A bit of a surprise

[exile]

I think we will all be aware of the generally good services we get with regards healthcare (exceptions do exist of course) but I was surprised today to find out just how complex things can get and how small hospitals can be on the edge financially.

I had an appointment today with our MT to renew a prescription. She asked how my wife was doing having recently been released from hospital and I commented that I had noted that some of the medications she had received before going into hospital were not on her exit prescription and I did not know if it was a deliberate move to help her off some of the meds or not. The hospital is a small affair covering a large but low population area (12 k inhabitants at a guess) . So what follows may not apply to large city hospitals.

This question seemed to touch something of a nerve with the MT who spent a good 10 minutes explaining the difficulties hospitals were in and the limitations they work under. With regards OH's meds, the doctor explained that the pharmacist had a list of "essential" meds that she could prescribe. For these the secu pick up the costs as usual. For anything else, the hospital becomes responsible for those costs with no reimbursement - even if CPAM would normally pass on the costs back to the UK! A long discussion about other issues, including that none of the town doctors (all MTs) get any payment from the hospital because the hospital could not afford to take on additional salaries - with all that entails. Another local hospital was she said in severe financial problems keeping its head above water.


Other examples were given on the complexities of who pays for what - ambulances to regional centres for specialist services for example.

The one that really surprised me however is that if you have a serious accident, the pompiers arrive and contact SAMU. The SAMU doctor decides an air ambulance is needed. The cost is taken up by the secu. If on the other hand, you are in hospital and your condition takes a sudden turn for the worse and an air ambulance is summoned to take you to a major hospital, the costs go to the hospital!

Thinking about it afterwards, I am not sure how much of these costs can be passed back to a mutuelle - even assuming the victim has one.

There is no doubt that having these small hospitals (probably equivalent to a UK cottage hospital when they still existed) saves a large amount of money for the state as well as families compared with transferring victims over 50km to a major city centre establishment. I would have thought their financial status should be better supported however.

Sorry a long post but I wonder how many of us were aware of such things, living (largely) in our S1 bubbles.

[Blaze]

Interesting points, Exile.
The "who pays for what" question is a big one, and sometimes I imagine it isn't always easy to be precise. But then French comptabilité has to be complex, doesn't it !

We had dealings with a Hungarian living in England who had come over in his lorry (working) but he caught Covid right at the beginning. He was in hospital for over 6 months and he had many problems apart from Covid itself : obesity, virtual paralysis due to lack of muscle use/stimulation and he was unable to speak due to having tubes in his mouth for so long.

So, who was going to pay the hospital fees ? He didn't have the money, neither did his daughter living in the UK, and he had no health insurance. He was not a UK citizen (neither was his daughter). The hospital eventually waived the fees ....
The next issue was getting him back to the UK when he was up to it : air ambulance was the only way. OH did a lot of back and forth with the NHS/hospital he would go to and the French health services/local hospital where he'd stayed.
In the end, the French health service said they'd pay ......

I don't think the Hungarian family had any idea of the work and time people had put in to literally save his life, and to get h im back home again. None of us ever heard from them again.

[Pathca]

Good that there are people around like you doing this Blaze

[exile]

Amen to that

[MAD87]

+1 Blaze.
Bean counters are the same the world over, I guess.
A couple of months back, I took a taxi to the CHU de Limoges for a rdv, without specifying a taxi-ambulance. Big mistake. The company didn't accept my bon de transport so I paid by card. I was told to claim from la sécu, which I duly did, sending the factures (€120) and bon by post. Radio silence, save for an email telling me to read my Amali messages. Can't access them, can't change the pw...
Meanwhile, my daughter and MT (hardened socialists), aided and abetted by my infirmiers and kiné, are busy digging a large hole in the sécu budget, while the govt refuses to disband all the 600 commissions and comités, gravy trains which cost 80Bn/year..