Hospitals in Europe: pain in the wallet

Article published on Jan. 10, 2008
From the magazine
Article published on Jan. 10, 2008
A guide to social security the French way (to help avoid a head-ache or heart attack when you check your bank balance)

The French social security system presents many peculiarities to the inhabitants of other EU countries. Despite the worrying reasons for being admitted to a hospital, we ought to pay attention to the health of our purse or wallet, which can become weakened by bureaucratic fees and multiple payments, even if part of these are reimbursed by the French government.

The notorious E111

Be it through illness or an accident, all foreign students or workers have the opportunity to rest their bones in any hospital bed. What do you need to do? The first line of defence in making sure you don’t suffer further worry is to have with you the European Health Insurance Card (the former 'E111').

The process for getting one is very simple and needs to completed before leaving your country of origin. It usually takes a few minutes in your local social security office. In the case of foreign workers, they already have a French social security number thanks to the 'Carte Vitale', supplied by the French Ministry for Health. Both cards allows treatment, as for as the costs are concerned.

The hospitals themselves

Imagine the scene: a hospital. To give it a name, we move to the Hospital Saint Joseph-Saint Luc, in the centre of Lyon, southern France. A modern building, with fantastic views of the Rhone. Televisions and a library service (mens sana in corpore sano, or 'a sound mind in a sound body'), 350 beds and more than 1, 300 employees. On the other hand, muggins here, who, during a visit to see some Spanish Erasmus friends, decided one night to climb a statue in the rain. Not a good idea following a bolletón drinking session!

Gaining access to the emergency services - I had to fill in a form (an obligatory process) within the first 48 hours of my stay. Luckily for me, the treatment was a success, and I managed to understand from hospital staff, albeit with my level of French (knocked a bit due to the reason for being there in the first place), that it was time to say goodbye, with my discharge papers under my arm (bulletin d’hospitalisation in French). An 80 euros lighter welcome to the world of bureaucracy.

The patient patient?

To a Spaniard, German or Brit, accustomed to the fact that post-medical treatment bureaucracy ends the moment you walk out the hospital doors, the idea of having to battle with further bureaucracy and pay fees is not met with enthusiasm.

In the majority of European countries, such as Spain, Germany, Scandinavia and the UK, social security covers the vast majority of areas related to health, from hospitalisation through to out-patients and post-discharge treatment, with neither of the two causing explicit damage to your bank balance.

It’s comforting to know that the French state reimburses the majority of fees paid during hospitalisation. The reimbursement of fees totals 80% of the total paid. Then, should we require post-discharge treatment, we have to choose, quite freely, a medical consultant from more than 110, 000 medical offices around France. Then, the patient continues in the same way as those newly admitted; payment upfront and reimbursements after … the same as the vast majority of treatments offered in pharmacies! Sometimes, the French consider their healthcare system – though not only their healthcare system – the most advanced in the world! Everyone chooses which doctor they want to see. But let’s be honest, it’s awkward and (surprise, surprise!) extremely bureaucratic!

French healthcare system in numbers

1.7 million workers in the healthcare sector (8% of the working population)

498, 800 hospital beds (8.5 for every 1,000 people)

64.8% of beds in public hospitals

9.5% of the French GDP is earmarked for healthcare

Life expectancy: men 74.6 years, women 82.2 years

157, 000 doctors

10, 200 midwives

248, 000 nurses

211 000 auxiliary medical staff

Photo homepage: (justicier 69/ Flickr)