This Sunday in Spain I am going to be watching the health care vote in the United States. Whether it passes--and whatever it may be that eventually squeaks through--it will still be years, or decades, before the U.S. has overall health care as good as that in Spain.
The key word, of course, is "overall." The U.S. has excellent health care for those who can pay. It's just that fewer and fewer individuals and companies can afford to pay exorbitant rates for health insurance and procedures. In Spain, if you are a legal resident, you can get pretty good health care for free, and if you want to pay, you can get health care equal to the best in the world. Spain has a public healthcare system that is administered through its 26 autonomous regions. That's why, when we moved from Roquetas de Mar in Andalucía to Alicante in the Valencia region, we had to get new health cards. Spain also has a thriving industry of private healthcare providers. I have used both public and private services during the years I have been in Spain.
This week I was approved in the public system for a cataract operation. Yes, I have to wait. There are three boxes on my authorization form: my condition is not Urgent, nor is it Preferred. It's just Ordinary. Within three months, the ophthalmologist at my regional Centro de Especialidades told me, I will get a phone call from the Vega Baja hospital. Then I will go in to talk with the specialists there, and it may take up to a month after that before the operation can take place. Well, I don't mind waiting, since with my particular eye history and my complicated schedule, I'm not quite ready to look this laser in the eye just yet. But it is amazing to me, as an American who has experienced several private insurance plans over the years, been in a few HMOs, and paid a lot for private individual insurance, to think that I might have this surgical procedure without producing money or processing paperwork. All I have to do is show my card.
All my previous eye care in Spain has been through private providers, because it occurred before I became a legal resident and obtained my health card. It was excellent, with the most up-to-date equipment and knowledgeable personnel. Because I had experienced the same procedures in the U.S., I can say that the Spanish care was equal to that in the U.S. The costs, though considerable, were significantly less--about half.
I have also used private care for a couple minor walk-in problems--a bad back spasm, a mysterious skin rash--and paid prices that I believe are comparable to what I would pay in the U.S. as a non-insured patient. When I severely twisted my ankle on a Saturday night just before getting ready to leave for Argentina on Monday, however, I went to the public clinic, because it was open on Sunday, and they sent me on to the public hospital for X-rays, binding up, and prescriptions for crutches, a painkiller, and injections to avoid complications during air travel. Since I did not at that time have my health card, I got a bill for that service a few weeks later, payable to the teller at the corner bank--a total of something like 117 euros and some cents, obviously the amount that some accountant has figured that particular event costs the system.
I do have some complaints about health care in Spain. Over-the-counter medications are expensive, so my suitcase on returning from the U.S. is always packed with the Meijer or Target equivalent of aspirin, vitamin and mineral supplements, and Ocuvite (which I can get here, but at more than twice the price). Medications prescribed by a private practice are also expensive, but the same compound prescribed through the public system is free. Dental care is not a part of the public system, so there is lots of competition among lots of dental practices.
Spaniards can buy medical insurance if they want to use the services of private practices, and judging from the number of Spaniards I have seen in the waiting rooms of the private clinics I have been in, they do. Private practices are also heavily used by foreigners who do not have access to the health card or who prefer medical staff who speak their own language, or at least English.
Public and private health care seems to work quite well in Spain, providing several options for the diverse population. I expect to continue to be a consumer of both. I wish the options were as good for people in the United States.
Sunday, March 21, 2010
Sunday, March 14, 2010
Cuaresma
We are deep into Cuaresma, Lent. You can tell by the rows upon rows of cod in the grocery stores: frozen, fresh, dried, all cut (or not) in several different shapes. You would also know it because the headlines in both the Spanish and foreign press are filled with plans for the Semana Santa (Holy Week) parades, and the advertisements are all about travel and hotel packages for four days or more during the week-long vacation period.
A few years ago I bought a small paperback cookbook at the cathedral in Seville with meatless recipes for Cuaresma. It was one of those old cookbooks that was basically a written recording of oral tradition. Directions were general and did not include measurements or detail--it served better for reading than for cooking. I don't think I ever made anything from it, and last year I managed to throw it away when it got stuck between several newspapers that went to the recycling bin.
