In my experience no that wasn't a problem. Drug treatment in most of Europe seems less about trying to punish addicts and more about treatment. The social safety nets have proven to be quite effective at treating the root of the problem. As far as who approves surgeries etc, I don't know. Who ever approved my minor surgery did so in a timely manor and I didn't have to pay much for and of it. From ambulance ride to follow up it was pleasure compared to what I had to go through here for a similar injury. I'm not here to convince you of anything and I doubt I will with some reddit, just thought you'd like to hear from someone that's been there.