Despite what Instagram may have you believe, my life on the road isn’t one giant lap of luxury. I may visit some of the most beautiful places on earth, but I rarely – if ever – treat my travels like a vacation.
Last fall, I made an exception when an impromptu trip to Fiji landed me in a rat-infested bungalow. I spent the night outside on a hammock and then made the executive decision to board the next ferry to the main island, where I checked into a five-star resort. It was a budget blaster, to be sure, but I figured it was far preferable to the alternative, which was catching the Bubonic plague.
But as the story goes, this luxury hotel was infested by fleas. It was better than the rats, but not by much since I later learned from a New Zealand doctor that I am “highly allergic to fleas.” I might have been more annoyed, but at the time of my visit I was actually just relieved that the bumps and sores erupting all over my body weren’t the early stages of shingles.
The fleas turned out to be only half my microscopic battle in Fiji. Several weeks later, after spending a few hours in the sun on a layover in Hawaii, I noticed that my chest had broken out in white-ish splotches. I knew exactly what it was: Tinea versicolor, an ugly but benign fungus that upsets the balance of the body’s naturally-occurring yeast and causes skin to lose its pigment.
I first became acquainted with that little gem from a yoga mat at the 14th St YMCA back in 2007. I took an antibiotic and, eventually, my skin evened out. I don’t know for sure where I got it this time, but I would bet almost anything that I picked it up in a five-star gym somewhere in the South Pacific.
I arrived back in New York a few days before Christmas, which didn’t give me much of a chance to see a dermatologist. By the time New Year’s rolled around, my tan had faded and the spots had mostly blended in. Since the problem was purely cosmetic and not at all harmful, I decided to ignore the whole thing. Then, having spent the bulk of the next eight months in a winter wonderland, I forgot about it too.
And then came Montenegro. After a few hours in the sun there, those little splotches not only reappeared – they grew. Still, I didn’t think they were that noticeable until one of my closest friends started a FaceTime chat with, “Hey! …. What are those spots all over your chest?”
“Oh just that skin thing I had years ago,” I shrugged. “It’s ugly, but that’s about it. I’ll go see a doctor next time I’m home.”
I truly meant that. Until this past weekend when I spent some time at a block party and was treated to a fresh round of splotches. Not only that, but I noticed that those little white spots were creeping up the side of my neck and dangerously close to my face. I might not be so vain as to worry about a little discoloration on my chest, but even I have to draw the line somewhere. And that point, coincidentally, is at my chin.
It was 1:45 p.m. on a Monday when I wandered into a pharmacy in downtown Helsinki. I took a number for a consultation and then waited about four seconds to be called. When I sat down in the cubicle, I explained my problem to the pharmacist.
“We sell over the counter medicine for that,” she explained. “But I think maybe you should see a doctor. He can give you something stronger.”
I sighed. “I don’t have a doctor here. And I won’t be back in the States until December.”
“Well there’s a clinic just down the street,” she said pointing out the window. “It’s open 24/7 if you want to make an appointment.”
Even with the risk of a facial fungus looming, I didn’t quite think my affliction warranted a trip to an urgent care facility. But I decided to check the place out anyway, if only because it’s smart to explore my healthcare options before I have a true medical emergency.
I walked into the clinic at 2:05 p.m. I answered a few questions from the receptionist and gave her my New York drivers license.
“Our next available appointment is at twenty past,” she said.
“Twenty past what?” I asked.
“Two,” she answered.
“What day?” I asked.
“Today,” she replied.
I looked at my phone. “That’s in eight minutes,” I said.
“Are you busy?” she asked.
“Well, no,” I said. “I’m just surprised is all.”
She had absolutely no reaction. Then said, “Since you aren’t a resident of Finland, you need to leave a deposit before you see the doctor. It’s 120 Euros.”
“Do you need cash, or can I use a card?” I asked.
“We’ll take a card, but we prefer cash,” she said. “There’s an ATM just down the hall, if you need. And we return whatever is leftover, of course.”
I didn’t know what to make of that last comment. I fully expected an urgent care visit to cost €120. Even in the States when I’m using my insurance, my out of pocket costs are about as much. To visit my doctor is cheaper, but I’d still pay a $35 co-pay, plus 20 percent of whatever astronomical costs they bill my insurer. And by the way, I would wait way longer than eight minutes to see a doctor.
I had just returned from the ATM and was waiting for a receipt from the receptionist when the doctor called my name. It was 2:21.
