Foreign Parts

À AIMER: European menswear (a.k.a. clothes that fit)

Photo: Louis Vuitton Men's Show, Spring Summer 2010.  © Louis Vuitton/Youssef Boudlal.

I used to work with a woman named Deborah who, each time a man passed by wearing a great scent, said, "Mmm-mmm.  I'm weak for a good-smelling man."

I, too, am weak for a good-smelling man.  I'm also weak for men who wear clothes that fit.  This is why I tend to walk around Europe with a half-smile on my lips that somehow fades every time I board the Eurostar for England or a plane back to the United States.

What is it with Anglophone men and baggy clothes?

The last time I was in London, I noticed that most of the men wore loose-fitting — if not ill-fitting — suits, jackets, and jeans.  Now that I am back in the U.S. for that tortuous dental treatment, I am astounded to see that nine men out of ten walk around in GIANT, and I don't mean large, clothes.  Even in fashionable New York, I lost count of the number of men whose shirts billowed out of their belted trousers, creating a weird sort of "balloon belt" effect.  

I know where they are getting these too-big shirts because every store from Neiman Marcus to The Gap carries them, and whether the label reads small or medium, the size is still XXL.

I do realize that many American men are now large to XXXL in body size, but just because you have what the French call "une bonne brioche" — a big belly — doesn't mean you have to wear T-shirts as large as pup tents.  And you're not hiding anything under that man's muumuu.  If you have une brioche, everybody knows it whether you're wearing huge clothing or not.  There are plenty of European men who are overweight and unfit, and many of them still manage to look great by choosing clothing that fits them well. 

And for those American and British guys who are en forme (in shape), why are you hiding it?  There are gorgeous French women (and men) out there who are just dying to meet "un bel Américain" or "un bel Anglais."  So treat yourself to a nicely-cut jacket and T-shirt, and perhaps a pair of lean trousers.  

With clothes that fit and a dab of divine cologne, you're sure to inspire weak knees.  And you can thank me later for all of the attention you've received.

À AIMER: Getting Sick, Part One

When you are an American living in France, getting sick has a silver lining.  That silver lining is: you're in France!  You're in France, the country that the World Health Organization rates the top on Earth for quality of health care and affordability. You're in France, where you know that, whatever you have, you will be taken care of.  All you need to worry about is getting better.

Don't believe me?  I do not doubt it, after reading the latest headlines on "the health care debate" from American news organizations.  There is a lot of conflicting information out there, a lot of misinformation, too.  So what's the truth?  Does socialized medicine, also known as "a public system of national health care," really work?  Do people in "those" countries really have to wait years in order to get reading glasses?  Do the rich have to pay insane taxes in order to cover the poor?  (If you're a European reading this, or if you are Japanese or Australian or Brazilian or Costa Rican or a person from any of the other countries that have socialized medicine, I apologize for what is probably, to you, a banal post.  Or maybe you find it funny.  I hope it's the latter.)  But back to you, my fellow Americans. Universal health care does work, and it works all over the world.  In a series of posts that I am calling "À AIMER: Getting Sick," I'll explain how it works in France and why it is something to cherish.

For today, Part One, I'd like to discuss the elephant in the room, the beast that is most responsible for driving the cost of American health care to unsustainable levels, and the beast that can be most easily trained: the American health insurance industry.  

As you know, all French citizens are entitled to health care paid for by their government.  It doesn't cover everything, but it covers a lot.  I, though, as an American living in France under a visitor's visa, am not entitled to French government health care.  So what do I do?  I buy my own, private medical insurance from an insurance company that is regulated under French law.

This is what I pay for my private French medical insurance: €696 per year.  

This is what I get: 

- 100% of surgeries and hospitalizations paid beyond €50*, up to €30,000.  

- 80% of hospitalizations without surgery paid.

- 100% of medical prescriptions paid.

- 70% of visits to medical doctors, both generalists and specialists, paid.

- 60% of laboratory analyses paid.

I am too lazy to write down everything for which my private insurance will reimburse me, but I can assure you that the list goes on.  Oh, and that asterisk*?  That's for the additional amount I must pay for my hospital room — €16 per night, more if I want a television.  So let's say I get hit by a Vélib and end up in the hospital, where the staff realizes that I need an emergency appendectomy.  And let's say I stay there three nights.  I would pay €98.  

