I wouldn’t have dared to write about this before the recent passage of health care reform, because I was sure that it would seem that I, a partisan in the debate, was exaggerating to show how wonderful universal health care is. Thanks to a courageous U.S. Congress, I can now share my experience with European health care, though you may still find it surreal, as I do.
A few months after we moved to Brussels, I thought it was time to schedule my annual health exam and establish a relationship with a local doctor in case of an emergency. There was a doctor’s office on our block I walked past every day, but it seemed never to be open. After my neighborhood French teacher recommended the same doctor, however, I telephoned to make an appointment.
“Dr. Marechal,” the masculine voice on the other end of the telephone answered. It couldn’t actually be Dr. Marechal, could it? It was. At this discovery, my mortification was so great that I nearly hung up, but years of Caller ID have cured me of this practical recourse. In my halting, tortured French, I apologized for reaching his personal telephone line (how did that happen?) and said I regretted terribly the interruption, but was calling only to make an appointment.
“I am sorry,” Dr. Marechal began gravely, and I silently berated myself for foolishly thinking I could just call a doctor in a strange country and make an appointment, as well as for blowing any chance I might have had by the unforgivable faux pas of bothering the doctor on his private line. “I cannot see you until tomorrow morning.”
What? Even if my French had been perfect, shock would have rendered me incoherent. “I’m not READY to see you tomorrow,” I stammered idiotically, amending it to “I’m busy tomorrow.” Both were true. I had called with the intention of trying to get an appointment in the next three months or so, as one does in the U.S. with one’s annual physical. We settled on an appointment the following week.
The point of this anecdote is not that I once lucked into an always-available doctor. The point is that every American I know in Europe has an equivalent story about the astonishing, easy access to medical care here. Here we are, all of us formerly fully-insured, savvy consumers of U.S. medicine, awestruck by the health care we find in countries where everyone is covered.
When I went for my appointment, I waited about five minutes in the reception area before Dr. Marechal came out to get me. I soon learned that he had no visible assistant (no wonder he always seemed “closed”), he always answered his own telephone and made his own appointments.
Dr. Marechal took telephone calls even while he met with me, making appointments, answering questions about medication, and opining whether he needed to see the caller again. At the end of the 30-minute visit, he collected 25 euros (about $35) in cash and gave me a receipt. Our insurance cooperative reimbursed 16.62 euros of the cost.
When my husband needed a travel vaccine, I called Dr. Marechal again and this time was prepared for, though still amazed by, his answering the phone himself and making an appointment that afternoon. Same casual procedure, same waltzing into the appointment, same charge.
Since then I have had similar experiences in France and Switzerland (although Switzerland is much more expensive). I’ve never had to wait more than a week to see a doctor, and many have open office hours where you can just drop in and wait your turn. And no long waiting past your appointment time, either.
Even in England, where complaints about the health care system are legendary, people expect prompt service. A community leader in London was 10 minutes late to our meeting because her doctor’s appointment ran over. Turns out she expected to make an 11 am meeting after a 10 am doctor’s appointment. I expressed amazement that she had thought she could get in and out of a doctor’s office in less than an hour. She seemed bewildered and said it never took that long.
In 2004 I helped fund a study at the Denver Health and Hospital Authority to explore extending health coverage to Denver’s uninsured. In our discussions, we usually assumed there would be trade-offs. If more people were covered, you would have longer waits to see providers. You could make health care cheaper, but then it would be less convenient with fewer choices. My experience in Western Europe refutes all of those equations. Health care here is cheaper, faster and fairer. Studies have shown it is also better.
In his excellent book, “The Healing of America,” Denverite T.R. Reid has a compelling analysis of how other industrialized democracies succeed with universal health care. As persuasive as Mr. Reid is, I would have had trouble believing his descriptions of just how cheap and accessible foreign health care can be had I not experienced it with my very own body.
While I confess that I cannot imagine U.S. physicians ever answering their own public phones, there’s every reason to believe that we Americans can have not only a fairer distribution of health care, but one that takes less of our time and money and still gives us outcomes that are as good or better than what we have now.
Kathleen MacKenzie moved to Europe in 2007 after serving two terms on the Denver City Council. She currently manages electronic communication for a global NGO in Geneva, Switzerland. EDITOR’S NOTE: This is an online-only column and has not been edited.
