Showing posts with label france. Show all posts
Showing posts with label france. Show all posts

Thursday, September 17, 2009

Health Care Abroad: France

(click the NYT logo above)

Victor G. Rodwin is a professor of health policy and management at the Wagner School of Public Service at New York University and co-director of the World Cities Project, International Longevity Center-USA. He teaches courses on health system comparisons and has widely published on the French health care system. He spoke with the blog contributors Sarah Arnquist and Anne Underwood.

This is the third in a series of occasional posts describing health care delivery in other countries. Previous posts have described Canada and Japan.

Tuesday, June 9, 2009

Oh, vacation suits me well

Some photos from the 644 total of southern France are up on flickr now.

Including: Cordes-sur-Ciel, Saint-Antonin-Noble-Val, and at a bend in the river sunning while watching rock climbers and military men on break jumping into the river and canoeing

Yet to go:

343 photos of...
France to Andorra via car and beautiful windy roads: I've seen heaven and it is the sunlight on the mountains. I've seen hell and it is Andorra duty-free city. I also have really awesome friends who drive like champions and make kick ass road trip soundtracks.

218 photos of...
Barcelona

And, am currently in Switzerland eating well, drinking good wine, enjoying the rains, and planning for future use of the documentary we made for our graduation project (curious what my grades are but unaffected by the doom or delight).

Cheers!

Tuesday, April 28, 2009

For Starman, RE: financial crisis

Really. I don't know how Europe is weathering the recession. Not that I can't comment, but I've been rather insulated from the inside scoop. It's been a lot of doom and gloom all over the world, but the US's market is heavily consumer based and driven by credit. The EU as a whole is a larger consumer base than the US, but parts (Germany) export more strongly and the money market is not the same. The USD to Euro is holding pretty steady at $1.30-ish over the past months. Unemployment has risen all over the world, but the social services net is wider and stronger in the EU to help citizens get back on their feet (in their same sector or otherwise, remaining healthy, and protecting their pensions), which leads to continued stability through small business loans, consumption, production for exports, etc. Also, they haven't had the enormous banking crises that the US has had. Perhaps due to better regulation, better banking practices, or just the fact that the banking sector is less influencing (while still tied globally and having purchased the same MBS purchases).

So, in my unprofessional personal opinion, I think the EU is fairing better in this recession, but is still feeling it.

Here's a portion of what the European Central Bank said on 27 April 2009

"First, there are profound differences in the financial structures of the euro area and the United States. The United States has a primarily market-based financial system; in contrast, the financial system of the euro area is largely bank-centred. A few numbers illustrate these differences. At the end of 2007, the stock of outstanding bank loans to the private sector amounted to around 145% of GDP in the euro area. The corresponding proportion of bank loans to GDP in the United States is only 63%. This means that the banking sector is more than twice as important in the euro area as it is in the United States. It also means that to be effective, ECB policy must focus first and foremost on the banking sector.

Similarly, direct debt securities account for 81% of GDP in the euro area. The corresponding proportion in the United States is 168%. This means that market-based financing plays a much smaller role in the euro area and is only half as relevant as in the United States. Therefore, the structures of private credit outstanding in the euro area and the United States are almost mirror images: recourse to banks on our side of the Atlantic makes up two-thirds of non-equity external finance. On this side, the equivalent proportion is only around 30%. Against this background, it is natural that the Federal Reserve’s “credit easing” policies mainly target markets for debt securities, whereas our policies of “enhanced credit support” focus on banks.

There are also many profound differences in our respective economic structures, which of course are also reflected in financial structures. For the sake of brevity, I will single out three characteristics of the euro area economy that our policies have to take into account in order to be effective.

The first characteristic is the very important role that small and medium-sized enterprises (SMEs) play for the euro area economy. These SMEs in general cannot tap credit markets directly. Guaranteeing continued access to bank credit is vital for SMEs to be able to finance their activities.

The second characteristic is the role of the housing market in the crisis. In the United States, the housing market is at the epicentre of the crisis. This is not true for the euro area. Nevertheless, the euro area is indirectly affected as banks there hold toxic assets partly backed by mortgage loans originated in the United States. Forcefully addressing the toxic asset problem is a precondition for reviving credit on both sides of the Atlantic. I should add that addressing this problem clearly falls into the realm of fiscal policy, not monetary policy.

The third characteristic is the flexibility of the economy. Goods and services prices and wages are more sluggish in the euro area than in the United States. This sluggishness, on the one hand, has drawbacks as it slows down the adjustment of the euro area economy to adverse shocks. At the same time it offers some protection against very bad outcomes, provided that the policy framework provides a solid anchor for private sector expectations. In the euro area, the institutional framework provides such an anchor through the medium-term stability orientation of fiscal policies and monetary policy geared towards fiscal sustainability and price stability. In this environment, overly activist policies risk destabilising expectations and, thus, being counterproductive.

