Healthcare: Portugal vs. the U.S.


  1. What scares me a lot about USA, is that capitalism machine is so heavy that any change on that is near impossible. This is very important to say, because one thing is to identify something is bad and get corrected, and another is to recognize that you can't do anything about it. This is how serious the problem is. Obama's care failed because it's near impossible to present something better for citizens
    discounting at an already high profitable market. The pharmaceutical and health care industry is already so deep in profit, they simply can't lose that! The only way is to bring external competitors to the table or create generic medicine. Start a new health public service just for the poorest, something really cheap, and slowly open it to all people. It's very different here in Europe because private health services have to compete with cheap social services, private sector has to adapt, not public sector. Health Care should be a fundamental right and not tied to a contract. And most of this applies also to weapon sector, but gets worse, it's not just trying to break profit on weapons, if you permit me, as I see, Americans are really really tied by law and ideal on self defense by centuries. A mental shift is necessary and that take ages, and otherwise the change has to be abrupt because no one wants to be the first without one. This is just my opinion, never lived outside Portugal. I've seen many health american TV series, I would say that profit and health are tightly connected, what I wouldn't expect is that quality could be even comparable to what we have here. Thank you for sharing, and sorry for my english. Beijinhosss!

  2. Can you make a video on how you learned Portuguese language before moving to Portugal. Im half Portuguese, my roots are the Azores, and wanting to visit Lisbon to research more genealogy. I want to learn some portuguese begore i come so any tips

  3. It goes without saying that USA healthcare is expensive. Take a few examples of how billionaires are making money from the USA healthcare industry, whether hospitals, private health insurance, drugs or doctor office administrative costs. The old Fitzsimmons Army hospital in Denver has been transformed by the billionaire, Phil Anschutz. The Grand Rapids MI downtown has been transformed into the medical mile by the DeVos and Van Andel billionaire families. The billionaire Sacklers of Purdue Pharma fame pushing the money machine of addictive OxyContin tablets. Just a few of the empathetic elite in the USA.

  4. In today's world America has not progressed socially. The government and in turn the people are very uneducated about social issues. The power of greed has permeated every day life. The creation of the economic myths of the 1950's still dominate media. This post WW2 era propaganda has not been replaced with more progressive thinking. Most high schools are no better than low level producers of semi literates. Thinks will not improve in the future. The world has moved on! Most politicians on both sides are quite ignorant.

  5. Why didn't the OBAMAcare pass ? America has got lots of money and all citizens should have the right to get decent medical assistance mostly provided by the state/government . I don't get it.

  6. Great video. Let me add some fuel to the fire. Long term health care costs in the U.S. are astronomical. All family assets have to be depleted before Medicaid kicks in, INCLUDING spouse's assets! Spouse gets left with house (with possible lien), 1 car, and $2,000. That's immoral!

  7. Thank you so so much for that example of the cost of healthcare in the U.S. I struggle all the time to explain this to my European friends. I always feel like I come across as hyperbolic but it's just so hard to explain how the system works when the truth itself is actually quite hard to believe and wrap your head around.

  8. Hi! I have a lifelong genetic disease called Cystic fibrosis. Here in Portugal I have almost all my medication free (it would cost me more than 1000€ per month if I had to pay for it). I also have my respiratory therapy equipment at home free. I have every 2 to 3 months specialist visit almost free (I pay the 7€ moderation fee). My hospitalizations are also free. I don't know how it works in USA, but believe it will much more expensive. Portuguese healthcare isn't perfect, but in this matter I am happy to be Portuguese. Cheers!

  9. Olá, sou português e gosto muito dos vossos vídeos, parabéns! 🙂 Now I'm going to write in English so that everyone can understand — You also have the "Cartão Europeu de Saúde" [European Heath Card] that will allow to have lots of benefits while travelling across Europe. Here goes the link — Enjoy Portugal and/e lots/muitos kisses/beijos and/e hugs/abraços!

  10. Hi guys thank you very much for your decision to come to Portugal. Portuguese people like me should listen to you and all the things you mention portuguese have and have for granted and barely give it credit for, like public health care and educacion that are affordable. About taxes we pay a huge amount to bailout banks, and nevasse of pior decions corrupt polititians made. And another thing, you are social democrats as the majority of Europe is. Defending public education and healthcare but also deffending capitalism where capitalism should exist. Thanks for the videos. Good fortune for all.

