This Deserves A Special Post

A comment thread from John on a recent post, leads me respond at more length than a comment can handle. In his most recent comment, he chose to call himself “John retired U. S. government”.  It is interesting that he choses too change his name from John to one saying he worked for the U.S. Government and yet enjoys criticizing one of its most important resources the U.S. Government has in Panama.

Not often, but sometimes, there are comments that come to Chiriquí Chatter from disgruntled U.S. citizens that are unhappy with where their country is going. They may be disgruntled because problems they have found living in Panama.

Sometimes it is because of not having the U.S. Embassy do things the way that they think it should be done.

I have met with two such U.S. citizens (both men over 60) who had come to Panama and married a young honey 1/3 to 1/2 their age and wanted to take them to the U.S.. It may have been to live or just for a vacation. When their new spouse was denied a visa, they wrote me and were very irate.

What they didn’t realize was that their new spouse may have left out a few details of her life, prior to him, and the Embassy discovered it. The Embassy would not discuss the case with them, which also made them mad. While I understand their frustration, I also understand the visas being denied.

John is here to complain and this time because of the Embassy requirement for a bank check for payment instead of accepting cash. He states that the Embassy should have known about the bank’s requirements or limitations for issuing a check.

The Embassy can only give its requirements. It was determined that it was not safe for Embassy personnel to carry large sums of money and they were instructed they could no longer do it. Now you would think that John, being a 35 year U.S. government employee, would understand receiving orders and obeying them.

What banks in Panama do and the Panama Government does is not under the Embassy’s control.

John chooses to use sarcasm, knowing full well my name is not Donald, and saying I am misguided. John is confused. Donald is name of the fellow hoping to reverse the current direction of the U.S.

I have to assume that John is wanting credit for serving in the Military. I assume he served in Viet Nam. During the Viet Nam War, I was working for McDonnell Aircraft Company in advanced design for the Phantom 4K (one of the most sophisticated aircraft of that era) and on the U.S. Gemini project. Both projects required a Secret Clearance, which I held.

I have a hunch John would have been challenged doing the work I did. Maybe not. However, working in the work I have done doesn’t make me great and serving in the military doesn’t make an individual (even John) great. Most of the people I have known, who have served the U.S. in uniform, are proud of the U.S. Embassies and are willing to lay down their lives for them. They don’t go around bad mouthing them. However, they may have been “misguided”.

I worked nine years in the Washington D.C. area for EDS. I often say that that time gave me plenty of experience to understand why my taxes were so high and why I felt that I received so little benefit from paying the taxes. Still, while the U.S. government isn’t perfect, it still is the best form of government going.

John says I have a bias against the Panama government and healthcare. I have no bias. However, I do feel that there needs to be plain talk about what people are going to find, if they move here to retire. You can get very good healthcare in Panama, if you can afford it. If you can’t afford it, you will go to a public hospital and hope for the best.

I just looked back over some of the cases I have worked on, meeting patients in the David Regional Hospital for the Embassy.

I had one person that was in the hospital because he was hit by a car crossing a street in David. The social worker called me one morning asking if I could come to the hospital and tell the patient that he needed to leave because the hospital needed the bed.

I went to the hospital and the patient could barely talk. He was still in pain. I had the Embassy talk to the social worker and she was asked what their plan was. The social worker told the Embassy that if he didn’t leave, they might be forced to put him by the side of the road. The Embassy staff person asked if that was the same thing that would happen to a Panamanian. I didn’t hear the answer.

I left thinking he was going to be transferred to Mae Lewis, a private hospital. He had the funds to pay for private care, but was taken to the Regional, because most accidents are taken there. I got a call at 6PM by his landlord saying he had been brought home and he couldn’t talk. Lilliam and I went to his house and called 911. He died while the 911 attendants were trying to stabilize him to return to the hospital.

In my mind, he died because of the doctor that instructed the social worker to have him released and the social worker following her instructions. I am confident he would not have died in Mae Lewis.

