Season 2, Episode 3: Illness, Healthcare in Portugal

SPEAKER_00 0:00

Welcome to As the Dinoson's Turn. We've been delinquent about recording podcasts in twenty twenty-four. We've had some excuses though. We've all been ill or I've had really bad allergies for a few. So um for several weeks we've had the crud. So we we've had an excuse, I guess.

SPEAKER_01 0:24

Yeah, definitely. I there's an upper respiratory infection going around. Um, and we're getting better, believe it or not. This sounds pretty good compared to where we were a week ago. But Tyler, who I think is patient zero, is still dealing with it.

SPEAKER_00 0:40

Yeah, he's been to the doctor.

SPEAKER_01 0:42

Oh, yes, he's been to the doctor, he's had x-rays. Um I likely will get to take him back tomorrow morning and we'll uh see if it's progressed. It's interesting though, because you know, if you have this for so long in the States, you would go and they would check you out and then they'd give you antibiotic, right? No, that's not the way things work here. Um, he got a um a couple of inf anti-inflammatories, some pretazone um inhaler, a special tea, right? Um just to try and like dry things up, give reduce the inflammation. He is not dried up, but they took x-rays of his lungs just to make sure it wasn't actually like in his lungs yet. It hadn't turned into pneumonia. Um but we have to take the x-ray back with us. Like you have the actual printout of the x-ray and you bring it with your files, so it goes back and forth with you. So he was very excited about that. He thought that was the coolest thing he'd ever seen. He's like, Look, it's my lungs. He just showed Jack when we got back. He was like, Look, dad, it's my lungs. I was very excited.

SPEAKER_00 1:47

Now, how much did all of that cost for taking him to the for an appointment and getting x-rays?

SPEAKER_01 1:56

So we, if we had gone to the clinic, like the health clinic, the center health clinic, that wouldn't have cost us anything. But it was a holiday. And so we went to the hospital. The private hospital then has an open clinic for SNS. So those who are a part of the health system. Everything cost us six Euros. So, and then we went and got all of our stuff, and everything there also cost about six Euros. So for about 12 euros, about 15, we had everything that we needed, and it was a good 30, 45-minute appointment. I mean, it was that was pretty nice. You wait a long time because everybody gets their time, but that was part of it. Um, if we had gone on a day when the health clinic was open and there weren't any appointments available, then we would have had a $30 fee. So it would have been $30 instead and or like plus the plus the x-ray would have been two. So $32 instead of six.

SPEAKER_00 2:57

But yeah, I'm thinking about like when we first moved here, even when we weren't in the system we were supposed to be, but we weren't, and that took it took forever to get it right. But I had to have the scope done, which I do as I did in the US also every two or three years, I have to have a scope done because of family history of some stuff. And you know, in the US, it's like you schedule that months and months in advance, and you go and you do it, and we had a $2,500 deductible. It was always more than the $2,500 deductible for getting my scope. Here, we weren't even in the system.

SPEAKER_01 3:42

No, we paid out of pocket.

SPEAKER_00 3:44

We got in in one week, right? One week, and the scope and everything was like $300.

SPEAKER_01 3:53

Well, 300 euro.

SPEAKER_00 3:54

Euro. So three.

SPEAKER_01 3:55

And then there was blood work on top of that. So total the whole thing was like 400 euro. But that's still a very different.

SPEAKER_00 4:03

And that's without insurance.

SPEAKER_01 4:05

It is. And I'd say that prescriptions here, depending on the prescription, so you get a discount for participating in the health system. Um, when something's prescribed as part of the health system. If something's prescribed outside of the health system, then you don't get the discount. Um, but the discount is like maybe four euros. It depends on the medication. Um, so it's not a lot. You still are expected to pay for things. The other piece of it though is that it's taxed, like it's on your tax ID. So they track all of these medical costs for you automatically in the system. It's associated with your tax ID. And then the government tells you like how much you've paid in all of those years. They tally it all up for you. So I love this that I'm going through and doing all these itemized deductions. Well, itemized deductions are expected as part of Portugal, right? There's this certain amount of the deduction you get for paying tax in so many different ways. But the government keeps track of all of that because it's all associated with your tax ID. Right? It's like completely different. I was like, oh my goodness, I didn't have to have a spreadsheet. Um, and then also if you have a receipt that's not tied into the system, you can upload it yourself. Just like people can upload the receipts into our system, but it's the federal government system. That's mind-blowing. Right? So it's like all tracked. So we know exactly what it is and how much it costs and all of those things.

