The state health system in the Czech Republic provides a high level of care, and many expats opt not to take out private cover when they move there. The main reasons for adding private insurance are reducing wait times and making sure you will see a doctor who speaks English.Those living with chronic illnesses will be familiar with the challenges of taking out private health insurance. Often insurers will flat-out refuse to cover any pre-existing conditions; and sometimes they will even refuse cover for the areas of the body affected by conditions at all, even if you have a new complaint. Sometimes you will be able to find an insurance package that does meet your pre-existing needs, but these tend to be very expensive.
When moving to a country like the Czech Republic, then, where the level of state healthcare is generally high, it might seem like an easy decision simply to go with what your local doctor is able to provide. However, care for chronic conditions is not the same all over the country, and it is worth checking out the provisions in your local area before you decide which doctor to register with. Bear in mind too that some doctors only have contracts with specific hospitals — this is particularly pertinent for maternity care — so if there is a hospital nearby that specialises in treating your condition, make sure you register with a doctor who serves that specific institution.
Life expectancy in the Czech Republic has increased in recent years, but it is still lower than the EU average, at 78.7. The most common chronic illnesses are cardiovascular diseases and lung conditions, probably linked to the high levels of cigarette smoking and alcohol consumption in the country. Non-communicable diseases make up 90% of deaths not from natural causes in the Czech Republic, and almost half of these are cardiovascular in nature. Obesity is on the rise here too, and alongside this stroke and type 2 diabetes are seeing an uptick in numbers.
With the high rate of cardiovasular disease in the country, you would be forgiven for thinking that the level of specialist care in this area should be very high; but the figures tell a different story. Reports from the Organization for Economic Cooperation and Development (OECD) show that the Czech Republic has an unusually high rate of deaths from heart disease and stroke, even when you look at percentages rather than numbers.
Deaths from heart disease are more than twice the average across the EU; 260.4 per 100,000 people compared with 115.2 on average. Rates of death from stroke are similarly worrying: just under double the number of people per 100,000 than the EU average. And the figures get worse when you go outside of the major cities. Hospitals in Brno and Prague are much better equipped to deal with life-threatening emergencies than those in rural areas, which suffer from a lack of modernisation in terms of equipment, and often do not have enough staff on duty to perform the necessary procedures.
One of the main suggestions the OECD gives for improvement is preventing people from getting ill with cardiovascular and pulmonary diseases in the first place, aided by their general practitioners. Campaigns to encourage people to quit smoking are less prevalent than in some other nations across Europe, and many people report that their doctors are overstretched and unable to give them the help and advice they need when they present with even minor complaints. And of course, what starts out as a minor complaint can easily grow into something much bigger if left unchecked.
The above figures paint a disheartening picture, but progress is being made. Rates of death following a heart attack have decreased by almost half in recent years, and local doctors are becoming increasingly aware of the need to help people with lifestyle choices that could make them less susceptible to chronic illnesses in the first place.
If you have a long-term illness that does not fall under the cardiovascular or pulmonary umbrellas, then you should be able to find the right level of treatment using the state health system, especially if you live in a city. Prague in particular has drastically improved its accessibility for wheelchair users in recent years, for example, and doctors there are able to refer patients to one of the city’s three excellent hospitals should they require more specialised care.
If you do have a heart or lung condition, then it may bring you added peace of mind to take out an insurance policy to cover yourself in the event that you need extra care or have a medical emergency. You can even opt to be taken outside of the Czech Republic for treatment if you sign up for a policy that includes a medical evacuation option.
Cancer screening is another cause for concern in the Czech Republic, although again the major hospitals are well equipped to deal with cancer care once people have been diagnosed. The rate of people having cervical smear tests is much lower than the EU average, and in turn the rate of cervical cancer is higher than it is elsewhere in Europe.
If you are worried about this, or if you have a family history of cervical cancer, talk to your doctor in the Czech Republic and explain why it is important for you to have regular screenings. If you still find that you are not being offered the right level of diagnostic testing, then medical tourism is always an option: both Germany and Austria have excellent cancer care facilities that are increasingly popular with people living in the Czech Republic.
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