There were two more patients I met in the Regional Hospital who had been transferred from Hospital Chiriquí after they had run up bills of $40,000 and had run out of funds. Both died after a couple weeks stay in the Regional Hospital.

Another person I met had been transferred from the Interior of Panama to the Regional Hospital after falling. He didn’t have insurance and this was the only trauma hospital that could take him, even though it would have been closer to Panama City’s Santo Tomás. He also didn’t leave the hospital alive.

I believe the Regional Hospital does the best they can with what they have and there is a tremendous amount of construction going on at the Regional Hospital to serve more people. There are a lot of good people working there, but the staff is stretched to its limit, from what I have seen. I will still say that I would want to go to a private hospital as my first choice.

I feel fairly confident that Marion, my friend that was shot and left for dead in Potrerillos, would not have survived had she not been fortunate enough to be admitted into Mae Lewis.

On another occasion, there was a U.S. citizen that was in need of surgery and his son came to Panama to see him. The Embassy asked if I could assist, as the son did not speak Spanish. After being here a few days the son needed to return to the U.S. and I took him to the hospital to say goodbye.

When we got to the hospital, I was told he could not be seen. I said it was important for the son to talk to him because he was returning to the U.S. and it might be his last time to see him.

The nurses started making calls, because they are usually helpful when I hand them my Embassy introduction letter. They finally came out and gave the son and me masks, gowns and gloves to put on.

We visited the father and after I left, I learned that the ward had a bacterial resistant virus and it was not safe to be there. Sometimes my not willing to take “no” for an answer puts me in places I shouldn’t be. It was good that he got to see his father because he only lived a few days after having surgery.

Because of volunteering for the Embassy, I have had the occasion to meet a doctor in one of the local clinics that always complains about freeloading and indigent U.S. Citizens that expect free healthcare from Panama. He always says he can’t understand why the Panama government allows these type of people to come here. He always says this in Spanish assuming I don’t understand.

Now this is not a criticism of the healthcare system, but it is a criticism of this particular doctor. In both cases he implied that he would treat the patient if they made an appointment at Hospital Chiriquí (I assume this is preferable because he wanted more pay).

Still, I agree with him in that no U.S. citizen should plan on coming here and taking advantage of a public healthcare that is intended for caring for the people of Panama. None the less, his attitude was not one of a doctor I would want in control of my life.

I have visited U.S. citizens (both men and women) in Chiriquí jails. I have had experience with the Panama judicial system,

Everything I write is from personal experience and I would characterize my self enlightened as opposed to misguided. John chose to try to insult me by his “draft dodger” and “robot” comments. Well done John. You are a class act.

To those that came here today wanting to see a feel good post about Panama, I apologize for letting John piss me off. I normally ignore comments from small minded people, however today the wind was in the right direction and he insulted an organization I watch go beyond the call of duty on a daily basis. I am proud of the U.S. Embassy in Panama and proud to be a volunteer supporting them.

31 thoughts on “This Deserves A Special Post

  1. Well Don, there are a lot of John’s in the United States…….so many Americans have this sense of Entitlement wherever they hang their hat. One of the reasons we are leaving the US to head to Panama full time is because of the attitude of so many Americans here….so tired of their whining….while living in such a great country……We appreciate your honesty and know heading in to our adventure that it isn’t always going to be smooth sailing and we are fine with that. We plan to be prepared with our Health Insurance when we finally settle there full time. We do not expect Panama to take care of us (as we don’t feel the US should either)….It is our responsibility as adults to take care of ourselves. Last month when we were in Panama we took a day trip up to Boquete. We had breakfast at a little restaurant and sitting outside were many “older” Americans complaining about one thing or another…..could not wait to get back to Boca Chica to our little community and listen to the howling monkeys instead!!! No wonder the rest of the world has such a bad opinion of Americans….Heck I’m sick of us!!!!

