Interesting Billing System at a Paris Emergency Room

You are not going to receive a bill. Take the time and research the France health care system and then send a "Merci" note to the hospital.

I had to visit an emergency room in Rome in 2017; was well taken care and received 4 stitches. The only thing I had to do was show my passport upon entry in the admittance room. At a farmacia the next day I paid roughly $15 for antibiotics and paracetamol. What a different experience than in a US emergency room.

My sister broke her wrist when she slipped on a wet tile bathroom floor at our hotel in Palermo, Sicily. This happened on a Sunday morning, the very first day of our Rick Steves tour. Our wonderful Rick Steves guide Nina, took her to the local hospital’s ER. She saw the ER doctor, a radiologist and an orthopedist, was cast from her palm nearly to her elbow and given a prescription for pain medication. She tried hard to pay them but they told her if anything was due, she would hear from them. This was in 2014 and no payment was accepted when she was released from the ER nor a bill ever received. Very unlike ER Sunday visits here in Colorado.

Yes, in France you collect/keep your x-ray and take it to your MD visit.
The very reasonable bill will show up later.

Healthcare and University are two huge reasons I wished I lived in Europe.

I had an accident in Greece and was in the ER for an hour and a half with an MD and a nurse. When I was leaving I was directed to the accountant to pay for these services. It was 3€ total. I insisted on being given an antibiotic as I had been cut on dirty barbed wires which was a 7€ charge.

Send a thank you to the French taxpayers too.

You may Eventually get a bill I did. It was not expensive but I did eventually get a bill and I did figure out how to pay it. It took about six months.

My Mom fell outside the Bayeux train station, resulting in a nasty gash in her lip and mouth. Someone called an ambulance, which took us the very short distance to the medical center. She got stitched up, had some meds prescribed, and we were asked to come back the next day to pay. We thanked them and left.

Ready for a hefty bill--this was our first experience with a European medical system--we returned and were told we owed a total of €68. The accounting clerk, apparently reacting to our looks of shock, apologized that it was so much. We assured her that this was not the reason our jaws had hit the ground, and thanked them all again for the great care she had received.

Send a thank you to the French taxpayers too.

This. They're taxed to the hilt for everything. Nothing is free in the end.

One of the reasons French health care is so affordable is that big corporations are generally not involved.

I second to come back to France and spend more. French taxpayers pay for their "free healthcare" through higher taxes. And in reality it's probably less paperwork for the French hospitals to write you bill off then to actually charge you the amount.

Vive la France. Even with insurance here that Xray would cost many several days of work here in the USA. La honte.

From experience, it's not a write-off. A very reasonable bill will arrive later. Maybe six months.
If there's no credit card option, you'll be able to pay with Wise, formerly Transferwise.

Seems like all well and fine for everyone in Europe. A big wow. Such a great system.
You may want to remember this if you ever encounter people with no insurance in the US (medicaid/homeless, etc) receiving essentially free care while you have all your deductibles and bills, etc. to pay.

So, keep your attitude expressed here in mind for the Euro system and do not grumble about those people receiving free care in the US.

Phred, no system is perfect. But a single payer system of healthcare is not ‘socialism’. Canada as well as many European countries ensure basic healthcare is available to all, typically referred to as universal access. And many, including Canada have private pay options for less essential healthcare. As populations age, many healthcare systems, even the US’s, are experiencing growing pressures and delays.

Indeed, Claire. Elderly friends in the US whose primary MD moved, told me their intake appointment with their new provider is set for February 2024. Systems are strained everywhere.

One should note that France is not a "single payer" system. There are various mutual-fund-based compulsory insurance providers which traditionally were associated with what your occupation was. There's also a state insurance company of last resort, which is subject to jokes that its clientele consists of the extremely poor who have never been able to get a job in their lives, and old-money types who have spent all their life living on the proceeds of the family property without having to get a job.

Might be worth pointing out that the OP's experience, and those of others applies to emergency care in most EU countries. Going to a Doctor will cost you an office visit (though not several hundred like in the US), and if that emergency care requires you to move over to hospital care, then the billing starts.

I believe Philip is referring to what the Brits around here call top-up insurance and the Americans call supplemental. As more doctors go beyond the very low rates set by CPAM, supplemental insurance is more and more important. A generalist office visit is set at 25€. Generalists have been having strike days, too, and want their rate raised to 50€.

I live in Austria. A portion of my salary goes to social and health care. I needed to be hospitalized twice this year - each time for three nights. I had one operation under general anesthesia during my first stay. Lots of meds, radiology and other diagnostics. I had a private room. All of this took place in a public hospital which was exceptionally modern and a center for learning for what I was dealing with.

My bill for the entire experience was 40 Euro, which was for my food.

Indeed, one's outlay for a generalist office visit is 25€ -- but you end up getting reimbursed most of that from the health social security system and your company's supplemental insurance ("mutuelle"), so in fact it only ends up costing something like €7 or €8. . . (they deposit your reimbursements right into your bank account, you don't have to submit a claim or anything).

We just received a bill from the hospital in Paris. It is for 102.83 Euros. There may be more bills to follow if their billing system is anything like the US. If this is the only charge, it will be nothing in US Emergency Room terms.

I would not expect any further bills: French hospitals have a centralized collection service. 103€ sounds about right for what you describe, a few years ago my partner was charged 145€ in similar circumstances.

Thanks, Balso. I truly marvel at the healthcare system in France and in other countries with such health programs.

@Lindy,

Was there an easy process to pay the bill? By credit card, for example?

I spent 5 days in a french hospital for surgery on a broken elbow and the cost was $4000 including everything. The cost was per day for medical and for surgical patients and posted in the business office. The charge a year later in Chicago to remove the wires in an outpatient procedure was $18000. Insurance paid most, but it still cost me $1200 above my insurance. -- no overnight in hospital.

American health care is all about wringing profit for middlemen. France has superior care and covers everyone for half the per capital costs of the US system.

When my husband was treated in an ER and released, there was not charge to us.

Vandrabrud I just paid online with my credit card! Easy, Peasy!
Janet, that is quite the difference in charges between the US and your experiences in France. The US allowed itself to be snookered by "managed care" which simply managed to insinuate themselves as middle men taking a piece of the pie while also "saving" the patient from the "unscrupulous" providers. (Somewhat bitter retired psychologist, here. . .)

One of the reasons French health care is so affordable is that big corporations are generally not involved.

So true. There is a book out now called "The People's Hospital: Hope and Peril in American Medicine" by Dr. Ricardo Nuila. His comment when asked why so many Americans have no health care is this; "Because the principal goal of the American health-care system is to make money."

While I've never been to a hospital in France, I would only expect one bill if i had to visit one.

(And for any Americans unhappy with your current system, keep that in mind when the next election comes.)