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No free treatment for sick pilgrims

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sillydoll

Veteran Member
Camino(s) past & future
2002 CF: 2004 from Paris: 2006 VF: 2007 CF: 2009 Aragones, Ingles, Finisterre: 2011 X 2 on CF: 2013 'Caracoles': 2014 CF and Ingles 'Caracoles":2015 Logrono-Burgos (Hospitalero San Anton): 2016 La Douay to Aosta/San Gimignano to Rome:
A friend who is walking the meseta got a really bad tummy bug. She writes about her illness and of another pilgrim with the same bug:

"... later that morning he was so sick they had to call a doctor because he could not even stand up. I could just get up and bobble about and was thus forced to leave the refugio at 9h30. The centro de salud ( health centre) wanted to charge me 73 Euros, that is around R730 to see a GP. Not being a member of the EU, that is what you pay. Treatment for pilgrims is certainly NOT free. The pharmacy could not help much either."
 

lynnejohn

Veteran Member
Camino(s) past & future
Frances(2005), VDLP(2007), Madrid(2009), Ingles(2009), Sur (2011), VDLP(2011)-partial, VDLP(2014)
So very unfortunate - hope your friend recovered well.

Do you think it's a function of the size of the city/town and the number of pilgrims seen? Both times that my husband had to see a physician they were adamant about not taking payment - the centro de salud as well as the ambulance. These instances were in Vilar de Bario (ambulance to Xunqueira de Ambia) on the Sanabrese and Villalon de Campos on the Madrid. Both fairly small towns.

I wouldn't be upset if they did begin to charge - since the volume of pilgrims is growing every year, it wouldn't be reasonable to provide free health care for the large numbers of non-citizen pilgrims seeking care.

lynne
 

sillydoll

Veteran Member
Camino(s) past & future
2002 CF: 2004 from Paris: 2006 VF: 2007 CF: 2009 Aragones, Ingles, Finisterre: 2011 X 2 on CF: 2013 'Caracoles': 2014 CF and Ingles 'Caracoles":2015 Logrono-Burgos (Hospitalero San Anton): 2016 La Douay to Aosta/San Gimignano to Rome:
Er..... because, if you are a member of the EU you are entitled to free basic treatment in all EU member states. But, as Fiorenza said, if you are not from an EU state you have to pay - big bucks!
 

jeff001

Active Member
I (US citizen) was treated free at both the Centro Salud and hospital urgencias in Logrono. It was my impression that they had no mechanism to bill or collect payments. They asked for an insurance card and when I told them I didn't have one they said there was no charge.
 

Trudy

Active Member
Camino(s) past & future
(2006) Roncesvalles to Leon (2007) Leon to Compostela
Perhaps it depends very much on who you see at any particular time. In 2006 I went to the Centro de Salud in Logrono and was told I could only see a doctor if I made a payment of 45euros through a bank transfer. Knowing very little Spanish, and feeling quite ill, I didn't have the confidence to tackle the bank, so got medications from a pharmacy.

By the time I got to Leon my condition was worse. I checked into an hotel and asked the receptionist if she could arrange for me to see a doctor, and once at the medical centre found I didn't have to pay a cent.

Oh, I'm Australian not a EU citizen so expected to pay something, but maybe the receptionist had mentioned I was a pilgrim and that helped. The doctor prescribed three lots of prescription medications and I was surprised to find this cost a fraction of what I would have paid in Australia.

Trudy
 

Javier Martin

Veteran Member
Why, in your opinion, have the doctors to work for free? Who has to pay their's work? Is it the same in your countries?

Buen Camino,

Javier Martin
Madrid, Spain
 

jeff001

Active Member
I expected to pay and would have if they had given me a bill. It just seemed they were not set up to do it since it apparently happened so infrequently.
 

lynnejohn

Veteran Member
Camino(s) past & future
Frances(2005), VDLP(2007), Madrid(2009), Ingles(2009), Sur (2011), VDLP(2011)-partial, VDLP(2014)
Yes, just to clarify - I really have tried to pay for my health care in Spain, as I know that there is definitely nothing free about it. I thought at first my Spanish was so awful that I wasn't understanding what they are saying, and we had quite a back-and-forth about it, so they sent over a translator and she confirmed that they did not want payment. I got the sense that they didn't want to do the paperwork involved.

I do not expect free health care anywhere. Although some think health care is "free" here in Canada, it is definitely not - Canada, Spain, and any other country with Universal Health Care has a robust taxation schedule to pay for it. And if you are not a citizen of Canada, you do pay for any health care you receive when you visit here.