This year I found an article with traditional recipes in Activa Orihuela, a monthly free paper I picked up at the ayuntamiento (town hall) in Algorfa, and decided to do a Spanish Cuaresma recipe for two other couples who were coming to dinner on Wednesday. I hadn't met one of the couples before, so I wasn't sure about making fish as a main course, but the other popular Lenten ingredient is garbanzo beans. There was a recipe for potaje de garbanzos that sounded good as a first course. This recipe said that it served four and yet called for a half kilo (one pound) of garbanzos (chickpeas). And it meant dried garbanzos, because it said to put them to soak overnight. I thought that was an awful lot of garbanzos for four people, but since I'm rather compulsive about following recipes carefully the first time I use them and even more compulsive about making sure I have more than enough to serve guests, and because I love garbanzos and wanted some leftovers for another evening meal or a couple lunches later in the week, I doubled the recipe.
It's now Sunday and we are still eating potaje de garbanzos. It served six people nicely on Wednesday, though I had to transfer it to a larger pot than I had originally intended to use for the soup. It was good again on Thursday for lunch. Friday evening supper was two big bowls of potaje, accompanied by paté sandwiches. We took Saturday off, but for a quick and late lunch today after our bicycle ride, I added some chunks of lomo de cerdo ahumado (smoked pork loin) to the potaje and heated it in the microwave. Talk about recycling Cuaresma recipes! There is one more main meal, or two lunches, of the potaje de garbanzos still to go, which I am sure that one person in the household is not thrilled to learn.
But I do like garbanzos.
Potaje de Garbanzos (Chickpea Soup)
1 pound chickpeas, dried
10 oz. package of frozen chopped spinach, thawed
2 large carrots
2 onions
3 garlic cloves (or more if you like)
1 tomato, chopped
Olive oil
1 bay leaf
Parsley
Salt
Pepper
Put the chickpeas in a large soup pot, cover with water, add salt, and let them soak overnight. The next day bring the chickpeas to a boil and then add a dash of olive oil, the carrots in large chunks, one onion, a bay leaf, 2 cloves of garlic (minced), and a little parsley. Cook until the chickpeas are soft (1-3 hours). Remove the carrot and onion from the pot, together with about a cup of chickpeas and a cup of broth, puré the mixture in a blender, and return to the pot. Add the spinach and simmer until hot. In a frying pan, sauté the second onion, chopped finely, one clove of garlic, minced, and the tomato in olive oil. Salt and pepper to taste. Serve the potaje in individual soup bowls with a spoonful of the onion/garlic/tomato garnish on top. Serves 6-8 as an appetizer. (This is the original recipe, translated, not the doubled version).
A few years ago I bought a small paperback cookbook at the cathedral in Seville with meatless recipes for Cuaresma. It was one of those old cookbooks that was basically a written recording of oral tradition. Directions were general and did not include measurements or detail--it served better for reading than for cooking. I don't think I ever made anything from it, and last year I managed to throw it away when it got stuck between several newspapers that went to the recycling bin.
This year I found an article with traditional recipes in Activa Orihuela, a monthly free paper I picked up at the ayuntamiento (town hall) in Algorfa, and decided to do a Spanish Cuaresma recipe for two other couples who were coming to dinner on Wednesday. I hadn't met one of the couples before, so I wasn't sure about making fish as a main course, but the other popular Lenten ingredient is garbanzo beans. There was a recipe for potaje de garbanzos that sounded good as a first course. This recipe said that it served four and yet called for a half kilo (one pound) of garbanzos (chickpeas). And it meant dried garbanzos, because it said to put them to soak overnight. I thought that was an awful lot of garbanzos for four people, but since I'm rather compulsive about following recipes carefully the first time I use them and even more compulsive about making sure I have more than enough to serve guests, and because I love garbanzos and wanted some leftovers for another evening meal or a couple lunches later in the week, I doubled the recipe.
