Hi there,
In the post in which I told you about the general experience in Portugal, I told you a little about my experience with public health, especially compared to Spain.
It should be noted that my perspective is as a person who has a European passport, because if you do not belong to any country of the European Union, the process to access public health is a little different.
Coming from Spain, where public health is an absolute disaster, we considered taking out private health insurance to be covered until we could try public health in Porto.
I contacted an insurance broker who gave me several options. Of all of them, there was only one in which we each paid 50 euros per month (which is what is normally paid in Spain); for the rest, all the policies ranged from 80 euros up per month.
The bad thing was that none covered the dental part, and all had a copayment that started at 15 euros.
When an average consultation in Porto was 40 euros and we do around 3 to 4 annual check-ups, it was not worth paying for medical insurance when we also had to pay a minimum of 15 euros per consultation.
Another very important thing is that no insurance covered the oncological part, so if you got any type of cancer, it was as if you did not have insurance.
We made the request for the cheapest one, just to have some type of coverage and two weeks later they called us to ask questions about medical history. From there, Diego was asked for a lot of documentation about the aortic operation that he had in Spain 15 years ago.
Since at that time we didn’t have time to look for documents and if something was missing there would be no way to go look for it in Spain, we decided to leave it that way.
To have access to public health, the procedure is a little more complicated than in Spain. After they give you the NISS, which is the social security number, you must ask for the user number at the medical center. Once you have the patient’s number, you must ask at each medical center to see where they have space because most family doctors are overwhelmed.
I had asked to be admitted to one medical center and was then assigned a family doctor at another. Since we liked the doctor so much, we stayed there.
In our case, the appointment for the first consultation with the family doctor was immediate, although there are people who wait months.
We fell in love with the family doctor. Alice is the nicest and most joyful thing you can imagine.
From the first consultation she asked us for blood and urine tests to have the basic information in the system since we were new. This is something unthinkable in Spain.
When she saw the results, she congratulated us and gave us both a high five. You really can’t imagine the rush of energy and optimism that this doctor gives.
One important thing is that you can communicate with the medical center by email and the reception staff handle emails efficiently.
In Portugal, public health has an agreement with almost all private clinics, so you can do the exams anywhere almost immediately.
In addition to the fact that you can choose the medical center, you can choose the hospital that you like the most. I chose the São João Hospital and although when I went it was always very crowded, everything worked well.
I took all my medical records and told her about the checkups I had every year and she requested as many tests as possible. Those who have lived in Spain know that it costs your life for a doctor to deign to prescribe any exam.
In addition, they asked us for documentation about our vaccinations. Since I had no way to prove the vaccinations that I had received in Venezuela, they recommended that I get all the vaccines again.
In Spain, no doctor was ever interested in knowing about my vaccines.
They immediately gave me an appointment with the specialist to do my annual check-up.
The doctor who treated me was incredibly kind.
She requested a breast echo, mammogram, and follow-up consultation.
When they told me that I would do the tests at 9AM and see the doctor at 10AM to know the results, I was surprised and asked them if the results were going to be ready in an hour and they said sure, as if it was obvious.
I was very amused because they made a face as if I came from living in the jungle.
The day I went to do the exams and the follow-up consultation, in an hour I had already done everything and was out of the hospital. I could not believe it.
In Spain it would have taken a year to make an appointment with the specialist, then it would have taken another 6 months or more to do the echo and the mammogram, and they would have done each one on a different day. After so many months, they would have given me an appointment with the doctor to see the results. All with the typical delay of more than an hour.
Besides, they would have treated me badly; because in Spain if you go to the doctor, they treat you as if you were a criminal.
Since Diego underwent surgery on his aorta 15 years ago, he does an exam every year to see if everything is okay.
The appointment with the cardiologist was given in 3 months. Our family doctor lamented because the cardiologist appointments were delayed. We were amazed because in Spain it would have taken more than a year. When he had the appointment, at the same time they did all the possible tests.
As I also had an MRI of my knee every year, they called me almost immediately to make an appointment with the traumatologist.
When they called me, they asked me if I could go the next day and I told them if it was possible to change the day and they answered me “Of course it is possible”, again as if I had just come from living in the jungle.
In Spain they don’t call you to see when you can go to the appointment, they send you a letter that may never arrive. If you can’t make it to your assigned appointment, there’s no way to change the date, so you’re back on the waiting list and may have to wait another year.
After going to the traumatologist, he told me that they would call me for the MRI and then again to consultation with him.
They just gave me the MRI appointment when I was going to the Azores. When I returned, I sent an email to my family doctor to see if she could request the date change and in 5 minutes, I already had the appointment assigned for the following week.
On the day of the MRI, the doctor was looking at the results at that very moment and asked for another MRI with contrast to be done at the same time. We waited 2 minutes for the doctor to approve the tests in case he asked for anything else before leaving.
I also asked to be sent to physical therapy because I have had plantar fasciitis for 3 years and they called me right away. They gave me 15 days of physiotherapy initially with consultations every 10 days to follow up, and then they extended it to 8 weeks because I had no improvement.
In Spain it took a year to be called for physiotherapy, the treatment was a circus of only ten days and, in the end, as I said it was still the same, they gave me an appointment with the head physiotherapy doctor (who had no idea either).
I can say that after 3 years, the public health of Portugal cured my plantar fasciitis.
Since at some point the HIV vaccines were very viral, I asked my family doctor if it was worth getting the vaccine. First, she requested blood tests to rule out that we had HIV, syphilis, or hepatitis. In addition, since she does cytology with an HIV test herself at the health center, she gave me an appointment and told me that if that was also negative, we didn’t need to get the vaccine.
In Spain you can only go to the emergency room if you are unwell or ask for a consultation with a gynecologist, which can take a year. That is, it is as if the specialty did not exist.
In addition, that thing about having a cytology done with an HIV test in your medical center, in Spain does not exist.
When in Spain the doctors are embittered, they treat the patients badly and even so they fill their mouths saying that “they have the best healthcare in the world”, I feel that in Porto the doctors have a more realistic view.
When I asked her about the dentist, she told me that unfortunately this was a big problem for public health in Portugal since only children, pregnant women and the elderly in a precarious situation were covered. In Spain nobody has a dentist.
As for the dentist, which is the only thing that public health does not cover, the dental cleaning that we do annually can range from 50 to 80 euros depending on the clinic.
In general, my experience with public health has been excellent and even more so coming from the disaster that is Spain. In Portugal they focus on prevention and consultations are managed in the most productive way possible since they do all the necessary tests on the same day of the consultation. Appointments with specialists are assigned very quickly and they ask you about your availability. In addition, of the almost 10 consultations we had at the São João Hospital, there was only one delay.
All the doctors and health personnel who have treated me have been incredibly kind, empathetic, and very humane.
Still, it’s far from perfect. It is enough just to look a little on social networks to know the true state of public health in this country and the situation worsens if you are outside of what are the most important cities.
To this we must add the strike that, since the beginning of 2023, affected many areas of the country.