  11. Here's a tip: Those fees are often what we call "taxa moderadora", translated roughly to "moderation fee" so that people don't "over-use" the system. That said, there is a health call centre called "Saúde 24" (808 242424). If you call that number, a nurse will make a diagnose and if she thinks you really need to go to ER…you won't pay a thing…because the system doesn't need to be "moderated"…you are going cause the nurse told you that you should. And it has also the benefit of making your ER visit quicker, cause the diagnose is already done. Sometimes I'm already going to the ER and I call just to make sure I need to and to make sure I won't pay xD

  12. Hi guys, thanks for the video, great job. I can share my experience with public healthcare here in Portugal which may give you an even better insight into how lucky we actually are! Even though we moan a lot, and sometimes with good reason, we are privileged to live in a country that does see the health of its people as a nonprofit business. I had pre-eclampsia and around 5 months into the pregnancy I started getting injections so that my son's organs would develop faster because I would not be able to take the pregnancy to full term. The doctor's wanted to take the baby out after the 35th week, but we only made it to 30 weeks as my blood pressure got completely out of control. Here in Portugal public hospitals also have a special ER entrance just for maternity cases, at least the one I went to! Anyway to make a long story short, I was in hospital for over a month, my baby in neonatal care and me in a room with only two beds and it's own private bathroom. When I was more up to it I actually asked my doctor how much my stay at the hospital was costing and just for me it was around 2.500€ a day, I have no idea how much my son's stay in the neonatal unit cost, I can only imagine it was a lot! I paid nothing when I left the hospital and every two weeks up until my baby was six months old we went to the hospital for specialist checkups and again these exams and tests cost us nothing! I don't have a big salary so I'm in the lower bracket of taxation, around 11% for Social Security, 7,5% for IRS, 3,5% for ADSE and 1,5% for private healthcare if and when I want to use it, just not to wait several month's for a specialist consultation of any kind.

  13. Thank you for sharing your experience and research. Where did you buy your private health insurance? Is there a discount when buying meds from a pharmacy in Lisbon? I love watching both of you!

  14. Hi guys, Liz and Scott. Just two comments about healthcare in Portugal. First is if you are a member of ACP you can get ACP Saúde Prime that will get you private consultations with specialists in private hospitals. Cost of consultation is around 30 €, but no dental plan I think. And the cost of this insurance is … 36 € PER YEAR per person. Being a member of ACP has other advantages specially if you drive. So take a look. Second, you can (and should) ask for Cartão Europeu De Seguro de Doença which grants you the same healthcare rights and cost that you have in Portugal anywhere else in EU (plus Switzerland and Norway, maybe Iceland as well). Cost is 0 € for this card.

  15. I agree with everything you said, there is only one thing that I think that Americans don't get quite right and that is classifying Europe as socialist. Our system, in my opinion, is a social-democracy, capitalism with a social security net. The issue with using the word socialism with your american viewers is that the word has been weaponized in the USA and it is used by the conservatives to scare american voters with the big red socialist monster that is going to eat their hard earned money by taxing them to death and take away their freedom. Every time the S word is mentioned in the USA in the context of the ongoing debate for more public health or education the discussion is immediately lost for those that defend a more European inspired approach. It's just a word but it's a word with so much historic baggage that immediately digs a trench between progressives like AOC and the conservatives, so maybe using a more appropriate and correct word will help the debate. By the way, despite all the work ahead, and it is quite a lot, to improve our social system here in Portugal, I am very proud of our achievements since the 25th April 1974. Great video.

  16. In Portugal treatment for chronic diseases is free for everybody. Paid by the SNS (Serviço Nacional de Saúde).

  17. Hi Liz and Scott, very interesting blog. I have lived in Australia and Portugal and yes the portuguese healthcare system is very good when compared to other societies. What I didn't see discussed in your blog was the contribuition made by the portuguese people to the social welfare. I lived 30 years in Portugal and I recall paying 11% of my wage for social security (healthcare + education + pension + others). On top of that your employer pays an extra 23%.
    Here in Australia, you only pay tax and still have a good healthcare system which is mostly very cheap. When you lodge your tax return you are expected to pay 2% of your gross income to Medicare. If you earn over $88000 a year you have a surcharge of 1,5%. Still a cheap system I reckon.

