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.