Tuesday, June 15, 2010

How the hospital system works

Disclaimer: I really have no clue how the hospital system works, this is my best guess pieced together through experience & conversations.

There are a lot of hospitals in Astana, and every hospital belongs to a microdistrict or neighborhood. If you live in neighborhood A, then you go to the hospital in neighborhood A. Kind of like public schools in America.

When you go to your hospital, your care is FREE. Kind of like public schools in America. Kazakhs don't quite understand me when I ask about how much it costs.

Children are also free in Turkey. My Turkish vice principal could not understand my question--how much money would it cost when my brother took her to the hospital? Why on earth would anyone charge you to take a child to a doctor?

Of course, I can talk about how wonderful it is for children's health care to be free, but I would never allow Sophia to have any kind of major care in this country. I would fly her back to the US and pay for it. So, yeah, it's free, but right now it's not high quality.

Doctors work from hospitals, so if you need to see a doctor, you go to a hospital--once again, free.

I don't know about medicines. I think if they give it to you in the hospital, then it is free, but I know I've paid for all medications I've bought at pharmacies.

Pharmacies are everywhere and called аптека. I've yet to meet a pharmacist who speaks good English; most don't speak it at all. The first time I went, I had the medicines & dosages written on a sheet of paper, which the school nurse had written for me. I don't know if this was an official prescription or if what I was getting was over the counter.

I've gotten different medicines from pharmacies--allergy medicine, versions of Benadryl, Tylenol, Ibuprofren--and usually I don't have much of a problem if I can communicate what I want (usually I have to write it down). But my brother recently encountered a pharmacist who explained, through a translator, that he needs a prescription for Benadryl (but allowed him 10 pills). So maybe I've been getting these medicines because the pharmacist doesn't know how to tell me that I can't get them?

I met an American who is pregnant and is flying to Turkey to deliver her baby. I've encountered 2 different blogs by Brits who returned to England to have their babies. So my guess is Westerners don't have too much faith in the obstretics part of the hosptitals.

Next year I'll have health insurance that works outside of Kazakhstan, so I'll be able to continue using the free/cheap Kazakh system just for minor things (colds and medications) and the expensive American system for major things plus routine check-ups.

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