  18. Those 18 dollars you paid in the er visit, it’s not a copayment per say, in Portugal healthcare is by law free, the amount you paid is just so that people don’t take too much advantage of the system and use it for not enough reason, making the system for those who need it far slower. And even that amount you paid it’s related to your earnings, because poorer people pay nothing for everything. In Portugal it does not matter the scale of what you need to be done, it may be the most advanced operation for heart implant or whatever, you will only pay those same 18 euros, as a controlling fee of entrance in the services.

  19. The waiting time is so that you don't get a pricy procedure done, get reimbursed, and then cancel insurance policy perhaps?

  20. Healthcare in Portugal sucks believe me I’ve married in Portugal and lived there for a while and the service it’s horrible!!!

  21. I hope that going forward you narrow down your ideas, and please, please get to the point. Obrigado

  22. The healthcare system in USA is a legal mafia. They disable and kill more people than a war and they not responsible for. They sent a lot of people to disability and they still charge them thousands of dollars for they mistakes.

  23. I hope that you are in good health and enjoying your travels.
    I would like to know from you if possible please if you could recommend a good and affordable medical travel insurance company .
    Have a wonderful day and thank you.

  24. Thanks for the video guys! I have wanted to move to Portugal for a year now, but to be honest, your video has kind of scared me away from it. You briefly mentioned the wait times for surgery for private insurance (not sure if it applies to all kinds), and that concerned me. I am still in my twenties, but the thought of needing some surgery because of disease and not being able to get is terrifying. Maybe I’m jumping the gun here…? I would love to know more about wait times in Portugal for both Private and Public insurance. Also, as an American without Portuguese citizenship, would I still have access to public healthcare like you and your family? Can you point me in the direction of where to find this information?

    By the way, it’s true that healthcare costs in the US are high, which is why I have opted out of buying Obama Care (even for a household making $36,000 a year, it is ridiculous) and instead joined a health share ministry (Medi-Share). My husband and I pay $253 per month (premium), $35 for co-pay, and our deductible is $4,250 per year. Still much higher than Portugal, but it’s much better than buying insurance as a freelancer.

    Anyway, thanks for all the info! 🙂

  25. Hi! Olá! I found your channel recently and you are such a lovely family. It's very interesting to see your point of view as US citizens living here.
    I noticed you visited the center and south, so I'm inviting you to come visit where it all started – Guimarães – the first city of Portugal!
    Little town but so much History. The New York Times mentions our town many times as a must visit.
    So… I'm inviting you to get to know the north! Beijinhos*

  26. Great video guys, thanks! 

    Once upon a time people decided to separate land in countries and by proclaiming oneself as king, who above the rest of the people, was entitled to the land and resources. And through force maintaining that land and resources as "theirs", sharing it with their pals, the nobles and not allowing others to benefit from it. This was, and still is, an act of aggression against the sovereignty of every being on this planet. 
    Later on even when those lands or resources were privatised the ones who had financial power to participate in the privatisation were the same "nobles". The system, as it is, is rigged and it will always be. 
    No one being born today should pay for what has happened before or have their lives "fucked up" for being born in the "wrong poor family" or "poor country" or "poor neighbour" or "by being of a certain race/gender/sexuality".

    Therefore, the only way forward in bring peace, harmony, love, freedom to all, is by providing every being on this planet with their fair share of the natural resources through a Universal Basic Income, from the moment they are born till they die. An amount that should be big enough to allow one to be out of survival state, enough to pay basic, rent, food, education, health, etc, and for people to pursue their individual expression of joy. What one does he/she ends up doing it for others. A doctor cares for others, a carpenter builds furniture for others, etc. All will benefit from this if people are able to pursue their own passion. By being happy and not in survival mode, people will stop fighting each other. This is not communism, all having the same thing. This is about providing equal opportunities for all; then one decides what to do with them. One can go on and choose to make/acquire money or whatever.

    Free Education, free health care most be a given. If you wanna go private, fantastic, that's one's choice, but free qualities choices must be provided.

    Where would the money come from for the Universal Basic Income/UBI… well the USA alone spends more than 700 trillions dollars in warefare.

