The Truth About Universal Healthcare: A Mom's Life

baby toddler doctors office national univesal healthcare
Flickr photo by Kevin Lawver
More than two years ago, I’d just left my full-time job to freelance when I found out that -- surprise! -- I was pregnant. Trust me, it was truly shocking. My bootstrap attitude about life would suddenly require a BellaBand.

Even more shocking was that while I had health insurance, my care options were limited and my deductible was through the roof. Luckily, I was unmarried at the time and New York State has a program called PCAP, which is basically Medicare for pregnant women.

My take on Medicare? The best insurance I’ve ever had. Once I jumped over my final bureaucracy hurdle, that is.

Flash forward a year or so. My now-husband (an EU national), toddler (as well, but American at heart), and I (like apple pie) had just moved to Spain. First item on the agenda: Sort out our health care.  

We suddenly found ourselves facing a bureaucratic decathlon.


Now that I’m on the other side of that, here’s what I can tell you about Spain's national system.

The World Health Organization ranks the Sistema Sanitario Público (public health service) seventh best in the world. Universal coverage is a constitutional right and even undocumented immigrants are covered. There are no out-of-pocket expenses, apart from negligible prescription drug costs. And by negligible I mean, like, a couple of euros.

When we first moved here we considered purchasing a private plan, but only about 10 percent of Spaniards do so. For the most part, they trust their system and their system rewards them in kind. Life expectancy in Spain is among Europe's highest and a third fewer patients die due to lack of access to care in comparison to the United States. While you might have to wait to see specialists -- including gynecologists -- what’s new about that, even with a fancy pants policy from a private insurance company?

As new immigrants who could barely speak Spanish, maneuvering the system did present its challenges, more lingual than anything. But -- get this -- we were covered long enough to learn the basics about our local bureaucracy, which is, I must admit, artfully extensive.

Here’s an abridged rundown.

STEP 1: Establish residency for my husband and son as EU nationals living in Spain.
Level of Difficulty: Moderate.

STEP 2: Establish myself as the spouse and mother of EU nationals living in Spain.
Level of Difficulty: Excruciating.

STEP 3: Get a social security number for spouse and me. I should mention here that I’m a part-time English teacher; as such I pay into the system, though this isn't required for coverage.
Level of Difficulty: Not excessive, but some persistence required.

STEP 4: Get a social security number for my son.
Level of Difficulty: Baffling and complicated, but we did it!

Take him to the Centro de Salud (healthcare centre) for diaper rash issues, flu, check-up … you name it … and get a same day appointment.
Level of Difficulty: Easy, easy, easy.

On the flip-side, there are, of course, challenges. The main one is la idioma, which is unique to our situation and gets easier to deal with every day. Another more pertinent one, though, is that even if I do find a doctor for my son that speaks English, we might not get to see that same doctor the next time around.

For me, I don’t view that as too much of a drawback. I just feel secure in knowing that we have access to care when we need it and take comfort in knowing that it won’t bankrupt us if we really need it.


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