The French are so spoiled. I didn't consider myself spoiled before coming to the US, mind you. I thought I was paying so many taxes to the government, giving away all that hard earned cash to health care, social security, retirement and unemployment benefits for the unemployed plumbers of our land. But I was in fact, spoiled. Spoiled and nurtured like a baby, really. I didn't need to think one instant about going to see a doctor or a dentist. I knew I wouldn't have to pay a dime, and the doctor would normally see me within one to 3 days if there were an emergency. He might even come to my home if I requested it.

France was spoiling me so bad, making me totally ignorant about my own body's manifestations. If I felt like something was not quite in place in the old machinery, I wouldn't try to figure out what was wrong myself, I'd just go see a doctor- whichever doctor was appropriate for my illness or discomfort. No questions asked, no money down…

Americans are raised differently by Uncle Sam (isn't it funny the US is represented by a man whereas France is embodied in a woman figure? There's a cultural tip fur ya…). Their health care system is such that for the majority of them, getting sick is not a desirable option. Even for those fortunate enough to be able to have health coverage, the US has devised things like HMOs, PPOs and other Managed Care organizations that make choosing such coverage a headache.

Started out of the sensible notion that managing the way medical care was administered would be more efficient than letting individuals make their own health care decisions freely, the US allowed private insurance companies to handle its population's health.

Whether in a company or at the individual level, one has to confront the different plans offered by these different types of organizations in order to decide which one will better suit one's health care needs, both financially and from a quality of care point of view.

While HMOs offer the financial security of low payments, they force you into first seeing a General Practitioner (known as a PCP) before ever letting you see a specialist. This can take some time, so you will learn to tolerate pain…They will also make you think twice before letting you see your general practitioner, asking you to contact a screening service (called an 'Advice Nurse') to help you determine whether you REALLY need to see someone or not. Furthermore, if your time is of limited value, you will not mind the long waits associated with seeing any doctor, be it a PCP or a specialist.

For those with a little more money or a greater need for freedom, there are PPOs. These plans warrant higher monthly premiums but in exchange, they will let you see an "in-network" specialist at will. You will only be partially reimbursed for your visit though (80% to 90%). Hey, this is a free country, but freedom has a price- around $ 2,000- $3000 a year in most cases! So does time. When you see a doctor as a PPO affiliate, you will generally barely have time to peruse the waiting room publications, and will be given ample time to explain your case to the benevolent practitioner…

Oh, and this is only for basic medical coverage. If you want to protect those teeth and those baby blues against any health conditions, you'll have to choose additional coverage …Teeth are a luxury in today's era of mushy fries, burgers, and milk shakes consumption, aren't they?

What was I telling you about being spoiled…? I was giving around 10% of my paycheck to state health insurance in France, but boy, did I save on aspirin for those headaches the US system is giving me, and on self-help books with titles like: "Fight for your health" or "The Every Day Remedy Book". Well, on the positive side, I feel lucky its only aspirin I need, and I am becoming more self-sufficient every day. I now know what a yeast infection is, and what to take when I have a sore throat. ("Throat Coat" herbal tea really works!) If only my grandmother was around…

Yours, "internationally",
Anne-Caroline Rougeot-Isautier

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