Home » Expat Focus International Healthcare Update July 2023

Expat Focus International Healthcare Update July 2023

Germany Introduces E-Prescriptions

Germany introduced e-prescriptions (“e-Rezept”) from July 1st 2023, after successful trials across the country. You should now be able to access your medication by taking your health insurance card into your local pharmacy, placing it in the e-reader and allowing the pharmacist to see your prescription on the national database.

Spain to Relax Mandatory Wearing of Face Masks

Spain seems ready to downgrade the compulsory wearing of face masks to an advisory measure in pharmacies and clinics, based on recommendations from the Health Alerts and Emergencies Coordination Centre. Health experts say, however, that it’s well worth considering the benefits of continuing to wear face masks, even though it might no longer be public policy.

Warning Against ‘Spiked’ Medication: Mexico

Expats and visitors to Mexico are able to buy certain drugs over the counter in pharmacies which are not available in the USA, such as opioids, but Vice magazine warned last month that some of these medications may be spiked with highly addictive drugs. Fentanyl is one of these, and so is meth, and these dangerous substances are produced by the country’s drug cartels rather than by legitimate pharmaceutical corporations.

Working with Bunk Police, a harm reduction organisation, journalists from Vice tested “Oxycodone”, “Hydrocodone” and “Percocet” pills that they purchased over the counter from local pharmacies in Mexico’s coastal towns and discovered that some of the fake pills tested positive for fentanyl and meth. Some also contained Xylazine, which is an animal tranquiliser. These pills had all been procured without a prescription, which is contrary to Mexico’s laws. The major pharmacy chains refused to supply these drugs without one, however. All of the packaging was labelled in English, signifying that these substances are aimed at the English-speaking market.

The U.S State Department has issued warnings about these drugs:

“Exercise caution when purchasing medication in Mexico. These pills are sometimes represented as OxyContin, Percocet, Xanax and others, and may contain deadly doses of fentanyl.”

Vice was told by a spokesperson at the DEA that the drugs pose “one of the greatest threats to the safety and health of Americans today,” and US citizens have died or been made severely ill by fake, spiked medication bought over the counter in Mexico. Expats in the country are counselled to take drugs that are on prescription from a certified doctor and that are obtained from a legitimate pharmacy. Bunk Police told Vice that Americans in Mexico, often retirees, tend to assume that local pharmacies operate to the same high quality of production and regulation as pharmacies back home, and they are concerned that expats might be buying tainted medication, such as Adderall (used for ADHD) and sending it back to relations north of the border. They say that drugs which are appearing in drug busts in the States are the same as those which can be purchased over the counter in small Mexican pharmacies – a phenomenon which points a clear finger towards their origins in Central American cartels.


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If you are resident in, or visiting, Mexico, it is highly advisable to stick to the big pharmacy chains and ensure that you have a proper prescription for your medication.

Germany: Calls for Dental Care to be Removed from Public Health Insurance

In the UK, British citizens have become used to increasing limits on dental care under the NHS, with many NHS dentists saying that they are not intending to take on new customers. State health insurance in Germany, however, does still cover basic dental treatment, but recently there have been calls for this to be scrapped in the face of a €17 billion deficit. The head of the IKK Krankenkasse, Ralf Hermes, has told the press that, “It would be appropriate … to remove all dental care from the catalogue of services,” including dental treatments, denture and also homeopathy. €13 billion went towards dental treatment in Germany last year. Hermes wants the health authorities to put more emphasis on preventative measures like dental hygiene.

The German government says, however, that it is not willing to make cuts to medical treatments, including dental care. Although, there are suggestions that they may change their stance on homeopathy. They also don’t think that the slack should be taken up by private insurers. If you are an expat living in Germany whose dental care is covered by the state, it might be worth keeping an eye on developments, unless you already have private provision for your dental treatments.

Expat Worries in Eindhoven

The press in Eindhoven, a city in the Netherlands, reported in mid-July on concerns about large numbers of expats flooding into the region due to a shortage of medical personnel and GP surgeries. The high tech sector is due to expand in the next decade by an anticipated 53,000 workers: a third of these are expected to be expats. The health authorities are calling on big employers like ASML to assist.

GP Maurits Westein told the local press:

 “We spend three to four consultations explaining how the Dutch healthcare system works. If employers give that explanation right away when they come here, we can help four other patients in the time freed up.”

He also suggests that local corporate employers should sponsor surgeries. Doctors in the area already have to learn English, but time is also taken up going through expats’ medical files, many of which are in English. Other local GPs suggest that the municipality should help out, too. They point out that many expats do not have a GP, resulting in their appearance in the local A&E departments whenever there’s a medical problem, thus putting additional strain on the hospital system. GP Pascale Voermans says:

“Sooner or later it’s going to pinch everywhere. We already see it with pharmacies, district nursing and social work. I do worry about that. Are vulnerable people getting the care they need? But also for the people working in care. They have to do their work every day with a lot of improvisation in quite difficult circumstances.”


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