Pardon my Rant

While I was waiting for Marion to finish a laboratory test last week, I started thinking about some of the recent discussions on some of the local forums.

Entirely too many people are moving to Panamá with no plan for their healthcare. This really concerns me.

They my be ignorant about Medicare not covering them in Panama. They may think their health is good and they don’t need insurance. They may not have money for insurance and think healthcare in Panama is cheap. They may think the country healthcare system won’t turn them away.

Let’s consider these thoughts.

First people need to understand that Medicare is not valid outside of the USA. If that is their plan, then they are not covered. They will not be admitted to any private hospital in case of emergency without providing proof of payment, often $4,000 dollars or more for admittance.

One should never think that good health is a reason not to have insurance coverage. Look are the increase in home invasions sending people to the hospital. Home invasions, automobile accidents, being in the wrong place at wrong time. Many things can send you to a hospital.

Since I moved here the private hospitals are becoming more insistent on proof of payment prior to admission. The minimum I have heard was $4,000 and normally it is $5,000 or more and depending on what the hospital expects the total care to be, it may request a payment plan.

Can people go to the public hospital. Yes I have not heard of any shooting victims or emergency cases not being admitted. That doesn’t mean I would ever want to have to depend on my life surviving the emergency care in a public hospital. I can say with 95% certainty that Marion would not have survived had she not been admitted to Hospital Mae Lewis.

Now let’s say you just need a gall bladder removed or something else that might be considered elective surgery. A Panamanian recently told me of a family member that needed to schedule an operation. They received a time frame several months away. They considered the problem significant enough to search and find a doctor to do the operation in Puerto Armuelles.

Panamanians have enough family contacts and connections to make that happen. If you are not Panamanian you may have to hope that your “many months away” schedule is met and not rescheduled.

I recently was sent an email of a person’s experience applying acceptance into the Panama healthcare system and paying a monthly amount. Following was the experience.

I went to the Panamá Seguro Social office in Beautiful Downtown Boquete,
which is between BDB’s main street and El Constructor, the big hardware
store that is on the next corner on that side of the street.

I presented our Turista Pensionado visa cards, mine, my wife’s and our two childrens’, and told them that I wanted to enroll us in their healthcare plan
on a ‘ pago voluntario ‘ basis.  They then filled out a form for an examination
at  their local ‘ polyclinica ‘, their medical clinic and asked me to go there for
a medical examination.  A medical examination was not necessary for either my wife nor for our two children.  My age was 67 at the time of application.

The next morning at 6:00 AM, I arrived at their polyclinica, which is approximately two blocks from Romero’s in the direction of David and made an appointment for later that same day.  There was a fee of 50¢ for the doctor’s appointment that day since we weren’t yet members of their healthcare plan.  The doctor examined me, asked a series of questions relating to my health status and gave me several forms requesting various healthcare tests to be presented to their laboratory there in the same building.

Following the doctor’s request not to have anything to eat or drink after I woke up the next morning, I returned to the clinic with my various bodily function samples nestled in the containers that the clinic had previously provided and presented them to the laboratory with the appropriate forms that the doctor had given me.  They then drew a blood sample for testing.

I returned the next morning at 6:00 AM and made an appointment with the doctor for that day and picked up my lab test results.  The doctor reviewed
the test results and filled out a form stating that my current state of health
qualified me for enrollment in the plan.

I returned to the Seguro Social office, handed them the form that the doctor
had executed and they requested that my wife and I take the form that then prepared to Panamá’s immigrations office in David along with a copy of our Turista Pensionada visas and passports.  I gave all of this and, as I recall, a $5.00 processing fee for each of the two requests, to the clerk there in the immigration office.

Approximately one month later, the forms were completed and I picked them
up and presented them to the Seguro Social office in BDB.  We then made our initial monthly premium payment of ± $54.00.  They said that all of the completed forms would then be submitted to their Panamá City office and would probably be approved in approximately six months.

You’ve heard of something taking an Act of Congress, well that’s we received
in ± six months, the official approval document of our enrollment was an actual Panamá Act Congress.

