Category: Healthcare

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Culture Food France Healthcare Moving to France

Some Moving Advice

I’ve lived in France for about a year and a half now, and I’ve gotten used to it. There was a viral story recently about a couple who went back to America after eleven months. Like others in the “stuff about moving to France” club, that story has inspired me to give a few words of advice. I’m going to skip what I’ve said before, because if you can’t at least say bonjour, au revoir, s’il vous plaît, merci you shouldn’t be considering even visiting France, because you won’t like it here. That said, here is what I am going to write about.

The pace of life is different in France. In America we’re used to having the means to push through to success quickly; the quicker the better, in fact. In France, it pays to be patient. For example, I started trying to apply for my residence permit (carte de long sejour) last February. I managed to do so successfully in April. I had an interview at the Prefecture (county administration is the closest thing in the States) in July, and was told that my card would arrive in November. All is in order. It is now November 26th, and my card has not arrived. There is nothing I can do. My temporary permit runs through mid-February, so I’m legal, so what I do is go on with my life and know that my resident card will, some day, appear in the mail. If that sort of thing seems like something you couldn’t endure, you’ll need to find somewhere else to live. Or stay put, whichever. I got a comment on an expat group that my experience with this was “light speed.” I was worried about this, and quite a lot. Until one day I decided not to worry about it any more, but just to trust the French system to work things out eventually. Not only have I felt better, but things have been happening as expected. Some advice for dealing with French bureaucracy:

  • Be sure that you know everything that you have to submit when first applying for whatever it is you apply for, and gather all of that information and documents before you start.
  • Most things can be applied for online, but you will, at certain times, need to appear somewhere in person and, preferably, interact with a bureaucrat at least mostly in French.
  • It will take forever for you to receive whatever it is that you have applied for. But it’s great when the thing arrives. My latest was my Carte Sanitaire, or national health insurance card. Just relax, live your life as if it will work out, and it almost always will. Work out, I mean.

You will have to learn French. You don’t need to speak like a native, but you have to speak and understand well enough to get along in a French speaking society. This seems reasonable to me, but here are some points about learning French:

  • You cannot learn French quickly. So forget it. If you took French in school, that may help, but the first thing you should do is de-emphasize all the conjugations and grammar and syntax, and emphasize simply conversing in the language. I can’t stress that enough: you must be able to hold normal, non-technical conversations with reasonable ease. You will have an accent. You will mess up. Those things are okay. If you want to fit in to France, you just need to understand basic French, enough to make some small talk, even though French people use a lot less small talk that Americans.
  • It took me four years of intense study to be able to use French at a B1 level, which is the level I discussed above. It’s roughly defined as “able to get along in normal society without undue problems.” You cannot simply devote six weeks to becoming “fluent in French,” which is pretty much a meaningless phrase in the first place.
  • To make it as fast as possible, a couple of things help. Maybe more than a couple. One, use French whenever you can. If they hear your accent and switch to English, bonus for you! I’ve had conversations where I spoke French, and they spoke English, and we’ve gotten along fine. We both got some practice, and we both understood the other person. Ultimately, understanding is the most difficult thing about learning a new language, though, and you’ll have to expose yourself to lots of French. Try French programs on Netflix, with subtitles probably in English initially, and in French as you get better.
  • Written French and spoken French are not the same language. They could be, but Cardinal Richlieu set up the Academie Française to keep the language “pure.” That very idea brings me to “and the horse you rode in on” but it explains why spelling French words is so difficult. There are at least five ways to represent what in English is the sound of a long “A”.

There are things that are almost impossible to get in France. Decent Mexican food, for example. Oh, they have Mexican, but they don’t use spice in it. You can read that again if you find it odd. Mexican food without spice is, well, it isn’t Mexican food. Fruits and vegetables are mostly seasonal, with some exceptions. For instance, right now, Thanksgiving time, you can’t find any strawberries. Turkeys can be hard to come by, although the local Lidl stores had some last week, and they were, while smaller than in the US, pretty ordinary, dressed turkeys. We plan to eat one on Thursday. French food, famous for being wonderful, uses herbs, not spice, so even if they do use some pepper, it won’t be at a level you’re used to. In the supermarkets, the American food section tends to feature Old El Paso. We have found some decent salsa, though, and one local store has a shelf featuring a variety of hot sauce, including Cholula, which is my favorite. You’ll have to learn how to find and/or order cuts of meat or certain vegetables. Zucchini is Courgette. Keep that in mind.

