. Such is the snail’s pace of french administration (especially now when they are stepping up their efforts to help the British who live here, get residency cards, get their drivers license, etc). I have taken the action and it is very satisfying.

My next action is to get a French Driver’s License. Much, much harder than in the US.

A bientôt,

Sara

A resident of Paris

On September 29, 2017, I had my fourth yearly date with an agent at the Prefecture to renew my Titre de Sejour (residency card).  Each year, it gets a bit easier to prepare for it.  The French want to make sure that 1–I won’t work meaning take away a job from a French person 2–I won’t end up living on the street and 3–that I’m covered by health care and don’t need to use their social security system.

I seem to get anxious anyway.  I know something will go wrong and this year, it was the printer that ran out of ink while I was making the required copies of all the documents I needed to bring with me and my translator’s vacation. (All English documents must be translated into french by an official translator).  She arrived home two days before my appointment and meeting up with her the day before demanded a dexterity of mind that is not a strong suit of mine.

The morning of my appointment, I went to the nearest Post Office to make copies.  I was under the impression that it opened at 8am and I arrived at 9:30am.  My appointment was at 10:30am.  The sign on the door informed me that this particular Post Office opens at 10am.  So I took myself off to a nearby Cafe for a cafe allongée (long pull as opposed to a short pull which is an expresso).  At 10am, I was back at the front door of the PO.  There was a man standing there looking very bewildered, checking his watch.  The PO was very closed.  I walked closer and read everything on the PO’s front facade.  In small print up in a corner of one of the windows, there was information telling us that this PO was no longer open on weekdays.  I had 30 minutes, and probably less, to find a printer.

I stopped in two cafes and asked if they had one I could use.  No, madame.  I called my old neighbor from my Git-le-Coeur days knowing she had one and was close by.  I reached her at the hospital where her mother was dying and she could barely get four words out.  I rushed to a Gibert Jeune, an all-purpose station for students of any age to buy books, supplies, maps and more.  The Security man told me that ‘No, madame, we don’t have a printer but if you go up that street, cross over past the Pharmacy, there is a Internet store that has a printer.’  I rushed there and, acting like a spoiled American, thought I could talk my way to the front of the line.  No dice.  I had to wait my turn which I did extremely ungracefully.  My heart was beating so fast and my anxiety was so high that I thought I might make myself sick.  With my copies in hand, I rush-walked back towards the Prefecture–it was 10:20am.  I asked myself what was the worst that could happen?  The Prefecture would ask me to make another appointment in the future, it wasn’t the end of the world.

I made it to the door at 10:30, made it through the TSA-like security and, after handing all my documents to a lady at the front desk of my particular department, receiving a number in exchange, waited two and a half hours to be called to one of the cubicles.  After twenty minutes, she renewed my Residency Card and told me I would receive a text of when I could pick it up.

I relate this experience without accompanying photographs because so many of my American friends are envious of my living in the city of their dreams.  And indeed, I am extremely fortunate to be able to afford to live in Paris.  However, at some point, one is no longer a tourist or a visitor but a resident.  And being a resident comes with a lot of anxieties, dealing with the French administration and a lessening amount of time to explore museums and tourist points of interest which continue to be interesting to me.

Days will go by now that I do not see the river or my favorite bridge, Pont Neuf.  I have responsibilities and commitments.  I live here.  I carry around a card issued by the Mayor of Paris saying I’m an official citizen of Paris! It’s actually not official but gets me in to many places that I wouldn’t see if I didn’t have that card.

Some mornings, I wake up thinking of the Bay Area, my other home, the way I used to think of Paris.  With an affection and longing that surprises me.  Sometimes I think it’s time to go home–meaning Oakland.  Paris is really home but I’m not saying that anymore.  It’s a luxury dilemma that doesn’t always feel so luxurious.  And a universal dilemma I believe–wanting to be somewhere else when the going gets tough.

For now, I will take my fiscal stamps to pay for my new residency card.  Paris will have me for one more year.  For one more year, I will wake up with the joys and the aches of being a resident in this city.

A bientôt,

Sara