Now here's another number—just as painful:
I pay $365 a month for private health insurance here in Portugal.
Full coverage.
For myself, my wife, and our 12-year-old.
No deductible. No copays. Just the premium, and then fixed, point-of-sale costs based on the procedure: €20 for a blood test, €70 for a CT scan, €3.28 for an electrocardiogram. And just to be clear, I didn't leave a zero off that last one.
I've lived in Europe for eight years now—first in the Czech Republic, now in Portugal. In that time, I've needed the healthcare system more than I'd have liked: a back and neck issue in Cascais, Portugal; a wisdom tooth extraction in Prague; more MRIs and radiology appointments than I care to count for nagging sports injuries; and a nasty six-week war with pneumonia that landed me in a Lisbon ER three separate times.
I've used state and private plans, navigated admissions clerks who spoke no English whatsoever, and sat in waiting rooms that ranged from gleaming modern hospitals to facilities that looked like sets from Chernobyl or some other Soviet-era movie—but where, I will note, the machines were entirely modern and the care was entirely excellent.
What I can tell you, having been through all of it: European healthcare is not the horror story American political culture likes to paint it as.
Nor is it the socialist utopia its admirers sometimes oversell.
It's something more useful than either—a real, functioning system that, for most expats, dramatically outperforms what they left behind, at a fraction of the cost.
The quality of care surprised me most. The doctors are well-trained, and the vast majority speak workable-to-excellent English—it's typically the reception staff where you hit a language wall.
What's genuinely different from the US is the pace. Physicians here actually spend time with you. They read your history. They ask follow-up questions that can run 10 to 20 minutes and which suggest that they're curious about you as a patient rather than as a billable unit.
In the middle of my pneumonia ordeal, when I was feeling the worst I’ve ever felt in my life, I told my doctor he might be the best I'd ever seen. Ever. And I was being completely sincere.
Wait times—the favorite cudgel of European healthcare skeptics—are a real consideration, but require context.
State systems in Portugal can mean waiting weeks for non-urgent specialist care; my wife once waited five hours at a state hospital before giving up and going home.
Private insurance largely eliminates that friction. I've routinely seen doctors the same day or the following one. And for what it's worth, a recent survey found that Americans in major metro areas now wait an average of 31 days to see a physician—and for specialties like gastroenterology or OB-GYN, it's over 40. The gap everyone assumes exists is narrowing fast, and not in America's favor.
The cost picture varies by country and visa type. Not every residency path qualifies you for the state system, and private premiums differ meaningfully across the continent. A single retiree in Portugal might pay €80 to €200 a month for private coverage depending on age and health history. Ireland runs higher, €200 to €400. Spain falls somewhere in between. In the Czech Republic, I paid around $250 a month for a comprehensive family plan covering three of us.
In every case, the coverage you receive per euro spent makes the American system look like a bad joke—told at your expense… while you wait on hold to dispute a claim.
If you're weighing a move to Europe and healthcare is the thing keeping you up at night, I'd suggest that you may be worrying about the wrong system.
