Hank: (walking out of the ER on our way home, deep sigh)
Me: (putting on my sunglasses) You’re thinking rather loudly.
Hank: I am happy the doctors said I am fine…
Hank: But now I feel like I didn’t need to go to the doctor. I wasn’t sick.
Me: Were you suffering?
Me: Were you in pain?
Me: To the point of tears?
Me: Did you know what was wrong with you?
Me: Then you go to the doctor. Ponte Final (Period)!
Hank: (shoulders slumped)
Me: I don’t think you realized that a major part, top of the Pro/Con List, of why I chose to immigrate to Portugal was for healthcare.
Me: Yup. Sure the food, climate, access to the sea and therefore sea food, the culture, language acquisition, the fact that we had an apartment here, family and friends made the decision much easier, but really it was for this, for today, for the day you called me from school crying and I didn’t have to give taking you to the doctor a second thought because I have already paid for the service and can make sure what ails your isn’t more just than growing-pains.
Me: In America, in my experience, a doctor’s visit, not an ER visit, would cost anywhere between $60-$120.
Me: (nodding) America has a different system of healthcare. In Portugal we all pay a solidarity tax based on our income that gives us access to our family doctor at the health center and ER as well as hospital and specialist care. When I go to the health center or ER I pay €5 out-of-pocket in addition to what I have already paid with my taxes. When you or Molly go to the health center or ER you pay nothing out-of-pocket until you are 18 years old.
Hank: I wouldn’t have wanted to go to the doctor if I knew it cost money.
Me: The doctor ALWAYS costs money, don’t be confused by what I’ve said, there is no such thing as FREE heath care. Your papa and I and allllllll the taxpaying citizens of Portugal have already paid for the health care provided and if we are not satisfied with the national health care system paid for by our tax dollars we can choose to pay to see a doctor through the private health service.
Hank: And you’ve done that for you doenças (diseases). You’ve gone to private clinics.
Me: Yes, I have paid for second and third opinions as well as complimentary care such as physical therapy, acupuncture, etc and when I don’t want to wait to see a specialist through the national health care services I have gone to see them privately. What I have learned is the level of care is the same at both public and private clinics and the same doctors that work at the public hospitals and clinics work at the private hospitals and clinics, too.
Hank: So why do people use the public hospitals and clinics?
Me: Preference or the doctor they’d prefer to work with doesn’t work at their assigned hospital or health center or as I have said, second opinions or because they want to be seen faster. Wait time is always based on your priority and urgency.
Hank: So America is like all private and no public?
Hank: So they don’t have options?
Me: They have many options, but all the options cost money and adds the burden of financial stress on top of being sick.
Hank: So if we lived in America and today happened I would feel bad when the doctor did all the exams and found out that my stomach pain was not appendicitis or a bladder infection, because I would have spent money for nothing.
Me: I am not telling you how to feel, but I would do everything in my power to not lay financial burden or guilt on you for needing to see a doctor.
Hank: I guess, I mean, that is exactly how I would feel even if you told me not to. I would feel bad for there being nothing wrong with me.
Me: But there was something wrong, Hank, and the doctors and I were so happy to tell you that you weren’t in dire straits and get the advice we needed for you to feel better faster. That was worth leaving school early, going to the health center to find out they were full for the day and being sent to the ER to see a doctor there. The whole thing took 3 hours more or less and the knowledge and piece of mind we now have is priceless.
Hank: And cost nothing… I mean, cost what we’ve already paid for it so we might as well go.
Me: Exactly, use it or lose it. Imagine how upset the doctors at the ER would be if you DID have appendicitis and we waited until it was a life or death emergency for you to go see them for help. They would be so angry, because there is no reason to suffer and wait. So much of Portuguese healthcare is focused on preventive medicine, making sure to handle an illness before it becomes an emergency. If something ails you it is your job to go to the health center or the ER so they can do their job making you better before you have a health crisis.
Hank: I don’t know what I would do if I lived in America and kinda felt sick, but not bad like it was an emergency.
Me: You would still go see your family doctor. There is a whole other area to this conversation about complicated levels of insurance, personal responsibility, cost and coverage that I am going to save for when you’re older. Regardless I feel the American system, no matter your access to care, puts too much financial stress on the sick and/or their caretakers, so yah… more for another day. What is important for today is this: I love that I grew up American. America gave me so much and I would never trade my first 30 years there, but my life-goals, my family and my health require a different heath care option and I am grateful I was able to immigrate to a country that recognizes access to affordable heath care as a humanitarian right. I find the system in Portugal infinitely less stressful than the one I had growing up with poor health and limited access to doctors and insurance. That system made me strong willed and a fighter, but ultimately let me down.
Hank: I know I’m ten and I don’t want to understand adult problems yet, but I think I understand why you chose Portugal, especially after today.
Me: Thank you for taking the time to ask questions and listen and I want to remind you immigrating here was MY best choice. I want you to stay open minded enough to know my best choices may not be the best choice for others or your best choices in the future.
Me: (throwing my arm around his shoulders, almost home) And thank you for critically listening to a complicated issue when you aren’t feeling well.
Hank: I am feeling much better knowing I’m okay and that I will always be okay as long as I listen to myself and get help when I have questions.
Me: No one ever…
Hank: I know… No one ever called me dumb, not one day, but that is because of you and papa teaching me things.
Me: Thank you, Hank, but our lessons would mean nothing if you weren’t an open-minded listener. Always remember to compassionately listen and learn from others, not just your papa and I.
Hank: (climbing the stairs to our building faster than me, turning back) Now all I need is a hot chocolate and some rest before my sister gets home and I want to play with her and make her laugh. She has the best laugh, doesn’t she?
Me: She does indeed. Molly’s laugh is like music and fills the whole house.
Hank: Her laugh will make me even more feeling better. Laughter is medicine.
Me: (fishing out my keys) True story.