How do monastics access healthcare?

The Watercooler
1

Hiya,

This question came up and I wonder how this works, especially in countries like in the US where you would need insurance somehow.

Like, in Norway, it costs around 20$ to go to the doctor. I guess someone would have to come with the monastic to the doctors office, and pay, or the bill could be sent to the monastery where a lay person or Anagarika takes care of it, I guess.

In any case, in Norway you can’t pay more than around 500$ each year for health care, at that point the care (with some exceptions) becomes free. When it comes to prescription drugs, some are entirely free, some are not, depending on the disease and its severity.

But in any case, for lay supporters getting their salary in Norway, it doesn’t take super much support to make sure monastics have full access to modern medicine.

How does this work in other countries? How does this work in the US?

Just curious to learn how monastics and their supporters work this out :slight_smile:

6 Likes
2

I’m currently in Germany, so I’ll share how things work here.

Health insurance in mandatory in Germany, and the cheapest policy is currently about 210 Euros / month. (Increases by a few Euros every year.) It is against the law to live in Germany and not have health insurance. So monastics need to have enough donations, or other means of accessing funds to cover this. It is by far the highest expense for monastics, and often the biggest barrier for people to ordain, or for already ordained people to stay in robes.
As for the actual payment, if you get a procedure that isn’t covered by the insurance, you’ll get an invoice, so you won’t need to bring any money to the doctor’s office / hospital. If you need medicine from the pharmacy, you’ll have to pay straightaway of course.
Unless your monastery is in the city, you’ll have to have a layperson with you anyway, since monastics typically don’t drive.

Before relocating to Germany, I was in Sri Lanka for 2.5 years. Seeing a doctor there is free, but you have to pay for medicine and special procedures (x-ray, lab tests, etc.).

8 Likes
3

My temple here in Thailand has an affiliated government clinic next door which will provide free healthcare for us monks.

6 Likes
4

This isn’t intended as a “how to” guide, just a description.

I am at Mettarama in Australia (urban, no live in anagarika). Australia has a number of government health subsidies, including Medicare and the Pharmaceutical Benefits scheme (PBS), as well as the low income healthcare card and some other state based free ambulance (it depends on the state tho).

It’s possible to get GP bulk billed (free) here under Medicare, but sometimes there are random clinic fees that you either have to ask for an exemption for or get help with. Dental and specialist is not covered. Ambulance depends on the state and low income healthcare card etc. Physio is not normally covered, however, you can get up to five free visits under Medicare though if you have a care plan for a chronic condition.

I don’t plan minor medical out in advance, I just see what needs to happen each time and then work out the best way to do it. We have a monastery account and I normally see supporters min 1-2 times weekly anyway, either they can come in to help pay and get reimbursed, or a donor can help. My GP is also Buddhist.

We have put a lot of work into building monastery structures like the account up in general, so the small medical expenses just become like any other expense. Medicare and the low income healthcare card helps a lot in this respect. There are things we could do that we haven’t done yet, like a pharmacy account or dedicated petty cash, that could also help.

The more major things are worked out together with the committee at the level of stay and spending policy as we would rather not cover things like full fare ambulance for monastics (you need ambulance cover in some shape or form) & our structures need to be able to let us do things like hospital admission. Much of our stay process came from NBM.

It’s easier to think about the big things in advance as to have people on the monastery system, we need to be confident we can meet expenses for them. Agreeing to look after a human being requires a significant financial buffer, especially as we have other ongoing expenses.

Apart from that, I think I probably have a similar experience of healthcare in Australia to any low income individual. Many if not most low income Australians do not have comprehensive health insurance. Non-PBS medication can be expensive even if it’s capped. Dental is potentially expensive. It is still nonetheless relatively easy to be a monastic here, thanks to what is covered by Medicare.

7 Likes
5

This is the same in Norway actually, I totally forgot about dental. Dental is unreasonably expensive and according to this Norwegian newspaper article, 1 out of 5 people in Norway simply don’t go to the dentist because it’s too expensive :disappointed:

4 Likes
6

It’s an important question. A good doctor is a great ally in life.

In Canada, we have public health care, but most of it is handled at the provincial level, so things differ across the country. In Alberta, which is an oil rich province, it is free for everyone. Other provinces charge (low) quarterly amounts that can be partially or fully subsidized according to income.

We have national public dental for children under 12. We’re all supposed to get some type of basic public dental, eventually. There’s talk of expanding access to public mental health care, which is overseen by a psychiatrist.

Dental, pharmaceuticals, ambulance, psychologists, physio/occupational therapy, walkers and other aids are usually covered by insurance (which can be almost public), but it depends.

My sister is a doctor, she was an associate professor of medicine, but she retired from that life, and now just practices, because she likes it best. She would tell you that, depending upon your circumstances and needs, if you don’t have an advocate in the health system with good “social capital,” the system can very easily clean you out, especially if you are a senior.

3 Likes
7

Yeah, I didn’t know how to really communicate this because it’s really mostly the generous efforts of individuals…but local Buddhists in the medical profession are a true blessing as a monastic.