    Eventually, the logical thing, is to make a world wide federation that will entice their members to join and share the resources between them, on the accounts of the of free health care, education, UBI, peace, and value for life, each single life. And by belonging to such federation war between countries would be long gone, as every country would eventually want to join, people would demand it.

    For such federation to work and not become a NWO oppressive system, it must be based on a new political system of Total Transparency in Politics and Finances!! Cameras and microphones in every office, real time on the internet, everything out in the open, no more hidden games in the shadows to manipulate, abuse and exploit the public; all money that comes in an out accounted for in real time, all this accessible to be monitored by any member of the public – the employer. The public is the employer, therefore the public should know what the employees are doing with the power they entrusted them.
    Also, it must be based on a new political system of equal representation and not based on size of the country or amount of population in each country, which always leads to bullies and unbalanced, abusive union. No matter how small or large each country is, it would be represented equally, by the same number of members in the senate, having the same power within the federation. 

    And of course, not only every being of this planet is entitled to their fair share of the natural resources as a sovereign right through a Basic Universal Income, that eventually every one should be entitled to free roaming on their own planet and settle anywhere they wish.

  27. The most prevalent health problem in the western world is heart disease. Although portuguese cuisine contributes a lot to it, typical american food is hell for the cardiovascular system, far surpassing the benefits of smoking less.

  28. Another great video! I would be interested in learning more about the private insurance available to expats and if you have done some research in the best carriers.

  29. The point is:
    in Portugal you can have insurance, and that can be useful if you want to be treated in a private hospital or clinic (sometimes the waiting time is less).

    Apart from that, you can go always to a public hospital, no treatment is refused there (with insurance or without it, is the same) and you will pay almost nothing in any case.

    In public hospitals or private ones, the quality is very similar.

  30. Hi there.. I'm Portuguese and a follower and watch your channel sometimes to watch you guys declare and argue about the differences between both countries and also your thoughts, pros cons about your living experience amongst us here in Portugal.

    I have to say a few words as a Portuguese citizen:

    1º Here people earn less vs USA but have much lower living cost (obvious)which will reflect in the following;

    2º Public Health Care in Portugal has been and will be for many years to come the Gov achilles heel along with education, don't misunderstand me, we do have a good to sometimes excellent public care service depending of your illness and where you are being seeing by the specialist, as the social program in the Health Care has been sabotaged for many years now by ruinous management wich gives way to longer waits in pretty much all spectrum of public health care and also to a unofficial system in place to cut costs (delaying willingly the treatment or exams in order to meet the budget for the region or hospital, etc), so if were not for this poor management that leads to a weaker budget this country would had enough money not just to reshape the public health care but could actually improve further the education system, boost the public transport system and lower the prices on energy which in Portugal are one of the highest in Europe;

    3ºPrivate health system is the result of this bad decision making and corruption installed in our gov still considering the rates a whole lot of people in some of most developed countries have to pay is somewhat fair taking in account of course your income, so public health care takes only so far but then after some degree you really need to have a private health insurance or else you can be left up to dry;

    4º Education system although has been raising prices university wise, still can be affordable and you get a very good education compared to other countries, still a lot of Portuguese enroll more and more to private colleges who rate higher than public ones hoping to get a higher chance of succeeding in their chosen career. College degrees are different to the US system cause if you want to change degrees or career you have to wait to the end of the semester I believe and you cannot choose classes while in the US you can choose classes and don't have to wait until the end of the semester which sometimes can give the student a much broader variety and expertise when looking for a job (that's the reason why some people in here are more looking after professional courses versus degrees since you get more practical course vs a theoretical degree with less investment of time and money as many professional courses here are sponsored by the gov or the EU). In the other hand the cost of degree, masters degree and doctor´s degree in here are much .. much lower than in the US although the quality can be most of the times lower as well, many portuguese students of course after finishing the degree apply for scholarship in some top notch US colleges and never return as in reverse I would found that very unlikely to happen;

    5º Security, this country ranked 10th or 8th most secure in the world, although we cant say about 100% that nothing will happen to you in this piece of heaven, statistically it's more likely to get hit by a meteor in the head here then to be mugged (joking) ;

