View from Rue Saint-Georges

Out of Pocket

By Thomas Chatterton Williams | February 15, 2017
Allan Foster/Flickr
Allan Foster/Flickr


One of my greatest fears when traveling back to the United States is getting so ill that I have to interact with the American health care system. In France, there’s universal coverage, and as is the case in most European states, were you to get sick while visiting, out-of-pocket expenses remain well within the realm of sanity. Last summer in Provence, when my brother hit his head and needed stitches, he paid €18 at the pharmacy for his medicine and never even received a bill from the hospital. (In the emergency room, he offered to pay upfront, but the hospital declined).

My friend Jake Lamar, an American novelist living in Paris, was hospitalized for weeks after nearly dying from a defective aortic valve. He has written powerfully about how radically different his life would be had his heart condition surfaced while he still lived in the United States:

I spent a total of 15 nights in intensive care units [in a Paris hospital] while a team of cardiologists put me through a battery of tests and tried to determine how best to treat my case. In addition to the tachycardia (accelerated heart rate) and the leaky aortic valve, the aorta itself was overgrown. I would need open-heart surgery. …

In addition to my surgery, I underwent an MRI, had a probe inserted in my upper thigh and extended into my heart, twice had a camera shoved down my throat to take photos of my valve, and more blood tests, electrocardiograms and sonograms than I can count. For all this, I was charged nothing.

I did have to pay for my hospital beds, TV, telephone, WiFi and meals. I spent a total of 47 nights in hospitals and rehab. During the second half of my stay at the Grands Prs, I switched from a double room to a single so that I would have more privacy to write. Naturally, that was a bit more expensive. In the end, this entire ordeal set me back about 1,300 euros, or $1,455. …

I sometimes wonder how my health crisis would have played out had I returned to America instead of deciding to stay in Paris more than 20 years ago. Me, a journeyman writer with no university or corporate insurance coverage. Would I have been kept under observation in intensive care for two weeks? Before Obamacare, my valve problem could have been considered a “pre-existing condition,” allowing insurers to deny me support for the surgery.

I was thinking about this last week in Brooklyn, as I found myself dizzy with fever and aches—probably something I caught from my sister-in-law. She had to go to the doctor and receive a host of treatments that easily would have set me back hundreds of dollars. I ended up going to an emergency care clinic near my parents’ house in New Jersey, where I knew that even the $100 required simply to walk in the door was a steal. Fortunately, I feel better today. But when the doctor suggested I go to the emergency room just to be sure, I realized that, at least in the United States, certainty is a luxury I cannot afford.

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