Healthcare: You win some, you lose some

One of the big differences in life in the US vs. Portugal is in medical services.

Some things are a lot of hassle here – probably the worst thing is dealing with the National Health Service. It’s complicated to get signed up, it takes forever to be assigned a doctor (I’ve been waiting six months), and scheduling anything that could be considered elective is going to involve an extended wait.

However, if you have an urgent issue, you can go to any clinic and they will take care of you – and the level of care is actually quite good.

As a citizen, I’m covered 100% for this. Kristie’s paperwork hasn’t gone through yet, so although she’s signed up in the system and has a National Health Number (her “utente”), she has to pay for public health care during her first year here.

But the cost of care, even retail, is substantially lower than in the US. Example: One of the earpieces from Kristie’s hearing aids got stuck in her ear, and we had to go to a clinic to get it removed. We were able to get an appointment the same day, and it took the technician about 15 minutes.

If we had gone to Urgent Care in the US, this would have cost hundreds of dollars. In Portugal, it was 8€ (less than $10) – and the technician was apologetic about the price.

Now, we have private insurance on top of public insurance. Ours is one of the more expensive policies, because we have some pre-existing stuff, but even so it’s a little less than Kristie’s portion of her employee insurance at Nike, and it provides much better coverage.

Another example – as I’ve mentioned, I’ve got a hip issue. It’s been diagnosed as pretty advanced arthritis, which means I’ll be getting a new hip by and by. But I need to put it off a little bit so that I get past the insurance exclusion period, so I went for a cortisone shot.

I had this done in the US before we left, and it involved two doctors, two technicians, and a scanner so they could verify where they were placing the needle. Even with insurance, it was over $300 out of pocket.

In Portugal, it was a nurse who told me to drop my pants, gave me an injection in the butt, and sent me on my way. The net result was exactly the same – no pain for two or three months – but in Portugal, the total price was 4.59€.

I will admit to one place where we kind of wish we were in the US right now – COVID vaccines. After a horrendous 2020, the US Health system has pulled off a major recovery in getting vaccines out to people. It’s been a lot slower here. Even though Portugal bought and paid for enough vaccine to cover everyone in the country, it was done through the EU exchange, and every single drug company has failed to meet their promised delivery dates (although they were able to deliver just fine to the US and UK, which pisses people here off no end).

Also, the vaccine program is being run by National Health; there have only been a limited number of vaccination locations, and you need to wait until you’re called. I got my first dose, but Kristie is still waiting.

On the bright side, there’s a new push that is starting – they’re opening up major vaccine centers and going to start letting pharmacies give shots too, and millions of doses are supposed to arrive within a few days. The goal is to get total number of vaccinations up to over 100,000 per day in May.

They’re also supposedly going to let people start scheduling appointments online (and the government claims that they have learned from what went wrong in similar tools in the US). I’m moderately optimistic that Kristie will be vaccinated within the next few weeks.