In technical terms, I would say that acknowledging the existence of structural differences between the euro area and the United States is crucial for understanding the mechanisms behind the policy models and concepts that we use in our decision-making processes. Structural differences imply that the policy response has to be calibrated to the structure of the economy."




And, here's what the French finance minister, Christine Lagarde said on Jon Stewart's "The Daily Show" - we're all in it together, so don a beret and grab a glass of wine. Somehow we'll pull through.

The Daily Show With Jon StewartM - Th 11p / 10c
Christine Lagarde
thedailyshow.com
Daily Show
Full Episodes
Economic CrisisFirst 100 Days

Friday, October 17, 2008

Finally French, with a Few Flaws

Oh, my horoscope is right:
TAURUS (April 20-May 20): I usually don't have to tell you Bulls how important it is to finish what you've started. You are, after all, among the top three signs of the zodiac when it comes to following through. But just in case you've momentarily fallen under the sway of a delusion that would encourage you to escape before the resolution is fully in place, I'm here to remind you: It's time to make the art of completion your graceful obsession.

I had to fire a colleague from conference planning and now am on my own as the leader of the event, but have learned so many good lessons from this: delegate, communicate, and then, move on if all else has failed.

&&&&&&&&&&&&&

So, the firing was Wednesday night. Thursday, I was tired and grumpy when I got up, and it trickled down all day until an outburst that wasn't so nice. Short on rest and finally fed up, I reached a point of no longer being patient with all things French (or Parisian).

The carte de sejour. It's a brutal process to re-apply for the residency permit, but it's made a bit easier at school because there's one poor, sweet woman who attends to all the students (between select hours) for our applications. I remember seeing her last year after waiting for 4 hours one day, and then on another day after a 2-hour wait. The first time I didn't even make it in to see her. After 4 hours waiting, she came out of her office and apologized, but it was the end of the day and she wouldn't be seeing any more students. The second time I made sure I had all the necessary paperwork to ensure I wouldn't have to return - and I didn't! Got the temporary letter of permission, followed it with the doctor visit, and then got the official card to say I could stay in this country.

So, now I'm renewing, which should be easy. But, no bureaucratic thing in France is. I went for my first visit two weeks ago. With about 12 people in line, she wasn't accepting any more applicants at the 3pm hour. Left defeated and irritate. It's about a fifteen-minute walk from class - not much, but it becomes a lot when you're squeezing it in between class, lunch, class.

Returned last week and got in line behind ten people. Waited patiently, got some good work done, and finally got my chance. Had everything needed but a 3-month set of bank statements - I imagine the French government wants to assure spending within its borders or enough money to weather the financial crisis.

While I waited there were like 10 legitimate people for their first visit and repeated line-cutters who only had a few papers to turn in after being turned away with instructions for return.

She's a sweet paper lady, the carte de sejour woman. Does she have a name plate? Nope. Do we know her name on her door? No. She's like anon carte de sejour lady. Smiling even while I could barely write my name for lack of food, which produced hand shaking. She is patient and even-spirited. I'm sure she drinks a whole bottle of Pinot Noir each night and must smoke a pack a day just to get through, although I'm not sure when she'd find time for a break.

Yup, everything in order but the bank statements - a new turn for this year.

So, I came back about a week later. Asked the waiting students how the day was going and realized we had a first-timer, and two who just needed to drop their additions off - bank statements or other papers. Gradually, over the hour I was there, more and more people came and thought they had the right to just go to the office and basically jump the line. I tried my horrible French to ask what they were there for and to indicate that, yes, we were all here for a carte de sejour, which humbled most into getting in line. After about a half-hour with the first-timer in the office, trying to navigate in broken French and English between carte de sejour lady and the applicant, people started to lose their patience. The Aussie gal was like, I'm gonna get sacked if I don't make it back to work. I was corralling people into line. The Canandian boy was too timid to coral and admitted it. The last woman was Chinese, who unfortunately supported my style of dictating to the others.

After explaining to two students, I told the Aussie and the Canadian waiting that it was their turn to keep watch and explain. Aussie had perfect French and convinced a Russsian girl to leave due to time constraints. The Canandian got nowhere and never spoke.

I let the Aussie jump me to get her paperwork in and get off to her job. Then, a woman showed up and I informed her we were all in line for the same thing. She acknowledged and yet still waited at the open door. After the first-timer left, the Aussie went in and was rounding up her paperwork, and then - after me waiting there an hour and half - the French woman took a step inside the office. I know where it came from, from the bottom of my belly, from desperation, from tiredness, from justice, from impatience, from what is right. I jumped up and cut her off and had a heated explain in Franglo (French-English combo) that, dude, she might just have to "posé une question" but we all to just pose a question so get in line, woman. It was quite a complex exchange of my fumbling words and her defensiveness.