"Ha," you say, "that can't be possible!"  What about the cost of the surgery and the doctor's fees and the anesthesiologist's bill and the cotton balls?  In the U.S., those fees would add up fast (in fact, they would add up to at least $10,400 and in some cases as much as $19,000).  In France, a laparoscopic appendectomy costs, drum roll please, €284.09.  And I would pay €50 of it, plus the €48 for my three-night hospital stay. Even if I had three surgeries in a year, I would not come close to hitting my insurance company's €30,000 ceiling.

Now do you see why I sometimes smile when I fall ill in France?  

When I lived in the U.S., I never smiled when I got sick.  The only silver lining I found stemmed, ironically, from the fear of financial ruin — it was so great, it sometimes made me forget my physical pain.  

I wonder, now, if things have changed.  So tonight, just for kicks, I am looking up the cost of private health insurance with one of my former insurers, Kaiser Permanente, which, back in the day, I referred to as Kaiser Soze.  Is Kaiser Permanente still Kaiser Soze?  Let's see.

Using my old zip code, I endeavor to find the cheapest Kaiser plan available.  

And here it is: $136 per month, or $1,632 per year.  It covers: 

- 30% of my hospital expenses . . . 

 after I pay a $5,000 deductible.

For readers living in countries with socialized medicine, let me explain that: Kaiser Permanente will not cover a dime of my expenses until I pay them $5,000.  Add that to my monthly dues for a total cost of $6,632 per year.  

Are you, my American readers, shocked that Kaiser will cover just 30% of my hospital expenses after I pay them $6,632 when my French insurance company covers nearly 100% of my hospital expenses for just €696?  If you are not, perhaps this will get you: in France, there is no deductible.  I think that statement deserves capital letters: IN FRANCE, THERE IS NO DEDUCTIBLE!

I hope that President Obama and everyone in the House of Representatives and the United States Senate hears that, because it is the single law they can adopt that will immediately improve health care for all Americans: nix the deductible!  Make it illegal.  Start now, this week, and take care of the rest after your August vacations.  

In the meantime, I'll be renewing my private health insurance — in France.

Note: The Kaiser plan also offers me one hearing test and one eye exam per year.  Both paid by me, for $50 apiece.

À DÉTESTER: French dentistry

Those who are weary of hearing that France has the best health care system in the world (and it does, despite what Fox News reports) will be pleased to learn that, when it comes to dentistry, the country is twenty years behind other developed nations.  Am I making this bold claim?  Not at all.  This was the declaration of Michel Yahiel, who, in 2001, when he was inspector general of social affairs in France, told the weekly news magazine L'Express, "Nous avons vingt ans de retard."  Yahiel was referring to French dentistry, which he had been assigned to assess.  L'Express summed up his verdict in the headline of an accompanying article: "Dents: le mal Français" (Teeth: the French Scourge).  

Why, oh why, did I not read this issue of L'Express before I moved to France?  If I had read it, the knowledge I would have gained would have saved me from a world of physical and monetary pain.  Mais non, instead I went ignorantly to a number of cabinets dentaires, where I submitted to rapid-fire cleanings by dental hygienists who, I now realize, were not dental hygienists at all because the profession does not exist legally in France.  

So who were these women who scraped the tartar off my teeth in less time than it takes to drive through an automated car wash?  I have no idea.  I suspect, though, that they may have been les assistantes dentaires, dentist's assistants who are not trained to do anything but take your X-rays and your money, and who receive eighteen months of schooling in preparation for le job.  But I have no proof.  I base my suspicion only on the number of times my teeth were hit accidentally with the handle of a dental instrument as I lay there, mouth open wide and eyes squeezed shut.  That clackety-clack of metal against tooth enamel?  I had never heard that before moving to France.  I should have known right away that I was in trouble. 

First problem: a very expensive porcelain crown, broken cleanly in half as if — well, as if someone had tapped it hard with a metal instrument, the way a geologist might use a rock hammer to split a geode in two.  Unfortunately, my crown broke the day after my "cleaning," whilst I was sinking my teeth into one of those chocolate-enrobed almonds that come with les cafés noisettes at Paris's more generous cafés.  So I could prove nothing.  

