But What About Healthcare?

One of the questions many Americans ask when they learn we moved to Spain is “what about healthcare?” The question often implies that we’ve moved to a third world country, sacrificing the excellent healthcare offered in the United States. We quickly tell them that we’ve heard very positive things from others who have had medical procedures in Spain and then we tell them that we have private insurance that costs about 1/10th of what we were paying in the States. That seems satisfactory to anyone who has asked.

During the first 18 months that we lived in Spain we didn’t need any healthcare services and therefore we never used our insurance.

A Trip to Urgent Care

Urgent Care in Órgiva

Several months ago I came down with a routine infection, but one that needed attention. Of course it was late in the evening and the local physician’s office was closed. We drove to Órgiva, about 45 minutes from home, where there is an Urgent Care clinic. The door was locked so we turned away looking for another entrance. As we walked down the street an older woman came running towards us gesturing that there was a button to push and that it would ‘Buzzzzzz!!” We thanked her and went back to the door where a man was already waiting with it held open for us. 

I used Google Translate on my phone to share what I believed was my problem, showed him my insurance card and Passport, and then we were directed to a simple waiting room. It wasn’t decorated, there was no soft music playing, and the chairs were the basic plastic variety. But it was adequate. 

After a few minutes I was instructed to enter the exam room. With my limited Spanish, the doctor’s less-limited English, and the help of Google Translate, we discussed my symptoms. He examined me and did some lab work, which was all performed in the exam room. It was very thorough and efficient. Before long I had a prescription in hand along with some complimentary tablets to quickly reduce my discomfort and we were sent on our way. 

The Farmacia across the street was still open and it only took a minute to get the prescription which cost less than 5 euro. That was the only money we paid for this entire experience. There was no co-pay and with such an inexpensive antibiotic, we’ve never submitted that receipt to our insurance. 

Typical Farmacia

We were totally satisfied with this introduction to Spanish healthcare.

I Think I'll Have Eye Surgery!

In July I decided to pursue laser surgery for my eyes. A year ago, after having worn contacts for over 30 years, I was suddenly unable to tolerate having contacts in my eyes and I switched to progressive trifocals. I was unhappy wearing glasses. I was miserable on hikes as my prescription sunglasses insisted on sliding down my nose, over and over. I didn’t recognize myself in the mirror and I just wanted to be free from glasses.

I thought that perhaps I would have it done while we were in the States. My insurance here wouldn’t cover elective surgery so I’d need to pay in full regardless of where I had the surgery, and it seemed like something that would be simpler without a language barrier. I called the eye doctor in Oregon and was told that my visit there would be too short to accomplish all that would be involved. 

So I got on my computer and researched laser surgery in Spain, and specifically in Granada, our nearest city. I found a clinic, Vistalaser, with offices in Granada and Malaga. The site answered all of my basic questions and even included testimonials. The information indicated that they offered free consultations, so I had nothing to lose. I completed the on-line inquiry form and asked if I should bring a translator for my appointment. 

Within 24 hours I had an email response that I could bring a translator if I wanted, but that they would do their best to communicate with me in English. That certainly was not something that I expected. We agreed on an appointment time and the next week Sam and I drove to Granada for my free consultation.

I really had no idea what would happen during the free consultation, but I certainly didn’t expect a thorough eye exam. They utilized every machine available and then put me through the more typical exam that I am familiar with. In the end there were four different people, over the course of 90 minutes, who gave me their full attention.  Finally I met with the doctor. He performed some additional tests and then told me that at “your age” they do not recommend laser surgery. Instead they recommended a lens replacement surgery, much like cataract surgery, but without the cataracts. He said that this would avoid my needing to return in ten years for cataract surgery as I would never develop cataracts if I had this particular surgery. In addition, I would be able to see at all distances, because they would implant multi-focal, rather than mono focal lenses. It all sounded too good to be true! But he wanted me to return in a week to consult with his colleague for a second opinion.

A week later we returned to the clinic and the second surgeon confirmed the recommendation of the first. He would be the one performing the surgery and seemed very certain that all would go well. 

After a quick discussion Sam and I decided to go ahead and schedule the surgery for after our trip to the States. We sat with the scheduler and this was the first time that money was discussed. There was no charge for anything up to this point, but if I wanted the surgery, they asked for a deposit, although it was up to us to decide on the amount. 