But after me not jumping the line, after being patient, after letting Aussie-freak-out-get-sacked, after all of it, I wasn't patient anymore. There is a process in the world - maybe not in France, but in the world there is respect for others and a degree of understanding that you have to wait your turn. And, maybe I was trying to transpose an American value, but dammit, I was fed up with the weird system I was subjected to. So, I Franglo'd my way through and she stormed out - after commenting that I didn't need to be so stressed, that all she had was a question, that it's not a big deal.

I entered to the empty seat opposite carte de sejour lady and she smiled, "Well (in French), I see you've been very patient. Thank you. Let's get this going." I informed her, with smiles and relaxed, that it was no big deal and that I'd be quick and all I had were my bank statements. She basically ignored the rest of my dossier (which she already approved, but generally wanted to look over in 2nd detail review), looked at the dates of my statements, approved, and signed a quick form.

It wasn't that I felt power at that moment, but that I felt justice. I'm still not used to this system where anything goes. Where the line at the post office all of a sudden becomes 2 strange lines because someone inches up alongside instead of behind and then thinks they can challenge you to the open window (when only 2 of 4 are open -- is this not just like Buenos Aires in 1988?). The lines at any window - a train station, a boulangerie - there's no form to them. They are layered and who cares who was there first - it's survival of the fittest - if you can edge up, you get served. So, damn me if I'm going to fight for that window then.

It was quite unusual for me. Even before entering carte de sejour hell, I'd spent 45 minutes in line at the post office to mail my election ballot. I'm patient. I'm even. I'm forgiving and I'm flexible. But only to a point.

I have started to understand the pattern of walking and transportation. It's like India, it seems like mass chaos, but people have their own patterns and rules for merging, signaling, crossing. In Paris, in Europe, the scooters take the free space of the roads or sidewalks, the cars merge quickly, the buses have a greater right if you don't beat them first, everyone has great brakes. Passing on the sidewalk there's no walk on the right, pass on the left. There is no order. It's free for all and each for their own - don't run over the bicyclist, don't rear-end the scooter, don't get rear-ended (and they are MUCH better drivers than in the USA). But it's a pattern I don't get yet. I still think it's more efficient to find a general agreement to path and passing. A conformist understanding. But they seem to make this chaos work. Not for me, not yet. So, when someone cuts the line, I take issue. Or, I took issue.

It felt good to defend myself, but I also felt tremendously like an a-hole.

I'm still not sure how to balance this.

Following this encounter, I was on my home, waiting for the bus. Three young girls, maybe ten or eleven years old, were goofing off waiting for the bus, too. One of them pushed another and she dropped her empty pop can on the sidewalk. They were giggling and pushing each other - you pick it up, no you. A mom walked by with her two kids and pointed the empty can to the girls and scolded them to pick it up. They laughed as she walked off and finger-pointed at each other again - you pick it up, no you. After I noticed that they were almost content to let it sit, I decided to say something.

Frankly, I'd been practicing this in my head since I saw a few juvenile boys launch their burger wrappers into the street. So, I turned to two of them, and said, "Mademoiselle, ça c'est pour la poubelle, c'est ne pas pour la rue." I'm sure this is wholly incorrect, but they both lurched for the can and picked it up and then giggle-fought over who had to deposit it. The bus came so I missed the end of it all. They got on and I read my homework the way home while listening to their giggles on the bus.

This felt less like power or old-lady-correcting, and more like, damn it, I like Paris and she gets trashed too often. Granted, there are paid sidewalk washers and street cleaners and poubelle picker-uppers, but people shouldn't just get lazy about it all. They'll still need the sidewalk washers and poubelle-picker-uppers since dogs still can't seem to pick up their own poops, and pigeons aren't trained yet, and there's still garbage in the poubelle. But at least we could stop adding to the crap.

I still felt like an a-hole. Who am I to think I can take a stand like this? I'm just a visitor. This isn't my country, nor my town. But I do like to abide by the "home is where I lay my head." So, I guess I do feel like I belong and I'd like to respect it.

My French has definitely improved though. So has my courage.

Wednesday, October 15, 2008

Autumn and things around Paris

School, class, conference - not necessarily in that order of importance or stress. So, for now, some pretty pictures of Paris.

You can always find more on flickr.com (including my snaps from the manifestation for Transsexual Rights, a trip to the country with my class, a party at the Sciences Po MPA)


alteration to a Galleries Lafayette poster in the metro












autumn in the Marais










autumn on the Seine










bowling off Rue Mouffetard










knee-high by July, ready for harvest - outside Paris









My friend as a Sister of Perpetual Indulgence in the march for Transsexual rights

Friday, October 10, 2008

The new "move to France" ad

One doctor visit, 15 minutes late, 30 minutes visit, prescription: 25E


Friendly pharmacist who assumed you were French because of your flawless accent, prescription filled, including antibiotics: 10.27E


Health care in France: priceless

Thursday, July 10, 2008

I think I can, I think I can

map

idea


We'll see if I can get a ride.


(for you, mom and dad)