note: Welcome to the Global Health page. The purpose of this feature is
to raise awareness of global health issues with an academic spirit to
help improve the quality of care provided to patients. E-mail
by Ségolène Lainez
Second year exchange medical student
One of the most striking things for a French person who comes to the
United States and has to receive health care is to have to pay the
doctor… with his own money!
Indeed, the French Social Security (SS) system enables any person
living on a regular basis on French territory (having the French
nationality or not), and regardless of their financial situation or
state of health, to benefit from this social protection. To provide the
money needed for that, the community adheres to the SS system and pays
taxes. The relation with the state is complex: It has to give to the SS
the product of different taxes collected from tobacco, alcohol and
other products affecting health.
The SS is divided into four parts that we can simply understand as:
disease, old age, family (includes also disabilities and housing) and
recovery. For the section disease, some regulations have been set. For
example, the “ticket modérateur” (deterrent fee) or the medical
“franchises,” consists of fixed small amounts of money that the assured
has to pay for one medical act (like a medical visit or the purchase of
one medicine). This money goes to special targets like Alzheimer’s
research or directly to the state.
The SS represents a total budget of 330 billion euros each year, in
other words one fifth of the gross domestic product (GDP) of France.
The downside is that the budget deficit increases each year, since
government spending exceeds economical growth. First, the modern
medical devices (like MRI’s, etc.) introduced into daily medical
practice tend to precipitate this, because each procedure has a high
cost. Then, the demand increases too, since modern citizens are used to
more comfort. And finally, this medical progress enables doctors to
save more lives, and so the number of times each person needs the
medical system is higher.
Therefore, whereas it has been the case for years in American medical
colleges, French medical students have begun being taught the
cost/benefit of any medical act. For a long time, French people haven’t
had to be aware of the costs of their health care.
But optimism remains. If everyone makes an effort, we’ll appreciate the amazing opportunities of this social system.
France has more then 35,000 bakeries. Visitors can feast on baguettes, ficelles, flûtes, boules, or longuets.
Facts about France
- 60 million inhabitants (10 million in the Paris region alone)
- France has 35,000 boulangeries (bakeries)
- 76 million overseas visitors in 2003, making France the top tourist destination in the world
- 12 million visitors come every year to the Louvre, Musée d’Orsay and Versailles alone
- 63 percent of French people consider themselves Catholic, and 30 percent declare themselves without religion
- The name France comes from Latin Francia, which means land of the Franks or Frankland
- The French Republic is a unitary semi-presidential republic with strong democratic traditions
International Family and Friends Picnic, 12:30 to 4 p.m., Sunday, May
10, Mount Pleasant Palmetto Islands County Park. Cost is $1, which is
the entrance into the park.
For information, contact Rebeca Mueller, director of international programs, at 792-2156 or e-mail Mueller at email@example.com.
An 80-year-old patient presents with the following EKG features:
rotation of the heart’s electrical axis by at least 180º; prolonged
QT-interval LQTS; and preceded by long and short RR-intervals.
What would be the most likely diagnosis?
B. MI [myocardial infarction]
C. Torsades de pointes
D. Wolff Parkinson White syndrome
The correct answer is C.
Diagnosis of torsades de pointes or twisting of pointes can be made.
The ECG reading in “torsades” demonstrates a rapid, polymorphic
ventricular tachycardia with a characteristic twist of the QRS complex
around the isoelectric baseline. It is also associated with a fall in
arterial blood pressure, which can produce fainting. Although torsades
de pointes is a rare ventricular arrhythmia, it can degenerate into
ventricular fibrillation, which will lead to sudden death in the
absence of medical intervention.
It was first described by Francois Dessertenne, French physician. He
first described this special type of ventricular tachycardia in 1966
known as torsades de pointes in an 80-year-old lady.
Friday, April 24, 2009