    6º Climate, We have a moderate to cold winter (various from region to region) to hot summer (sopmetimes very hot summer in the south) which gives way to another issue that both countries have which is wildfires .. it's a drama every summer; the water along the coast is cold but can reach 18/19 celsius in the summer sometimes and down in the Algarve the western shore gets around 20/22 celsius and the eastern shore gets up to 24/25 celsius in the summer. It's a small country but with a huge variety of landscape for its size;

    7º Pay Tv (cable) we have one of the cheapest cable rates in Europe almost all the country has fiber optics these days, of course the prices can rank up if you go for the premium services add ons available;

    8º We are one of two counties in the world that charge taxes on top of tax when buying a new car, the gov pays a heavy fine each year to the EU but since the earnings top the fine costs that practice will not go away sometime soon;

    9º Bureaucracy, yeah it's no t a myth, we do love it (not) but huge steps were made and are being made towards removing it again and again so in 2019 the speed of overall process in the public service are much much better then they used to be;

    10º Corruption (Mr. Cunha = slang), that's our major concern, the grassing growth this past decade of this unofficial and silent (most of the times) crime is debilitating and

    dilapidating the budget which gives way to other issues (just one example dual citizen businessmen Joe Berardo personal debt ranks close to 1 billion euros and his institute has debt to close to 400 million euros and that just to mention one example) , this situations are investigated, turned public and go to make believe trials on the parliament on tv as you watch the guy laughing and making jokes as he knows hes protected by a lot of people in higher positions), the ones that do reach the public prosecutor's office can go forever sucking even more money just to reach in most cases an


    11º Housing, the prices of houses and flats or land are still cheap considering the US but for most Portuguese people it's too high resulting an avalanche of reappropriations by the banks, but losing your house here doesn't mean you will stop paying the debt if the amount raised in auction does not meet the debt you will have to pay for the remaining, in the other hand the quality of construction is high and getting better each year resulting in best bang for buck, the pricing is particularly high in the major cities but if you are willing to live in the suburbs you still can get a excellent bargain like me who bought a 2 bedroom flat with two terraces with a interior space of 125 square meters plus a parking spot and a storage with all of the needed comforts for the actual modern life for around 130k euros in a 35 year mortgage resulting in a monthly payment of 400 euros… if only we had in Portugal those crazy US coupons oh boy wouldn't that be great !!!

    Can write a whole lot more but will stop here, if you need some advice or help please feel free to abuse of our famous hospitality 😀

    Cheers and have a great day !!!!

  31. Definitely keep Scott in the videos, he's so entertaining – you guys make a great comedic duo while providing great content. I'm from the UK and I've been to Portugal a couple of times now and it's amazing; in fact I'll be in Lisbon in July and I'm really looking forward to it. Btw you should have called the channel Lizbon Diaries :))

  32. To be honest USA pays most of the profits of the global Healthcare industry, in a weird way its financing the Healthcare of the world.
    Pharmaceuticals and others charge as much as they can in any country maximizing their profits, basic math (no money is left on the table). BUT…. globally most of their income comes from the US aka USA pays for most of it, so the rest of the world says thank you ;).
    If the USA would fix their absurdly broken system, and unless the entire sector of research and health machinery becomes public, the rest of the world would have to pay a fair bit more.

    Also the private insurance system in Portugal gets to piguibank on the public system, if something is expensive, they offload those cost in the public system. In my opinion one should avoid those as they are slippery slope into the USA mess…

  33. Elizabeth, here in Portugal, public workers also have the option to discont 3% of their salary to ADSE, that's a very low price comparing to the benefits. 😗
    By public workers I mean people that work in goverment institutions (sorry for my english😊)

  34. Hi!!! HIV, cancer and I think more 2 or 3 disease, treatments are 100% FREE. Childrens don t pay till 18 years old.

  35. Thanks guys for another great topic. I'm a Portuguese-American that lived in Portugal most my live and moved to the US in 2011. I honestly think that the prices of healthcare in the US are also linked to the high education prices. It seems that any doctor when leaves college has a huge amount of debt and of course that makes them want to charge more. In Portugal doctors go to public universities, that are basically tuition free. It's really a full circle.

  36. Portuguese healthcare , u die before you’re taken care of , at least in the Azores , u want to have a drs appointment it’s like very hard, u need surgery sometimes have to wait years, u need to have tests done like ct scans mri’s
    and the like also have to wait a long time, medical negligence, gets sweapt under the rug, horrible system

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