SPEAKER_00 5:34

Yeah.

SPEAKER_01 5:34

Right?

unknown 5:35

It's crazy.

SPEAKER_00 5:36

But well, I suppose I shouldn't say this, but I will. In America, you have the illusion of freedom that you could choose not to pay for health insurance or choose not to go to the doctor or whatever, but you know. I think sometimes maybe the setup, you know, Portugal isn't perfect, but some things, some things are not so bad.

SPEAKER_01 6:01

I would say that yes, of course, we're paying taxes. I mean, we pay taxes in order to help pay for these things, but that's actually I'm gonna be honest, I'm looking at the taxes that a lot of our clients are paying, and they're not gonna pay more taxes here than than they pay in the United States.

SPEAKER_00 6:19

People in the United States, you know, everybody, I think regardless of your political affiliation, everybody complains about their taxes in the US. But you have no idea how lucky you really are when the vast majority of average people are either in the 12% or 22% tax bracket.

unknown 6:40

True.

SPEAKER_00 6:41

But then you also have to remember, like with us, you know, at your job that was providing your health insurance, the the premiums for a family of four were twenty-four thousand dollars a year total. That we didn't pay all of that. They paid your employer paid two-thirds of it, but yet, in a way, theoretically, that reduced your wages by sixteen thousand dollars or something because of the health insurance cost. So it's like, you know, your tax rate is low. I think the only difference between like the US and a European country is in the US you could choose not to have health insurance, I guess. But then if something happens, which it will, and you don't have insurance, then you're gonna declare bankruptcy or something.

SPEAKER_01 7:32

So I mean, there's even when you have insurance, that's an astronomical son of money. Yeah. Like if you told a Portuguese person, okay, great, well, with your insurance, that's gonna be 2,500 euro, they'd have a coronary. And of course, the wages here are much lower, of course. And I think that that's something for us to keep in mind. And the tax rate is higher, but then you literally go to the doctor whenever you just don't feel well. And that actually was something that was very different, and we're still adjusting with, right? So I don't feel well. Um, I'm like, oh, it'll pass in a couple of days, no big deal, I'll just rest. Well, you have to have an excuse for when you're not at school. You can't just not go to school, right? And your parent calling and saying, Oh, they're not gonna be there today because they're sick, that's not a valid excuse. Like you have to have a documented reason. So you have to go to the pharmacist. The pharmacist has to tell you if you can't get into the doctor, here's what you're gonna do. You have to actually see somebody and they give you an excuse. You go to the hospital, you have an excuse, right? Like those types of things. You go to the clinic, you have an excuse, you go to the dentist, you have and you have some type of a valid reason, but you have to have a note. And I remember being a professor, and there was a time where you were like, oh, well, we need a doctor's note to excuse you from class, right? And then it's like, oh, please, nobody can afford to go to the doctor. We're not going to do that. And doctors don't want to write notes, like, what is this? But that's really a thing here. Um, and I think though, that it's it's definitely a shift in mindset. It's like, okay, a child's responsibility is to be a student, that is their full-time job. If they're going to miss their job, not only does it have to be justified, but it has to be documented as the reasons why they missed. And that documentation goes into a national system. So it's not just like, okay, teachers got a file folder. It goes into a national system. And if your child misses so many days of school that are like unexcused, they just disappear, you're fined. I'm like, wow, like it's like it's completely different. And so I was like, okay, it's like the whole community is just saying, like supporting each other to say, okay, you know, and I know it sounds like big brother in a lot of cases, but I would say that there, it's it's a different system. Um, it takes some time to get used to. There are still things that boggle my mind. I'm like, no way. Like, no, that's not a real thing. And it turns out, oh, yeah, that's a real thing. It's like, what? There's a national system. Are you kidding me? No, no, we all have it. It's it we all have our logins and those things. It's like, okay then. Um, but I also would say that um it helps with funding, and they also have a lower rate of people dropping out of the education system. And I think it's because of the fees, right? It's because of all of that. I think that, you know, when you have a little bit of money, uh you don't want to give it to be like, oh, well, you didn't go to school today. And so there you go, there's your fee. I mean, it just, I'm just amazed. It's like, okay. And I don't think it's like a large fee, but it's still enough that you're like, no, I don't want to pay you. And of course, the Portuguese are like, oh, everything's taxed, everything's so expensive, everything is this. And they're right, you know, it is taxed, and that's part of the reason why things are a little bit more expensive here and there. But then there are other things that are not even close to as expensive. Like when we talked about the healthcare piece, or we talk about utilities. Utilities, I'm sorry, paying for electric and water and gas in the United States compared to in Portugal, yeah, I'd say Portugal is definitely cheaper when it comes to utilities. And when I'm talking about like an electric bill, you know, let's say what in January, our electric bill for the for the apartment was like 15 euros, right? And of course, this is the time of year where you don't use a lot of electric, right? Because it's you need heat, you need gas. And so the electric bill for or the grass bill for January was like 35 euro. Our water bill, because there's a lot of us, you know, was like 75 euro, you know. But you add all of that up, and then I look at some of the utilities we were paying in the States, and I'm like, well, we were paying like 300, 400 a month sometimes in utilities, depending on the time of year. And so I think it just kind of averages and blends out in some respects. So, and of course I know that some of this is like controlled by the government of how much they can actually charge and all of those things, but it's also because wage limits, like what the wages are, are kind of controlled there too. There's a minimum, and a lot of people make right around that. So it's not like there's money going everywhere. I don't know. It's really interesting to sit back and look at it all now, though, and after a year almost, and say, okay, so where are we spending our money more? You know, and like gasoline, way more expensive, right? So having a car is definitely a privilege. Car insurance is about equal, car payments less, but also over 10 years, so you wind up paying more.