“One moment,” I said. “I just need to finish paying.”
“In Finland, it’s very important to be on time,” he replied.
“Yes, I understand,” I said. “I’m sorry.”
“We keep very tight schedules and have many, many patients.”
I nodded as he went on to explain, in great detail, how schedules work. It seemed an excessive lecture to give considering I was only 60 seconds late and through no real fault of my own, aside from not carrying around €120 in cash. I didn’t say any of that though, because I know better than to get snippy just seconds before admitting to a skin fungus.
“So next time,” he concluded. “Please be on time. Otherwise we will give the appointment to a walk-in.”
“I will,” I said. “I actually am a walk-in. But they asked me to pay cash, so I needed to use the ATM.”
“Oh!” he laughed. “Why didn’t you say so? I thought you were late!”
I couldn’t care less what he thought about anything other than my splotchy skin. After a quick look, he agreed it was tinea versicolor, the same thing I had years ago.
“I’m 99 percent sure,” he said. “You’re American? So they gave you tablets last time?”
“Those are very strong,” he said. “I’ll write you a prescription for that, but I’m also going to write one for a shampoo that you can try first. It’s better because it won’t wipe out all the good yeast in your body. If the shampoo doesn’t work in two weeks, then take the tablets.”
He handed me two prescriptions and a bill for €79, which included the doctor’s time and a €20 processing fee. When I went back to the front desk, they refunded me the difference from my deposit (€40) and then sent me next door to the pharmacy.
By this time, it was 2:41 and I was waiting for the catch. Just how, exactly, can I make an appointment, hold the appointment and pay for the appointment in 35 minutes? How does seeing a doctor at a private clinic cost less than €60? How, without a Finnish phone number and address, are they going to mistakenly send me a bill for $3000 two months from now when the billing department comes to the unlikely conclusion that I also had a colonoscopy during my visit? What am I supposed to do with all that excess mental energy I would have spent waiting for an appointment, arguing over my statement of benefits and begging the doctor to not jump right to an antibiotic?
Is this how things work in Europe? You go to the doctor and then just focus on getting well?
I walked to the pharmacy next door and handed the woman my prescription for shampoo.
“Do you have insurance?” she asked.
I smiled knowingly. Here’s the catch, I thought. This shampoo is probably 60 Euros a drop.
“I have travel insurance and an American health plan,” I said. “I don’t think either will cover it, so I probably just have to pay out of pocket.”
“I see,” the woman said. “Well I only ask because we sell this shampoo over the counter and it’s a few Euros cheaper than the prescription.”
“Well let’s do that!” I said.
“But if you have insurance here, most of the time the prescription is free to fill,” she said. “But for you, it’s better to buy over the counter.”
She walked me across the store and handed me what looked like a year’s worth of dish soap. The instructions were in Finnish, so she translated them for me and reviewed what my doctor wrote on the prescription. I held my breath as she began ringing up the medication.
It was €21 Euros. Which is less than my co-pay would be in the States – even if I used the generic.
When Ice Bath came home from work, I couldn’t wait to tell him about my exciting day. I got only as far as the deposit when he interrupted.
“120?!” he said. “I’m sorry.”
“Well wait,” I explained. “I got a lot of it back. The visit was only 80.”
I understood that the Finnish healthcare system works a little differently than I’m used to, but I still thought that a doctors visit and a prescription for €100 was a pretty amazing deal. But Ice Bath was not impressed.
“Why?” I asked. “How much would it cost for you?”
“Well that’s a private clinic you went to,” he said. “So I’d still have to pay something if I went there. I don’t know how much. I always use the public service because it’s free.”
I nodded. “Free-free?”
“Free,” he confirmed.
“You mean, when you broke your jaw a few years ago, that didn’t cost you anything?” I asked.
“Nope,” he replied. “Free-free.”
And look, I get it. The United States is a much bigger country than Finland. We can’t realistically provide the same level of social services and support that some countries in Europe do. It’s fiscally impossible.
But still. We can do better. And I say that with certainty because I, as a foreigner, should not be able to walk into a private facility in Europe, get treated the same day, pay out of pocket and still walk away with more money in my wallet than if I had used my corporate insurance plan in my home country.
Make no mistake, this isn’t my left-leaning self making a thinly-veiled political statement. Regardless of where you fall on the debate about healthcare health insurance, everyone should be able to agree on this much: our system shouldn’t make an outrageous profit off people being sick.