One of the many attractions to life outside the United States for Americans emigrating abroad is access to better healthcare systems. Now, this does not mean the U.S. has poor healthcare, per se, but accessing that healthcare is problematic for many, and it is frequently especially problematic for those who need it most.
Our first significant encounter with the Spanish public healthcare system was nothing short of magical from the American perspective and yet it was mundane from the point of view of the Spaniards, who are puzzled by our incredulousness.
Brian’s First Encounter with his Doctor
I will describe the details of the Spanish healthcare system in another post. For now, I want to tell the tale of Brian’s first visit to his doctor for a significant health issue.
First, though, to address one common caution we hear about universal healthcare in the U.S. is the anecdotal story the person opposed to the concept has about that one friend’s aunt’s husband’s friend who died waiting their turn for an appointment with their doctor. Putting aside for a moment the fact that that happens all the time in the U.S. and acknowledging that every system has its strengths and weaknesses, it’s simply not the everyday experience of patients in high-functioning universal healthcare systems like Spain’s (#7 in the world in the 2020 WHO rankings.)
OK, with that bit of context, let’s continue.
Over the course of a few days, Brian had increasing pain, pressure and swelling in one knee, to the point it was affecting his mobility. One morning he woke up and could barely get out of his bed, his knee having swollen to at least the size of a softball. He finally, grudgingly decided he needed to see his doctor.
Our assigned primary care clinic — called a Centre d’Atenció Primaria or CAP for short — is about a 10 minute walk from our apartment. Every neighborhood in Barcelona has its own CAP that serves only the residents of that neighborhood.
He put himself together, refused my offer of assistance, and slowly hobbled down to the CAP at 8 a.m. without an appointment. Brian does not speak Spanish or Catalan, so there was some anxiety there. He reached the reception desk, found someone who spoke English and requested an appointment with his doctor. He was given an appointment later that afternoon.
When he saw his doctor, she examined him, took some history and determined that he needed a higher level of care, so she referred him to the hospital but advised him to go early the next morning at the start of a day. So he came home and rested that night, got up early the next morning and took a cab to the hospital.
He went to the emergency room. The doctor had sent orders over. Within 40 minutes, he was in a bed. Over the course of about 8 hours, he was seen by nurses, technicians, doctors, and a specialist. He was even seen by medical students, since it was a teaching hospital. He was X-rayed and poked and prodded. Blood was drawn and test results were evaluated. His knee was drained of fluid and the effluvia was tested and evaluated. Protein crystals were detected in the fluid and a determination was made that it was an arthritic event.
He was sent home with prescriptions for steroids, omeprazole (because steroids can cause heartburn) and OTC painkillers.
The out-of-pocket for the entire experience was €6 for the two OTC medications.
And he will NEVER see a bill for the rest of it.
And he didn’t die while waiting for an appointment with his doctor.