On this particular day, I had been nervous from the morning. Before the shot, I explained to the nurse how difficult it is to find my veins. She smiled and said, "Don't worry. I'm a professional." Just as I had worried, she realized that I was right. After a while she said, "I really can't find a good one, but I will try with this one," and finally succeeded.

After she drew blood, I felt faint. I blacked out and came to with the nurse slapping me. "Wake up!" she shouted, and put a sugar cube into my mouth. This direct method was successful. However, sometimes I think that French medical care needs to be more delicate.

France has a National Health Insurance program, the Securite Sociale. It is subsidized by the government and contributions from employers and employees. Foreign residents can also benefit from this policy as long as they hold a proper visa. If you are employed, your company is responsible for filling in the required forms, although you may have to register yourself with the Securite Sociale office in the place that you live.

After registering, you are issued a Securite Sociale card. Every time you need to apply for benefits, or to receive a social security reimbursement, you submit this card.

In general, the system works as follows: When you see your doctor, you pay the consultation fee, then you go to a pharmacy to buy the prescribed medications. It's rare to get your medicine at the hospital or the doctor's office. Your doctor gives you two copies of the prescription, together with a reimbursement sheet stating the price paid for the consultation. You give this sheet to the pharmacist and you get it stamped along with the second copy. On each box of medicine there is a small detachable sticker that you or the pharmacist affix to the reimbursement sheet, which you then mail, with the second copy of the prescription, to your local Securite Sociale office. The amount reimbursed (usually 70 percent) is paid to you a few days later by means of a bank transfer.

I have heard that many people are discontent with the delay in reimbursement. It has been reported that the system generates more than 12 million complaints. Some people go unreimbursed for more than three months, causing some difficulty, especially for those people on fixed or low income. Nevertheless, a World Health Organization study ranked the French health-care system first in the world.

With the arrival of the Carte Vitale things are changing for the better. This green-colored card contains all of your medical information. Not only is it useful for both doctors and patients, it also shortens the time for reimbursement.

If you feel uneasy consulting a doctor in French, I advise you to visit a private hospital which offers medical services in foreign languages.

The American Hospital has a section that you can call any time, even in Japanese. There are two Japanese doctors and you can always request an interpreter, too. There is a wide range of specialties, such as cardiology, digestive medicine, gastroenterology, endocrinology, neurology, urology, rheumatology, dentistry, as well as gynecology/obstetrics and maternity services are offered. The rates are higher than the standard, but patients are eligible for Securite Sociale reimbursement.

My Japanese friend underwent an operation there. She told me that the equipment and services were superb. "It was like staying at a luxurious hotel," she said.

A hospital I visited was also super-clean and bright. My impression of Japanese hospitals is that they are rather gloomy and depressing. I always think that it would look better with brighter wall paper and more windows. We should not become even more tired and feel depressed when we are sick.

You might be surprised by the number of pharmacies in Paris. Pharmacies have a big green cross on them. Every pharmacist is eager and willing to give you advice. They will even give you the names of doctors, nurses and other medical or paramedical professionals in the neighborhood.

Pharmacists play an essential intermediary role between doctor and patient. There's always several pharmacies open on Sundays. Some of them are even open 24 hours a day.

There are merits and demerits, respectively, in both the French and the Japanese system. I hope, however, that the merits will come to outweigh the demerits.

ST

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