At a Glance
The main difference between the Czech hospital system and the US system, but somewhat similar to the UK and Australia, is that the system is a mix of state and private hospitals, though mostly state. Even if you do not have Czech health insurance, you will be treated at a hospital. Whether you pay up front or not, depends on whether your insurance company recognizes the hospital and is willing to provide a coverage letter. In emergency situations, a hospital will not turn you away – but your insurance company may not want to foot the bill. If you do have Czech insurance or a European Health Insurance Card, you will have to pay 60CZK per day in hospital. If you DO NOT have either of these you are exempt from the 60 CZK fee. Health insurers often will prefer that you be treated in a state hospital as it is cheaper. They may ask you to be treated at home if the procedure is not life saving, and they may refuse to cover certain procedures if you have a medical history with this problem. If you are insured from home, it’s best to check what they will cover while you are living or staying here.
When going into the hospital, you might wonder how Czech hospital care compares with the rest of the world. Quite well it seems from the point of view of statistical data. According to a recent article on Aktualně.cz, the Czech health care system is among the top five in Europe. The claim is based on a report by the European Health Consumer Index, which is published by the Health Consumer Powerhouse, a Swedish private health care analyst and information provider of European health services.
It should be pointed out that the report included two tables of results. The Czech Republic was ranked fifth after adjustments for per capita spending on health. In the ‘raw scores’, based on a survey of patient rights and information, e-Health, waiting time for treatment, outcomes, range and reach of services provided, and pharmaceuticals; the Czech Republic was 16th out of 31 nations. In other words, smack in the middle of the field. Of the categories evaluated, the Czech Republic faired well regarding waiting periods, having the seventh shortest waiting period on average.
One of the reasons for this is that the Czech Republic has quite a high number of beds and doctors per person. According to the OECD (Organization for Economic Co-operation and Development), there is an average of 8.7 beds per thousand people, placing it eighth out of the 29 surveyed countries. This is more than double the same study in the USA which has 3.6 beds per person. The number of doctors per thousand people is also a little higher at 3.6 versus 2.4 in the US (2005 figures). Regarding medical technology, the Czech Republic does not compare so well. Based on slightly older figures, the US has about six times as many MRI units and almost three times as many CT scans.
Up Close: FN Motol
Fakultní Nemocnice Motol, (University Hospital Motol) located in Prague 5, is a public hospital which treats both adult and children. It’s quite a large hospital with 2,410 beds (667 children, 1743 adults). It has departments for every branch of medicine except adult psychiatry and dentistry. According to its annual report, its pediatric departments, which have just been refurbished, is one of the largest in the world. It is also a major center for lung transplantation. The hospital was in the news recently as it was where former president Havel was treated.
It is also the place you will most likely go if you need hospital treatment and you don’t have Czech health insurance and/or you don’t trust your Czech language skills enough to be treated in another hospital, though I should point out that Czech doctors in both public and private hospitals have quite a good level of English. However, FN Motol has the added bonus of having a Foreigners’ Department, which is there to assist non-Czech speaking patients with their medical needs.
To get to Motol you can take trams 7, 9, 10, 58 and 59. The later two are late night trams. Get off at the tram stop “Motol”. Just up from the stop, across Plzenska street, is a bus stop also called “Motol”. You can take buses 174, 179, 180, 184, 347 and 510 and get off at the stop “Nemocnice Motol”. You can also take the 167 bus, which does not stop near the tram. There is a bus 13 for disabled patients or visitors. Once you enter the grounds, cross a pedestrian bridge and turn left. You will see signs saying Foreigner’s Reception. Follow these to the Foreigners’ Department.
I was fortunate enough to speak with a representative from the Foreigners’ Department, who clarified some of the ins and outs of treatment and stays at FN Motol. She stressed the importance of coming straight to the Foreigners’ Department, except in the case of emergencies. When you are there you will need some form of photo ID. According to this representative, a driver’s license, student card or even a photocopy of your passport would be acceptable. The Foreigners’ Department will then make the appointment for you. It’s not possible to just walk in off the street and see a specialist. They will also give you a consent form to sign regarding whether you are willing to allow student doctors to be present. It is not obligatory, but it could be a good idea because student doctors will probably speak English better than the nurses. Most importantly, the Foreigners’ Department will also check your insurance. This is where it gets a little complicated.
If you have a European Health Insurance Card (this is a card which shows you have national insurance in another EU state) or Czech insurance, you are fine. If, however, you are insured through a company at home, you need to obtain a coverage letter from your insurance company. The Motol representative said that the hospital has an agreement with the US insurer Cigna. In emergency situations this is the last thing on your mind, but if you are seeking treatment for a non-life-threatening condition, it might be a good idea to see if your company will cover you while you’re here, otherwise you will have to pay. The representative added that many people choose to pay upfront and then deal with the insurance company themselves later.
Of course this only applies if you are going for an ordinary procedure. In life-threatening or trauma cases, you will be taken straight to emergency. The former are taken to the emergency ward immediately. At this point, you might be wondering what happens when a friend or loved one is in a life-threatening situation? How do you communicate? In life threatening situations, a doctor will rendezvous with the ambulance at the scene, and doctors in the Czech Republic have a high level of English. Paramedics, who are high school graduates, will know something, as will the medical nurse (zdravotní sestra) in the emergency ward. The Foreigners’ Department will then contact people after the treatment. You will go directly to emergency in three instances. The first two are situations which are life-threatening, that is ER, and trauma, for breaks and burns. The final category of emergency is after hours treatment. This is between the times of 7pm and 7am. In the latter case, there is 90CZK charge for people who have Czech insurance or EHIC.
If you are treated as an in-patient, you will be in a ward room with the general patients. This means you can be with Czechs and/or non-Czechs depending on who is in the ward. The Foreigners’ Department does not have a separate ward for expats. Ward rooms sleep three people and have shared bathrooms. The level of English of the nurses will be lower than that of the doctors, though the ward nurse should have some basic English. The ward nurse, whom the representative introduced me to, was able to communicate in basic phrases and she certainly gave the impression of at least trying. In the case of communicative difficulties, the Foreigners’ Department will translate. Some rooms have TVs. You are permitted to do whatever you want so long as it does not disturb the other patients and follows hospital regulations.
Each ward does contain one private room, which can sleep one person, or two people on request. The rooms are quite spacious, well equipped with a fridge and TV. But there is a cost of 1000 CZK per night which is not covered by health insurance. Also, the additional cover of the private room only entitles the patient to privacy, not special treatment. As the representative was keen to point out, the hospital staff does their utmost to make people comfortable.