When Health Care is a Sacred Principle — One Frenchwoman’s Thoughts about the U.S. Health Care System
March/April 2010
By Sarah Gondy As a National Women’s Health Network (NWHN) intern for the last nine months, I have had the opportunity to observe both the differences between the French and the U.S. health care systems, and people’s experiences in trying to use the two systems. The main difference is that, in France, the principle of universal health care is cherished – and taken for granted. Despite recognition that the system is threatened by abuse and profligacy, the principle of universal access to care is not in jeopardy. In fact, we French take health care system so much for granted that few of us ever bother to delve into its intricacies.
Although the system has very simple guiding principles, its specifics are quite complicated and defy succinct explanation in such a brief newsletter article. But, in short, the French system is intended to provide health care for anyone who resides in France longer than three months, whether the person is in the country legally or not. Government statistics from 2004 suggest that up to 130,000 undocumented immigrants have access to the French health system. For the very few things that are not covered by national health insurance, such as orthodontia or glasses, complementary insurance plans are available to cover these services. Low-income people can also access complementary insurance plans, thanks to a special program targeting this population. Employers and employees fund the system through taxes, but paying taxes is not a prerequisite for getting benefits, nor is employment. The majority of French who are employed subsidize those who are unemployed – but this has never been a major issue of contention in a country that is otherwise well-known for its contentious politics and social conflicts.
Perhaps personal examples, rather than characterizations, best illustrate how un-American the French system is. As a student, I pay only about 100 Euros each year (about $144) to be covered for most of my health care. There is no need to tell you that, for a U.S. college student (especially a female college student!), it would be a complete different story. My own mother, after getting divorced from my father, was seriously cash-strapped and struggled hard to make ends meet. During this time, she suffered a serious back injury. Yet, that was the aspect of life she had the least to worry about: the health care system took care of her. She received as much medical attention as the next person, experienced no restrictions, and was not denied any needed procedure or medicines. Hers is a common story in France.
The French system costs an enormous amount for the government to administer. In 2002, for example, the country’s total expenditure for health care was an estimated 9.7% of the gross domestic product (GDP, which measures countries’ economic output). That is a lot, but it’s still less than the U.S., which spends 16 % of the GDP on health care, while leaving 47 million Americans without coverage. Reforming the health care system is always a source of great debate in France. In 2004, new measures attempted to contain costs, including a requirement for a referral from a family doctor or primary care physician in order to access specialists (with the exception of pediatricians, gynecologists, and ophthalmologists). Without this referral, specialists may seek a supplementary fee from the patient. This relatively minor reform aroused considerable opposition, thus reminding the French government how politically costly a major reform might be.
The French perceive universal health care to be a trait of their collective identity. I am proud of our system, and ever proud that that the French have accorded a universal, affordable, and high-quality health care the status of an inalienable human and civil right. In the U.S., I have noticed that values are different, to say the least. The NWHN has opened my eyes to how inadequate and unfair health care systems can be. My experience here this last few months taught me the importance of securing health care for everyone, and being vigilant about changes to the health care system – not only here, but also in France.
Thanks to my internship, I saw how crucial it is that health care reform meets women’s needs. I worked directly with women who were affected by the U.S. health care system, in my work on the Women’s Health Voice, the NWHN health information line, and at health care reform events held by Raising Women’s Voices. This was a truly enriching experience. Talking on the phone with the women who called could be hard (especially when English is not your native language!), but it was worth it. Hearing people’s needs and concerns directly from them had a much larger impact on me than just learning the same facts from a teacher or a book.
As I write this, health care reform has not yet been finalized by the U.S. government, and there are doubts about whether the final plan will meet our expectations and needs. I really hope it does, because I have been outraged by the abuses of the American health care system. I have listened to women crying over the phone because they were in a lot of pain and had no way to get the care they needed. Just yesterday, I talked with a woman and advised her to get a blood test to confirm whether she was pregnant or not. In my country, this would be really easy to do and would be completely affordable. Here, it is more complicated. The woman did not have any access to health care or to a physician. It was heartbreaking and revolting. How could so rich and powerful a country as the U.S. do such a bad job with health care coverage? This is simply not comprehensible to a French person. I really hope the situation improves in the U.S. as a result of health care reform.
Finally, I want to add that NWHN gave me the opportunity to meet wonderful women and wonderful feminists. I am very grateful for the opportunity. Without the activism of women in the past, without their strength and tireless efforts, my generation would not be as free as we are, nor have as many opportunities. Feminism is a trans-generational fight. It is important that young activists get involved and continue to raise their voices for feminism. After nine months as a NWHN intern, I know that all the staff carries their voices for all of us. Helen Rodriguez Trias, for whom my internship is named, underscored the importance of the Network’s work with young women and NWHN continues that value today. It was wonderful to work in an environment in which people wanted to share their knowledge and help me improve and develop my skills. I want to express my thanks to the staff! My internship is reaching its end, but the same is not true of my commitment and involvement.
Sarah Gondy, a French intern at the National Women’s Health Network, is studying political sciences at Sciences Po. Paris. Her career interests include focusing on law and women’s rights.
