PORTLAND — I'm far from the first American living in Europe to extol the virtues of universal health care. It's almost a cliche at this point, but may have renewed relevance as the pandemic has laid bare the failures in medical systems around the world. After living through COVID-19 in France, a trip home would give me at least a glance at how that old comparison is holding up.
Working for several years as a freelance journalist in the United States, I had experienced the struggle of obtaining health insurance. The cheapest plan (determined by my limited income) under the Affordable Care Act still cost over $100 a month with few benefits. When I needed a dental procedure, I had to pay out of pocket and went to a student at a dental college instead of a licensed professional to save hundreds of dollars.
My move last year to Paris as a graduate student granted me immediate access to full coverage from France's national health insurance, even though I'm not a citizen. I now pay pennies for the pills I take for my chronic illness and, contrary to the stereotypes back home, I have never had to wait long to make a doctor's appointment.
When the virus hit, I'd read about all the American hospitals — working within an economic model of scarcity and having just enough materials at hand — having to bid against each other to acquire PPE, ventilators and other equipment. Meanwhile, hospitals in France and Germany developed emergency procedures to triage resources. Of course, the situation in France hasn't been perfect: President Emmanuel Macron was slow to promote widespread mask wearing (partially because of a shortage) and the country's much touted StopCovid app failed to facilitate widespread contract tracing.
Luckily, I haven't gotten sick, and never even needed a COVID-19 test during the first wave. But as I prepared to fly back to my hometown of Portland, Oregon, I knew I would have to get tested — twice.
People in cars line up to receive free COVID-19 rapid tests at a drive through site in Florida — Photo: Paul Hennessy/NurPhoto/ZUMA
Before leaving Paris, as would be expected, getting a coronavirus test was bound to be smooth. After a quick phone call, I had an appointment at a clinic down the street from my apartment. I showed up to the outdoor site and had a free test completed in less than five minutes. My negative result came in less than 24 hours.
After landing safely on the West Coast, I would need a test in order to limit the time quarantining in my childhood bedroom (with my mom delivering meals on trays). But hours of research yielded confusing results. I no longer have health insurance in the U.S. and can't join my parents' plan because I am over age 25. I could go to a clinic but that could cost more than $100.
The only free solution: a large-scale testing site in a convention center parking lot, where the waiting time was more than three hours. But even more importantly, unlike France, it would take up to five days for a result.
Some of the delay was due to the virus spreading exponentially in Oregon and around the country, with the number of new COVID-19 cases reported in the U.S. topping 200,000 for the first time this past Friday. And while France has also struggled to limit the toll, the second wave of the coronavirus looks to have slowed after a series of government measures, including national face mask requirements.
Perhaps the hour for cliches and comparisons have passed.
Eight months or so into a pandemic, there is no "model" management to cite anywhere in the West. Still, the view arriving back in the U.S. is particularly troubling, and made more so in my mind as the hours passed in the dark concrete lot, breathing in the car fumes as I waited for my test.
A momentary burst of light arrived the minute I was in the hands of the healthcare staff. They were efficient, friendly and made any nervous test taker at ease. It was the only part of the experience that mirrored my test in Paris: Despite months of heartbreaking and exhausting work, the nurses, doctors, cleaning staff of often broken healthcare systems around the world continue to shine on the frontline of the pandemic.
Indeed, perhaps the hour for cliches and comparisons have passed. And I wonder if this crisis (and a new president in the White House) will finally be the tipping point for Americans to decide that good medical treatment should not only be reserved for those who can afford it. France and the rest of Europe will be asking their own questions about how the crisis has been handled. Yet there is nothing like a highly contagious, potentially fatal illness to confirm what has always driven universal health coverage: if my neighbor is sick, it is of priceless value to me that she is taken care of.