This is another subject on which I can't quite get a handle. In essence, similar to many other countries with national health care, it is a tale of two systems. The national system available to everybody and the private system available to those with money. No pretty photos here ;-)
We, fortunately, have only had a few encounters with the medical establishment so far and have only gone the private route. It is very similar to the level of health care that we get in the States with the one exception that every time you go to the pediatrician for even something as simple as pink eye (ended up being allergies) there is a 30 minute appointment and the doctor uses the full slot to find out how life is going in general and to do a full examination. We chose a pediatrician with a specialty in juvenile bronchial issues since Elisa's asthma is the only chronic condition that we worry about. After only visiting him four times I feel like he knows me and my kids better than any doctor has in the States. Cost-wise we pay the same amount that we would have (or rather our insurance pays) in the States but that is a lot more than an average Chilean can afford.
Most (73%) Chilean's have the public health insurance known as
FONASA and the majority of the rest opt for private plans, mostly
ISAPRES, and a very small percentage is uninsured. Healthcare is funded by an income tax deduction of 7% and then supplemented by the government to cover indigents and public health care. Chilean's covered by FONASA can pay a co-payment to see a private provider (if they can afford it). Most of the hospitals are run by the state but, as would be expected, there are often long waiting lists for procedures. Care is free at the public hospitals as long as you meet the earning or age criteria.
One interesting thing is that if you have tests done (Elisa had allergy testing) you actually have to go to the clinic to get a formal record of results and bring it with you to your next appointment. The same goes for things like x-rays. You end up having a lot more paperwork and having to visit the clinic more often. Word to the wise for future expats - live close to your clinic of choice!
In order to ensure that all kids are vaccinated, vaccinations actually occur on a schedule at schools. Elisa's class had an MMR vaccination this spring that thankfully Elisa didn't have to get because I had her paperwork with me (some of my planning panned out).
Also, unlike in the States if your kid has had a fever for a while (over five days), rather than appease the parent by throwing some antibiotics at the kid, they run many, many tests first and then will give you the antibiotics. Of course, after six days of fever our Nana implored us to use her childhood fever-reduction technique, drink a lot of Bilz (sickly-sweet Chilean soft drink):
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Coincidentally(?), after drinking it he actually started to feel better....... |
We are using our Notre Dame insurance down here and just filling out the paperwork for reimbursement. I just submitted a bunch including for some asthma "maintenance" medicine for Elisa. Here they give you a paper prescription (that you have to go and pick up!) and you can get as many refills as you want with the same prescription. They don't track the patient, doctor, batch number or anything. I wonder what they do for narcotics??????
Couldn't cover this subject without a word on paid maternity leave. They just passed a law that extended it from 12 weeks state paid (and 6 weeks before the birth) to 6 months. Sigh.