A ‘Camino’ Lesson in the Real Cost of Healthcare

While on el Camino, walking more than 500 miles to Santiago de Compostela, my travel companion fell hard, landing on their knee, which absorbed the full brunt of the impact. Once on their feet, it became obvious they could not walk.

Fortunately, we were in a city and not on some isolated trail, so medical services were available. Fearing a fracture, we went to the closest hospital for X-rays and a diagnosis.

During the drive, several concerns arose in my mind. Besides a possible injury and the need to treat it, my thoughts turned to the financial implications of medical care in a foreign country where I didn’t have insurance.

According to my local hospital in Denver, it would cost between $2,000 and $2,500 for a knee X-ray and consultation. It would be about $500 if I instead went to urgent care. These expenses are before insurance kicks in.

I could only imagine how much more expensive a hospital visit would be in a foreign country, especially without insurance. I also assumed we would be spending all day in the emergency waiting room, as I have consistently been told by U.S. politicians opposed to socialized medicine that the European system is inefficient and slow.

We arrived at the hospital, showed them our passports, and received a number. We were told to sit down and wait. Less than five minutes later, we were whisked into a room to explain our situation to a multilingual triage doctor.

Less than 10 minutes later, my Camino companion was in the X-ray room. After the procedure, we were told to wait until a doctor could read the X-rays. They would call our number when a doctor was available.

We settled in for a long wait, so I took advantage of the downtime to use the restroom. By the time I returned, my companion was already being taken for their consultation with the doctor.

Good news. Nothing broken. 

Ice it and put no weight on it for two weeks. Use crutches.

My companion was discharged. Our entire hospital stay lasted less than an hour.

Then came the moment of truth. As we walked to the cashier, I resigned myself to paying whatever they told me. 

Placing the charge on my credit card, I would worry about covering the expense later, when I returned to the States. I was told the total amount: 55 euros, or about $64.

I asked the cashier where we could procure crutches. He didn’t know, so he got on the phone and called a local general store, which was out of stock. Then he called a pharmacy, which had several. Can you imagine a U.S. hospital cashier providing such service outside their job description?

The pharmacy was about a mile away, so I left my companion at the hospital and walked over.

If I were to purchase crutches at a Denver hospital, the cost could be as high as $200. It would be about $50 if I purchased them at a pharmacy or medical store. I paid 19 euros in Spain, about $22.

My companion recovered after two weeks, as the doctor predicted, and resumed walking el Camino, albeit at a slower pace.

Obviously, it would be problematic to evaluate the entire Spanish medical system based on just one anecdotal visit. Still, I received better, faster, and cheaper medical attention and service than I have ever received in any U.S. hospital.

The United States has the greatest medical system in the world—for those who are wealthy. But for the vast majority of us who comprise the bottom 90% of wealth holders, we have a medical system designed to enrich itself through our illnesses and diseases.

That’s how capitalism works.

In Europe, medical care is a human right. In the U.S., medical care is a capitalist venture driven by profit. Hence, even if you are middle class and insured, you are just one illness away from bankruptcy.

No longer do we save for our golden years, building wealth for our descendants. Our nest egg is now for doctors, medical facilities, and assisted living. Here are some numbers that are simply shocking.

To insure my wife and me, I pay close to $1,500 a month. This does not include an additional portion paid by my employer. This provides me with 80% coverage and a high deductible of $5,000.

If I have a $25,000 medical bill, I would have paid $18,000 in premiums, plus the first $5,000 deductible, plus $4,000—20% of the remaining $20,000—in coinsurance, equaling $27,000.

I pay $27,000 to cover a $25,000 medical bill.

I contacted an insurance company in Spain and asked how much it would cost to be insured there. For noncitizens our age, with no deductible, 100% coverage, and the ability to choose our own doctors, it came to about 374 euros a month for both of us, or about $432.

That’s about $5,184 a year—just a little more than the total U.S. deductible. Now, if we were Spanish citizens, then the cost for 100% medical coverage would be zero euros. That’s $0 in the U.S.

We have been duped into fearing socialism. What we should fear is socialist capitalism, where the uber-rich and corporations receive government support in the form of tax cuts and bailouts while the rest of us pay into the system for their benefit and are told to pull ourselves up by our bootstraps. But as Puerto Ricans remind us, our boots have been stolen due to the upward transfer of wealth; we have no boots.

We would rather make multimillionaires into multibillionaires; we would rather spend billions bombing other countries than declare health a human right and provide it for our citizens.

And here is the irony: Those who need it the most become the defenders of their own pauperization by consistently voting for politicians who reside in the pockets of Big Pharma and the medical establishment.

Fearful of the words “socialism” and “socialized medicine,” they defend a savage capitalism that benefits only plutocrats while witnessing Nana’s premature death because she can’t afford medical treatments.

Jesus said: “I was sick and you cared for me. … Surely I tell you, whatever you did to the least of these my siblings, you have done unto me. … Come now, enter into eternal life” (Matthew 25:36, 40, 46).

This is why I am a democratic socialist. If you are a Christian, why aren’t you?