I was recently listening to the Radio 4’s Start the Week talking about TB and how poor access was one of the real barriers to treatment and care. Lack of access, or perhaps more to the point lack of access to information, sums up my experience of healthcare in Argentina in recent months. The actual care itself, when you get it, is good; my beef is that the system and the way it operates is more about making a quick buck than what’s in the patient interest. And I’m largely talking about the private sector.
A couple of Mondays ago I was supposed to have an operation for a hernia, which I developed after pregnancy. I was all set to go when at 5pm on the Friday before my health insurers called me to say that I had to pay AR$16,000 (~£800) just for the materials. A bit of gauze, staples and forceps. Of course I just happened to have that amount of cash lying around. “Oh but you can pay in two instalments,” said my health insurer.
Access to good healthcare, particularly information, is a pretty big deal, even more so when you’re abroad. We’re lucky that we have private medical insurance through my husband’s work. However, what I’m realising is that private doesn’t always mean better, just quicker and likely to cover more conditions/procedures if you’re willing to shell out a load of pesos.
Sloppy
More about my uneventful hernia shortly. Up until when my daughter was born the heathcare has been good, perhaps even a bit OTT as I had to go for endless scans and blood tests while I was pregnant. My daughter’s birth was wonderful, overall the staff at the hospital were professional and competent, and as an added bonus my husband was allowed to stay with us in the hospital.
However, when it has come to medical care for my daughter, my faith in the system has begun to erode. Again, I’m not saying the care itself was bad or that I didn’t trust the doctors themselves, but their manner towards me and my baby daughter has been sloppy, at best blasé. It doesn’t help that I’m a foreigner and I’m conversing in a second language. Yes, you could argue that we chose to come here, but locals also seem to suffer from the same thing.
The price of vaccinations
The details are too tedious, but one incident that exemplifies this behaviour was getting vaccines for my daughter. For every procedure here (in addition to medicines), you need an orden (a prescription), including for vaccines as they are not done by the paediatrician.
I didn’t know this at the time, that I could simply go to a public clinic and get the vaccinations done for free, as long as I took my daughter's booklet, without showing an orden. Unknown to me, my pedatrician had given me a private orden for vaccines that are only covered by the private system. I went to the public clinic and made the mistake of showing them the orden. Even though my daughter is Argentine and the fact I didn’t need an orden, they refused to vaccinate her with vaccines available in the public system.
Consequently, I went to the pharmacy, which wanted to charge me AR$5000 (~£250) for the vaccines. That was until I showed them my private insurance card, but then they also refused to give her the vaccines because the paediatrician had failed to write down the name of the drugs.
By this point I was losing my tether as the prescriptions are largely illegible in the first place and I had wasted hours and taxi fares for nothing. It wouldn’t have mattered if this had been for me but for a two-month-old baby? Really??
Another example was getting a newborn hearing test done for my daughter. In the UK, she would have had this within the first month. My paediatrician only wrote me an orden for the test when my daughter was almost three months and after I had asked for it.
I had no idea who I was meant to see and assumed it was an ENT specialist. Of course not, I was supposed to see an audiologist. My daughter’s left ear failed this test twice but the audiologist gave me no information as to why it had not passed. Instead, I was simply given an orden for another hearing test that no one seemed to do in babies. It was only after I spoke to a really helpful consultant in the UK and sent him the test results did he explain what they meant and that it wasn’t anything to worry about.
I’m very grateful that nothing serious has happened to my daughter; again not because I don’t think the doctors don’t know what they’re doing – but simply because they wouldn’t bother telling me crucial information. It's only her health after all.
Trying it on
So back to my hernia. I was due to have keyhole surgery, which the surgeon claimed would have also sort out my diastasis recti, where the stomach muscles separate and you’re left with a not-so-attractive tummy bulge. In the UK, most private health insurers won't cover the diastatis let alone the NHS.
Two working days before the day of the operation, my health insurers called me to say that they would only cover the conventional (open surgery) procedure. However, the hospital called me the next day to say that no, keyhole had been approved. The surgeon also said that the cost of the materials would be covered too (bearing in mind this was the first time that materials had been mentioned).
At 5pm on the Friday, the last working day before my operation, I found out that I would have to pay for the materials, regardless of the procedure. Plus an undefined amount in the difference of cost between conventional and keyhole surgery. I don't know who was trying it on here - the doctor because he would get paid for the procedure or my health insurers. Probably both.
My hernia’s one thing, but the cost of medical care for my daughter (I don’t care about the several wasted taxi journeys) has come at too high an emotional price for me.
