Men in Handcuffs and Health Insurance in Turkey

 

Just a note, the two concepts in the title are very loosely related, very loosely.

When we first moved out to live in our apartment over a year ago now, well to be precise 16 months ago, we applied for residency. That is to allow us to stay out here for an unlimited time, well in the first place for two years. It’s an interesting process and best carried out using the services of a Turkish speaker who knows what they are doing and knows their way round the system and a Turkish hospital.

Fethiye Nazar tree to ward off evil

at aside, as that’s another story for, the first year you have to provide for or pay for your own health insurance. Although treatment at one of the private hospitals is generally quite reasonable if needed, as long as I understand, you don’t need to stay in hospital.

Only after one year’s residency can you apply to be part of the Turkish state social security system SGK for short . Naturally you have to pay for this. Additionally if, you decide like we did, to live out here when you are both over the age of 65, the system requires you to both be insured separately.

Now the man who carried out our residency papers told us all of this (as he told us about Turkish law and wills) and was correct in everything he said. We then come across many other people who will tell you the information you have is wrong and that they know better. All of this can be checked on a wonder information site run by a tireless man, Martin Redman,  and his team of volunteers who collate and verify all the useful, correct and up to the minute information you would need to know.

Our residency year became one of year age on the 3^rd and 6^th March 2020, (two different dates as our applications were entered online on two different dates due to the ‘system’ crashing for which it is renowned apparently. We actually weren’t in Turkey on those dates this year as we made a quick trip back to Forres to see a VIP (in our lives) and we are so glad we did as we would have missed face to face contact with many people for longer than we had intended this year.

The plan was to start the application process when we returned, but first we had a 14 day voluntary self-isolation period to go through. Now, here in Dalyan, this was very fluid as many people both Turkish and foreign residents here told us they didn’t think it was that important here and ‘it wasn’t like that here’! Watching the scientific news and checking out what was going on, I had that week bought 100 paper masks and stocked our store cupboards and freezer as far as I could. Then lo and behold on the evening of the second Saturday after our return, we received the text telling us we were to stay at home ‘evde kal’ due to our age. (Turkish children had already been out of school that preceding week and had started online lessons.)

Our application for health insurance became a nonstarter. This proved to be a sticking point when I tried to get my lupus medication that here I had previously been able to buy over the counter. That’s probably another story.

After some discussions about who would go to which hospital with us to start this application and who would go when and where and did we need an appointment and previously someone giving us incorrect information on the type of insurance we should apply for (so back to the original man who clarified what he had told us previously), plus a discussion on why we had to have two separate insurances. We finally managed to leave at 6.30 am last Tuesday morning for Fethiye Devlet hospital, with some muttering about why our local Devlet (state hospital) in Ortaça wouldn’t process the application (when in Fethiye we discovered Ortaça does not have an ENT specialist).

We arrived at the hospital at 7.47 am. We had been told to be there for 8.00 am with passports and photocopies, residence permits and photocopies and photos of each of us and 200 Turkish lira each. The ‘friendly’ international department who have signs in English and Turkish saying ‘happy to help’ arrived about 8.30 am. We were entered into the system by standing at the doorway and then sent to the admin room. There we were entered again and low and behold our photos were taken using a camera attached to computer. For some reason we were then sent to a pharmacy (local pharmacies spring up around all Turkish hospitals - well not the new Devlet in Ortaça, but that’s up on a hill). Whatever we were supposed to do there, didn’t happen as we did not ‘appear on the system’. Can’t thin why, hmm. Back again. Then started our round of doctors and tests.

I’m not entirely sure what order it was all in but we had to see a Psychiatrist. Optometrist, ENT Specialist, Specialist for Internal Medicine, Orthopaedic Surgeon, Neurologist and General Medicine (though I’m not sure how that differs from Internal Medicine). 

The psychiatrist was a hoot he just asked if we had any psychiatric problems and were we on any medication and signed us off. The optometrist required three different rooms and pretty normal eye tests, albeit testing what you could see with your glasses on, pressure testing and also photographing the backs for the eyes. This took four visits to sign off, none of the rooms are near one another, needless to say and the Turkish way of getting in the room, even if it’s your turn, is to shoulder your way in first. The ENT Specialist looked in our ears and sent us both for a hearing test, that didn’t happen til later in the afternoon and took place in little more than a box, which could have been frightening if you were claustrophobic as it was warm and you needed to wear your mask.

I can no longer remember the difference between what took place when we visited the Specialist for Internal Medicine and General Medicine but one of those ordered copious blood tests. Blood was removed by an evil eyed yet pleasant phlebotomist who clearly knew her job but the needle hurt like hell at the time (I have disappearing veins, especially when a phlebotomist is in sight). One of the two also ordered chest X-Rays.