SPEAKER_00 12:56

Yeah, well, I mean, cars. I wanted to just buy an old beater car, and you can't in the United States, you could buy an old rust bucket, or like I went and bought an old pickup truck for five thousand bucks. Maybe you could do that from a local Portuguese person on like Facebook Marketplace, but really there's not the corner, you know, used car lot with someone who's gonna sell you an old car for a few thousand bucks. I mean, there are the corner lots, but the cars are minimum ten thousand, and really it's more like fifteen to twenty. Ours were more like fifteen to twenty that we bought.

SPEAKER_01 13:41

I'd say it's definitely like the lowest you're gonna get is ten, and that's because of the environmental impact. And so it has to pass. And of course, like we can talk about from the state of Iowa, we didn't have to pass an inspection in our car every month. There are states that you have to do that, right? I mean, so it depends on where you're from, but there are certain um guidelines said that a car has to be taken off the road after it does a certain amount, and so people can get around this. You'll see um you'll see people on like really old motorcycles. So they're not motorcycles are not um monitored in the same way. They'll have their windscreen, right? And then they've got like this big old coat basically in the front of them. They've got their helmet on, and they've got this motorcycle that goes maybe 20 kilometers an hour. Like it's really, really slow, but it gets them from point A to point B, and and they're fine with that. Um, but when it comes to cars, like there's also the idea of buying something that's of quality that you pay for for a long time that's going to last and meets the requirements. Um, and then it's an investment and you don't have to do it again. And so there's not an idea that you're gonna be putting a ton of maintenance into your car or those types of things either. Like that's all kind of included into pieces. So it's a different approach. I don't know. But you're right, you can't just find like you can, but there they're going to be um a lot of fees and things that go along with a cheaper car that then end up it ends up costing about 10,000. Like that was our experience where we are. I think it really depends on where you are in Portugal.

SPEAKER_00 15:21

Um well, you had said before people around here drive nicer cars than like in Lisbon.

SPEAKER_01 15:26

Oh my goodness, yeah. So I would say that the south is very different than the north of the country. But here people are always like, there's the BMW, there's the Audi, here's a Porsche, here's a Lamborghini. I'm like, Yeah, I just I don't even know what to think. You know, like it's I've seen cars here that I've never seen in person. Like before. I'm like, wow, I've always seen them on TV, or like you see them randomly and you go to really expensive cities. So it's like where people put their money. And of course, the car loan is over 10 years instead of five. So you can buy a more expensive car.

SPEAKER_00 16:02

Well, yeah, the car loans are over 10 years. Home mortgages are over still 30 years, right?

SPEAKER_01 16:08

Up well, no, because ours is ours is like 33 years. 32 or 33 years. You can have a mortgage that lasts until you are 75, right? So it's 70 or 75, depending on the actual mortgage company. And so they will allow you to go to a certain way. Everybody has a variable mortgage. Um, you don't lock in until rates go down. If rates do go down, but when we're talking about a variable mortgage, we're not talking about all of a sudden you've got these giant balloon payments, you know, where you're like, oh, guess what? Your payment went from 500 and now it's gonna be 3,000 or something like that. Um, and so and the interest rates are much lower, still, even with a variable rate mortgage than they are in the states. So I think that that's very interesting. You pay fees in different ways, um, but the interest rates are always lower.

