Wednesday, June 18, 2008

The Heart of the Matter
’ve had a couple of near Tim Russert moments over the last decade. In fact, I’ve got two stents in the left anterior descending, the vessel that sank him. I like to kid that I keep a locker at Yale New Haven Hospital and have a zipper installed in my femoral artery for quickie catherizations.
All my half dozen or so catherizations were done at Yale--except for one. The exception was performed seven years back at the Hôpital Cochin at the Port Royal in Paris.
The American health care debate tends to be ideological and/or financial. The right wingers demonize any proposal for a public system as socialistic, a death ray pejorative that instantly zaps any scheme for civic improvement in its tracks. Liberals point out that our private system is heading from atrociously expensive to monstrously unaffordable.
I once got involved in the details of those differences. But since enjoying the hospitality of a French hospital, I just tell my story when the subject comes up. For me, that pretty much sums up the issue. Here it is:
Suffering severe chest pain, I was taken by ambulance from my Montparnasse hotel to the nearby hospital. A catherization was immediately performed. It was determined my stents were okay and I had no new blockages. They kept me overnight for observation. I was released in the morning. The doc in charge of my case gave me a DVD of the procedure to bring back to my cardiologist at home.
Meanwhile, my wife was on the phone to the states getting authorization for payment from Yale Health Plan. On the way out the next morning, we stopped at la caisse to pay the bill. The tab was the equivalent of $1,300. The cashier gave me two pieces of paper: my credit card chit and a hospital bill listing just two items: specialité cardiac and 2 forfait journalier (room charge for two days). Had I been a French citizen, I would not have paid a centime. There was no charge for the ambulance, that being a free public service for anyone who happens to need one in France.
Back at home, my health plan was paying somewhere between $16,000 and $25,000 for my catherizations. The bills, of course, looked like the Manhattan phone book. On the few occasions I needed an ambulance, that was an extra grand or so.
At the time I wrote a more detailed op-ed on this incident for the Hartford Courant. It was headlined “Getting Sick in a Healthy Country.” At the end, I advised the Yale Health Plan that they could fly their catherization candidates first class to Paris, put them up at the Ritz, throw in a couple of three-star meals and ooh-lah-lah shows and still save themselves a few bucks on on the deal.
The difference between France’s socialized medicine and our commercialized medicine is obvious. The aim in France and the rest of the first world is to keep their citizens healthy at a reasonable cost to the society. The aim here is to make profits on their sickness. The French live longer and healthier lives than we Americans at far less cost to their nation. We produce billionaire hospital and pharmaceutical executives. Take your pick.