Your Health Choices in Eastern Europe
The flow of Western expatriates into Eastern Europe region to take advantage of investment opportunities is testament to its growing prosperity. However, the question of healthcare is sometimes overlooked and living in a developing country is not always plain sailing – and healthcare in particular can throw up some nasty surprises.
With the growing popularity of Eastern Europe as a retirement or second-home destination for the British, the question of healthcare is often overlooked. Health provision in the ex Soviet Block countries is relatively undeveloped and unsophisticated compared to the West.
As anyone who has visited countries such as Bulgaria, The Czech Republic or Croatia recently will tell you, there is a vast wealth gap between these countries and Western Europe. The average GDP per head in Eastern Europe is around $8,300 compared to $45,000 in the UK.
But times are changing. Bulgaria and Romania have now joined the growing number of EU members and Croatia and the Former Yugoslav Republic of Macedonia have applied.
The flow of Western expatriates into the region to take advantage of investment opportunities is testament to the growing prosperity. But living in a developing country is not always plain sailing – and healthcare in particular can throw up some nasty surprises.
In all Eastern European countries participation in the public health insurance system is mandatory with no opportunity to opt-out. The overall standard of provision in the public sector is relatively poor. The customary complaints are about over crowding and under funding.
The limitations of the private sector are two-fold: firstly there are nowhere near enough private clinics and, secondly, where expansion is taking place, the treatment options are limited. Private medical policies can only be used to finance supplementary services. No overlap is permitted between public and private. So the standard public health insurance will cover all basic outpatient and inpatient services. Private insurance will typically fill the gaps where the state provision falls down: dental care, longer hospital stays, serious illnesses and plastic surgery.
So how do most people access the health system in Eastern Europe?
Generally speaking the basic state system is considered inadequate for all but those on the lowest incomes. If the condition is not too serious, a visit to a local private clinic will be the most likely solution. However, private clinics have a captive audience – one in Budapest, for example, has 90% expat clients – so they don’t come cheap.
For a chronic condition or a major operation the most common route to the best local specialist treatment in the public sector may be to offer the doctor a “˜reward’ for successful surgery. In the Czech Rep “˜success fees’ are common for child birth and for operations such as hip replacements. However, the shortage of high-quality doctors and consultants represents a major problem. Doctors are poorly paid and many have drifted to the West for better salaries.
The pressure for better healthcare means that private medical insurance is experiencing double digit growth in most countries of Eastern Europe. These local plans are generally good value although they don’t allow movement out of the country. There is also a question mark hanging over their financial security if they suffer a bad run on claims.
International health insurance providers currently serve the expat market offering $1m worth of cover, a network of approved clinics and hospitals and repatriation for chronic conditions. In the current climate some form of international health cover is essential in Eastern Europe, particularly for families and older expats. And it’s worth checking that your policy is portable and will cover you when you return to the UK.Author Andrew Apps is the Global Sales Director for Goodhealth Worldwide. Goodhealth is a specialist provider of international health insurance for expatriates offering a full range of health insurance plans.