In the Czechoslovak Socialist Republic all health care was free for everybody! Oh, what a paradise….well, until you actually experienced the “worker’s paradise,” as the communists proudly called it, in real life.
First, everybody contributed to the cost of the health care, but in a hidden way – through the income tax. There were no tax returns to be filed at the end of year. All taxes were automatically deducted from the gross pay. There were no write offs. The only difference was in marital status and number of children. The young, single people, paid a so-called “ox tax.” That was a bit alleviated by marriage and then every newborn child lowered the tax and generated so called “child bonuses.” The state used the money from the taxes to cover all the state’s spending -- health care being one of them.
Well, you get what you pay for, right? Right!
What do you expect from a dentist on a salary set by the state’s pay scales? How about a really ugly crown and no anesthetics (Novocain was in short supply, distributed by the state to dentists by a system of rations on monthly a basis); well, a small envelope with big money…casually left at the receptionist’s desk, would make miracles.
What do you expect from a doctor on a state’s salary? Don’t you worry, you always got your aspirin!
People were assigned to general practice health centers according their address. Nobody was allowed to veer out of his or her health care district. In the waiting rooms you would always see some elderly people, sitting on white painted benches, discussing their illnesses. The free doctor visits were welcomed opportunities for the pensioners to socialize and commiserate about life. The district doctors gave out aspirins and recommended patients to specialists, generally located in hospitals. The specialists did not have their own offices and practices. They were simply employed by hospitals on fixed salaries (the only extra pay would be generated by overtimes and shift bonuses for nights).
Once hospitalized, you would not have “your doctor.” You would be completely under the control of the hospital’s staff.
The rooms were large, with six, eight, ten….beds. It was really busy during visiting hours (Wednesday afternoon and Sundays) with visitors sitting or standing around their hospitalized family members, depending on how many chairs were scoured from halls and other rooms. Some visitors just carried a little folding stool with them and so they could always sit down.
It still was not as bad as in, say, Cuba, where patients have to bring their own sheets to the hospital. However, if you had to stay in the hospital for a prolonged period of time, it was customary to drop every once in a while an envelope with some money into the large pocket on the nurse’s apron. That way you would make sure that your sheets were changed on a regular basis, the cup of tea would be on your night stand without a long waiting period.
There were actually two health care systems. One for the ordinary mortals, one for the elites like well positioned communists and top athletes.
I had some problems with my lower jaw. I did not want to have a surgery in an ordinary hospital. It was a bit scary for me. So I waited till I was in the military (mandatory draft at age of nineteen, two years service). Then I started complaining about my problems and, exactly as I planned, I was sent from the small town where I was located to the Central Military Hospital in Prague. There I underwent surgery; total success, everything was hunky-dory. They used a totally new procedure on me, at the time yet unknown in the ordinary hospitals.
I spent about two months in that top notch hospital. Being bored, I volunteered to work as appointment clerk at the dentistry department. Folks, those machines they had there… I had never seen machines like that. All modern “painless” drills, luxurious seats, etc.
My duty was to pull patients' file from the file cabinet, mark his appointment time and time of arrival and then slip the file into a tray at the designated dentist’s station. Of course, I was curious about the names on the tabs sticking out from the files in hanging folders. So I looked at those names. I saw names of top communists, members of the government and the Central Committee, Politburo, famous athletes. I just shivered with excitement.
There was one funny episode. When my mother was leaving the hospital after visiting with me, she spotted the surgeon who performed the operation. He was digging foundations for a garage at the house where he lived. With a pick axe. My mother was totally thrown off kilt.
I did not understand what made her so upset. She exclaimed: He will ruin his hands!
You know, even at the Central Military Hospital, the salaries were not that high. Later this surgeon was delegated by the state to set up a plastic surgery center in Switzerland (that guy happened to be a real genius), so, I believe, he saved his hands and made some real money. I mean “real” money as the communist Czech Crown was not accepted for international exchange. It was basically kind of “prison money,” usable only inside the country.
Oh, by the way: After my arrival in America, the American dentists re-did virtually all the dental work that we brought with us inside our mouths. Some dentist just could not believe what they found in my and my wife’s and mouths. They threw it all in the garbage.
Borek Volarik defected from the communist Czechoslovakian military in 1980.
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