Outpatient Card: Fill & Download for Free

I moved with my boyfriend (now husband) from the US to France in 2006.One must live in France for 3 months to begin receiving health coverage.In the French system, each resident is eligible for a basic health card. The card covers basic care and most prescribed medications. No fee is attached to the card. The fee for each doctor visit is about 25 euros per visit.The French system also has an adjunct system called a mutuelle (private insurance) which is similar to health insurance in the US. There are several levels to the mutuelle, from the basic level, which we have, to fuller coverage. Our monthly fee is about 154 euros a month. Our mutuelle pays some or all of the 30% of costs that the national health card does not cover. This means that the national card pays for about 70% of costs. After one turns 65, the card pays 100% of health care costs for each individual. There are no deductibles.There are no networks. One must establish a primary care physician, and in the absence of networks, the choice of physician is up to individual preference. This freedom to choose also applies to hospitals, clinics, emergency care, etc. The lack of networks also means that rates for treatments are fairly standardized across the country, so there are no surprise fees.In fact, I have often been surprised by the low charges when seeking care.A few of many potential examples of the awesome French health care system:Recently, I was experiencing debilitating pain in my left hip that was severe enough to wake me up at night. My doctor recommended an x-ray. I went to a nearby clinic a few days later and had the x-ray. Afterwards, I was told to go back to the waiting room. I was called back several minutes later and met with a doctor at the clinic who had reviewed my x-ray. She wanted to also capture an image of my right hip for comparison. As this is unfolding, the American in me couldn’t help but think of the cost. Two x-rays along with a consultation.Know what I paid? A grand total of 36 euros. Turns out that the consultation is simply part of the procedure.The hip pain was a stubborn case of adductor tendonitis. The doctor prescribed 6 weeks of physical therapy, which was not sufficient. Soon after I returned to my sensible exercise routine, the pain returned. I went back to my doctor, who provided a blank prescription for physical therapy and told me that it was up to the therapist and me to decide when my hip was better. I had 4 more months of physical therapy.Know what I paid? A grand total of 0 euros, because the mutuelle covered the costs.I broke my nose many years ago during a bad fall. Reconstructive surgery was required to put the bone back in place. The surgery was supposed to occur on an outpatient basis; however, I had an adverse reaction to the anesthesia and was kept overnight. I don’t recall the fees for the initial consultations with the surgeon.Know what I paid for the surgery and an overnight hospital stay? About 50 euros for my private room.No surprise fees. Freedom to choose one’s providers as a patient. No fears about whether one can afford a visit or procedure. You just do what you need to do in order to be healthy and well.This is what health care should be like for everyone.

I wish it was easier to convey my feelings on this in writing. But let me try:Oh… oh… OH GOOD GOD NO. Absolutely not. Under no cricumstances, for any reason, at any time would I accept that. I'd consider armed revolution to be a viable option if any Canadian government seriously tried it.You know the most difficult experience I've had with Canadian health care recently? I moved from Alberta to Ontario and there's a 3 month waiting period before you can switch from one province’s insurance system to another. In that time your province of origin gets billed for any services you access in your new province. I had to access some specialist ear, nose, and throat care at one of the big downtown research hospitals in Toronto in that three month waiting period and discovered I'd lost my Alberta Health Care card in the move. I had my Alberta Health Care number, but the receptionist (let's call her Cheryl) said they'd need a copy of the actual card, or I'd get a bill from the hospital.I ordered a replacement card, but in a comedy of errors they sent it to my old Alberta address and the mail redirect didn't catch it, so I still didn't have the replacement card by the time I had to go in for my follow-up.Fearing I'd be presented with a demand for payment before I could see the doctor again, I walked up to the receptionist with a light sweat. Her reply?“Oh sorry, Cheryl was new here. We have your Alberta number on file, we don't need the card. You're all good, have a nice day!”Oh, and for the Americans who think our system comes with unacceptable trade offs around timing and access - I booked the appointment with my GP to discuss my issue on Monday morning, saw her that same afternoon and she made the referral. The hospital called me on Tuesday, and I saw the ENT on Friday. Total cost to me for outpatient care with a specialist at an enormous research hospital… The $9.00 uber I took to that hospital. It was a nice day, so I walked home.The US can kindly keep its dysfunctional, unjust, expensive, inadequate, bloated, confusing, and broken system to itself, thank you very much.

Making sure that the discharge instructions are clear, they can get the drugs that you ordered for them as an outpatient, and they have follow up appointments scheduled.The things that I have seen most frequently are…Not being clear on how their old medication regime fits in with the new one at discharge.For example a patient was taking Lopressor at home but the doctor orders Metoprolol.Ok. New medication. Patient fills the prescription and takes both Lopressor and Metoprolol. Only trouble is that they are the same drug.Oops! Back to the hospital.Here’s another. Doctor orders a medication. The prescription goes to the outpatient pharmacy.Any number of troubles can happen here.Patient doesn’t have transportation and can’t get the medication.Patient goes to drug store and prescription is too expensive.Patients insurance doesn’t cover THAT drug but covers something just like it. Patient doesn’t know this.Patient gets medication but it interacts with some other medication that they already take.Oops! Back to the hospital.Patient is home from the hospital. Patient is told to make an appointment to see Dr. X in follow up.Patient still doesn’t feel all that well.Patient can’t remember the doctors name.Patient can’t find his/ her card.Patients family member can’t get off from work to take Patient.Oops! Back to the hospital.It’s still a problem but it appears to be getting better. Hospitals have had to step up or lose money.There are lots of hospitals that, now, have follow up calls or clinics to ensure that the barriers to completing treatment are removed.