Poter the blood tests and at some point, I'm no longer sure when, we went for lunch. I ate a healthy tuna salad they guys all had chicken curry and chips. this was along the promenade (Kordon) in Fethiye, a welcome change.

The Orthopaedic Surgeon was a pleasant man and quite funny. It was on leaving his room we came face to face with the Jandarma, well first one as I came out the door, who looked me up and down, Momentarily I worried if we were in trouble for leaving way before we were allowed out but then he stood back as he noticed Jim and our friend coming out of the room and motioned and said something to the others behind him. I saw to my left a man in handcuffs with a Jandarma either side, just to my right a man in handcuffs with two Jandarma either side of him!! Plus a further two in handcuffs one flanked by two Jandarma and one with just one, but then his other one was probably the one at the door. The strange party moved to let us through. A little strange to say the least.

Everything was very spread out over three areas that did not interconnect due to some changes at the hospital and the payment window that was being used was actually a window to the outside, accessed along a path and you paid through the ornamental wrought iron work.

Oh the cost is minimal (compared to the UK) and the test is done there and then, unless they've gone home as in Jim's case later). It was just that you go from the doctor (who omits to say oh you need to pay for this next step) to the place for the test and there are told, can't do it until you've paid. Then one of you has to trip outside of the hospital to the 'emergency' payment window, which is literally a window on the outside of the hospital, as the office is shut for 'personnel safety reasons' so you go along a path to the window and pay through the ornamental wrought iron. Would be funny if you had the time to laugh and it hadn't been so hot. Put it this way we had X-rays, blood tests (and results), ultrasound of Jim's heart, hearing tests, eye check-up including photo of backs of eyes for about £35.00 and paid to start about £60.00 in total for all the doctor visits, we saw 8 specialists. Just a great deal of walking about and delays.

We were finished, we thought and went back to the admin room to collect our signed off papers. But the eight doctors who sit there all day, with a ninth for the overall signature had decided although they had signed me off, they were holding my paperwork back because Jim should see a neuro surgeon. We tried to see this surgeon on that day, but were told to come back at 10 am two days later.

Off we went two days later, at a later time, some consolation. We arrived in time at the admin room, but had to go to the orthopaedic surgeon first whose secretary entered a code on the system so that we could go off and pay another 29 Turkish lira. Then we went to the Neurosurgeon. We had missed him by two minutes, come back at 1.30pm the cheery lady said.

We went for coffee, well I did, Turkish Coffee and a Milk Shake whilst the guys had toasties or

wrap and chips. Then after some travelling around to buy wheel bearings (as you do), we returned to the hospital. Saw neuro surgeon after some pushing through crowds or at least getting your numbered sticker in the room first so that you are seen as a priority. He queried a spinal op Jim had had 44 years ago, checked the scar and signed him off. Back to the admin room, come back at 3.30 pm.  We did and success we were given a report with eight signatures and stamps, signed by different doctors to the ones we had been seen by, who all sat in the admin room, it seemed, then the whole document was signed off by another doctor.

We came home rejoicing, but all not finished yet. Next step the SGK office.

The next day we went to the SGK Office, down a typical town side road with bumpy road and bumpy pavement. Security guard outside on the carpeting that is obligatory at all state buildings, it is watered with disinfectant (I noticed at the hospital that because it was wet some people chose not to walk on it!). Security guard just inside the door and another who took our temperature when we finally allowed in. Not because it was busy you understand, just because they seem not to like to allow people in. We spoke to an older man behind a glass screen. He looked careworn with the stress of his job and was at pains to point out that we both have categories that are not covered by the insurance (pre-existing conditions) and that if we are out the country we still have to pay. We knew all of this and we need to go ahead, if only so that I can get my medication for SLE that I used to able to buy over the counter here until a decision was made to use it in the current pandemic treatment. After some toing and froing, to anther counter, back again, to the photocopier and back again, to complete a form and back again, oops we had forgotten to sign. All was complete. The careworn who was just doing his job and had clearly had problems with these darn foreigners before, not entirely convinced we really understand everything, said that was it complete, we would ‘be on the system’ the following day and on Monday our man who was assisting us needed to comeback to get the paper with our registration numbers (as it was now too late in the day) and the n all we need to do is pay though the bank.

Currently it’s Saturday and we and most of the rest of Turkey is at home again until 3pm due to University Entrance exams. (Some complaining happening generally among the ex-pat community.) Joy life in Turkey. I think life in Germany in the 1970s was easier (for me)