We deposited a modest amount, both thinking that I might still change my mind, and we agreed on a surgery date for the week after our return to Spain. I was given a sedative to take the night before my surgery, instructions for a required blood test, and the name of antibiotic eye drops that I would begin using three days before surgery. We stopped next door at the Farmacia and purchased the less-than 5 euro antibiotic eye drops. 

The following day I went onto our insurance provider’s website and found a doctor in Salobreña, a town on the coast. I scheduled an appointment so that I could get the blood test done before we left for the States. We made the hour and fifteen minute drive to Salobreña several days later and I showed the instructions to the doctor there. He wrote an oder for a blood test and I was told to return on Wednesday morning for that procedure. We were a bit baffled by the need to come back, but were not in a position to question anything. 

We returned to Salobreña on Wednesday morning and found the only person in the clinic was the slightly nervous technician. She seemed particularly flustered that morning, but we eventually provided the information she requested and after trying both arms and wiggling the needle a bit, she eventually found the vein she needed to get my blood. Then she told us to return in a week for the results. We indicated that we would be out of the country in a week and she shrugged as she ushered us out the door.

We were a bit annoyed by this seemingly inefficient routine, but told ourselves over croissants and cafe con leches, that we had different expectations based on our culture and that this is just part of what we’ve signed up for by moving to a remote area in Spain.

Back at home I emailed the doctor and he said that the results could be mailed to me, which was a relief. While we were in Oregon, he did email me the full results with a brief message, “tienes colesterol alto.” But that’s a concern for another time…I forwarded the results to the eye clinic and they responded that the emailed version was adequate.

Day of Surgery

For convenience, we rented an apartment in Granada for the night before and the night following surgery. My appointment was at 8:30 am and soon after I arrived, totally mellowed by the sedative, I was taken into a room and instructed to change into scrubs. Once changed, a hat was put on my head and booties over my shoes and the anesthesiologist started an IV for the light sedative that would be used during surgery, “like too much whiskey,” he said. 

I was led into a bright room with various people busy with their particular tasks and instructed to lay on the table. This all happened in a dream state as the various meds were clearly doing their job. I was aware of some heavy duty tape pulling my cheek down and my forehead up as my eye was fixed wide open. They did the right eye first and, although I’d been told that I would only feel pressure, I was very uncomfortable. I remember slurring that “this hurts more than I expected,” and then the doctor instructed, in English, “Put additional numbing drops in her left eye.” They must have done that because the left eye didn’t experience any discomfort. The surgeon told me to look at the light and then look at my feet, and then I was done.

A sample Vistalaser surgery

Back in the room where I’d left my clothes I couldn’t really see anything so I felt around, fumbling through the pile of clothes left there by the next patient until I found a shirt and pants that felt familiar. I dressed and then was led to a dark room to relax for a few minutes. Soon I was taken out to where Sam waited, given sunglasses to wear, instructed to purchase a second type of eye drop and to administer both types every two hours for the next three days, and then was told to return the following afternoon for a follow up. 

Recovery begins

That afternoon and evening I rested, between doses of eye drops, and by the next morning I was seeing pretty well. My follow up was with the first doctor I’d met back in July and he seemed very pleased with my vision and recovery. He gave further instructions for my recovery and I was scheduled to return a week later for another follow up. 

It has now been two weeks since the surgery. I am typing this at my computer without reading glasses and when I glance out the window at the view, I can see clearly. I can’t say that my distance vision is 100% sharp, but I’ve been told that will take several weeks. I have one more week of eye drops and then the following week a final re-check appointment. 

I have been beyond satisfied with this experience. The professionalism and thoroughness of the procedures and the personnel have exceeded my expectations. And the graciousness of each person who has done their best to communicate with me in English when there is no reason for them to accommodate my limited language skills, has been very kind. And while the cost wasn’t inexpensive, it was far less than I would have paid in the States, where this particular surgery has only recently been approved (due to barriers set up by the insurance companies), and is rarely practiced.

And for those who worry about the quality of healthcare in Spain - in a recent report, Spain was ranked #9 in the world for healthcare, while the United States was ranked #35.  

I think we’ll be ok.

Because every blog post needs a beautiful photo