An Expat Adventure into Healthcare

Health insurance is a requisite for expats traveling or taking up residence in a new country.  I think many of us get travel airline travelinsurance to cover us en route (though I thought at the time if the plane crashed over the Atlantic, what would be the point?).  Once I arrived and was gainfully employed, I was assigned health insurance by my company.  I wasn’t given a choice about either what company to go with or the amount of my co-pay that was deducted out of my monthly salary.  But the company, VZP,  was one of the best in Czech Republic.

I know that health insurance and healthcare overall in Europe are much different than in the US.  I can only address my experiences in the Czech Republic thus far.  The co-pay is rather high comparatively.  In fact the tax percentage deducted from paychecks is higher than what I was used to.  But the coverage for what you get is so worth it.  With insurance, an office call costs 30czk or about $1.50.  The nurse was even a bit apologetic to have to ask me for it.  And that fee covers lab work, x-rays and diagnostics.  Prescriptions are purchased at lékárnas, Czech pharmacies – some even open 24 hours.

I was told that the first step into healthcare was to register with a local doctor.  I surveyed my colleagues and 3 of the girls suggested a doctor 5 minutes from our office.  One of the girls called and made an appointment for me.  After being greeted by everyone in the waiting room (I still think it’s a sweet custom to say dobry den upon arriving and na shledanou to a roomful of strangers upon leaving.) – I stood awkwardly outside the closed door to the nurse’s office.  I’ve found that knocking may or may not illicit a response.  Usually you just have to wait until the nurse is ready to open the door and see what you want.

scary nurseI had written in Czech what I wanted to say – something to the effect that I had an appointment for a new registration – but the looming figure in the doorway of the tall and sturdy nurse in whites glaring at me banished any semblance of preparedness, and I meekly handed her my Czech note.  She looked at it, then back at me, then turned and shut the door.  I looked at my fellow patients in the waiting room for some sort of explanation, but they were mum (likely most didn’t speak English).  Eventually my name was called and I was ushered to the inner sanctum and the rather astere doctor’s area.

The doctor was young and quite good looking.  His English was passable, at least more than the frightful nurse.  He asked a lot of questions, jotting down my medical history.  Then he preceded with the exam.  In the US there have been too many law suits regarding sexual inproprieties with male doctors and female patients so that it is required for a female assistant to be present during an exam.  This is not the case in Czech Republic.  In fact this particular doctor’s office was also a learning center for interns, and I was introduced to a small group of students passing through just as the exam was starting.  Luckily they left before I took my shirt off.

Right.  The doctor said take off your shirt and bra.  No modest changing corner or little paper shirt to wear.  So I half-stripped and laid down while he poked and prodded and assured me that my breasts were good.  I closed my eyes and tried to concentrate on the clinical aspects over the casual nature of the experience.  At no time did I feel sexually harrassed.  He was pleasant but professional.  This was followed by a rudimentary and relatively short pelvic exam where he determined my lower lady parts were also properly positioned.

Then he asked that I stand up and drop my drawers because colon cancer is also a risk for women.  I was mometarily Katie Couric picture of healthshocked, thinking that this sort of thing was reserved solely for men’s prostates.  But he was the doctor and I did trust him.  So I closed my eyes and thought of how Katie Couric would be so proud of me.  Later that afternoon back at the office and squirming a bit in my chair, I asked my colleagues if they had been submitted to the colon test.  I had accepted it as part of my new health care.  Oddly most of them had not experienced such a probing first time exam.  At least I’m now confident of my colon.

As I said, I trusted my doctor.  He was kind and compassionate (as I mentioned previously in “The 5 Stages of Culture Shock and How to Ride the Waves”).  Even a simple head cold will garner me a week off from work.  It’s odd that here one needs a doctor’s note provided to one’s employer on the first day of illness as an accepted excuse.  When you’re lying in bed feverish and congested the last thing you want to do is not only trek to the doctor’s office, but then to your work (looking less than lovely) to deposit the note to your manager.  And then you’re not allowed back to work without a second doctor’s note declaring you to be cured.  I appreciate the focus on health as opposed to the States, where I once had a manager congratulate my work ethic for coming to work with the flu.  I wonder if he also congratulated my string of co-workers as we passed said flu around the office all winter?

xray modelI haven’t needed a hospital stay here (knock wood, or hold thumbs as the Czechs do), but I did need to visit a hospital for x-rays once.  (I cracked a rib and told the doctor it happened at the gym.  Sorry, dear readers I can’t tell what actually happened until I know you a bit better – wink!)  The hospital was a cold imposing structure built likely in the communist era, with the same imposing white-clad, croc-wearing staff.  I was fortunate to have my flatmate along who speaks Czech since no one but the technician I saw could communicate with me.

Dental care is also much more affordable here.  I had an unfortunate situation of breaking a tooth here, and the total cost of exam, x-rays, 3 appointments and a lovely new tooth was 13,000Czk or abot $700.  And at that time I did not have insurance.  I was also blessed by my local community of friends who took up a collection to cover my costs.  Not only would the cost have been at least double in the States, I love the Bohemian sentiment of the village taking care of one of their own.  That was the best healthcare ever.

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