It's now Sunday and we are still eating potaje de garbanzos. It served six people nicely on Wednesday, though I had to transfer it to a larger pot than I had originally intended to use for the soup. It was good again on Thursday for lunch. Friday evening supper was two big bowls of potaje, accompanied by paté sandwiches. We took Saturday off, but for a quick and late lunch today after our bicycle ride, I added some chunks of lomo de cerdo ahumado (smoked pork loin) to the potaje and heated it in the microwave. Talk about recycling Cuaresma recipes! There is one more main meal, or two lunches, of the potaje de garbanzos still to go, which I am sure that one person in the household is not thrilled to learn.
But I do like garbanzos.
Potaje de Garbanzos (Chickpea Soup)
1 pound chickpeas, dried
10 oz. package of frozen chopped spinach, thawed
2 large carrots
2 onions
3 garlic cloves (or more if you like)
1 tomato, chopped
Olive oil
1 bay leaf
Parsley
Salt
Pepper
Put the chickpeas in a large soup pot, cover with water, add salt, and let them soak overnight. The next day bring the chickpeas to a boil and then add a dash of olive oil, the carrots in large chunks, one onion, a bay leaf, 2 cloves of garlic (minced), and a little parsley. Cook until the chickpeas are soft (1-3 hours). Remove the carrot and onion from the pot, together with about a cup of chickpeas and a cup of broth, puré the mixture in a blender, and return to the pot. Add the spinach and simmer until hot. In a frying pan, sauté the second onion, chopped finely, one clove of garlic, minced, and the tomato in olive oil. Salt and pepper to taste. Serve the potaje in individual soup bowls with a spoonful of the onion/garlic/tomato garnish on top. Serves 6-8 as an appetizer. (This is the original recipe, translated, not the doubled version).
Monday, March 1, 2010
Speaking of Spanish
Speaking of Spanish, as I was immediately prior to this post, there was an interesting article in yesterday's Babelia section of El País titled something like "The Economic Strength of a Rounded Language." The "rounded language" is Spanish; the allusion is credited to former Colombian president Belisario Betancur, who said that when the Spanish discovered America and proved that the earth was round, Spanish began to become a rounded language.
Spanish is spoken by 440 million people in the world. It is the official language of 21 countries and is accepted as a strong second language in the United States and in Brazil.
An ingenious graphic accompanying the article in print, but alas, not in the online version, shows circles representing countries in which Spanish is spoken, sized proportionally to the number of Spanish speakers. The largest circle is for Mexico, but curiously the number of Spanish speakers is missing from this one country. The next largest circle is for Colombia (41,129,000), which is larger than Argentina (36,060,000) and Spain (40,026,000). The United States shows 36,305,000, which is far closer to the number of those in Spain than I ever would have guessed.
The article is part of a special section in the cultural magazine celebrating the 5th international congress of the Spanish language (V Congreso Internacional de la Lengua Española) that was scheduled to take place in Valparaiso, Chile from March 2-5, 2010. Chile, before the earthquake, was listed at 15,015,000 Spanish speakers. Babelia is "moving the cancelled congress to the Internet" with a special publishing program during the coming week under the title "Lost Papers."
Spanish is spoken by 440 million people in the world. It is the official language of 21 countries and is accepted as a strong second language in the United States and in Brazil.
An ingenious graphic accompanying the article in print, but alas, not in the online version, shows circles representing countries in which Spanish is spoken, sized proportionally to the number of Spanish speakers. The largest circle is for Mexico, but curiously the number of Spanish speakers is missing from this one country. The next largest circle is for Colombia (41,129,000), which is larger than Argentina (36,060,000) and Spain (40,026,000). The United States shows 36,305,000, which is far closer to the number of those in Spain than I ever would have guessed.
The article is part of a special section in the cultural magazine celebrating the 5th international congress of the Spanish language (V Congreso Internacional de la Lengua Española) that was scheduled to take place in Valparaiso, Chile from March 2-5, 2010. Chile, before the earthquake, was listed at 15,015,000 Spanish speakers. Babelia is "moving the cancelled congress to the Internet" with a special publishing program during the coming week under the title "Lost Papers."
Sunday, February 28, 2010
¡Vive en España!
"¡Vive en España!" That's what the Spanish man in the waiting room at the local health clinic said incredulously to the woman with whom he was chatting across the aisle, as an English man disappeared through the door into the doctor's office. And he sighed. And the meaning was clear: "This man lives in Spain. Why can't he speak Spanish?"
