Un sistema de salud

I left the U.S. an unhappy healthcare “customer.” I had recently been prescribed a medication for a minor but ongoing skin condition and, after paying for an office visit and labs out of pocket (because deductibles for our healthy family are so high), I learned that insurance would not allow me to fill the prescription beyond a 30-day supply unless I paid full price. Even if I’d been willing to pay, it turned out the doctor wasn’t going to renew the prescription without me repeating labs and an office visit every six months.

So today we walked to the nearest Centro de Salud, which happens to be across from Lou’s school, and learned that I could make an appointment for a medical consult within the next couple of days for $45. However, we were advised to start with a visit to a pharmacy because maybe they could fill the prescription I already had.

Sure enough, Pete presented my case to a pharmacist, handed over the prescription bottle, and after a brief discussion I paid $6 for a month’s supply.

It sounds too easy, doesn’t it? The pharmacist didn’t even ask for my ID! But the medication is an inocuous one, and I have experienced none of the potential side effects in the three months I’ve been taking it. I don’t know why exactly the drug costs nearly 20 times more in the U.S. than it does in Spain, but I can guess that the higher cost of an office consult in the U.S. has to do with high administrative costs related to insurance and the high salary of a specialized doctor (plus a little for free Keurig coffee, cable TV, and tasteful decorating in the office waiting room). Pete wondered if the U.S. doctor’s requirement that I repeat labs and office visits was some kind of CYA in the unlikely event that I did experience a serious side effect.

It’s worth underscoring that I did not take up a doctor’s valuable time with an unnecessary consult or put any other burden on the health care system here. In this instance, I think the Spanish system — including a for-profit pharmacy — worked the way a health care system should.

5 thoughts on “Un sistema de salud

  1. Mom

    Welcome to the world of the raping of the American public by the health system. It would be nice if it could be changed into the “Affordable” Health Care System for real.

  2. Steve

    The above comment means insurance companies/big business is taking their profits from the patients/providers/employers, whoever they can get to pay the exorbitant rates.

  3. karla mcgray

    Have we shared willie’s health care experience in Spain many years ago? Gastroenteritis which led to dehydration which led to a one hour ambulance ride from the costa brava to Figueres plus two hours of Iv treatments in the ED- $120 total. Zack had the same thing in southern France on the same trip . Doctor came to hotel, gave him a prescription- $20 bill. Amazing! Good for you!

    Sent from my iPhone


  4. merediemartinez

    Did you ever see the Michael Moore documentary “Sicko”? His stuff is usually a bit much for me, but this movie was intriguing. It focused on the health care industry comparing several countries, including France, UK, and Cuba. There was an entire vignette dedicated to maternal and child health, including prenatal and postnatal care and what women and families receive in other developed countries compared to the U.S. I was 7 months pregnant when I saw the movie and left crying and wishing I lived in France. It was another reminder of how un-family friendly the US is in almost every way, including policies on work environment, health care, benefits, living wage, parental leave, etc. That is really neat that you have the opportunity to experience something different (and better!).

    1. ellentveit Post author

      Hi M – In contrast to the dominant view in the U.S. (the State is a necessary evil whose powers must be continuously held in check lest they infringe too much on individual liberties), I think many Spaniards see the role of the State as a promoter and supporter of the health and well-being of citizens.

      At a very superficial level I can see some of the problems with economic development in Andalusia, for example, too many projects are publicly funded and there’s excessive red tape creating a barrier to entrepreneurship. But those seem like management problems rather than ideological ones. I hope to learn more during our year here. And I’m bracing for a return to U.S. economic and social problems, which are shocking to read and think about from afar.


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