Well, sure enough, we were finally approved for enrollment and their BDB office give us the enrollment number for our family.  A picture ID card is optional and the camera in their BDB office was broken, so I had my picture taken at their office in David there on the Pan American Highway and immediately received a picture ID card.

And that’s the way it was, Judy.  I make my ongoing monthly premium payments to their office in BDB.

We have only required their services once in the last year, we’re all quite healthy, and the service there was on a par with any that I have ever received at any healthcare facility in the United States.

I cannot speak to this still being possible. I will say, I think it is preferable to coming to Panama and expecting the system to take care of you. At least you are making monthly payments. I have seen many foreigners enter Hospital Regional and leave promising to pay a substantial bill only to high tail it back to the US leaving the debt behind.

This is the reason many doctors consider all US citizens as irresponsible or indigent. Why do you think the private hospitals now demand a down payment before admitting a patient.

Many people move to Panama because they hear the healthcare is excellent and cheap. The two words “excellent” and “cheap” ,Abu be correct, but should not be in the same sentence.

There are some excellent hospitals in Panama City and they are not cheap. Many procedures may be less expensive than the similar procedure in the US, but if you can’t afford to pay in Panama or the US, what difference does it make?

For simple treatments of colds, etc, you can go to a local clinic and pay $3 to $8 to see a doctor. Granted that is a lot cheaper than in the US.

If you have a permanent residency, and are a jubilado in Panama, you can go to one of the local centers and get free flu vaccinations. That is a good deal and probably not taken advantage of often enough.

Another rant. I have also heard of young families moving here and being unsatisfied with schooling for their children. It may be a surprise to some, but Panama is a Spanish speaking country. Anyone moving here expecting schooling to be the same as public schools in the US has not done their due diligence.

If you have school aged children, you better be prepared to handle the English part of their education. If you can’t do that, don’t come.

If you plan on coming to Panama and retiring and spending your money, welcome. If you plan on coming to Panama and creating jobs for Panamanians, welcome. And if you plan on moving to Panama and taking jobs from Panamanians, please don’t come.

Now let me rant a little about the increase in violent crime. A little over three months ago a good friend of mine was shot and left to die in a home invasion in Potrerillos. Three young men broke into her home and shot her twice and stabbed her multiple times. One of them was only 14 years old.

Just a few days ago another home invasion took place in Volcancito.

There have been many others and in the 13 years I have lived in Chiriquí, the violent crimes have greatly increased. Chiriquí is not a large province, but is is a very important province. It is know as the breadbasket for Panama, because so many food products are produced here.

Also, there is Boquete. It is the most popular tourist attraction on the western part of Panama. It has the Baru, which is Panama’s only active volcano. It is home a famous flower festival that takes place in January. It has also been the location that International Living listed as one of the best retirement places in the world.

This has cause individuals from all over the world to want to move to Boquete, many with idealistic fantasies about living in paradise. This growth has also attributed to the increase in crime in my mind. Many build houses in US fashion without bars on the windows minimal external security. Why would anyone living in paradise put bars on the Windows.

The laws in Panama are also conducive to minors committing crime. 14 years old and younger will be immediately released independent of the type of crime committed. If this doesn’t change, there will be more and more violent crime.

I have had some of this conversation with new retirees that have moved to Boquete and had team me she couldn’t have an opinion and didn’t want to voice objection about how Panama was handling crime or their lax laws because she was merely a guest of the country. I was shocked.

Guests deserve the right of protection as much as anyone and it is loud voices of those investing in Panama that may get the attention of the Panamanian government to make the needed changes. To ignore a problem is the same as being part of the problem.

I feel as strongly as I do, because I see every day how three young men changed the life and almost ended the life of a good person. A person that gives to others and helps the needy. They knew that Panama laws were lax enough to make it worth the risk of breaking into a house.

They watched for the right opportunity and planed what they were going to do. If they had to kill the owner to remove a witness, so be it. It was premeditated.