The English man had asked us, as he rose to take his turn when Johannes and I came out of the doctor's office, "How do you say "It's getting better" in Spanish?" And Johannes, ever helpful and a near-native speaker of Spanish, volunteered to go into the office with him and help him say to the doctor that it--whatever it was--was getting better, and perhaps to facilitate the conversation a little more. After all, we had just come out of that same doctor's office, and we knew he spoke no English, that he spoke Spanish very quickly and not clearly, and that he was difficult to understand even if you were a near-native speaker.
I sighed when I heard "¡Vive en España!" because it was said in exactly the same tone and with the same disapproval that I have heard too many Americans express when talking about Hispanics and other immigrants in the U.S. "But they live in the U.S....!" and presumably should be able to speak English on demand.
I sighed because I always suspected, and because I now know from experience, that it is one thing to be able to speak Spanish, or any foreign language, and another thing entirely to be able to speak it well enough to feel competent when the subject matter is technical or the situation is stressful.
I sighed because I know that I, despite many years of studying and practicing Spanish in the past, and many more scheduled for the future, know in my bones that there will most likely be times ahead when I will not feel comfortable or competent--in the medical emergencies, legal proceedings, and other dependent situations that must be faced as we get older.
And I sighed because I wanted to be able to explain to the Spanish man and his conversation partner that most of us foreigners know that we should try harder in Spanish, and some of us do try harder than others, but that proficiency and fluidity in a foreign language do not necessarily come with a certain degree of effort or after a certain number of years--and definitely not when one moves to a new country at the age of 60 or more--and that speaking to a doctor can be one of those emotional circumstances that just seem to make you forget whatever it is that you have learned....and that all of this is no excuse.
But this matter of hearing, for the first time, two local Spanish residents give vent to some impatience and frustration with the large number of European immigrants that Spain by and large has welcomed to its Mediterranean coast for decades, made me a little surprised and emotional. And I did not trust myself to be able to embark on a complicated conversation about language in a language in which I am not fluent. So I did not take upon my shoulders the burden of defending immigrants with insufficient language skills. I buried my head in my book and continued reading in Spanish until the man and his translator emerged from the doctor's office.
The English man had asked us, as he rose to take his turn when Johannes and I came out of the doctor's office, "How do you say "It's getting better" in Spanish?" And Johannes, ever helpful and a near-native speaker of Spanish, volunteered to go into the office with him and help him say to the doctor that it--whatever it was--was getting better, and perhaps to facilitate the conversation a little more. After all, we had just come out of that same doctor's office, and we knew he spoke no English, that he spoke Spanish very quickly and not clearly, and that he was difficult to understand even if you were a near-native speaker.
I sighed when I heard "¡Vive en España!" because it was said in exactly the same tone and with the same disapproval that I have heard too many Americans express when talking about Hispanics and other immigrants in the U.S. "But they live in the U.S....!" and presumably should be able to speak English on demand.
I sighed because I always suspected, and because I now know from experience, that it is one thing to be able to speak Spanish, or any foreign language, and another thing entirely to be able to speak it well enough to feel competent when the subject matter is technical or the situation is stressful.
I sighed because I know that I, despite many years of studying and practicing Spanish in the past, and many more scheduled for the future, know in my bones that there will most likely be times ahead when I will not feel comfortable or competent--in the medical emergencies, legal proceedings, and other dependent situations that must be faced as we get older.
And I sighed because I wanted to be able to explain to the Spanish man and his conversation partner that most of us foreigners know that we should try harder in Spanish, and some of us do try harder than others, but that proficiency and fluidity in a foreign language do not necessarily come with a certain degree of effort or after a certain number of years--and definitely not when one moves to a new country at the age of 60 or more--and that speaking to a doctor can be one of those emotional circumstances that just seem to make you forget whatever it is that you have learned....and that all of this is no excuse.
