The sentence: Mission oriented rather than mercenary approach and in the end Missionary approach wins.. is from Jeff Bezos, the founder of Amazon.com
I will tell you about a personal experience with a Doctor in private practice in the USA and how France figures into it.
I am a doctor with an international practice but I am not engaged in a fee for service system or an exploitative system which has become the de rigueur in many parts of the world whether it is Cambodia or Iran or Brasil or Jamaica or India ...
When I was in Miami, I was asked to see an Otorhinologist regarding cerumen in my ears. After inserting various tubes into my auricular canals and nasal septum, he did remove the wax and then pronounced that there was an inflammation in the ear, the origin of which he did not know and prescribed by ear drops:
ciprofloxacillin plus dexamethasone. His office made an error in calling the pharmacy and I was without medications for nearly two weeks and he still insisted that i get the medications. Taking a friends advice many years ago, I do have good medical insurance in the USA (assurance). I was surprised when I went to the neighbourhood pharmacy and asked for a bottle 7.5 ml of the aforesaid ear drops. My jaws dropped when the pharmacist informed me that it would be 211 dollars for the drops!! I kept on asking myself ..how can two medications which are both very inexpensive cost so much..
During my travels, i try to help people with their medications and I stock up on medications in INDIA, the best place to buy medications for common illnesses (and also twice I was able to save thousands to two friends struck down with Chronic Granulocytic Leukaemia, medicines in their countries cost 50-100 dollars for a daily dose and in India it was between one and two dollars. Thank you INDIA ..) I called my pharmacist friend in Cochin. Yes it is freely available here.. if you just want ciprofloxacillin ear drops they are 70 cents USD and if you want dexamethasone added it would be twice as expensive. But Covid restrictions had been reintroduced and neither he nor his pharmacy was able to help me, procuring, taking it to the post office etc. He said he will send me when the current lockdown was over.
I decided to check the price in the USA for these precious ? (are they made of gold pellets?) drops of two simple medications.
The generic medications which are from India is sold for a price 75 times greater ..
Who's is to blame ? I am sure it is not the poor doctor, who probably does not even know the price of the medication? The pharmacist whose hands are tied ? DEFINITELY THE INSURANCE COMPANY, IN MY CASE I HAD BLUE CROSS BLUE SHIELD OF FLORIDA who decide which medications can be covered or not covered. When I checked the web, it did say that 99 % of the insurance companies covered this drug with a copay of 30 to 70 dollars.. so if you are the lucky one, you pay only 30 dollars for a drug that is sold in India for less than 2 dollars.
Talking to the pharmacist my impression was different. In his opinion, the easiest way to get the medication was to pay the generic price of about 125 dollars.
I was three weeks away from my diagnosis of inflammation and I was symptom free and within a week I was leaving for France.
I am an admirer of the French System of Medical Care for its population. I am not a citizen of France so I do not have the privileges of this excellent system. But France does offer courtesy to the doctors registered in certain countries.
I went to a proper pharmacy in a small town and was received by a young pharmacist who spoke English very well. From an anthropological point of view, from her accent, I deduced that she had gone from Czechia, Slovakia or Hungary ? to England, possibly studied Pharmacy there and now living in France. She was very accommodating and helpful. After reviewing and validating my license, she informed me that it is possible for me to get a 5 ml bottle of the same medication. The cost would be under 5 dollars, I was willing to pay 20 dollars knowing the prices elsewhere. The drops were of German manufacture, so it was 50 times cheaper than in the USA..
THE HEALTH CARE SYSTEM IN FRANCE IS MISSIONARY, ITS MISSION IS TO PROVIDE HEALTH TO THE POPULATION. THE SYTEM IN THE USA IS MERCENARY IN THAT IT MAKES SURE THAT THE PLAYERS ALL GET A GOOD SLICE OF THE PROFIT. HEALTH OF THE PATIENT IS SECONDARY.