20 thoughts on “Pardon my Rant

  1. After years of watching that big ol’ moon promote itself shamelessly in the night sky, I finally succumbed to the advertising hype and booked my trip on the spaceship, with visions of all the free cheese I could eat dancing in my expectant imagination. Man, it pissed me off when I got there, only to learn that they don’t even have AIR! Even the gravity is sub-par! I’m gonna hire a lawyer to sue that lunatic promoter for all he’s got. The nerve! Who knows, maybe it will be a nice place to visit some day, after it’s been properly terraformed. Meantime, take some free advice and DON’T BOTHER!
    I’m gonna stay right here in good ol’ Bondad, even though the air is redolent of manure. Ya get used to everything except the damned roosters!

  2. If you have insurance do you still have to put the $5,000 dollars up for a deposit with the private hospitals. I believe that one of your friends neighbors put up the cash for her when she was shot. One man told me that he had insurance and he was asked for the deposit and was told that his insurance company would reimburse him. If this is the case you and everybody else better have $5,000 laying around for an emergency situation.

  3. Gordon,

    It depends on your insurance plan as to whether you need to make a deposit. My insurance (expensive) covers everything if I am admitted through emergency at both Mae Lewis and Chiriqui hospitals. Others, maybe not so much, get your insurance agent to explain the procedure to you. It is way too late to try and do it when you are in the middle of an emergency.

  4. We also had to give a credit card for $5000 for the hospital in David. hospital Bill came to over 27000. Then Had to be airlifted to another hospital. Total bill $70,000 It is definitely not cheap please also know that if the specialist leaves town on vacation, many times there is not a back up. If there is a heart attack and the doc who does the stents is not in town, you will have to wait or go to Panama City

  5. What is the US govt. doing, and if in collaboration with Panama, to protect us citizens – as the US govt protects its foreign immigrant rights?

  6. does anyone know if hospitals accept credit cards for the “up front payment” or does it have to be in cash?

  7. Marco: This is Panama…not the USA. The USA (generally speaking) does not dictate to Panama how to keep American citizens safe and secure. On the other hand the USA can strong-arm Panama to free up information on US tax evaders who settle here. International organizations can tell Panama it should not incarcerate youth in its adult prisons. The same organizations will not pay for Juvenile detention centers. Panama is very gentle with kid criminals. Don’t hold your breath for rapid change on that. With regard to your personal well being….listen to Wry. Have that trip to the moon well investigated and thought out before you launch.

    Thanks Don…all that needed to be said.

  8. I think the deposit is based on why you are there. I just spent 2 days in Mae Lewis and all they asked for was a $300 deposit.

  9. Very good post Don.
    I find too many people are falling off the turnip truck into Panama. Either they don’t get sufficiently informed before making the move here or don’t care to get informed expecting the country and it inhabitants to conform to their ideology.

  10. Nice summary of many issues that have been floating around, Don.

    To clarify one point. If you have insurance with a company that has established a relationship with the hospital, you will not have to pay a deposit. Most (maybe all) of these companies do business in Panama. So even if you have international insurance, it may pay only on a reimbursement basis. As insurance companies often are slow to pay, this could put you in the same financial position as someone without insurance. I originally had insurance through a company in the U.S. but have switched to one here to avoid this issue. When one is ill or injured, the last thing he or she needs to be worrying about is insurance. It’s expensive, so make room for it in your budget. I agree with Don: it’s vital.

  11. Congrats to this person. As i always said you need to know the system well. Ouvkic hospitala are not bad. And most important they do haver better equipment than private ones. If you are really on a life threatening situation mae lewis will send the patiwnt to the public hospital. If msriin werent stabilized mae lewis wouldnt hace tajen her.

    Many times the complibts i hear are more about comfort which is ok if you have the money. I find it very unfair . And yes, if foreigners come here they should pay insurance. Ymthe same every body does ib the usa or in their countries.

    Yes don i kniw you mentioned the case of a gentkeman who died after he was sent home. That has happened here and in the usa. That doesnt mean that everybody who goes to the public hospitals die. Your comments many times were unfair unrealistic a as you said a rant .

    Some private indurances do civer pre existing conditions after the 2nd year same as in the usa. Iived there fir 14 years and had the same tyoe of ibs which civered pre existing after 2 years

    Was an immigant n the u.s. and the government never sent soecual protection . I l7ved as any other citize. Thee was no oh ketscfive soecual protection to immigrants (guests).