But this matter of hearing, for the first time, two local Spanish residents give vent to some impatience and frustration with the large number of European immigrants that Spain by and large has welcomed to its Mediterranean coast for decades, made me a little surprised and emotional. And I did not trust myself to be able to embark on a complicated conversation about language in a language in which I am not fluent. So I did not take upon my shoulders the burden of defending immigrants with insufficient language skills. I buried my head in my book and continued reading in Spanish until the man and his translator emerged from the doctor's office.
Sunday, February 21, 2010
Microsoft Research Center in Torrevieja
For two weeks, the free foreign newspapers in the southern part of Valencia Community have been buzzing with the news that Microsoft was considering establishing a health research center in Torrevieja. Details in most of these papers are usually sorely lacking, and this time has been no exception. Since most of these newspapers are weeklies, it's been hard getting a straight and up-to-date story. Not only was Torrevieja in the running for the Microsoft center, but also the larger cities of Alicante itself (the provincial capital) and Valencia (the Community capital). But the latest round of the free press seems to be saying that the new and very modern Torrevieja hospital has won out over the the capital cities.
Now the national paper, El País, is lending credence to Torrevieja's win. Yesterday's newspaper carried a story saying that Bill Gates had received Community president Francisco Camps at Microsoft headquarters "in the American state of Washington" (which was more likely than some of the reports that said the meeting had occurred in Washington, DC). But El País still reports that Camps had gone to lobby for the Valencian Community--specifically one of the capital cities. Apparently it is Microsoft that prefers Torrevieja, based on a successful installation of Microsoft's "Florence" medical system software that has helped reduce the average waiting time for emergency intakes by 50%--from an hour to a half hour--over the past year.
It's not clear to me that the Microsoft research center is going to do anything more than research even further improvements in software development. The 300 square meter facility is supposed to employ ten people and cost the Community, Telefónica, and CAM bank 800,000 euros over two years. But the story is getting a lot of play locally, as just the latest in the accolades accorded to the very modern and efficient Torrevieja hospital since its establishment in 2006. So far I've only driven past the huge campus less than half an hour from my home, but I suspect that at some point in the future I'll have need of its services. So it's nice to know that the computer systems will be up to date.
Now the national paper, El País, is lending credence to Torrevieja's win. Yesterday's newspaper carried a story saying that Bill Gates had received Community president Francisco Camps at Microsoft headquarters "in the American state of Washington" (which was more likely than some of the reports that said the meeting had occurred in Washington, DC). But El País still reports that Camps had gone to lobby for the Valencian Community--specifically one of the capital cities. Apparently it is Microsoft that prefers Torrevieja, based on a successful installation of Microsoft's "Florence" medical system software that has helped reduce the average waiting time for emergency intakes by 50%--from an hour to a half hour--over the past year.
It's not clear to me that the Microsoft research center is going to do anything more than research even further improvements in software development. The 300 square meter facility is supposed to employ ten people and cost the Community, Telefónica, and CAM bank 800,000 euros over two years. But the story is getting a lot of play locally, as just the latest in the accolades accorded to the very modern and efficient Torrevieja hospital since its establishment in 2006. So far I've only driven past the huge campus less than half an hour from my home, but I suspect that at some point in the future I'll have need of its services. So it's nice to know that the computer systems will be up to date.
Sunday, February 14, 2010
新年快乐 The Year of the Tiger
Tired and very hungry after putting the finishing touches on Johannes' upcoming art exhibition at Procomobel, and then shopping for glasses and paper goods for the opening reception, we just had to have some lunch at 2:00 yesterday afternoon. So we fell into the Chinese restaurant next to our closest shopping center for a quick meal. It was only the second time that we have eaten Chinese in Spain. The first time was about a year ago, when our rental house suddenly lost power late one winter afternoon, and it was freezing and dark both inside and out. We walked across the street to the only restaurant that had lights, where we were surprised to be able to order Peking duck, a dish that normally requires 24 hours notice in the U.S. It was excellent, and we took enough home with us for a second--or was it a third--meal later on in the week.
