For my 3-month sabbatical in Spain, I decided to get private health insurance there. The policy was cheap, only $70/month (including dental). I did not have any co-pays or out of pocket expenses. Since I had a lot of free time, I planned to get all of my medical check-ups while in Spain. I scheduled appointments for a physical and labs, pap smear, and dental exam and cleaning.
My physical was interesting…. the doctor was at lunch and showed up to the appointment 1 hour late. There was no one to take my vital signs or weight – he worked solo. The doctor asked me what I was there for, I said a physical and labs. He gathered a medical history and then gave me a lab order. Since I had no complaints, he didn’t bother touching me or doing an exam at all which I thought was strange. Not to mention I didn’t even have my blood pressure taken.
I thought Europe was supposed to have a better healthcare system than the USA? So far, it seemed like the only benefit is that private health insurance is incredibly cheap and covers everything, but the quality of health care isn’t that great. I mean how can a doctor not even touch me for a physical? At least I was able to look at my lab results online so I didn’t need to schedule a follow up.
My dental exam and cleaning went well. In fact, both were done within 30 minutes. The xray machine they used, took pictures from a 360-degree angle, just by me standing under the machine. I didn’t have to put those uncomfortable gadgets in my mouth for the xray that is often used to take pictures in the USA. The dentist there did the cleaning himself, which was similar to the USA minus the flossing.
Lastly, my appointment with Gynecology for a pap smear was an interesting experience. Being an NP that does well woman exams, I am used to the medical assistant having the patient undress and put on a gown in private, before I go in the room. In this instance, the doctor’s office and the patient room are the same.
So, after the doctor gathered my history, he told me to undress and put on the gown, as he called his nurse into the room. It was really awkward undressing in front of 2 strangers. Then the nurse told me to lay down on an obstetrics bed and insisted I lay with my legs open while waiting a good 5 minutes for the doctor to re-appear. Awkward. Once he appeared, the nurse donned gloves on his hands – which weren’t the regular latex/rubber gloves we typically use in medicine. They were the type of gloves workers wear at subway to make your sandwich – which of course I thought was very bizarre.
I will admit he completed the procedure well, I didn’t feel a thing. But then he shoved a vaginal probe to do an ultrasound, which I didn’t realize is part of the well woman exam there. Everything was fine but I didn’t care to have that extra procedure. Anyways, I think I will save any future well woman exams for the USA, for a more comfortable experience.
On the other hand, my boyfriend had public health insurance in Spain since he is a resident. His experience with the public health clinics and hospitals were absolutely awful. Similar to my experience, when he went to his primary doctor with abdominal complaints, she just ordered tests and didn’t bother doing a physical exam. Similarly, his vital signs were never taken. To be honest, all of the doctors in the clinic looked really unprofessional, wearing a white scrub top with jeans, and white crocs.
To complete the ordered labs and imaging through the public sector, there were no appointments available until 3 months out. This was ridiculous considering the acute nature of his symptoms. We decided to try our luck in the Emergency Room, thinking we could get tests completed sooner than 3 months. Honestly, the ER there is a joke. There was no sense of urgency, and we witnessed the doctors walking out every hour for a smoke break.
After waiting 5 hours to be seen, one of the doctors came to the waiting room and told the patients that they were full so if it wasn’t an emergency to come back tomorrow. I thought that was insane. When we were finally seen, of course the doctor was useless. He referred my boyfriend back to his primary care doctor. He said he could not order any imaging there unless it was a life or death situation (which he would have no idea if it was life or death without any tests)? He was trying to give some sorry explanations for my boyfriend’s symptoms and with my medical background I had to speak up and tell him what he said was false. Even after advocating for my bf, the doctor would not budge and said “I cannot order any tests”. Since there is no “magnet status” or patient satisfaction surveys after a hospital visit, there are no incentives for the hospital employees to actually do their job well.
Feeling defeated, my bf decided to just apply for private health insurance. It is very affordable after all, and the public health system in Spain is a joke. Having the private health insurance was like night and day. He was able to schedule himself to see a specialist right away, complete imaging and labs the same week, and follow up with the specialist the following week for results.
I am fortunate that I do not have any medical problems so my need to use my private health insurance was just for screenings. But I really got to see the perks of using the private health system in Spain when my bf had to use it. For example, he needed an MRI which is costly but he didn’t have to pay anything out pocket. That means, somehow his $70/month premium covered it. Normally in the USA you have a $400/month premium for health insurance and several hundreds of dollars copay for an MRI.
Additionally, the doctors in the private clinics spoke English whereas they don’t in the public system. They are also look and act more professional, and guess what – they touch you!
After this experience, I won’t generalize to say that the public health care system in Europe is great. From what I’ve heard, it is in certain countries like France and Belgium. The quality of healthcare in Spain is not good. It showed me some disadvantages of having a public healthcare system such as long wait times to have basic tests done like labs and the lack of ordering necessary tests by physicians.
I also felt like the doctors in Spain care less than the doctors in the USA – I wonder if it’s because there is a huge pay disparity between the two countries. Or it can just be cultural. The only benefit is that having private health insurance in Spain is way more affordable than in the USA. After this experience, I think the quality of US healthcare is actually really good. The main problem with the US healthcare system is that it is unaffordable and costly. Instead of it being a business and keeping hospital CEOs, insurance companies, and Big Pharma rich; it should be reformed to be way more affordable for the average American.
I’d also note another difference would be the litigious culture in the US that will sometimes drive unnecessary tests etc.
Oh yeah good point! And Also leading to unnecessary documentation.