Wednesday, April 1, 2009

Home Sweet Socialized Home

I've not had much luck this year when it comes to maintaining my health after a big trip. I got sick after going to Berlin and I got sick after going to Australia...and I hope it stops there! But when I realized that I didn't just have to suffer through my illness--that I could go to the doctor so easily and at no cost to me--I decided that I better take advantage of it while I can. I've already seen several doctors and booked all the preventative appointments I need while I still have my amazing Austrian insurance. And as I was thinking about how wonderful this all is, it occurred to me that I should share with you the wonders of living in a socialized country.

Taxes in Austria
are only slightly more than in the U.S., yet their social security provides so much more. Basically, I can feel completely taken care of in Austria.

Since I'm employed by the regional school board, I get all of the same benefits as the Austrian teachers. This means that my health insurance is also provided by the government, through my employer. (In Austria, if you are self-employed or unemployed, you will need to provide your own health insurance; however, the rate is based on your income and there is government assistance for those who couldn't otherwise afford it.) At the beginning of my stay, I was provided with my e-card, which is an amazing handy-dandy credit card-sized proof of insurance and social security. The e-card has all of my insurance information stored on it and serves as an electronic signature, as well as a document of my medical records.

I can choose to see any doctor who accepts this national insurance, which is pretty much most of them. (There are also private doctors you can pay extra to see, but that is unnecessary.) The Austrian doctor's offices are much more relaxed than the American ones, with more (although sometimes unusual) office hours and a generous walk-in policy. The first time I went to the doctor, I simply showed up at the door and requested to see the doctor. There were not dozens of pages of medical history to fill out or a stack of forms to sort through; rather, I simply handed the receptionist my e-card and gave her my contact details, and a half an hour later I was called in to see the doctor. It was remarkably easy and astoundingly accessible.

A visit to the doctor, however, is not without it's fair share of Austrian formality. When entering the doctor's office you first must go through the waiting room, where it is customary to greet everyone as you enter. The receptionist is in another room behind a closed door, so then you must ask if anyone is already in there. If so, you wait there (not knowing in which order you are being seen) until it somehow becomes clear that it's your turn to enter. After giving the receptionist your e-card and telling her the reason for your visit, you go back into the waiting room and wait for your name to be called. Upon leaving, you once again wish everyone in the waiting room farewell.

The doctor's offices that I've been to are entirely unassuming, and they are often two or three rooms in an apartment building where only the one doctor has set up an office; the doctors I've seen are congenial and casual, often wearing jeans under their white coats. There's no changing into hospital gowns, and there's very little of an examination for any non-pertinent things. In my experience, the doctors are quick to give you a prescription and will simply give you a referral upon request...even the receptionist is authorized to give you a referral--so you can see basically whatever kind of doctor you want, whenever you want. The visit is free, with no co-pay required. The prescriptions can be filled at the pharmacy (where you have to get anything from ibuprofen to cough syrup to actual prescription-strength drugs), and the medicines are often quite cheap. As for more serious issues, hospital stays and treatments as well as ambulance rides are completely covered. ...So basically, if I were to get run over by a bus or get some terrible illness, I'd want it to happen here.

And it's not just the convenience of the health system (i.e., free doctor's visits, easy referrals, no forms to fill out) that's so great--it's also the attitude that Austrians take towards health in general. Whereas the American mentality is to work unless you're seriously ill, the Austrians have a much more generous definition of what constitutes a sickday. Likewise, the Austrians will encourage you to stay home until you're absolutely 100% better, acknowledging that being healthy is actually better for productivity than going back to work as soon as you're not deathly ill anymore. I was quite shocked when I went in with a virus that my doctor told me--before she even examined me--to stay home at least from Monday to Thursday and immediately wrote me a doctor's note; she made me come back on Thursday for a follow-up appointment and extended her doctor's note until Monday before even asking how I felt. My suspicion is that the Austrians are all slightly hypochondriatic at heart (taking into account their superstitions and their propensity to complain about their health), but it really does work to the sick person's advantage.

...Oh, and did I mention that the doctor can prescribe a week at the spa for your overall well-being?? Pretty much all you have to do is ask--and you better believe that the Austrians love that state-approved sick leave every year!!

It's not just the healthcare system that takes care of the citizens--they're also protected by certain laws ensuring optimal provision and care.

Let's take maternity leave, for example. Just as I'd want to be in Austria if I got run over by a bus, I'd want to be here if I had a baby. Mothers are required by law to stop working 8 weeks before their due date--no exceptions. This is called Mutterschutz, which literally means protection of the mother. After the baby is born, the mother is allowed to take up to 2 years of paid maternity leave! Even more impressive, there is even the option of up to a year of paternity leave for fathers--although this year counts as one of the 2 years allowed. It's a popular trend for mothers to time their pregnancies every two years apart, thus ensuring an indefinite amount of maternity leave. And let's also not forget the concept of Kindergeld, or the monthly payment of government money to support families with children. In Austria, parents receive the Kindergeld until the age of 26 for girls or 27 for boys (because they have one year of mandatory military or civil service and are often at university until that age), amounting to
€105 -
€150 per month (depending on the age of the child) for the first child, and more for any successive children. Some parents simply give this money to their children as allowance.

Austrian unemployment is also amazingly lax and generous in comparison with the American system. Not just those who have been laid off are eligible to collect--even if you quit your job, if for not other reason than you didn't like it, you are eligible for unemployment. The benefits kick in immediately and are about 80% of your former salary--which is almost certainly enough to live on. There is no going down to the unemployment office, and you do not have to prove that you are applying or even looking for other jobs; you can simply keep receiving unemployment benefits for up to a year until you find the right job; otherwise another social welfare program takes over after a year, offering about 60% of your former salary to keep you afloat until you get a job. During the time that you are collecting unemployment you may also choose to turn down jobs offered to you if you deem them not the perfect fit. While this is a wonderful safety net for those who have lost their jobs and have difficulty finding new ones, I personally find it a bit too lenient and terribly enabling for people to take advantage of the system. I've known several people to live off of unemployment money and not even bother to look for a job--including one woman who remained unemployed for three years, because she couldn't find a job that was "right" for her!

And as if that wasn't enough, as of this year Austria is back to free university education. In 2000, Austria decided to institute a tuition of about
€360 a semster--roughly the cost of books in the U.S.! There was a terribly uproar and this decision remained controversial for the next 8 years. (Particularly laughable to me was the financial aid offered to cover this tuition to "needy" students! Although the cost of a college education in America is ridiculous, there are a lot of good arguments for charging a tuition.) But last year they voted to remove tuitions and restore university education to they way it had always been. This semester, the lack of tuition takes effect and students may once more enjoy the benefits of a free education.

America is a good country. There are advantages in America that Austria doesn't have. But I find that the social security here (in the broadest sense of the word) is something the U.S. could learn from. Through the healthcare, etc., in Austria, I get the sense that I am taken care of and valued as a member of society. It's no wonder I want to stay.

3 comments:

Kelly said...

Can I move there, too?

Sam said...

No new posts?

miss clara said...

Hey, this article totally made me think of your post:

Going Dutch
http://www.nytimes.com/2009/05/03/magazine/03european-t.html