I believe the responsibility for administration of universal health care is Spain rests with the Autonomous Communities, so there may be differences in application of the regulations, but I've read that " non-EU citizens are required to pay, although they are usually not charged for basic services". Leaves a lot of room for interpretation (and loss of revenue).

So Javier, as you already know - your tax dollars are paying for the "free" health care often provided to pilgrims who are non-EU.

lynne
 
Camino(s) past & future
2002, Toulouse/Aragon 2005, Cami S Jaume/Aragon 2007/9, Mont Saint Michel/Norte/Vadiniense 2011, Norte/Primitivo 2013, Norte/Primitivo 2014. Norte 2015, Cami S Jaume/Castellano-Aragonese 2016
A friend of mine is currently on the Camino and getting treatment for tendonitis. In Estella, they charged her 45E for the consultation-- at my strong advice, she had a travel insurance policy and will be reimbursed in due course-- but in Santo Domingo, her offer of payment was waved away. As Javier & Lynnejohn point out, health care is not free, but is very expensive-- skilled and highly trained practitioners (doctors and nurses) are at work and deserve a fair wage. My provincial income tax pays for it here in Ontario and I imagine that Spanish taxpayers are forking out for the services at the Centro de Salud. My offer to pay for a consultation in Jaca was also waved away two years ago, and so I put 20E into the donativo box at my next albergue stop as a (perhaps inefficient) way of acknowledging the gift. And, of course, on return to Ontario, I have been buying Spanish wine as a very effective means of supporting the economy of the Camino's host country.
 

lynnejohn

Veteran Member
Camino(s) past & future
Frances(2005), VDLP(2007), Madrid(2009), Ingles(2009), Sur (2011), VDLP(2011)-partial, VDLP(2014)
:D Oursonpolaire, I never looked at it that way. I regularly buy Spanish wine at the old LCBO, so my guilt at burdening the Spanish economy with the 2 instances of unpaid health care we've received will be somewhat assuaged...

lynne
 
If the amount of Spanish wine drunk becomes a qualification for health care in Spain I will be due a rebate.Seriously you should never travel without health care insurance.
Buen Camino,
stpatricksbhoy.
 

SisterPearl

New Member
I passed out in a shop in Madrid two years ago, and I received excellent and immediate medical attention. When I asked how much it would cost, they laughed and told me that the care is completely free. Now, my husband is a Spanish citizen, so I don't know if that had anything to do with it, but I certainly am not. Regardless, I am so appreciative of the care and attention, even if it had cost me something, I would have been glad to pay.
 
Camino(s) past & future
Nearly every year since 2006, often walking more than one route.
Nobody should expect "free" health care in Spain or any other country.
You certainly wouldn't get it in the USA!
In fact, the sticker shock would probably kill you here!

But I will say that the medical treatment Joe received when he had a burned leg was exceptional and unbelievably inexpensive (I think it was around $6 for the ointment and no charge for the consulation).

I think it depends on who you see and where you are.
At any rate, $75 is not too much for a consultation.
Here in the USA, you can expect to pay upwards of $200 for a first visit!
 

dougfitz

Veteran Member
Camino(s) past & future
Spain: Mar 2010, Apr 2014, May/Jun 2016. Norway/Sweden: 2012, 2018. Other: 2011 (2019)
I agree with those who suggest that one needs to have adequate travel insurance with medical coverage.

Any treatment you might need has a cost - it is not free. It takes time and might require medical consumables. It may have no charge - that is a matter for how the state pays the provider, or the individual generosity of the provider.

And Anniesantiago makes a good point about charges in the US. Whenever I add the US to my destination list for travel insurance, the premium increases!

One final point, in most places I know, emergency medical treatment provided, for example, by a hospital emergency department, is provided free of charge. Whenever I have had to seek such treatment from individual GPs etc, they have required payment. I haven't had time to determine if the same approach to not charging for emergency treatment applies in Spain.
 

falcon269

no commercial interests
Camino(s) past & future
yes
The curious thing about the current U.S. medical system is its "gainsay" nature. A treatment will have a price of $15,000, which no one pays. Insurance companies negotiate it down by two-thirds. The Medicare system has a reimbursement rate which is probably lower than the insurance companies. The indigent likely get it for free. Only the chump with no insurance and a home is hit up for the list price. He pays or they sue and levy against his assets. What I find curious is that the medical system prefers to throw someone out of his house instead of asking for an amount, probably affordable, they would readily accept from an insurance company. They sort of save your life, then take it away. Routine medical care in France and Spain is affordable, but there are big ticket items, like a medevac home, for which it is good to have insurance. I have no qualms about accepting medical care, anymore than I have qualms about using the roads for which I have paid no taxes. That is different than demanding free care when it is not free. It is about graciously accepting what a culture offers because it treats people decently. In aggregate, pilgrims leave behind tens of millions of Euros annually, and there is a piece in there that compensates for the "free" medical care that is occasionally rendered. Be grateful that the Camino is not in the U.S., where there would be no municipal albergues, no pilgrim meals, and no "health clinics" for blister treatment. That said, there are some great state and national parks with fantastic hiking and camping opportunities.
 

