By paying close attention to the advice given from my predecessors Chibuzo and Garjae, I arrived safely and settled quickly into Porto and the Hospital São João. I am certainly appreciative of their insights (such as the monthly metro card and the café pingo), as they’ve helped me to step right into my new life and new rotation in Porto. Through this blog, I hope to share my own experiences and thoughts on working in the national healthcare system of Portugal and perhaps even share my own insights to facilitate the transition for future UNC students.
I thought I would start this blog with a brief introduction to the Portuguese health system and touch on current health issues of the nation.
The National Healthcare Service (NHS) of Portugal
In 1989, the government of Portugal passed a law that would protect the health status of its citizens through the establishment of governmental agencies and health service providers. Under this law, all tax-paying citizens* (and family members) are entitled to medical care for a nominal fee, although most people are exempt from payment (pregnant women, children, unemployed, patients with DM, TB, CHF, MS, alchoholics, blood donors…or any ICD9 code, it seems...)
Under the Ministry of Health, the NHS is comprised of hospitals, local health centers, and ancillary medical services. The Ministry also sets the National Health Plan (NHP) to direct health priorities and health goals for the nation, including guidelines for standards of practice. The top current programs include the prevention and control of cancer, cardiovascular disease, mental health, and HIV/AIDS-- consistent with the nation’s most frequent causes of mortality (top five include cerebrovascular disease, ischemic heart disease, DM, and colon cancer).
Like any other dynamic and improving healthcare system, the NHS has a history of continual reform. Recently, there has been increased integration with the voluntary private sector to increase efficiency and decrease waste, as well as improve overall cohesion of health services. With the global economic downturn in 2010, Portugal will undoubtedly feel the constraints of the necessary austerity measures which will tighten the belt of most social services throughout Portugal. Unfortunately, Portugal is also an aging population with a shrinking workforce and even lower birth rate. This is very much like the economic issues that America will face in 2011 as the Baby Boomers start retiring, making them eligible to Medicaid and Social Security benefits. With the new Republican House of Congress challenging the Health Reform Bill of 2010, it will be interesting to follow the events unfold for Portugal, the US, and the rest of the developed world.
For the eager beavers who want to learn more about the Portuguese NHS, go to their website at http://www.portaldasaude.pt.
*Medical coverage of EU residents and foreigners may be covered by the national healthcare system as well. Separate rules apply, but this is beyond the scope of this brief introduction.
I realize this is a rather dry entry for a traveling blog…next time I’ll try focus on something a bit more palatable—food and wine and health in Portugal! (As well other daily habits...tobacco and exercise). I'll leave you with some pictures to spice things up.
(Sorry, I didn't have any people-less pictures of Faro)
Porto-Unreal, isn't it?