SPEAKER_00 17:03

Some countries, I think Canada is going to like 40 or 50 year mortgages. You know, it's because I think that in some places it's more of an acknowledgement of the rising cost of living and the fact that wages don't keep up with the cost of living and here I am going off the rails again. You know, in the United States we all whistle past the graveyard on all those things, and it's all fine and dandy and great. Let's get the credit card out and put it on the credit card, but you know, it's all great, I'll stick my head back in the sand and pretend like nothing's wrong. Whereas in other countries it's like, well, you need a car and a three-year mortgage or three-year car loan or whatever all the gurus say, either pay in cash or do it at a three-year car loan or something. Well, that's not gonna work. And you can Well, here I am starting to foam at the mouth. I mean, what else are you gonna do if you need a car and it costs a certain amount of money and you gotta you gotta get a loan?

SPEAKER_01 18:08

So loans, uh so the loan is is a longer period of loan. You can pay things off ahead of time without any penalty at all. Um, you can you can also put things towards principal balance balance. Anything you pay over in any payment actually goes automatically to principal. Um, it's not something you have to request or anything like that. It doesn't go to offset any interest or any of those things the next month. But credit cards are not really a thing. And so that's where your credit is. Your credit is in your home, your credit is in your car, and your ultimate goal is to get rid of all of those. And so um I think that it's it's a different approach to to budgeting and um, you know, to like making making things work, but it also is a different approach just to everyday life. I mean, you're not gonna go out in a town like Povo de Lonoso and you're not gonna eat out every meal, and you're not gonna drive through going from point A to point B and get all of those things. Like you're just not. You're going to go and have your coffee and you spend a euro or two on coffee, you know, and that's your big coffee expense, you know, and then you're going, you can go to the supermarket or you can go to the fruteria or the talo, right? So you can go to the butcher, you can go to the bake shop, you can go to the fruit and vegetable stand, and that's always going to be cheaper. You can do your stuff at the actual market, the farmer's market every week, and that will also be cheaper. You're buying direct from the farmer. And so you have options, um, even as a small town, and that's not always the case in some of the places that that we have lived or that we have friends who live. Like there really are food deserts where the only thing you have is fast food, and that is not that is not the case where we are. Um, but again, I think that you you spend your money on the actual ingredients and you cook every day. And there's an expectation that you cook. And most people go home for lunch. There's not a go out to lunch in the area where we live. They go home for lunch. Um, students might stay at school for lunch. The boys hate it. They hate school lunch now, which is funny because they loved it at the beginning, thought it was great, and now they're like so over it. Um, but I think it's it's interesting, it's very different. Um, the pace of life is just different. Going home and eating lunch and eating lunch as a family or cooking your meal, those are things that are expected. So yeah, um, you're expected to leave the office. You're not going to be in the office for your lunchtime. Actually, the entire office closes at lunchtime. Everything's closed. Um, so I think that that's an important thing to keep in mind too. And, you know, you stagger shifts and and things at the hospital and at the clinic and uh places that are open so that there is enough coverage, but everybody leaves for their lunchtime, which is at least an hour, sometimes an hour and a half, depending on the the location. So I don't know. I'm enjoying it, but it's it's hard to wrap our minds around still of trying to adjust some of those cultural elements. But just saying, like we're gonna have to do our first Portuguese return, tax returns here soon. That's true. So we're gathering, gonna gather all that information. Hi, dogs. The dogs have come to say hi. Oh. But um, and I think that that will be an interesting process to be able to talk about, you know, what is that like as an expat. Of course, we're in the non-habitual resident regime, so NHR, um, and that has ended in his being adapted um for a different program. So our experience for any of you who are thinking about coming later on will be different than your experience. Um, but yeah, I don't know. I think that we're having some some times. So we're hopefully getting better. Um, and we're just working.

SPEAKER_00 22:19

Yeah.

SPEAKER_01 22:20

Yeah. I don't even know if we like we spanned a whole bunch of mumbo jumbo. Like we talked about being sick, and then we started talking about medical costs and tax and cars, and it's like there's no rhyme or reason to this one.

SPEAKER_00 22:31

Well, you just never know.

SPEAKER_01 22:33

Apparently, not.

SPEAKER_00 22:35

All right. Well, that's that's what Stad was trying to talk. You gonna say anything?

SPEAKER_01 22:41

Oh, that was his little hi.

SPEAKER_00 22:44

All right, we better wrap this episode up. Then thanks so much for joining us. We'll catch you again next time on As the Dinoson's Turn.