Salud

Health. It’s what we all strive for – some of us more than others. Staying healthy as we age can be a challenge for some. It takes more effort and diligence. Taking care of your health while living in another country can be, at the very least, confusing. And at the most, intimidating. Navigating a system that is unfamiliar adds to the anxiety and can mean that we just put off getting help for something when if we were back in our home country we would run down to the local doctor to get checked out.

I’ve written about Spanish medical care before. It’s speed and efficiency. The level of care – both medically and the actual caring demonstrated by the providers – is head and shoulders above what we’ve experienced in some of the best clinics or hospitals in the US. And now there is actual evidence via a study of it published in US News and World Report no less. It’s one of the reasons people here will live so long.

https://www.usnews.com/news/best-countries/articles/2019-02-26/spain-is-considered-healthiest-country-according-to-new-report

So far, we’ve had private health insurance here and I have zero complaints about the care we’ve received. In total, I’ve encountered exactly one less than super-friendly appointment maker. But even her level of enthusiasm was higher than that of an average person in the same job in Seattle. This was yesterday while making an appointment for an MRI. Seems I have a couple of herniated disks in my neck from the motorcycle mishap near Gandia last June. I kept trying to ignore the signs – we even walked a Camino in October where ibuprofen was my best friend. But I couldn’t ignore it anymore after weekly massages failed to provide relief. And my hands started going numb.

So off I went to my GP who promptly referred me to an orthopedic surgeon. This took 2 days. In the US, it would be weeks until I saw the specialist because I was still breathing and able to talk, so they’d say it was ‘Non-urgent care’. My new surgeon wanted his own MRI and some other tests. This took one day. You heard me right – ONE DAY. Crazy.

The medical debate in the US is raging now with the election. Bernie and Elizabeth’s ‘Medicare for All’ or ‘The Public option’ that Buttigeg is touting. And Biden saying that none of this is viable since it’s too expensive. But let me tell you – in the documented finest medical system in the world in Spain, even with private insurance, there were ZERO additional out-of-pocket costs for all these tests. And my surgery will cost me exactly zero euros, dollars, or drakmas. Nothing. So while America debates healthcare, Spain is actually getting it done.

Spain now has a socialist prime minister. The government is a coalition government. For Americans, this will be difficult to understand, but here they vote for multiple parties – not just 2. Whomever wins the most votes is invited to form a government with their leader as prime minister. If they don’t win 50% of the vote, they must form compromises with other parties – meaning those parties get to have cabinet ministers and help shape the agenda of the government. It means small parties get to have a big impact if they get above 10% of the vote. This is because the larger parties will need them to get over the 50% mark. (Spanish reader: I’m sure I’m not 100% accurate but you can chime in to correct inaccuracies in my rudimentary political overview). Full disclosure – I’m an enthusiastic Democratic Socialist myself so PSOE or Podemos would have my vote if I were a Spanish citizen. But you can learn more about it here:

https://en.wikipedia.org/wiki/List_of_political_parties_in_Spain

In the last election, the two left leaning parties formed a coalition and we have a Socialist prime minister, and much of the agenda is a democratic socialist agenda after years of a very conservative right-leaning government after the 2008 financial crisis. When the Socialists came to power – right after we got here – they put through a bunch of edicts. One was that health care is a human right and that all people residing in Spain legally – on a visa, refugees or citizens – have a right to public health care. So we are actually entitled to be on the public health system now. But I haven’t moved forward with this because it was one more thing to try to figure out and because of our experience in Italy a few years ago.

in late 2015, I slipped on a ramp in Milan and was taken to ‘the finest public hospital in Milan’, according to our AirBnB host. It looked like something out of a war movie. The walls had falling plaster and peeling paint. People were openly bleeding in the waiting room and there was a person on a gurney surrounded by their family and a priest – I think giving last rights. I’m not joking about this. It happened right in front of us. Jeff and I watched all this and wanted to run. But the actual care I received for my arm was top notch. Delivered by an orthopedic surgeon who looked like Mussolini’s twin brother – both in appearance and demeanor. He stuck out his chest, waived his arms and shouted a lot – at me and others in the waiting room. Strutting about and looking down his Roman nose at me, delivering several ‘Hrumphs’ when I was found wanting after his thorough assessment of me as a female physical specimen. But he was good at his job – hence why Italy is number 2 on the Bloomberg list of best medical care in the world. But that experience made me shy away from claiming my right to Spanish national health care. And I know why. In the US, we confuse pretty with good. It’s part of a ‘cancel culture’. We do this with people too. But with medical care, if the building is lovely it must be a good facility, right? I did this very thing, again yesterday. But sometimes lovely and good actually are the same thing.

A friend of ours had a stroke the other day. He’s an American married to a Brit so he’s on the national health scheme here in Valencia, having moved from London 3 years ago – where he was on the UK NHS. He was taken via ambulance to the Hosptial Universitario y Politecnico de La Fe – or Nou la Fe as the locals refer to it. It’s the new public hospital and it’s amazing. I met his wife outside their flat and we took a taxi to the hospital. I had never been to a public health facility in Spain. This one is a vast building and stunning. Nothing like you’d think a public hospital would look. And its facilities and care are state of the art.

Both Jeff and Emilie have been treated at the big trauma unit at Harborview Medical Center in Seattle. It’s the regional trauma center for three states in the Northwest of the US. When you find yourself at a trauma center something very bad has happened. And you’re out of your depth – completely. You’re afraid and you don’t even know the right questions to ask. Harborview is an old, cobbled-together collection of buildings and the experience left me soured on US healthcare. Hours and hours waiting for one doctor after another. The staff would wheel them out of the room for a test, and 2-3 hours later they’d return. This would go on all day. No communication. Leaving you without answers and a bit adrift.

But yesterday at the Nou la Fe was one of total efficiency. CT scan – 15 minutes – in and out. They never removed our friend from our presence without the test being ready to be performed immediately. And since your Spanish language skills totally fail you under stress – everyone there did everything they could to either speak ingles or find someone who could. Compassion was evident on their faces. Communication was paramount and they clearly understood that.

The only cultural differences that I saw was in eating and drinking. They delivered the food for him, but here in Valencia, family and community is everything. A person in the hospital would never be left alone throughout their entire stay. The patient would be surrounded by people who love and care for them. When food is served to the person who is ill, the staff don’t feed them. That’s the family’s job. So when our friend was served food last night, and we were out of the room and came back a bit later, the food had sat there. We quickly realized that we were expected to perform that task. It would have sat there all night if we hadn’t returned. The hospital room has an actual bed it in it so that a family member can stay with the patient 24 hours a day. Not just that chair that pretends to be a bed.

As far a drink, I’ve joked about this once before but it turned out to be true. Even in the hospital cafeteria, at a public hospital, they serve booze. Good News! I can keep up with my doctor’s prescription of one glass of red wine per day – even while visiting our friend in the hospital.

So, after I have my surgery and get this little neck issue of mine straightened out, I’ll be signing us up for the Spanish National Health. It’s about 60 euros per month – total. Thats less than $70. But from what I’ve seen it’s money well spent in a country where, when it comes to medical care, nobody in the world does it better.