Panicked, I called my dentist in the U.S., who sighed before suggesting that I either return to San Francisco so that he could fix it, or have a new crown put on in France.  I chose the latter, and soon discovered why so many people in France walk around with missing teeth.  Crowns and implants are prohibitively expensive — sometimes as expensive as they are in the United States — and the normally generous French insurance system does not consider them something worth reimbursing.  The average French citizen, unused to paying out of pocket for anything health-related, even a 100-watt smile, thus decides to go sans dents.

In 2007, the newspaper Le Figaro published its own article on the state of the French bouche.  One in five Frenchmen, it reported, brushed his teeth less often than once a day.  French citizens had fewer cavities than before, but the average amount of toothpaste they purchased was just three tubes per year — well below the recommended six.  French dental hygiene, it concluded, was "trop souvent négligée."  But the worst fact I uncovered was not from Le Figaro; it was from a link I followed to a 2006 study by the ADF, the French Dental Association, which found that 80 percent of French root canal treatments were done so poorly that they had to be done over.  

Which brings me to the reason why I truly detest French dentistry: I got one of those failed root canals, courtesy of a very expensive Parisian dentist.  Not only did he-who-shall-not-be-named fail to seal the gap in my de-nerved tooth, thus resulting in a nasty infection that I have been walking around with for over a year, unbeknownst to me, but he also sent me off with a booby prize: a shard of dental instrument, which had apparently broken off during surgery and which he subsequently left in my tooth. 

The result: I am now back in California, where I am undergoing very pricey, and painful, re-treatment. At least I can be reasonably assured that, this time, the root canal will be done correctly.  According to that same French Dental Association report, only 10 percent of American root canals are considered insatisfaisants — and these are the root canals performed by general dentists, who are not specialists in endodontics.  

Still, I am not taking any chances.  I am going to a highly-regarded endodontist who, years ago, had successfully treated another tooth of mine.  And in the future, my biannual visits with my friends and relatives will coincide with my biannual visits with — my American dental hygienist.  

Now, about that French health care system: stay tuned, next week it will be the U.S.A.'s turn to take a beating.

À AIMER: July 13 in France — the firemen's ball

Most Francophiles know about July 14, Bastille Day.  But they don't always know about July 13, the night of le bal des sapeurs-pompiers (the firemen's ball).  This Monday, all around France, firefighters will host their annual fundraising fête for anybody who wants to join l'équipe in drinking, dancing and perhaps nibbling a merguez sausage or two until the wee hours.

The boots (see above) come off for this often-raucous event that, depending on the firehouse, might feature handsome pompiers performing rehearsed — or impromptu — stripteases. The first year I attended, I went to the firehouse in the Marais, where it seemed all of the single women and men in le quartier had gathered in order to find a fireman to call their very own.  Alas, given the ratio of pompiers to citoyens, most attendees went home disappointed.

À AIMER: picnics along the Seine

This week, France's new restaurant tax went into effect, lowering the TVA (taxe sur la valeur ajoutée, or value-added tax) that restaurant owners pay the French government from 19.6 percent to 5.5 percent.  In theory, this should translate into cheaper bills for diners.  In theory.  So far, though, the French press has reported that very few cafés and restaurants have lowered their prices.  Some restaurateurs have said that they are using the tax savings to hire more help, while others have explained that they are busy reprinting new menus and, well, what with vacations looming, this could take a while. Ahem.  

For summer visitors who would like to save on meals right now, I suggest heading to the banks of the Seine, the Canal Saint-Martin or the Canal de l'Ourcq, where Parisians go when il fait beau.  Hit the morning markets or one of the city's great foodie streets (for example, rue Cler in the seventh arrondissement, rue Montorgueil in the second, or rue de Lévis in the seventeenth) during the day, pick up a bottle of chilled rosé en route, and don't forget to pack a couple of glasses and un tir-bouchon (corkscrew).

Voilà — une pique-nique à la française, not at all cher (expensive), and the view cannot be beat.  Enjoy.