Getting the Most Out of My Austrian State-Funded Health Care

After college, like so many other recent graduates frantically staving off real life (or, in my case, the purgatory of a PhD program), I taught English abroad. I got a gig with the Austrian-American Educational Commission that seemed to be designed solely to encourage post-collegiate irresponsibility. I worked 12—you heard me—12 hours a week, and took home about €1,000 a month after taxes. Even after paying €350 in rent each month for the bigger bedroom in our two-bedroom flat, that €650 still stretched a long way.

I also got state-funded Austrian health care (funded in part, I presume, by the €300 I paid in taxes each month). That would be the big government, wealth redistributing, freeloader-encouraging single-payer health care that would supposedly wreck our morals and our economy if we tried it here. You know, the kind of health care system where you have to wait months to see a doctor, and they ration care, and you’ll probably drop dead in the waiting room, if they don’t euthanize you first.

Even though I was paying my taxes every month, I didn’t really take advantage of the free health care, except for one ill-advised visit to the lady-doctor, who was an old bearded guy who spoke limited English. I am actively repressing the details of that exam, so I’m going to skip right over that experience as if it never happened. Which, in my mind, it didn’t.

But about a month and a half before my job ended, it occurred to me that my shins had had these weird splotchy welts on them for several months. My general philosophy about my health is, if it doesn’t hurt, leave it alone and it’ll go away eventually. And my shins didn’t hurt or even itch. But it was the middle of April, and I was pretty sure they’d been splotchy since at least January.

I figured I needed a second opinion, so I rolled up my jeans and asked my American friend, “Does this look weird to you?”

“Yes,” he said, and then did this shiver thing. “Your legs should not look like that. You should go to the doctor.”

That sounded like a lot of hassle for something that I only noticed when I got out of the shower.

“Look,” he said. “You’re going to a wedding this summer, right? Do you really want to see all your friends with your legs looking like that?”

The appeal to my vanity proved surprisingly effective, though I think his mild disgust also went a long way to convincing me that my leg thing could actually be a problem. So the next morning, I looked up the German word for “dermatology” and rode my bike to the Landeskrankenhaus Klagenfurt.

The dermatology wing (“Abteilung für Dermatologie und Venerologie”) was hard to find, but when I did, there was plenty of bicycle parking out front. I followed the signs to the waiting area and explained to the receptionist that I didn’t have an appointment, but I needed to see a doctor about my beine (“legs”—I didn’t know the German for “shins”).

Forty-five minutes later, I found myself sitting across from a friendly-looking Austrian doctor, trying unsuccessfully to explain about my shins in a mix of German and English. Finally, I rolled up the leg of my jeans and pointed.

He peered over at my leg and said, “I think I know what this is, but you’ll need a biopsy to confirm it. Can you come back next week?”

Well, no, I really couldn’t, I explained. I was leaving in a few days for a week and a half of travel. Maybe I could come back when I returned?

“Hmmm,” the doctor said. “Let me call downstairs.”

He talked to someone on the phone in German for a bit, and then he hung up and said to me, “They can do the biopsy right now, and you can come back in a few days for the results.”

He then led me down the hall to an elevator, and into a pre-op room. I don’t remember this part very well. Did they make me take my pants off, or just roll the leg up? What did they tell me about the procedure? How did I stay calm? I faint when *other* people get their wisdom teeth out.

However it happened, I ended up on an operating table and somebody cut a little chunk out of my right shin and patched it up with two tiny stitches. Then they put me in a wheelchair and took me up the elevator to the front door, at which point I got out of the wheelchair, walked outside, unlocked my bike and rode it home. The whole thing took less than three hours, and I was only a little light-headed on the ride home.

The problem was, the doctor hadn’t actually told me anything about what he thought was wrong with my shins. He had just said that if it was what he thought it was, I’d have to get treatment when I got back to the U.S., because it was a long-term sort of thing.

I called my dad. “Am I still covered under your health insurance?”

“No,” he said. “Why do you ask?”

I explained about the leg thing and how the doctor really didn’t say much, and how the biopsy results would come back in a few days.

“Let’s figure this out after you get the results,” he said. “In the meantime, let’s not mention this to your mother.”

Two days later, I went back to the hospital. The Abteilung für Dermatologie und Venerologie was a lot easier to find the second time around. The doctor told me my leg thing was what he’d thought it was, but that he didn’t know the English name for it. He handed me a printout in German about my condition: granuloma annulare, which, since it’s Latin, is exactly what the name is in English.

I went home and googled it. Granuloma annulare is most common in children and young adults, and more common in women than men. It’s pretty much harmless. Treatment isn’t all that effective, and most cases usually clear up on their own in a few years. I called my dad and told him not to worry.

By the time my friends got married that June, my legs looked just like anybody else’s.

I never got a bill. I don’t remember if I even signed anything, though I must have, because I still have the sheet that the doctor gave with my diagnosis on it, and my name and Austrian social security number are at the top. Six years later, the whole thing seems like a fever dream, though my father can attest to his very real concern when he thought I had leg cancer. I was never worried, but then, I was 23 and goofing off all over Europe, so what do you expect?