Caminando

Veteran Member
On the camino, I hope no-one needs medical help, and if so, that it's given freely in a humanitarian way. As it was hundreds of years ago, for pilgrims in medieval Europe. When you see different systems discussed, socialism or barbarism seem to be the choice. I wish we could all move towards a world system where food, water, health and housing were rights and not commodities. Certainly, many find kindness along the way.
 
S

Sojourner47

Guest
As a citizen of the EU, I am entitled to reciprocal basic medical treatment in other EU countries.(as long as I'm carrying my E111 card) This is NOT "free", but paid for by taxes levied on all EU residents. Thus I can get treated in Spain, as a Spaniard can get treated in the UK. The NHS is often quoted as being free, but is of course paid for by every worker via national insurance contributions and income tax, as is the Spanish health service. The key word is "reciprocal".
Those from outside the EU are not automatically entitled to "free" medical care, any more than foreigners visiting their countries would be. In any event, the entitlement only covers "basic" treatment, and certainly not repatriation in cases of major illness, so ,as stated earlier, it's essential to have adequate insurance in place.
 

jameswberk

New Member
This is an interesting topic precisely because of the ambiguity seen in the other answers. Legally speaking I believe non-EU citizens are not exempt from payment. In practice this may not be the case.

Speaking from my own experience I have twice walked the Camino. Once as a non EU citizen, the second time as one. Both times I went to a walk in center. The first time as a non-EU citizen I went in for shin splints in Belorado. The doctor greeted me himself and saw to my problems, applied an elastic bandage (which really helped) and sent me on my way. I paid nothing.
The second time, I had flu like symptoms in Fonsagrada, was seen to Rx-ed some medicine and sent off without payment. This time however I had an EU health card and showed it during the visit.

So, it is very possible that they will not charge if you are not an EU citizen. This does not mean that it is not smart to get travel insurance, though, full disclosure, I didn't have it when I walked as a non-EU citizen. But I would also say that it should not be a hindrance to walking if you have none.

Buen Camino,
James

PS I think the title of this thread is a bit alarmist. It should read "no guarantee of free treatment for sick pilgrims."
 

newfydog

Veteran Member
Camino(s) past & future
Pamplona-Santiago, Le Puy- Santiago, Prague- LePuy, Menton- Toulouse, Menton- Rome, Canterbury- Lausanne, Chemin Stevenson, Voie de Vezelay
I went to a doctor in a French town, well off the Chemin last month. Doctor was very thorough, and charged 25 Euro.

To someone from the US, that is free. My insurance has a $10,000 deductable.

My wife picked up a prescription for 8 Euros which is $130 here. Glad they preserved our freedom and gutted the governmental horror proposed by Obama!
 

michaelwalker

Member
Camino(s) past & future
2010 Spring, Tours Route and Camino Frances. Tours to Bordeaux then SJPP to Santiago.
2011 Autumn, Voie de Soulac, Tours Route and Camino Frances. Bordeaux to Bayonne then Dax to SJPP to Finisterre
2013 Summer, Camino Frances. O'Cebreiro to Santiago, then part of Portuguese route.
2014 Autumn, Via De La Plata - Merida to Astorga.
2016 Spring GR 10 and Caimno del Norte
I'm on the camino in Los Arcos, walking with my brother. He has gastro and saw the doctor this morning. He is resting now. The Flemish hospitaleros and hospitalera have been great. One took him to the doctor to translate. The doctor was good and printed out a treatment plan and recommended drugs, that he has taken and improved. the costs - 87 for doctor and 16 for drugs. We are Australians and love Spain and the Vlaams Genootschap Van Santiago De Compostela!
 

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
Usually the first thing a surgery will ask for is the insurance document. On one of my first aid summers I took a (non EU) Norwegian woman to a surgery as she had the worst bedbug attack and allergic response I had ever seen. She didn't have any insurance but the doctor waived that away and happily treated her for free, that good man.

