Sick Day in Slovenia, Part Two

Like some woozy, shambling zombie, I wandered the streets of Škofja Loka, Slovenia, hoping to find a clinic or doctor’s office and get a prescription for some antibiotics when I came upon a pharmacy. The woman behind the counter saw the state I was in and directed me to a local hospital about half a kilometer up the street.

Slovenia, like much of Europe, has a national health insurance program–a kind of Medicare for all. No copays, no questions, just show them your card. Given that I was obviously not a Slovenian citizen, the intake nurse at the emergency room explained that I’d have to pay for my treatment. I nodded my understanding and asked if I could use a credit card–no problem.

Lubljana, Slovenia

Just like any visit to the emergency room in the US, I spent the better part of a couple hours in the waiting room. Unlike a visit to the emergency room in the US, however, I didn’t need a second mortgage to pay the bill. More on this in a moment.

It took a bit, but I was eventually seen by the emergency room doctor who was especially busy as she also had to go out on calls with the ambulance crew—something I’d never seen before. Later, when she returned, we chatted (she had perfect English…) and she told me there weren’t enough doctors or EMTs in Slovenia, and so doctors often had to go out on emergency calls.

As we talked, she submitted an order for blood tests as well as a course of respiratory therapy with a nebulizer. The blood tests suggested some sort of infection and she wrote a prescription for antibiotics along with an expectorant then cleared me to go.

Being American, I was bracing myself for the sticker-shock of the bill. In the US, an emergency room visit like this along with tests would tally up somewhere in the range of $400 to $800. So, imagine my shock when the intake nurse, who was also the cashier, told me the bill for all this was a mere 22 euros and change. I thought I’d misheard him: twenty-two euros and change? That was a little less than $25 US.

Church and Julian Alps, Slovenia

I hoped my astonishment wasn’t too obvious as I gave him my credit card, thinking, ‘this can’t be right…?’ though I’m sure I did a double take. Now, I’m willing to bet real money there’s not an emergency room in the entire United States of America where I would’ve been charged only $25 for all that. The meter starts at almost $200 or more to just walk in the door. With doctors fees and tests, that figure starts to really bloat. Even the copays for those with insurance would very likely be way north of the $25 mark. What accounts for the difference? In terms of treatment, there wasn’t any. The Slovene doctor was as conscientious and thorough as any American doctor. Time spent in the waiting room, etc. was about the same. Bottom line from a patient’s standpoint: no discernible difference in quality of care. 

Then I started thinking about pay and later did a quick search on the web. What I learned is, the average salary for doctors in Slovenia came to about $7500 US per month, or about $90k a year–hardly astronomical, especially for a doctor. Now, throw in a tax rate of almost 40% and you begin to realize that money can’t be a big draw for the profession, at least not in Slovenia.

Lake Bled, Slovenia

For instance, compare those numbers to the average salaries of doctors in the US. Once again, a quick search on the web puts the average salary for an American primary care doctor in 2019 at almost $300k. The nominal tax bracket on that kind of dough ranges from 32% to 37%. A little quick math reveals that, even at those kind of tax rates, an American doctor’s take home pay is still almost four times that of her Slovenian counterpart. 

Just to be clear, I’ve got no pony in this race. I simply had an opportunity to experience first-hand the delivery and cost of emergency medical care in an EU country. Both free-market and nationalized health care systems have their flaws and, where they’ve been adopted, both cultures have come to accept those flaws. From where I stand, however, there’s an awful lot to like about a system of health care in which citizens don’t have to fear being bankrupted by an accident or illness.