The experience didn’t exactly inspire complete confidence in the Austrian health care system—it did seem a bit profligate, after all, to just hand out biopsies willy nilly. But I do know that I’ll never get same-day service like that in the states, no matter how much Blue Cross and Blue Shield bleeds me for insurance premiums.

 

Sydney Bufkin has perfectly normal-looking shins. Photo: Emmanuel Dyan

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11 Comments / Post A Comment

Poppy (#1,438)

I love state-funded health care. I love it SO much. After having lived in two countries that have it (New Zealand and England) and one that doesn’t (the U.S.) I can tell you that the level of care I have received in each country has been exactly the same – that is, good, and sometimes great. I want to stand on a roof and scream about it until the whole of the U.S. accepts that it is a GOOD THING. But I don’t want the next thing that my health insurance pays for to be psychiatric care for me, so I won’t.

Robin (#1,320)

I sort of wish all Americans, especially opponents of socialized medicine, would have to spend some time living in a country where health care is a human right. And then get sick. But not so sick that they’d die. Just sick enough to see that maybe it actually is a good idea to take care of all your citizens, not just those with the wealth/foresight to get good private insurance.

honey cowl (#1,510)

If going to the doctor were that easy and that free I WOULD DO IT ALL THE TIME. Like right now, when I am itching all my skin off for the third time in as many months, but the freakin’ dermatologist charges me $150 that I don’t have, even with insurance.

Megano! (#124)

I can’t even imagine American health care. Like, I basically could not move to the States unless I was going to be raking in the dough, because I have to get xrays and see specialists fairly regularly. I could never afford it if Canada didn’t have OHIP.

@Megano! I get a little anxious if I think about potentially moving to the States, and I have no health problems and never even bother going to the doctor when I do. I could not live there. I know people who won’t even vacation to the States because they worry about getting in an accident there. I could never move there.

I’ve never met anyone with experience in both kinds of systems who finds U.S. private health care preferable. I’ve encountered the health care systems of a number of different countries, but the best comparison I think is the time I got stitches in Kyrgyzstan versus the time I got stitches in Florida.

In Kyrgyzstan I was treated at a free, state-run hospital after receiving two huge gashes under my eyes during a mugging. My service was fast, professional, clean, and efficient. The stitches, from arrival at the hospital to leaving, took maybe an hour. No payment, no paperwork. I was asked to come back in a week, which I did, and the stitches were promptly removed. Total turnaround maybe 15 minutes. At this point the doctor agreed to accept about $40 in compensation, probably due to my repeated requests about payment. He also gave me the name of an ointment to buy, which cost a couple of dollars. The gashes completely healed and are virtually invisible today.

In Florida, I cut my pinkie finger on a soup can lid, and the cut was deep enough that I decided it needed stitches. Well, one stitch, which took about 7 hours in the ER and for which I was billed several hundred dollars. It would’ve cost several hundred dollars more to have the stitch removed, but the doctor was nice enough to give me the suture kit (which apparently they throw away?) so I could take it out myself at home. Which I did, and now I have a % scar on my finger.

Just to be clear: Kyrgyzstan is a very, very poor country. They spend about $150 per capita on their health system, as compared to $8,000 in the U.S. Obviously you wouldn’t want to get cancer treatment or complex heart surgery there, but it’s still a telling comparison.

pearl (#153)

A little late, but… I spent a year abroad in Berlin through my UC study abroad program and of course, it included health care. At some point, I ran out of the birth control I brought from home and decided to see a doctor about getting more. I called her, had an appointment within the week, and she did the whole shebang down there. I paid her €5 for her troubles, and she wrote me a prescription, the cost of which ended up being around the same price I paid in the US for my school health insurance-subsidized birth control.

Then I was like, “my back hurts.” So I went to another doctor and said, my back hurts. I think I might’ve paid €5 again, but maybe not if it was in the same 3-month period as the earlier visit. He referred me to a physical therapist… which cost something like €70 for 10 sessions. The best.

Another friend of mine accidentally rode her bike in the rails of the tram and got knocked over really hard or something. A quick trip the hospital, where she was given a splint and MRI and was discharged later that same night. Again, only €5 on her part.

And now I’m paying $221 a month for an individual Kaiser HMO (just for now until my work insurance comes through, but it isn’t much more appealing) with a $50 copay and no prescription coverage. AMERICA

cmcm (#267)

I find it impossible not to comment when the topic of healthcare comes up. Because as an American living in the UK, this is seriously one of the biggest issues that prevents me from ever moving back. I cannot even imagine the mental struggle of deciding whether or not an ailment is worth going to the doctor for.

Every once in awhile I get annoyed about the NHS. Yes, it took a few weeks to get an appointment, it took over 6 weeks to get a referral for physio. But you know what? If I lived in the States, I wouldn’t be getting physio because I couldn’t afford it. I might not have gotten that funky looking mole removed. I wouldn’t be able to afford my prescriptions. The NHS is the best thing in the world.

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