You will need a French drivers’ license. A few states (Ohio and Colorado among them) have reciprocity, most do not. Within one year of moving here you are supposed to have a French license. Without reciprocity you must pass two tests, one written (it’s online) and a practical. They are very strict, but few people fail completely. Keep in mind that it will take several months out of your life to get a license, and plan accordingly.

That’s all for now. When more things occur to me I’ll post them. I hope this helps somebody either decide to move or not, or to organize better before they move. Until next post, Au revoir!

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Culture France Healthcare Moving to France

Bureaucracy

If I live long enough, I may get one of these. (Not my artwork, by the way.)

The image above, from the web site of the agency issuing them, is of a Carte Vitale, which is a card indicating that one is in the French insurance system. I already have a French nombre se securité social, not to be confused with my American Social Security Number, so I am covered, but without the card I must apply for reimbursement of every medical expense (this is automatic with the card, and I can’t buy “top off” or supplemental insurance to make it all free. Also, I can’t set up my éspace sanitaire, or personal online area where I can do all the stuff one needs to do to use the French insurance. You can even link your “top off” insurance, so everything becomes automatic. Swell, huh? Buy why, I know you want to know, do I have that SS number, but not the card? Well . . . . .

First thing I had to do was apply for the social security number. The initial application was one simple page. Short and sweet. Then I heard nothing for quite a spell. Quite a spell. Then I got a letter explaining what my next steps were, which involved filling out the form again only online this time, and sending documentation like proof of residence (electric bill) and ID. Done. Now more time passes. And some more. Then I get a letter telling me how to log into the site to proceed. Which procedure does not work. Thus begins the real fun part. I go online looking for help to log into my account. I get some help. I really want that card, and the only advice I get is not working. I do receive my social security number along about now, but that in itself isn’t sufficient. I am told, finally, by someone whose job it is to dispense useful advice, to log into my account, click on a certain icon, and fill out the forms there. Unfortunately, I can’t log into my account, you may recall. After a week or so of back and forth I got the definitive word: one cannot log into one’s account without that card! Hmmm. I think I see an issue here. So, I fill in the original application, this time with my social security number on it, and mail it in. Two weeks later I get a letter explaining how to get them to send my card, one way being to log in (!) and another using la poste, which was easy enough. I had to send another photocopy of my passport, plus a photograph in the format of a passport photo. I had already sent these items, but hey, I remain optimistic. I may get that card yet this year!

I am not badmouthing the functionaires who handle these things. Even they, in surveys, say that it’s over-the-top. They are all very polite, helpful, and nice to deal with. The overall system? Patience is key. In another example, I applied for my residence card in April, had an appointment in July, and should get my card in November. See? Things do work out. For the patient. Now, on to my drivers’ license.

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Culture France Healthcare

Sheesh, Those French!

Last week I posted about some things I think France does really well. There is a flip side, of course, and here it is, according to moi.

1 Roads

France has some beautiful highways. The Autoroutes are the best, with speed limits a bit above 80 mph, beautiful construction, excellent maintenance, and tolls. Rather steep tolls. But that isn’t the problem.

There are also “Limited Access Roads” such as the N10 which passes near us, and is the quick way to Poitiers and Angouleme (and the A10 Autoroute, come to that.) It is mostly what we’d call a freeway, but there are sections with intersections where the speed limit drops to about 55 mph, and the top speed is 110 kph, or about 65 mph. But that isn’t the problem, either.

A Limited Access Highway.

Down a notch we find the main roads of France, which are usually two lanes wide, and generally have center lines and edge lines. They look like this:

Many are straight. I thought this was due to the Romans, but actually Napoleon started straightening them to move his troops faster, and other administrations liked the idea so much that they kept up the practice. Actual Roman roads do curve around sometimes, although you’ll seldom hear that mentioned.