  2. there is an upside to your troubles, I got to hear some personal experiences that sheds to light on a circumstance I may need to deal with. Thanks for sharing!

  3. Thank you for your valuable work with the Embassy. We plan to settle in Boquete for a few years (from Ohio). We’ve researched the 3 types of healthcare and understand it is our responsibility to use the private market and would never want to take resources intended for Panamanian citizens. We aren’t freeloaders in US and don’t intend to be in Panama. We consider ourselves guests on pensionado visa and hope to give back to the community in some ways. It’s too bad the “johns” paint a poor example of Americans to the medical community when there are probably many more expats that respect the locals and intend to be self sufficient.

  4. ….sigh. About all we can say is thank you Don for your willingness to serve as our Warden and as well to keep us informed.

    When you share your pissed-off-ness we feel your pain.

  5. Bravo, well said/written. My wife is Panamanian but, left here when her Grandmother sent her to Chicago to live with an aunt who was a nurse. My wife worked part time and sent herself through Univ. of Ill, Chicago and graduated with 4 different degrees in Education. However, we met, I an BSEE by then, and moved to South California. My wife has 7 Tia’s in Panama along with over 30 cousins. We moved to Panama on 02 Dec 2010 after I retired from JPL having completed my task of preparing “Curiosity” Rover for her famous trip to Mars. Well, my wife became a little agitated with the fact that our 4 children and 11 grandchildren were being taken care of by our in-laws…..thus, this past Feb, 2016, we moved back to California to be close to our 11 grandchildren instead of seeing them only once every 49 weeks (once a year). Yep, we’re adapting again at 72/68 to I hope, our last international move. Don’t want to do this again……We live in the Mountains East/North of Los Angels and its nice and cool most of the time and we can be with our children within a couple of hours. That makes my wife feel a lot more at ease but, we will, beginning next year, start traveling back to Panama to visit our relatives there for 3-5 weeks at a time…Can’t let go entirely…so, keep up the good work with your news….enjoy reading it and we use to enjoy coming up to Volcan and David at least twice a year…..we’ll be back…..just, not as often OBTW, our home was in Las Cumbres great view…..Regards to all,, Ron y Bedalia
    .

  6. A spot-on post, Don. The part about the hospitals, sadly, are exactly why I’m getting ready to repatriate. I LOVE PANAMA. I LOVE THE PANAMANIAN PEOPLE! I’m going to miss this place terribly. But it’s impossible for a 74-year-old guy with COPD and three arterial stents to get health insurance, and as you know, Medicare doesn’t cover you when you step outside the borders of the U.S. It’s been a wonderful six years here.

  7. I recently talked with Marion and she has left to live in the neigjhborhood near her daughter in Mexico. She will NEVER be the same but she seemed excited to start a new life in Mexico. Her daughter deserves the credit for pushing to get proper care and giving her mom every possible chance to survive. You Don helped a great deal as well. I believe that if folks helped each other and stopped attacking each other, the world would be a better place. US politics should be left in the USA. As they would have to put handcuffs on me and put a gun to my head to make me go back to the USA, I will pray for my sons and my grandchildren. But I won’t go back. Panama is a much better place. Sadly, there is more freedom in Panama than in the USA.

  8. Don, I couldn’t help but think after reading ” complains about freeloading and indigent U.S. Citizens that expect free healthcare from Panama. He always says he can’t understand why the Panama government allows these type of people to come here. ” that this doctor qualifies for honorary American citizenship – free Republican registration included!

  9. My personal experience with the health care system in Panama.

    About 3 /12 years ago, my father in law was having trouble with a persistent cough and sore throat. He went to the local doctors who diagnosed the early signs of throat cancer and sent up an appointment for him to see an oncologist in the public oncological hospital in Panama City.

    He traveled to Panama City and met with the doctor who decided he should undergo a series of radiation treatments. Over the next several months, he travel 9 hours each way, each week on a bus from David to Panama City for the treatment. The treatments lasted about 6 months.

