You would wonder why they charge a handling fee of €3.95? Was this always the case or only introduced because they can no longer charge a card processing fee?
€150/190 is not expensive, when you consider that a private GP visit in Spain/Portugal would be €200. If you have worldwide cover and travel to US, then it would barely cover the tip!
€150/190 is expensive compared to what a healthy 25yo would be charged, but then the chances of the 25yo claiming for any medical condition would be much less than a 66yo.