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Public or Private?

Evora, PT (View on map)

Everyone who falls sick or goes to university basically has one fundamental choice: public or private. In health care, public stands for slow, inefficient but affordable. In education, the situation is quite different: public universities have very strict admission policies and in many cases are more prestigious than private ones. Here`s a quick overview of both systems.

Sofia (19): `Some people voluntarily resit their final exams of secondary school. Higher marks give more choices for university`

Portugal assures basic health care for its working citizens through the social security system. Contributions to the system are automatically subtracted from salaries. It allows people to go to a family doctor for 2 euros per visit, and gives them access to low-cost care in hospital.

Health insurance
Ines (24) finds the basic care sufficient and does not have a health insurance. She says it may not be smart, but she prefers to pay per consult whenever she needs to. Even though she works in a (public) hospital at the pharmacy department, she does not like to take drugs herself. She relies on her good health, and most people think about it in the same way. For women, it is quite normal to only apply for an insurance when they expect to get pregnant. Having a child is a certain way of making the maximum use of a health insurance - or at the minimum a coverage against the mounting costs that babies bring about.

Private health care is not limited to people with insurance. Uninsured people also have access to it, but they will not get any discount on the price. Vanda (26), who does have a health insurance, tells that even when you have insurance, you still need to pay for health care. A typical consult fare for a private doctor would be reduced from 70 euro to 12 euros, but a family doctor would still cost the same.

The biggest difference between public and private health care is speed. Don`t be surprised if you have an appointment at 8 but need to wait until 9h30. It`s the standard procedure. Doctors are usually the same people, regardless of the public-private difference. Many start out working in a public hospital to gain experience, then set up a private office to turn their skills into financial gains. For a long time they combine their activities, allocating some time to the hospital and some time to actually making money. The positive side is that you don`t need to bribe them to finance their living, as is still common practice in some Central European countries.

Falling ill
The steps to follow when you fall ill, is to first see your family doctor. If you don`t have one, because there is a severe lack of them, you will go to a family doctor central and have one assigned to your case. In case of serious illness, he will refer you to a specialist. Private or public is up to yourself, but if you wanted to see a private doctor, you could have skipped the family doctor in the first place. Some diagnostic test are only performed by private doctor, but pretty much every other illness can be treated by the institution of your choice.

Emergency cases are likely to lead you to a public hospital first. Depending on your own choice, or your family`s, you may be transferred to a private one. Once again, the price difference is substantial, especially when you have no health insurance.

Medicines are available at flashy pharmacies, but prescription is required. Discounts are granted on the basis of social status: unemployed, working, insured, pensionado, but even with insurance you will need to pay a small contribution.

Public education
Sofia (19, photo) is a psychology student in Evora University. She explains me how universities choose their students. They base their selection on the results of each candidate`s final exam scores in secondary school. Each student is allowed to submit six options in order of preference, including both subject and location. Top students have a chance of making it to their number one choice, others are forced to move to another city, to pursue studies in another subject, cancel their plans, or try again next year.

Some people do not want to wait and study a different subject for one year. They hope to be admitted to their favourite studies by re-passing their final secondary school exams in the subject that matters most for those studies. It is a risky method, because universities discourage this practice by augmenting their admission criteria.

A last option, but not very unfavourite, is to leave to Spain. Many students, especially for the more popular studies, choose to emigrate. They often do, and most of the time do not return to Portugal.

Students who insist on staying in Portugal and do not get access to their preferred study curriculum oftentimes end up studying a subject that they may not like. Which may cause them difficulties, because it is very hard in Portugal to change the direction of your career at a later stage.

Private universities
While public universities are considered reasonably affordable, the private equivalents are very expensive. Count on paying 800 euros, an average monthly salary for a graduate, for each year of study. Private universities charge by the month, with fees rising up to 3600 euros per month.

A private university degree will not necessarily give you an advantage over public graduates. Everything depends on the employer and the institute you graduate from. Going to a private university is a certain way of spending a lot of money, but even at that price, some people may consider you half a drop-out, because you managed to evade the strict recruitment policy of the public education system. On the other hand, it can be a perfect way to start your own business, which is exactly what many alumni from private universities do.

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