As an American living in France, the spread of the coronavirus has presented me with a tough question. Where would I rather be during a global health emergency: in America, with my family, or in France, with my health care benefits? Americans across Europe are facing the same dilemma, and there’s no easy answer.

I’m an “assistante de langue,” a classroom aide who helps teach English in French public schools. We don’t make much money — 785 euros per month, well under minimum wage — but we do get the same social safety net as any French resident. That safety net includes health care.

If I became seriously ill with coronavirus right now, the French government would reimburse 80% of the cost of hospitalization. My 22-euro-a-month supplementary insurance would cover most of the rest. If I took a plane to the United States and was hospitalized for COVID-19, it could cost hundreds, if not thousands of dollars in out-of-pocket costs not covered by my family’s health insurance. For someone without insurance, it could cost $20,000 or more.

On March 19, the State Department issued the maximum warning against traveling abroad, “strongly urging” Americans to come home as soon as possible unless we “are prepared to remain abroad for an indefinite period.” There is currently one direct flight from France to the United States per day; railways have cut train service down to just 7% of its normal frequency. If I found a way to Charles de Gaulle airport in Paris — an eight hour journey by car — I would need to carry a signed document explaining my situation: a foreigner, trapped in France, trying to get home.

So it’s time to make a decision. Should I stay or should I go?

I miss my mom, my stepdad, my brother and my sisters. I’m worried sick for my father, who is recovering from brain surgery, and my grandparents, who are in their 60s. I miss my country. I miss hearing English conversations; I miss McDonald’s breakfast; I miss the Appalachian mountain range.

But I can’t afford to be sick in America. So for the next I-don’t-know-how-long, France will be my home.

Thousands of other assistants, students and others in Europe for the school year planned to return to the United States in the next couple of months. We were booking our tickets for friends’ graduations. We were buying presents for our mothers. We were looking for jobs. Some of these Americans have rushed home, paying thousands to get flights to a country in crisis. Others, like me, will stay.

Claudia Siegenthaler, an assistante in Caen, France, is on her way back to California. A dual Swiss and American citizen, she feels at home in Europe and the U.S. — but at the end of the day, Siegenthaler told me, “Being American is my biggest identity.” It wasn’t an easy decision to leave France, but Siegenthaler hadn’t seen her loved ones in months and wanted to spend this uncertain time with them, not alone. She has health insurance, but worries how American health care will hold up under strain. Noting PG&E’s recent donations to hospitals, she asked, “Why should private corporations be giving money to the healthcare sector? Why should it depend on that?”

When I asked my friend and fellow Floridian Marea Frazel her opinion on Americans repatriating due to COVID-19, she replied, “Can my comment just be ‘yikes’?” Frazel, an engineer, has no plans to leave Hamburg, Germany, for the United States. “The health care system is better here, I’m insured here, I’m not insured in the U.S., and my parents are fine.” She feels safer in Germany, where the state health care system is “more stable.”

Americans living in the European Union can extend their visas for up to 90 days due to “force majeure,” or exceptional circumstances. What happens after that is uncertain.

Before this, my time in France was temporary. I planned to return to the United States and build a life there. Now, I’m not so sure.

COVID-19 has exposed the cracks — or gaping chasms — in the American health care system. A mix of private and public laboratories struggle to coordinate testing efforts. As of 2018, 10% of non-elderly Americans lacked health insurance, while millions of others have high-deductible, high co-pay plans. That means sick people avoid medical care for fear of the expense, increasing the spread of the virus.

The vulnerabilities of the system go beyond health care. The shocking spike in unemployment as COVID-19 forced businesses to close revealed the fragility of the American economy. For food service workers and others who have lost their jobs, a $1,200 stimulus check is a Bandaid on a bullet hole. No wonder sick people continued to go to work as the virus spread — without guaranteed sick leave, staying home was not an option.

Things aren’t perfect in France — or in any of the other European countries currently overwhelmed by the coronavirus outbreak. But with single-payer health care systems and broader social safety nets, European governments were in a better position to protect their citizens.

How can I return to a country that can’t take care of its sick and vulnerable — a country that doesn’t even try? Thousands of Americans abroad are asking themselves the same question. If the United States doesn’t respond to the pandemic by reforming its broken system, some of us might not come back.

Ciara McLaren is an English teacher and writer in southwest France. You can follow her newsletter, A Lot to Say, on Substack.

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