Saturday, February 22, 2014

February 22, 2014 — The French Way of Cancer Treatment

Today’s title is borrowed from a provocative Reuters blog posting by Anya Schiffrin, who describes her family’s experience in bringing her father to France from New York, to receive treatment for pancreatic cancer.

Now that may sound incredible to many Americans, because of what we’ve long been taught about our healthcare system. Doesn’t everybody know our healthcare is the best in the world? Why would anyone forsake Memorial Sloan-Kettering — a destination renowned worldwide by those lacking adequate healthcare in their own countries – for treatment on foreign soil?

Well, part of the reason is that Anya’s father, the writer Andre Schiffren, is a native of France (and presumably still a French citizen), who’s used to spending part of each year in that country. He insisted on going to France as usual, and his family gave in to his wishes. After some initial skepticism, they learned that healthcare in France is much easier — and cheaper — to obtain.

Anya compares the grueling all-day experience of bringing her father to Memorial Sloan-Kettering for chemotherapy — which required hours of idle time in waiting rooms — with the much more patient-friendly French system:

“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.’”

OK, this is all about patient convenience, some may observe. What about the quality of care, the access to cutting-edge treatments?  There’s an answer for that, too:

“When the gemcitabine stopped working, the French oncologist said he would put my dad on another drug — one my dad’s U.S. insurance plan had refused to approve in New York.”

The cost to the patient for all this high-tech care? Next to nothing. Except for small co-payments (example: 18 euros for a doctor’s office visit), it was nearly all funded by the French taxpayers. It included house calls from nurses and the free loan of a wheelchair.

This approach has a staggering effect on overall healthcare costs:

“I had read many articles about the French healthcare system during the long public debate over Obamacare. But I still I hadn't understood fully, until I read this  interview in the New York Times, that the French system is basically like an expanded Medicaid. Pretty much everyone has insurance, it explained, and the French get better primary care and more choice of doctors than we do. It also turns out, as has been much commented on, that despite all this great treatment, the French spend far less on healthcare than Americans.

In 2011, France's expenditure on health per capita was $4,086, compared to $8,608 in the United States, according to the World Health Organization. Spending as a percentage of gross domestic product was 11.6 percent in France while in the United States it was a far higher 17.9 percent.”

Bottom line? We’re simply not getting good value for our healthcare dollars. There are too many people in our system — insurance executives, medical coders, financial clerks — standing there with their hand out. These people aren’t providing care, nor are they even supporting it. They’re supporting the powerful corporate interests who are deeply invested in siphoning off profits.

These corporate interests command a powerful public-relations machine that continually spews out lies about the alleged wastefulness and poor quality of publicly-provided, taxpayer-funded, single-payer healthcare in other countries.

Those like the Schiffrin family, with real experience of the best of those systems — France, Japan, Canada, Britain — tell a very different story. Sadly, it’s a story few Americans get to hear.


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