Yesterday we found that the specialty was a buffet, but we didn't want to gorge ourselves, so we ordered from the menu. No Peking duck this time. Chinese-Spanish food is different from Chinese-American. We had a choice of spring rolls (five small ones) and sweet-sour soup for starters, and then a choice of curried chicken or spicy chicken with white rice, fried rice, or French fries. Yes, French fries are a standard accompaniment to a main dish in Spain, or, as chips, for the numerous English living here. Beverage was included in the price of the meal. No tea. Again we had the typical Spanish option: a glass of red wine or bottled water, in our case, one of each. My chicken was delightfully spicy, but the rice was simply white rice pilaf--no frying evident. In fact, there was a marked absence of soy sauce--nothing noticeable in the sauces of either dish, and nothing on the table. Dessert was another typically Spanish choice: ice cream or flan. When my tiny portion of ice cream came, it was in a little individual plastic container just as I might have bought it at a seaside refreshment stand or in quantity at the supermarket. When it was time to pay the 11 euros for our two lunches, we did not get any tidbits of pineapple or fortune cookies, as one often gets in Chinese-American restaurants. Instead we were urged to try the complimentary fruit liqueur, a non-alcoholic variety that is often offered after a filling meal in Spain. The peach was lovely and the apple was also.
It seemed like a fitting way to celebrate Chinese New Year's, and our English and Chinese speaking server obligingly told us how to say Happy New Year in Chinese before we left: xīn nián kuài lè. And I did remember how to say it until I got home. But I had to look up how to spell it.
Sunday, February 7, 2010
Settling In
I was home again to our house in Montebello by Tuesday noon this week. The clear and sunny sky that greeted me at the Alicante airport disappeared soon, and we had two gloomy and cold days, and I missed the central heat of houses in the U.S. But on Friday morning the sun came out and warmed the rooftop terrace to above 70 degrees, so I did some laundry and hung it out to dry. When I came home from our pétanque game and a wine-tasting preview that evening, I started another load of clothes in the washer so I could be the first person within view of my rooftop to hang clothes out on Saturday morning. It proved worthwhile--Saturday was as beautiful and warm as Friday had been, and I did two more loads of laundry.
This Sunday morning I opened the bathroom window to enjoy the view and listen to the birds as I prepared for the day. We walked by the orange grove--oranges still on the trees, and brighter orange than a month ago--to our own pétanque playing field in Montebello, and I won two games out of two. Then we went to the outdoor Sunday market (Zoco), which was very crowded today with people out enjoying the sunny weather. Strawberries are coming into season and every produce stall had them, but I'll wait for a week or two until the price comes down and they look a little more ripe, and in the meantime be content with the sweet and juicy mandarins that smell like spring as soon as I thumb one open for our fruit salad at lunchtime. I was comfortable in sandals without socks and just a thin undershirt and linen open-necked blouse--maybe I can put away the turtlenecks and heavy socks I brought back from Ohio with me.
We sat in our sunroom for soup, fruit salad, and two big rundstykker rolls from the Danish baker at the market. Goldie rolled around on the tile floor catching sun rays, and we enjoyed the view of our trumpet plant that is once again blooming, now for the third time since last May. And tried to fathom that people are digging out from 28 inches of snow or more on the mid-Atlantic coast.
This Sunday morning I opened the bathroom window to enjoy the view and listen to the birds as I prepared for the day. We walked by the orange grove--oranges still on the trees, and brighter orange than a month ago--to our own pétanque playing field in Montebello, and I won two games out of two. Then we went to the outdoor Sunday market (Zoco), which was very crowded today with people out enjoying the sunny weather. Strawberries are coming into season and every produce stall had them, but I'll wait for a week or two until the price comes down and they look a little more ripe, and in the meantime be content with the sweet and juicy mandarins that smell like spring as soon as I thumb one open for our fruit salad at lunchtime. I was comfortable in sandals without socks and just a thin undershirt and linen open-necked blouse--maybe I can put away the turtlenecks and heavy socks I brought back from Ohio with me.
We sat in our sunroom for soup, fruit salad, and two big rundstykker rolls from the Danish baker at the market. Goldie rolled around on the tile floor catching sun rays, and we enjoyed the view of our trumpet plant that is once again blooming, now for the third time since last May. And tried to fathom that people are digging out from 28 inches of snow or more on the mid-Atlantic coast.
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