The speed limit on main roads is 90 if they’re good and wide and straight, the default speed limit is 80. The roads are found in narrower and narrower sections as you travel around. First the edge lines disappear, then the center line degrades into a series of dots and disappears all together. A lot of common roads around where we live are about as wide as the one here:

A country lane. What doesn’t show is the curves, the way you can’t see oncoming traffic due to bends and crops (yes, crops; maize (corn) is pretty tall you know,) and the uncertainty that one feels when one sees an oncoming vehicle. Unless it’s farm equipment, then one is not uncertain because one gets out of the way!

Speaking of Roman roads, there is one in town. Here’s a picture of it:

Notice how it turns in from stage right? It’s a part of the roads Agrippa made for Augustus when Gallia was first getting organized. I think it was about 13bc. I don’t think they used Macadam.

2. Non-emergency medical specialist visits

I was referred to a cardiologist last April. I went to the office (in a nice hospital) with my referral form, and got an appointment Next October tenth. The condition is that a-fib you probably have seen advertised somewhere. It isn’t dangerous, but it’s a serious nuisance. This only applies to non-emergency services. If you’re in an accident, or really ill, you get right in and receive the care you require. But, six months? Sheesh!

3. Prompt response from tradespeople and others

It isn’t always that you can wait an eternity for a tradesperson to get back to you, but it happens. I’ve had a couple of electricians come out, look at what we wanted done, say they’d get back to me and then fade out like a ghost. This is sad because we do need some electrical work done. France is slower paced in general, but I mean a case where a customer (client in French) is forgotten entirely. Another example of French attitudes toward custom is that estate agents do not work Sundays (the British one we bought from did, so there!) They will tell a potential customer that they are simply too busy, and oh, I don’t work Sundays at all. I was a (Real) Estate Agent for six years. I would never have said anything like that. Nor would anyone in sales. Also, there is no MLS, so you need to find an agent from the agency listing the house you want to see.

4. Supermarket organization

Not where they put stuff. Just like in America, those stores rearrange at intervals to keep you on your toes or whatever. I mean that, for instance, rather than have people come in at say 4 in the morning to stock the place, they have the stockers hauling hand trucks of pallets full of merchandise during peak shopping hours. The loads passing down the aisles are a lot like combines on narrow roads: you get out of the way. Why do they do this? I have no idea. Union resistance? Inertia? The management enjoys watching customers scatter like tenpins when the big pallet rolls through? Heck, you tell me!

5. Over-the-counter medications

Sure, you can get them. Pretty much anything you can buy in the US you can buy in France. Except, if it is at all a drug, you must go to a pharmacie to buy it. Aspirin? Pharmacy. Athlete’s foot creme? Pharmacy. Vitamins are not considered drugs, so you can buy them in the supermarket. Likewise CBD oil is not a drug, and you can even mail order it. I find it irritating to have to make a special stop at a specialty store just to get a simple bit of medicine. Also, the packages are smaller, so you end up going back more often. Luckily aspirin and the like are light and easy to bring back from America and good old (WalMart, CVS, Walgreen’s, Kroger, etc.)

That’s five pros and five cons, and that’s enough for now. This blog is sort of stream of consciousness, so perhaps I’ll return to this topic again sometime. You never know unless you follow along. Feel free, please, to follow along!

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Culture Food France Healthcare

How ‘Bout Them French?

The Flag of France

As promised, here are some things that I think the French do well. I’m not going to compare one-to-one with how Americans do these things, in case you’re wanting to see something like that, but here goes what are simply my opinions, after living in France for the past 15-1/2 months straight, of some things I think France does well. I’ll post about things I think they do a lousy job of later, so stay tuned.

#1: Health Insurance

Contrary to what you may have heard, health care in France is not free. It is, however, not so expensive that anyone has ever gone bankrupt from developing cancer, for example. That only happens in America, which I guess is “exceptional” in its way. I went to see my doctor to get a prescription the other day. She charged me 26.5 Euros. At the exchange rate as of this writing, that is $29.42. Due to the speed (ha ha) of French bureaucracy, I don’t have my insurance card yet, but the doctor gave me a form to fill out to get my 60% reimbursement. As my income last year was entirely from pension, I don’t pay for the insurance, as they do not tax pensions in any way. For other income, the fee is income based.