But - if travelling abroad do buy medical insurance before you go - what if you have a real accident and have to be flown home, it costs thousands! :shock:
 

jpflavin1

Veteran Member
Camino(s) past & future
CF(10,11,17), Vasco(12), Salvador(13), CP(13), CN(14), Madrid (16), Mozarabe (18), VdlP(19)
My first Camino I only made it to where the road splits off to Arneguy. My heart rate was 225. I was sitting on the side of the road and a passing German Pilgrim asked if I was ok. I said, I was not and He stopped and sat with me. I had Atrial Fib that I believe was exacerbated by the altitude. He got in contact with the Pilgrim office and the head of the CSJ in the area drove up and brought me to the care center in SJPdP. They asked me several questions and took my vitals and said they thought I had a minor stroke, which they could not test for or treat. They billed me 264 Euro's and called an ambulance. The ambulance took me to the regional hospital in Bayonne and charged me 178 Euros. I spent two days in the cardiac ward in Bayonne. Had an MRI, 2-ECG, and an Echo cardiogram. Total bill $2,450. Euro's. The ambulance and clinic bills were very similar to what one might pay in the U.S.. The hospital bill was very inexpensive in comparison to the U.S.. I had insurance and was re-imbursed when I returned to the States.

Before leaving the States, I got a letter from my insurance provider with contact information while traveling that was very helpful. I would recommend anyone traveling to have insurance.

The major difference in the U.S. vs. E.U. system is that American doctors and medical institutions are for profit. I found the French system to be every bit as efficient as any good hospital in America.

There is much more to this story that I may share in another thread some day.

As a footnote, my German friend and I met the next year in SJPdP and walked the entire Camino w/o incident and still remain good friends.

Ultreya,
Joe
 

David

Veteran Member
Camino(s) past & future
Moissac to Santiago Spring 2005 was the first foray.
Glad you were so well looked after and survived Joe - shows strength of will to return the next year too!
But- Total bill $2,450. Euro's? Crikey!!! Enough to give you a stroke (if you hadn't had a stroke) :D
 

jirit

Veteran Member
Camino(s) past & future
Camino Frances 2007,
Via Francigena Italy, 2008,
Jakobsweg Austria 2010,
Camino Frances 2011,
Le Puy to Lourdes 2012,
Via de la Plata 2013,
Future:
Ökumenischer (Via Regia), Germany,
Lycian Way, Turkey
While walking the Camino for the second time this past May and June, I fell and sliced open my hand. My accident occurred about approx 15 km east of Triacastela and was forced to take a taxi to the clinic there, in order to receive 6 stitches to close the wound.

The medical visit at the clinic in Triacastela, and the follow up visits at 2 additional clinics on my way to Santiago, and the final hospital visit in Santiago when I had the stitches removed, were all free of charge.

I only costs I incurred was the taxi ride to the clinic and the drugs I need to take

All I had to present was my provincial health card from Canada and my passport.

I did see on my file that I was classed as a pilgrim. Thus it is very possible that they simply waived the charges. Or alternatively they might have sent the bills to my provincial plan who would have reimbursed Spain in any case.

Neville
 

Abbeydore

Veteran Member
jpflavin1 said:
My first Camino I only made it to where the road splits off to Arneguy. My heart rate was 225. I was sitting on the side of the road and a passing German Pilgrim asked if I was ok. I said, I was not and He stopped and sat with me. I had Atrial Fib that I believe was exacerbated by the altitude. He got in contact with the Pilgrim office and the head of the CSJ in the area drove up and brought me to the care center in SJPdP. They asked me several questions and took my vitals and said they thought I had a minor stroke, which they could not test for or treat. They billed me 264 Euro's and called an ambulance. The ambulance took me to the regional hospital in Bayonne and charged me 178 Euros. I spent two days in the cardiac ward in Bayonne. Had an MRI, 2-ECG, and an Echo cardiogram. Total bill $2,450. Euro's. The ambulance and clinic bills were very similar to what one might pay in the U.S.. The hospital bill was very inexpensive in comparison to the U.S.. I had insurance and was re-imbursed when I returned to the States.

Before leaving the States, I got a letter from my insurance provider with contact information while traveling that was very helpful. I would recommend anyone traveling to have insurance.

The major difference in the U.S. vs. E.U. system is that American doctors and medical institutions are for profit. I found the French system to be every bit as efficient as any good hospital in America.

There is much more to this story that I may share in another thread some day.

