Private Health Care

When we first moved to Spain, we had very little experience of the lifestyle and that included provision for healthcare. As we were both reasonably healthy and because our knowledge of the language was still limited, we were somewhat scared of approaching social security offices and medical centres to gain more information, putting it off for another day.

However, with the rise in older men developing problems with their prostrate and my awareness of prostrate cancer, I decided I needed to see a doctor for a check up. Not being eligible for the Spanish health service at the time meant I had to go private. I had this dreaded feeling that this is going to cost a fortune. Not necessarily so.

The couple that we rented our villa from in Mojacar recommended an English speaking lady doctor in Garrucha and we found to our surprise her fee was only 40 euros per consultation. On my first visit, all my details were entered into the computer and then a comprehensive examination was done including arrangements for a blood test.

Everything was extremely thorough and the staff was very helpful wanting to get a full picture of my current state of health. I was given a letter indicating what blood tests were needed and directions to a nearby blood analysis clinic. At the clinic I was seen straight away and the necessary blood sample was taken. What was most impressive was that I was called back the very same day for my results. Back in England I would have had to have waited ten days. Even better, when I phoned the doctor an appointment was made for the next day.

The blood test results came to a cost of 80 euros, but they had tested for virtually everything. At my second consultation I was told that I would need to see a specialist in Almeria and an appointment was made for 3 days time, again very impressive and quick.

At this point I felt somewhat amazed that in less than 24 hours, I had seen a doctor, been examined, had a comprehensive blood test, seen the doctor again been reassured that I have nothing major wrong with me and an appointment made to see a specialist in a couple of days all for 120 euros. Fantastic.

When I saw the specialist in Almeria, Dr Francisco Gomez Berjon, he was most charming, spoke perfect English and was completely at ease with me. Once again I was given a thorough examination and a course of medication prescribed, a further appointment was made for six months, and his fee, only 80 euros. I now see Dr Francisco twice a year for a

If you have ever visited Spain you will know that pavements either do not exist, which means you walk in the road, or are uneven and have a kerb that is about 18 inches high (how disabled people in wheelchairs get by I do not know). You will also notice that the local Spaniards always walk in the road, apparently fearless of being hit by a passing vehicle. They obviously would rather face the car than risk walking on the pavement.

Anyway, to begin our story, one Sunday morning, my wife was on her way back from the newsagent, when she tripped and fell off the pavement. Ouch! We later found out she had broken her little finger and fractured her wrist.

At the time we had just started our estate agency business and as such we had to make social security contributions which meant we qualified for free medical care. If you do not have private health insurance, you should join the Social Security system.

Once you take any job in Spain your employer is obliged to process all the paperwork for you, pay part of your contributions and deduct the other part from your salary. If you are self-employed you will have to go to the local Social Security office and fill in all the paper-work yourself. Unless your knowledge of the local language is very good, then it is probably advisable to get a gestor,official agent - a bit like a lawyer for menial bureaucracy to do this for you. Beware of using a British accountant who does not speak Spanish fluently - you may find that you have not been registered correctly.

We needed to find a hospital quickly but not ever needing emergency medical treatment in Spain we had not a clue where the nearest hospital was. We found a place near the beach with a red cross painted on the outside of the building but were then advised they only take private fee paying patients. Fortunately, they directed us to a health centre on the other side of town.

As opposed to my wonderful private health care experience with English speaking staff, at this health centre, the receptionist only spoke Spanish and we had some trouble understanding each other. Fortunately for us, a doctor was passing by and kindly offered assistance. However, to our dismay we were told we had come to the wrong hospital. In fact, you are supposed to attend the hospital that is registered for the district where you live. We were then given more directions and this time found the right health centre.

We were seen straight away, only to be told that the diagnosis of a suspected broken finger needed an X-ray, but that the centre did not have an X-ray facility and we were told to go to the main general hospital in Lorca, which was 35 km away. All this time my wife behaved remarkably well even though the pain was excruciating.

As with most things in Spain everything is located in the town centre and parking was difficult. We walked to the A E department and just like in England it was very busy. After explaining our problem to the reception desk, we filled in a form, and proceeded to wait. Of course, we assumed we were going to be here for hours. Actually things were very fast and after a very short wait, Carol was examined and whisked off to X-ray. After the x-ray, we waited only another ten minutes before a doctor confirmed the broken finger and fractured wrist. Carol received the necessary treatment and an appointment was made to visit the hospital in another seven days.

In all fairness if we had been better prepared it would not have turned into such a drama. The lesson to be learnt from this experience was that accidents do happen and you do need to be prepared. When you arrive at your final destination, register immediately with your local health centre, find the location of your local hospital, drive there and have a look around.

Also, make a note of useful telephone numbers that you are likely to need in case of emergency and keep them close by a telephone. You never know when you may need them.

We have put together a list of various forms and information that you may find helpful.

Form E121

If you are a pensioner from the UK, 65 for men, 60 for women, and intend to live in Spain permanently then you can get free medical care and medications under a reciprocal agreement between EU governments; you should obtain form E121 from the DSS in the UK prior to your departure. You may need a separate form for each member of your family.

This form should be handed in to the Seguridad Social (Social Security) in Spain. It provides permanent health cover and does not need to be renewed. You will receive a temporary health card and eventually you will receive a insurance sample cancellation letter giving the name of the medical centre you are to visit in case of illness and a permanent card. Until the form has been registered at the social security office you are not covered for healthcare. Private health clinics will not accept this form as payment.

Form E106

The E106 is for people who have moved permanently to Spain but have not reached pensionable age, its period of effectiveness depends on the state of your past National Insurance contributions record. The period of medical cover commences from the date you leave the UK. You must however apply and receive your E106 entitlement form before leaving the UK to ensure you are covered and to know what that cover entitles you to.