    Why dont you guys out money together and buy your own country and have all the laws you want. While you are here adapt like other immigrants from other countries are doing.

    I agree that this is a spanish speaking country. The same way immigrant kids in the us go to english speaking schools, here the official language is spanish and their kids will learn spanish.

    What makes some americans not all, unpleasant is that they think that they or the u.s. are the sun and the world revolves around them. Narrow minded sometimes.

    Maybe that american beauty contestant was right when she was asked why do you think americans dibt know much geography. She said because americans dont have maps ????? As you said they dont do homework and they live in their own little world.

  12. Noris, estoy de acuerdo con usted un 100%, yo no lo hubiera dicho mejor, todos los extranjeros q se mude a panama, deberias tener la misma mentalidad.
    Gracias, saludos.

  13. Noris, I agree with much that you say, but I do think your experience with the Regional Hospital is much less than my experience since I have been Warden with the U.S. Embassy.

    You like to bring up one case. I remember it well. The doctor that recommended the patient be released and the Healthcare worker that said he needed to leave or he would be put beside the highway are totally responsible for his death.

    He had financial means to go to a private hospital and should have been there, except he was struck by a car when he was walking the street and taken to Regional Hospital. If you are in an accident and an ambulance picks you up, I don’t think you will be given an option. You will be taken to the Regional Hospital.

    He is one of four cases I have been involved with that I feel could have turned out better if the patient could have afforded different care. The other three were moved to the Regional Hospital after they had spent between $30,000 to $40,000 in the private hospitals and ran out of funds.

    I can say, with 90% certainty, that Marion would have died had she not been admitted to Mae Lewis and the doctor that saw her in the emergency room had called for an ambulance to take her there when Dr. Cattan interviewed and said he would operate in Mae Lewis. I am not saying that she would have died because of a less qualified doctor. It is likely that Dr. Cattan would have been the doctor that attended her in the Regional Hospital. However the care after surgery in the emergency section of Mae Lewis was much better than it would have been in the Regional Hospital.

    I expect that I have spent more time visiting the emergency ward of the Regional hospital than you have Noris. It is an experience I hope most reading this blog never have.

    I will also take issue with the statement that the best equipment is in the Regional Hospital. I have had several patients that were in the Regional Hospital that were shuttled to Hospital Chiriquí to have an MRI or CAT scan. That was either because the needed diagnostic equipment was not in Regional Hospital or was needing repair.

    To the best of my knowledge, there is no longer any accredited surgeon for the heart practicing in Regional. The one that was there is now only seeing people in Hospital Chiriquí. If you need heart surgery and it has to be done in the public hospital for financial reasons, you will have to go to Panama City. Good luck getting there in a true emergency situation.

    I think one thing all people planning on moving to Chiriquí should have on their inspection tour is a visitation to the three major hospitals (hospital Chiriquí, Hospital Mae Lewis, and Hospital Regional). They should set up a meeting with the hospital director and ask him questions. Of course for most from the U.S. the ability to communicate with the director in Spanish may make that difficult.

    They should spend some time sitting in the emergency areas of all hospitals and observing the comings and goings. They won’t be allowed in the actual patient emergency rooms. As I said, my Embassy letter and special requests from the Embassy has gotten me in too many times.

    If people are moving here they need to serious due diligence. Not formed their opinion from some book, internet publication or blog or quick retirement tour of the country.

    If your plan on healthcare is to utilize the public system, you owe it to yourself to spend a day or two visiting the Regional Hospital. Make sure you continuously use the hand wash dispensers if they are filled and working.

    Bacterial resistant infections are often in one ward or another. I visited one patient in a ward with his sob that had to leave the following day. We were issued gowns, gloves and masks. Only after we left did I understand we had entered a zone that had recently been marked off limits because of one of these infections.

    Caution is the best thing to have on your inspection tour of Panama. You will not be take to any place on a tour that will really educate you in what to expect. Only living here provided real experience.

    It also needs to be current experience. A lot of things have changed in my 13 years here.

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