    Julio went back to his normal life and 6 weeks later the cancer was back. He went back to the oncological hospital and met with the doctor who said, “Its your fault, we were going to suggest chemotherapy but you missed an appointment”. That of course was not true but how can you argue with them and what would be the point.

    The next step was to take him to see a specialist at Paitilla (Central Medico in Panama City) who said that because he had his limit of radiation and they had not given him chemotherapy, they would to perform surgery. He was admitted but had a bad lung infection that had to be cleared up prior to surgery. That was done, he had the surgery to remove the cancer and his ability to speak. This cost $40,000.

    Julio returned home and recovered pretty well, stared eating solid food (he had a tube before) and went back to working a little at a time.

    A year later the cancer returned and there was no money for private care and therefore he returned to the public system. The Oncologists were miffed because he had sought private care and again blamed him for his plight.

    The next 12 months saw him traveling each week to Panama City, on a bus, 9 hours each way, take an hour of chemotherapy, then return another 9 hours to Chiriqui.

    The tumor appeared to be shrinking however at times, it would grow; due to holidays, a lack of medicine, they would often cancel his appointments for 2 weeks and it seems that would put him into a bit of yoyo treatment, with the tumor shrinking and growing then shrinking again.

    His tumor then started to grow again at which point the doctors decided to increase his dosage of chemotherapy.

    Again traveling on a bus 9 hours each way, now while getting sicker and sicker, the treatments were never consistent.

    I late June, he was admitted to the Regional Hospital in David as his tumor was at the point where he was having trouble breathing. He spend 3 days in the hospital and was not provided any food because the hospital did not have the liquid food (ensure) to give him, they did not allow visits for 2 days because they said there was too much danger from A1N1 virus. When family were finally able to visit, we discovered he had not been given ANY nourishment, they brought ensure and fed him, they released him the next day.

    On July1, he had to be readmitted to the hospital in David at which point they declared his condition terminal and placed him in palliative care. Again due to the stated reason of the virus, they would not allow visits by family. His stepson was finally able to have a short visit with him on July 3rd after getting aggressive and loud.

    On July 4th at about 6:30 PM Julio died, alone and most likely starving. He had lots of family willing and able to visit and be with him at his final time of need but it was not to be.

    You can imagine what I tell people now when they ask me about health care in Panama. Many if not all of the doctors that work in the public system also work in the private system.

    I do not accept that the care in the private system is ‘good’; how could you entrust your health to the same people that torture and allow their own fellow citizens to be maltreated? Those people that have had a good experience in my opinion have just been lucky.

    In Panama, the public system cares nothing for its patients, I fail to understand why they would make a sick person, almost 70 years old, travel in a cold bus, all night long to receive chemotherapy? Wouldn’t it make more sense to put the medicine on the bus?

    While I am certainly no doctor, my reading and understanding about treating cancer is that you throw everything you can at it as soon as possible, radiation, chemotherapy and at the highest level that the patient can tolerate, seems that the system here is to use as little medicine as possible and prolong the treatment.

    Doctors in Panama are dead set against letting doctors from other countries come and work in Panama, it is laughable that the stated reason is to protect the health of Panamanians, it is clear that what is being protected is the income generating opportunities of the doctors; better to make the people wait and keep the revenue flowing than allow doctors to come in and take a cut.

    My advise if that if you have the means and the possible to seek medical treatment outside the country, you should do so, instructions to my family are: Get me stable, then send me outside for treatment.

  10. I have a message for those old fools, I mean gentlemen.

    If it flies, floats, or fu@ks, RENT IT.

  11. To Tim: Ding Ding Ding!!!! You win the price on your very first guess!!!! First & last time we go there…..put a sour taste in our mouths the rest of the day,,,,,

  12. Great posts Don. And, as others have already said, keep up the good work. (Not that you need my encouragement).

    Alas, here I am, nearing retirement age and still living in the USA, hoping to move to Panama for three main reasons:

    a) escape from the sort of Americans represented by “John, Retired US Navy”,
    b) to make my Social Security income stretch just far enough so that I don’t have to work at the same soulless job until I drop dead, and
    c) find affordable healthcare when I need it.