As a footnote, my German friend and I met the next year in SJPdP and walked the entire Camino w/o incident and still remain good friends.

Ultreya,
Joe

Lovely story, hope you continue in good health, & have time to tell us more, Thanks, David
 

falcon269

no commercial interests
Camino(s) past & future
yes
I did see on my file that I was classed as a pilgrim.
That notation got me a free vital signs checkup in Sarria when I was feeling "weak." It was only five minutes for a blood pressure and blood sugar test, but it would have been $500 in any U.S. emergency room.
 

renegadepilgrim

Veteran Pilgrim and Traveler
Camino(s) past & future
2010: Camino Frances, 2011: Santo Domingo de la Calzada (Hospitalera), 2012: Camino Portuguese from Porto, 2015: Camino Norte
falcon269 said:
I did see on my file that I was classed as a pilgrim.
That notation got me a free vital signs checkup in Sarria when I was feeling "weak." It was only five minutes for a blood pressure and blood sugar test, but it would have been $500 in any U.S. emergency room.
If you come into my ER and ask for a blood pressure check, it's free. You can also go into any firehouse in pretty much anywhere in the US and ask for a blood pressure check and a blood sugar check and it will cost you nothing (usually, sometimes there is a small fee), according to my firefighter sister who says it happens all the time in Portland, OR where she works.

Not sure where you live but if you are going to slam the US healthcare system, at least be accurate. :) Your ER visit would be about $800 minimum. You get a bill from the hospital, the doctor and if you have blood tests, you get one from the lab, if they do imaging studies, you get one from the imaging department and the radiologist. Oh, and if you take an ambulance for the blood sugar check (yes, people do this...) then you have another $1000 bill plus a few dollars per mile plus supplies. I work in an ER and I've seen people take ambulances for stubbed toes. :D

I think getting care in Spain is hit-or-miss. Some people get lucky and don't get charged for simple urgent care matters (blisters, tendinitis, etc) and others like Joe, get charged but also get really good care. If I were to pay out of pocket for healthcare in Spain it would cost MORE than if I were to pay out of pocket in the US. Last year, as I have previously posted, I was sent to a private clinic to have my foot looked at for tendinitis and they asked for 95 Euros. Add a 25% exchange rate to that and it was WAY more than I would have paid at my own doctor's office without insurance. I am sure it would have been different if I had gone to an Emergency Room, but I refuse to go when it's an urgent care matter, not an emergency. Getting travel insurance is relatively inexpensive in Spain, check out http://www.squaremouth.com and don't worry about it!
 

jameswberk

New Member
What's interesting and I think very important to understand from Joe's case is that it all seems to have happened in France. I live in France myself and find the prices he was charged very high, but I've been lucky enough not to require anything beyond simple care (i.e. no expensive tests) up until now. What I think is important to take from this, and for non-Europeans to understand in general, is that health systems (and costs) vary widely from country to country in Europe. Judging from other posts in the thread it seems in Spain they can classify you as a pilgrim, which I doubt happens in France due to the differences culturally and economically of the Camino here. So for those of you planning to walk for a long stretch in France it may be worth it to read up on their health system.
Regardless, Joe, it is fantastic to hear that the experience gave you a lifelong friendship in the end! Glad to hear you got to finish the Camino on the second pass. Ultreya!

James
 

cdiazcamino

New Member
Camino(s) past & future
Future 2018
I passed out in a shop in Madrid two years ago, and I received excellent and immediate medical attention. When I asked how much it would cost, they laughed and told me that the care is completely free. Now, my husband is a Spanish citizen, so I don't know if that had anything to do with it, but I certainly am not. Regardless, I am so appreciative of the care and attention, even if it had cost me something, I would have been glad to pay.
Ya pagamos los demás por ti con nuestros impuestos. La atención sanitaria NO ES GRATIS, la pagamos todos los españoles con el sudor de nuestro trabajo. Si estás casada con un español, que te lo traduzca y espero que tenga trabajo.
 

SYates

Camino Fossil AD 1999
Camino(s) past & future
First: Camino Francés 1999
...
Last: Santiago - Muxia 2019

Now: http://egeria.house/
Welcome to the forum @cdiazcamino I answer in English: Spain has mutual agreements with other EU countries when it comes to health care, meaning if y Spanish person falls ill in one of these countries they are treated like a citizen (provided they carry an EHIC) the same applies vice versa.

In case of non-EU citizens giving simple first aid isn't expensive in a lot of cases, but the paperwork to get the money back from a travel insurance might be more costly than worth it.

Buen Camino, SY
 

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