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03.02.11 – I’ve been on a prescribed medication for 15 years, so one of my biggest concerns before moving to a foreign country was whether I would be able to continue with my meds. Before leaving the states, I made sure to stock up. I spent hours during my last couple weeks before moving in a phone, fax and email communication “hopscotch” between my doctor, insurance company and pharmacy. “You’ll need a new prescription.” “The insurance company needs to approve this.” “We sent the prescription three days ago.” “We can only give you 3 months and then you need to order another 3 months immediately after for the second batch.” Besides the fact that Walgreen’s mail in service plays some good music while you are on hold, it sucked!

My hard work had paid off. I was set for the first 6 months in Finland but the entire time I’ve been here, a thought would creep into my head… what if? What if I can’t get my meds? What do I do then? What if the Finnish doctors thought Americans are pill-poppers? Every time the thought popped into my head, my heart would sink and my stomach would turn.

I finally received my Kela card, Finland’s personal health insurance card, in January and my meds were running low so it was time. Time to figure out how difficult getting my prescription filled was going to be. I had to meet some friends for lunch in an hour so I thought I would at least schedule the doctor’s appointment. One foot in front of the other. Just do it.

And here is how it unfolded…

1200: I find the Mehiläinen office in the city center. The lobby consists of an elevator and the listings for the seven floors of offices are all in Finnish and Swedish, no English. I ask the only person by the elevator “Puhutko Englantia?” Do you speak English? Her response is a curt “Ei.” No! I decide to follow her.

1202: My instincts are correct. She must be in pain and in need of medical care which makes her… curt and she is going to the doctors for a curt-ness cure. I take a number and within minutes I’m talking to a receptionist. “Puhutko Englantia?” A polite but somewhat somber “a little”. She asks for my Kela card and if I can write my address so she can add me to the system. I need to take off my jacket, “phew, it’s warm!” We start to talk about the weather, this is always a great “ice breaker” for Finnish conversations. She asks where I am from and I tell her Portland, Oregon. I tell her I prefer when the temperatures in Finland are below freezing, unlike the wet and balmy +2C we are experiencing today. “The doctor will see you in 10 minutes.” What? I thought I would have to come back another day. I tell her that her English is very good which makes her chuckle. She is now my friend.

1208: I barely make it down the short hallway to room 409 before the door opens and the doctor pronounces my name correctly, “Beidler?” I enter and sit down and start on my “pitch” for my need for medication. The doctor starts banging away on his computer at his desk. He asks several questions about my medical history as he types away. He looks concerned! “We have this medication… but it… doesn’t have, what is it, the line!” My medication comes in pills where I need to take one and a half pills so I usually break one in half. No problem, I’ll buy a pill splitter. He gives me the prescription and a receipt for the copay, Mehiläinen is considered private, so you pay the difference between the public and private expenses. My bill is 45€. I can live with this. I grab the paperwork and shake the doctor’s hand which I immediately realize from his expression is awkward. I hear later there are signs in Finnish in the lobby which say “Do not touch anyone!” I am overjoyed though and it’s difficult to hide my elation. I tell him this is so much better than America which makes him smile broadly.

1215: I return to my receptionist friend and ask if I need a new number to pay the bill. She waves me up to her window just before her next patient who has a number and looks like he needs a curt-ness cure fast. His eyes are wide but he does not say anything. This is also a Finnish trait. I pay my bill, my receptionist friend tells me the Apoteekki (Pharmacy) is across the street. I leave and tell her to say hello to her family for me.

1218: I enter the Yliopiston Apteekki (University Pharmacy), located across the street from Mehiläinen, and grab a number. I sit down and marvel at the network of pneumatic tubes radiating from the intake counters which are used to deliver medications. An occasional blue container passes through the tubes with a barely audible “whooomp.” I find this comforting.

1222: My number is called and I start off “Puhutko Englantia?” I get a confident “Yes.” She asks for my Kela card and if I’ve ever been to the pharmacy before. This is my first time so she needs to input me into the system. She asks if I’m ok with generic which I am. Do I want 6 months or the whole year worth of meds? Give me 6 months. There are three companies which sell generic and they are all the same price. We both agree on the local Finnish company ;) While she is working, I ask if I can take a picture of the pneumatic delivery tubes. She says yes. I’m thinking maybe I need to go and wait somewhere while the prescription is filled. “Should I get up and go?” She thinks I mean to take the picture. “No, go right ahead and stay here.” I pull out my iPhone and take a picture, run it through my CameraBag app and save it to my photos. As I finish, she is putting stickers on boxes, the boxes in a bag and tells me I can pay at the register. I have my meds.

1228: I have to wait a minute or two to talk to one of the Apoteekki employees to find a pill splitter. The service in most Finnish pharmacies is exceptional. I’m not sure if the floor staff are licensed pharmacists but it’s common to walk into a pharmacy and talk to one of the employees and get accurate information about some relatively potent over the counter medications. I need to wait a bit to ask about where to find what I need, a pill splitter. These people are always popular, especially with little old Finnish ladies. The pill splitter is 10€. I pay at the register a total of 22€ for my meds and hardware. 12€ for 6 months of meds! I almost collapse from joy.

1232: I leave the pharmacy, walk outside, jump and click my heels.

I still have a half an hour before I meet my friends for lunch. I walk the streets of downtown and think about how lucky I am. The whole experience took a little over 30 minutes and cost me less than 100€. In the states, a similar process was days and cost three times as much. More importantly, I have spent so much time worrying about how difficult the process would be and here it turned out to be a breeze. I’m not saying my future issues of settling into this country are going to be as easy but it’s probably better to know what you are up against rather than sit and worry about possible outcomes.

This is just one persons experience with Finland’s National Health Insurance (NHI). I’m sure I will deal with other issues in the future where I might see the pros and cons between Finnish and American ways of doing things. For now though, it’s Finland 1, America 0!

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