#2. Education

The reason you can see a doctor for thirty bucks is because they don’t charge for higher education in France. Come to think of it, what is called “Vocational Education” in the US is also free. (You must buy books and groceries and pay rent, though.) Applied to a medical degree, this means that doctors do not start their career a quarter of a million dollars in debt, so they do not need to charge exorbitant fees to pay that off and still feed their families. Nor do members of any other profession or trade. It’s sort of like the state provides you with some bootstraps to pull yourself up by, if you get my meaning.

#3. Food

Not French style cooking and famous French dishes, which, to be honest, while delicious, seem a bit bland after a while to someone used to living and eating in the Southwest. I brought my own Cholula! I mean that the food is simply of better quality. You can go to any old supermarket and get the sort of quality you’d have to go to Whole Foods or Trader Joe’s to buy in the US, except you don’t pay Whole Foods or Trader Joe’s prices. In fact, most things cost less, at least in our part of France. Thus, whatever you’re eating, even McDonalds (McDo), tastes better. Fast food such as what’s at McDo even looks like the pictures on the menu. M&Ms are mostly not as brightly colored as in the US, nor are any foods, because of stricter rules on additives in food. With fewer additives, no “factory farms” anywhere, and a ban on a number of things that are allowed in the US, the overall quality is enhanced greatly. Yum, I say, yum!

#4. Manners

Somebody is going to read this and comment about how rude the French were to them, or to somebody they know. It happens, usually for one good reason. That person they were rude to did not use good manners on them. Here’s the way, again, to be mannerly in France. a) Say “bonjour” to anyone you’re going to interact with. If in doubt, say “bonjour” anyway. Worst case you’ll embarrass them and they’ll quickly return the greeting. That word has interesting roots, but it just means “hello” to anyone in France. Only exception is to only to say it to one person once in a day. If you meet them again you can say Salut, or even just hello! b) if you need something say s’il vous plait. Never mind how that’s spelled, say “see voo play” and you’ll be close enough. When you get it, say merci. When the interaction is over, the polite thing to say is au revoir, which means until we meet again. Don’t let that put you off. Say it every time. For brownie points, throw in a bonne journée. Say bone journay to get close enough. No one expects you to know French, but using these four words will go a long way toward making your visit pleasant. In fact, most French people strive to help strangers, and I’ve never met anyone who disliked Americans for any reason. (Can’t say the same for Brits, but that’s for another day entirely.) After my first visit to France in 1976, I started greeting shopkeepers and others with “Hello” or at least “Hi how are ya” and was surprised that my life was improved. Americans may not insist on manners, but we appreciate them even if we aren’t aware of the fact. Trust me. You can practice at home right away. Through the speaker at McDonalds, even.

5. Intelligence

Not everybody is gifted, whatever they teach you in M.Ed. school. France knows that, but here they respect intelligence. There is a career path for virtually any profession, including being a government employee. To be in the government, there is a school to help you do that, too. The system isn’t perfect, but at least you know that those who succeed in the democratically elected government have had training, internships and experience that means that they are most likely intelligent, and that they most likely know what they’re doing, even if you disagree with their policies. Same for any profession, really. And trades are not held to be any less intelligent or important than any other choice of career. It sometimes seems as if the U.S. celebrates the stupid, but France never does.

6. Elections

A campaign for president lasts for six weeks, period. Sure, there is posturing and gesturing, especially by an incumbent, but the campaign is short and mercifully sweet. For the Assembly (representatives) the campaign is only a couple of weeks. The only losers I can see are the TV networks that don’t make a fortune off of all those ads. There are also elections for Maire (Mayor) and Departmental Council, also with short campaign seasons. Mayors nominate candidates for President (there are thousands of Mayors) and also elect Senators. There is a lot one could write about French politics, but this is about how they elect the politicians. The posters have a designated place in towns and villages, and they come down shortly after election day. Much easier to take, especially if, like me, you can’t vote here.

There is more I like about France, but I’ll let those five items stand for now. Keep your eyes peeled for my “Things France Does Poorly” issue, coming to a screen near you!

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Culture France Healthcare

Sproing!

