Health Care the American Way

Change had been promised by President Obama and change has arrived. Thirteen months of wait for a bill that will transform the landscape of American health care. Nobody knows yet how far it will take us and how much will still be needed. Progressive citizens find it insufficient. Conservative citizens fear excess. If one thing is sure is that each major change in a society needs a first step and on Sunday night that first step was taken. With team work and disagreement, with hope and fear, and palpable passion, promised change during the electoral campaign has been delivered.
This bill upsets some Americans, who uncertain with its results, fear failure. Big changes are scary. My move to the USA has taken me far away from the big umbrella of the French health care system. My first experience with the American health care world opened my eyes onto the unknown. And unknown isn’t always bad.

I gave birth to my second child five months after my arrival in America. When we hunted for health insurance, I became an alien with a preexisting condition. I noticed how being pregnant in the United States doesn’t give you access to an automatic special status like it is in France. When I expected my first child in Paris, I entered the magic world of pregnant women. People would open the door for me and offer me their seat on the bus or subway. I could skip the line since French pregnant women receive a priority card allowing them special treatment. After my baby was born, I followed free postnatal exercise séances at a professional place.
In France I had read alarming articles about the high rate of C section in North America and although my French physician had been reassuring, he admitted that the chance to have a C section was much higher in America than France. It concerned me even though I convinced myself that it wouldn’t be the end of the world.
Being pregnant in the USA was a total different business than expecting a baby in France. At my first American prenatal checkup I had, à la française, fully undressed. A nurse handed me with a polite but embarrassed smile the strange paper gown she had left on the exam table before exiting the room. In France, nobody cares about your private parts yet I was weighed every single month during my pregnancy and ordered to keep my gain weight reasonable. In America, it didn’t seem to matter and being pregnant lost some of its drama.
However, on my way to the hospital, on a busy Saturday night in San Francisco, I wondered if delivering a baby in America would be as surprisingly different as the prenatal visits had been.
My little girl took only a few minutes to travel from the dark cocoon of my womb to the brightly lit American world. It was such a fast delivery that no physician made it in time to my room. I had delivered a year ago in Paris, surrounded by my OB, an anesthetist, the midwife who had taught me the tricks of the sans- douleur accouchement or the painless delivery, two nurses and another hospital staff or two.
In my San Francisco room, the word hospital took a different meaning. Only a nurse and a resident assisted me, giving to the event an intimate atmosphere I had missed in Paris. Yet, it would have been somehow reassuring to see a few white coats here and there. I hadn’t eaten anything since breakfast and my stomach embarrassingly rumbled.
“Are you hungry?” The nurse asked as she wrapped blankets around me.
A mouthwatering vision of a tray loaded with food instantly came to my mind. A warm vegetable soup, then a fresh tomato and mozzarella salad. Some crusty baguette and a piece of creamy cheese and to end on a sweet note a mousse au chocolat. Yes, it would be perfect. I envisioned a sparkling Perrier with a zest of lemon to appease my thirst. After all, last year in France, the service had been close to a Relais Château.
The nurse read my mind. “The kitchens are closed,” she said. “Let me see what I can do.” She returned with a huge grin. “I found something for you!” she announced cheerfully, handing me a can of freezing cold coca-cola.
My husband politely declined his and we toasted our baby girl with one single can of coke. If it didn’t taste like the champagne we uncorked in Paris, it was however cold and sparkling and I polished the can with the ferocity of a marathon runner.
The nurse peeked at the baby. “She’s gorgeous and so healthy. You can go home,” she said.
“When?” my husband asked.
“Now.” The nurse looked surprised by his question.
“Now?” my husband repeated. I could see his Adam apple traveling along his throat and I knew he felt sorry for declining the coca cola. At least, he would be able to swallow the tight ball of anxiety stuck in his throat. “You’re kidding, right?”
The nurse smiled. “Your wife and baby are doing well. You can return to the comfort of your home,” she went on.
I was tempted. I had done my grocery shopping the day before and I easily pictured the loaded fridge and pantry.
“No way,” my husband said. Although I felt better now that the nurse had wrapped me as tightly as a mummy in thick blankets and the baby had already returned to sleep, my husband certainly didn’t seem ready for another ride on Highway 101.
So, I spent the rest of the night in the company of my satiated baby and my roaring stomach.
The morning tasteless cereal, whole milk and weak coffee were close to the French Relais Château after the forced diet I endured until breakfast. I slurped my soggy Raisin Bran in a few spoonfuls as I had savored my fresh squeezed grapefruit juice, granola yogurt, croissants and fancy tea across the Atlantic.
Nothing better than a nap after a meal but I wasn’t allowed this small luxury.
“You are good to go!” the doctor decided, cheerfully.
I was expecting some kind of checkup or stamp of approval but we only received our baby’s birth certificate. We held it with pride. She was the first American of the family.
Later that day, my mother called. “Why are you picking up the phone?” she said, obviously shocked. “What are you doing here?” She hadn’t expected to talk with me yet.
After all, I had stayed five days at the hospital for her first granddaughter. She almost fainted when I told her that I had returned home after being suggested to leave in the middle of the night, a couple of hours after the baby’s birth.
“I know that you like it over there,” she said. ‘Over there’ sounded like a bad word. “But do you think it’s safe to treat new mothers like that?”
I skipped the coca-cola episode; otherwise she would have called the French embassy to require an emergency rapatriement.
My mother-in-law was shocked too. “What are these Americans doctors thinking?”
She was born in Champagne, the capital of the French best known brands, so I didn’t mention the coca-cola toasting either.
I listened to both of them, sitting at my kitchen table as the fragrant scent of the eucalyptuses wafted through the open window. France seemed so far. How could I tell my family that I was now living in the USA where the cost of health is so high that you go for what you have to do and are sent back home ASAP?
How could I also tell without hurting them that if I had only stayed for a few hours at the hospital, everybody had been supportive and caring and that I had felt much more in charge of my body and baby than I had been in Paris where the medical staff had decided for me what was good or not?
How could they understand that I had come to a country where my destiny was not anymore in the hands of the government and that I was accepting to live without a safety net above my head and beneath my feet? The beloved French social security system was only a word to me anymore and neither my mother nor my mother-in-law had lived without this reassuring feeling of being taken care of.

Today, President Obama signed the health care reform bill into law. It upsets many Americans. And for a good reason. They have never been taken care of. Yet I have little doubt that what they fear the most won’t happen. Americans will keep their unique independent way of life including how and when they want to be taken care of. I have also little doubt that, in the end, their genuine generosity will open their minds and hearts. Such a great land can only do better with healthier people. It can be done with a little bit of willingness from each of us. The American way.

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