Form E111 (EHIC)

The best solution for someone wanting to stay in Spain for a short period of time without becoming a resident is the form E111, now replaced by the EHIC (European Health Insurance Card), this card is issued by the National health Service in the UK, and you should carry it with you together with your passport at all times, in case of an emergency. This card is only to be used in cases of emergency and is not for the treatment of chronic illnesses.

Private Health Service

If you are not covered by the Spanish social security, then it is imperative that you have private medical insurance. If you have private health insurance in the UK, then find out from the insurance company if they will pay your medical bills in Spain. There are a large number of private Spanish or English companies offering health insurance. The policies offered generally differ considerably in the extent of cover, limitations and restrictions, premiums, and choice of doctors, specialists and hospitals.

Health care points to remember when moving to Spain

Make sure you know where your nearest hospital is located.

You need to go to the hospital registered in your district.

If you are working in Spain then make sure you make social security payments in order to qualify for the Spanish National Health Service.

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If you've paid any attention at all to the emergence of all the new opportunities that are presented by the expansion of the Internet in general and the World Wide Web specifically, you probably don't want to be left out of any of it. However, in order to fully take advantage of all the opportunities and riches of the Internet, you need a high speed Internet connection. That said, the prospect of figuring out what kind of Internet connection to get and which company to get it from can be problematic to say the least. This is even more true if you aren't gifted with an aptitude to understand technology. Fortunately, there are only a few types of high speed Internet that you need to sort through and which company you get your Internet access from is largely dependent on which type of Internet access you get.

For instance, broadband cable high speed Internet technology is a good choice in many ways and it's available through digital cable TV companies like Comcast. Broadband cable high speed Internet has numerous advantages. For example, with download speeds of up to eight megabytes per second, it's the fastest type of Internet access that you can get in your own home. (T1 lines are faster, but they're reserved for big businesses, academic institutions, and governments.) Broadband cable is also extremely stable and reliable, and since it doesn't rely on phone lines to transmit information it presents the unique option of allowing you to divorce the phone company entirely and using a VoIP service for your telephone needs instead.

DSL is probably the most widely used technology for accessing the Internet. It uses conventional phone lines to transmit data, and for that reason DSL is most often provided through traditional phone companies. The speed of a DSL connection depends on the quality of the phone line and the distance of the user from a central node. Even at its best, DSL can only attain download speeds that are about a sixth of what broadband cable connection can attain. Because of the need for a working phone line, DSL obviously won't allow you to sever your connection with the phone company entirely.

Satellite Internet technology is another form of high speed Internet technology and perhaps the most widely available one in the geographical sense, but it's plagued with a variety of drawbacks that make it extremely unattractive for most people. The first drawback is that it's extremely expensive, despite the fact that it's only a little bit faster than DSL. The fact that with a satellite Internet connection all of the data has to travel to and from high orbiting satellites produces a lag in response time that makes it completely unsuitable for both VoIP applications and video gaming.

After examining all of these options, it becomes clear that broadband cable high speed Internet technology is the ideal choice for accessing the Internet.

Hopefully this article has given you a good idea of the relative merits of different types of Internet connection technology and help you find the best provider of that technology for your specific needs.

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The Brother forwarded me a surprisingly good Richard Rodriguez interview. Rodriguez, who's gay and Catholic and Latino, argues that church support for Prop 8 is really fueled by panic over the disintegration of the traditional family. As more women get out of the kitchen and into the workplace, the old notion of family fractures, the church loses its stronghold, and there has to be someone out there to scapegoat--might as well be gay people. It's an interesting argument, but more interesting--I think--is the underlying suggestion that Rodriguez never plays out. I've said this before to several of you: I think much of the hatred directed toward gays has little to do with sexuality and everything to do with gender.

Put simply, there's a lot of hatred for women. Men are supposed to be at the top of the food chain. But gay men are threatening because they're viewed as effeminate, as something less then the men they are expected to be. They veer dangerously close to those hipped and breasted second-class citizens that men keep around for sex and dinner parties. And gay women are threatening because they're viewed as masculine, as having usurped the roles of men. They let men know that someone else can fix the car and the toilet, buy a strap-on for the wife. As a rule, I think gays are perceived as threatening because they make the idea of men less necessary. Gays make it too painfully clear that a man's man is not the only one who can lead and defend a home, support a family, and carve out a place of power and influence in the world at large.

If you could extract gender from the gay/straight equation, what's really left to hate? I doubt it would have much to do with which pegs go in which holes; after all, most men boast about all the other holes they've put their pegs into. Plus, there's that favorite argument among homophobes that what lesbians do in the bedroom isn't real sex anyhow. (Because the best way to neutralize the threat to your manhood is to pretend that the threat doesn't even exist).

I don't think the gays have much of a chance for a modicum of the equality they deserve until we get more men and women to stop hating women. Until we legitimize what it means to be female. Until we expand the tired, suffocating notions of gender. So while we work on finding more successful angles to the Prop 8 appeal, how about also discussing why women continue to make less money in boardrooms and factories across the nation. Or why this nation continues to hold as allies other nations who legally sell acid to men who burn and torture their wives. Why a woman still cannot be elected president in 21st century America. Why a woman wearing a man's clothing, or a man wearing a woman's, is a thing to beat and spit on in the street. Why a pushy woman is called a bitch while a pushy man is called ambitious.

I'd love to hear your thoughts on this. Winter and I hashed around some of this weeks ago, but she's no easy convert. I'll be writing more on all of this later, especially where the trans world fits in to this problem. As you can probably tell, I am avoiding my immigration outlining and my banking law paper.

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