The first day I arrived in Spain I was more than a little distressed. I had tried to get all my prescriptions filled, but unfortunately my doctor didn’t send one to the pharmacy before I left for the semester. I was anxious and worried – partly because I was missing the medicine that relieved my anxiety – but I still thought I could get it filled in Spain.
When I arrived, I went to a clinic and asked if they could prescribe me medicine, based solely on a bottle I had brought from the United States. The nurse explained to me that I would have to get a new prescription from a psychiatrist here, but that I could have an appointment that day. I had no insurance – the international insurance provided by Case Western Reserve University was for emergencies only and did not cover a trip to the psychiatrist – but even without insurance the total cost of the visit was only 45 euros (about $48.65).
Back in the US, my co-pay would have been about the same, but that’s with private insurance covering most of the costs. The pharmacy in Spain was able to fill my new prescription, a supply of 60 pills, for 5 euros. In the US, I pay $20, with insurance, for the same amount of medication. I was amazed, flabbergasted and amazed.
In the United States, the general prices of drugs are decided by the company that produces them. This process is largely without limits or regulations, even for critical drugs. Insulin, the life-saving drug for people with diabetes, is the best example. It costs between $2 and $7 to produce the drug, but $450 for a monthly supply in the United States.
However, in Spain, el Ministerio de Sanidad – the Spanish Ministry of Health (MOH) – decides not only which drugs are classified as prescription drugs, which is also standard in the United States, but also which drugs are so necessary that the price is capped. to stay affordable.
Sometimes the Ministry of Health reimburses the pharmaceutical company that produces these essential drugs. In these cases, the Ministry of Health pays the drugs to the pharmaceutical companies according to different reimbursement categories: 100% for hospital drugs, 90% for drugs necessary for the management of chronic diseases and 60% for the majority of drugs. issued by prescription only. Then, the Ministry of Health decides on the ceiling price for the drugs to enter the market. If the Ministry of Health does not decide that the drug meets the necessary criteria for reimbursement, the price of the product is then set by the company and the Ministry of Health can only intervene for the protection of the public interest. This system explains how the drugs needed to manage chronic diseases in Spain cost only a fraction of the US price. Insulin, for example, costs 5 euros (about $6) for a box of five Treisba pens in Spain, while the same product costs $500 in the United States.
In addition to government regulation of drug prices in Spain, there is also a public healthcare system which, although imperfect, is able to provide more accessible and affordable services than the US Affordable Care Act, better known as the Affordable Care Act. Obamacare’s name. The Spanish system provides public health care to anyone with a job in Spain, as well as their family. As a result, approximately 99.5% of the Spanish population receives free public health care, excluding dental and eye care.
That being said, public health insurance can only be used in public hospitals, where waiting lists for specialists can be long, resulting in months of waits for surgeries or office visits. However, there is also the option of consulting a private practitioner, and using private insurance, to quickly see a specialist.
In my experience, I have found that the public healthcare system in Spain is not half as bad as many make it out to be. A few weeks into my stay, I caught some sort of virus that made me vomit constantly. I couldn’t even hold water, so I decided to see a doctor. Once at the public health clinic, I waited 40 minutes to see a doctor, who was quickly able to make a diagnosis and prescribe medication that completely treated my symptoms. When trying to pay for the appointment, the receptionist told me that I had nothing to pay. Again I had a big moment of “not calculating”, during which the receptionist, thinking I didn’t understand his Spanish, repeated himself twice before I managed to thank him and leave.
The disparity between the costs and accessibility of health care and prescription drugs in the United States and Spain is indicative of a systematic problem that worries America. The fact that approximately 27.5 million people in the United States were completely uninsured in 2018 and that approximately 29% of insured adults in 2018 were underinsured shows the desperate need for some sort of insurance system. universal health. While it is clear that there is no strong consensus in the United States on what this system would look like – just look at the Democratic presidential debates, if you need examples – the insurance system Private disease and Big Pharma’s lack of regulation are harming the health of many Americans. I shouldn’t be shocked that I don’t have to choose between food and my medicine or hospital bills.