Springtime in Paris? Well, yes to be accurate.

The sound in the title of this post is spring, springing. Last month it was colder than heck for around here (I used to live in Minneapolis, don’t bother with examples of when it gets “really cold.”) Yesterday it was 65 degrees Fahrenheit and sunny. The cranes (grue) have been flying north over Lizant. It’s actually rather pleasant, and not terribly cold even when it rains. This weather is premature, but I haven’t heard any complaints. Maybe next summer the weather will continue to smile upon us and it won’t get up to 30 degrees Celsius every other week like it did last year. Maybe.

My French is improving. I had my medical exam for my Titre de sejour, residence card, last Tuesday. So on Monday I had to drive to Poitiers, about an hour away, to go to a French equivalent of a county hospital to get a chest X-ray taken. Then on Tuesday morning I walked into what we’d call a “Class C office building” again in Poitiers, with uncertain lighting and disturbingly bland decor, at 9:25 in the morning. At 11:55 I walked out again, having had a six minute interview with a nurse, and a fifteen minute interview with a couple of doctors. I’m telling you here and now, if you want to live in a particular country, be sure to be born there. It’s a lot less aggravating. I’ve since applied online for my official “can you live in France?” interview, which should be easy enough to pass. I had to send them many of the same documents I had to send the agency that gives out visas. France has a huge bureaucracy, with many branches, and apparently no two branches do much effective communicating with each other. This is itself very encouraging, as a scary situation would be where you give your documents to just one office, and the entire government apparatus knows all about you. I tell myself that while awaiting another step in a bureaucratic dance.

Besides awaiting that appointment, I await eagerly my carte sanitaire, or health insurance card. French healthcare is priced according to income, and they do not include pensions. Our income being all pensions at the moment, it should be cheap enough, huh? I applied in October, sent further documentation in late December, and as soon as I receive the card I plan to visit my French doctor, if only because I promised those doctors in Poitiers that I would do so. I do believe that there is no way that one could overestimate the ubiquity of French bureaucracy. But, what the heck, I do like living here.

Speaking of which, I’m considering reviving my “Grumpy American Moves to France” YouTube channel. Please let me know if you’d be interested in such a thing. If you want to check out what it was a couple of years ago, click here: (483) A Grumpy American Moves to France – YouTube

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Culture France Healthcare

Healthcare

Looks healthy to me . . .

Yesterday I had my first experience with French health care. Also, a comment on some French prejudices. Read on.

I have a not especially dangerous (as I take aspirin) heart thing called A-fib. It started in my 30s, and has been off and on ever since, but for the last few months, it’s just here. Sometimes worse than others. So, even though I’m not on French insurance yet (I’ve applied, but this is France, so I’m hoping by May, when my current insurance expires) I checked around and found a doctor taking new patients. Her name looks Spanish, but she’s native French. She’s not far away, down some amazingly rural roads, so it takes over half an hour to get to her. Once there, her office, in a medical complex that looks a lot like 1950s tourist cabins, is modest, but modern and nice. Right on time, she called me into her exam room.

She asked about insurance, and for a while was pretty adamant about why I needed to have some. I told her I did, but she didn’t seem to believe me, until that is I gave her my passport as ID, and she said, “Oh, you are American?” in her good English (one reason I chose her). I said yes and suddenly we were good friends. This is the French prejudice part. Brit? Pouffe! American? Do come in! I do not exaggerate. So anyway, she took down my information, listened to my story, and I was there for a full 1/2 hour. She set me up with an appointment with a cardiologist (in another town, but one down better roads) and gave me some forms for both the cardiologist and to get blood drawn (fasting of course.) None of that is unusual. What came next is, to an American.

She charged me 25€. That was the price, not a copay. In fact, I don’t think my insurance will cover that low a charge, which is okay, because 25€! I don’t know what the cardiologist will charge, but I’ll find out as soon as I get the official appointment (rendez vous) confirmation. Half an hour of a doctor’s time, being listened to, and sent to the appropriate help, for 25€. That is the difference between US healthcare and, I guess, anyplace else. Seriously, the US has some catching up to do in matters pertaining to serving citizens’ needs, doesn’t it?