    And I’d been given to understand that Panama could be the place to fill these needs.

    Now I’m not so sure.

  13. Right on! When you only complain about something without offering a solution you are whining. But this guy is beyond that. Well done (as always) Don Ray!

  14. PS: also, to stay far away from Anerican expat communities such as that in Boquette described by Susie up above.

    Cheers – Wendy (my real name – I post under my blog name – the blog is rather new and raw – I’m collecting and posting thoughts, discoveries and experiences on my “planning to move to Panama stage.”)

  15. Don,
    Your post is good…but don’t waste your important time with guys like :John Retired US Government. He is not worthy to be in your thought process!
    The conversation about health care here in Panama can be discussed indefinitely! Search the WEB… !!
    If folks are going to move here and not do their homework they are SOL.
    While we were in Medellin recently we met a gal who is working for the US Embassy in Panama and the stories she told of some of the most outrageous commands requested by US citizens were appalling and embarrassing to be an American.

    To Wendy:
    You stated:
    ” PS: also, to stay far away from Anerican expat communities such as that in Boquete described by Susie up above.”

    If you are going to base an area or community in Panama on a comment here on this blog or any other blog without having first hand actual experience to see for yourself, you are not making informed decisions.
    Opinions should be formed from actual experience being in a particular community. Not from hearing some coffee shop gossip!
    Yes…Sugar and Spice is at times gossip central for SOME US expats that want to complain about the US. The majority of the customers at Sugar and Spice are enjoying living here and are not part of that very minuscule crowd.

    Boquete is a heck of a lot more then just Sugar and Spice. Just like Boca Chica is great in many respects so is Boquete.
    Life is what you make of it ,no matter where you live.

  16. Boquete is a wonderful little town…..just need to stay away from the places frequented by disgruntled Americans who aren’t happy no matter where they land…..

  17. I have visited Panama many times. My wife & I rented an apartment in Boquete getting the flavor & deciding if we wanted to move. After 4 months, doing everything we felt was fun & interesting many times, we decided Panama was not for us. Our decision had nothing to do with Panama. It was just I was not able to do the things that interest me most. I love shooting, reloading & collecting guns. This is impossible in Panama. My wife was perfectly happy with her internet & friends.

    We fell in love with the people & the food. I needed lots of dental work done & found the perfect dentist in David. Excellent work at about 1/3 the cost of work done in the states. My wife needed surgery for cancer on her lip, & once again we found the perfect doctor in Panama City who did the surgery for about 1/8 of what would be the cost in the states. Anyone who thinks they are just moving to a more southern United States hasn’t done their homework or checked it out personally. We will be back for visits, but home base will always be Louisiana.

  18. #1 problem with medical care in Panama: no blood bank.
    It is not much of a problem for Panamanians, they have family and friends to donate.
    Expats will not have that advantage.

    jim

  19. To John & Susan @ Latitide Adjustment – regarding my comment on the expat community in Boquette – apologies, I meant no offense (realizing you’re part of the expat community in Boquette). Generalizations are never a good thing. But I was referring to the sort described in Susie’s comment. I have every intent of making my own conclusions after I actually visit several locations in Panama, including Boquette.

    And as to finding all sorts of information on healthcare in Panama out on the web – of course it’s out there, but it certainly would be helpful to receive some guidance from someone with first hand experience.

    What troubles me is that everything I’ve read on healthcare on recent posts and comments to those posts on Don’s site here goes completely against everything else I’ve come to understand about the healthcare in Panama – from other expats who live in Panama. So, what then is the real answer – where does one get reliable information on healthcare & health insurance for foreigners desiring to settle or retire in Panama?

  20. Wendy,
    Try these agents for information and quotes for health care:
    Gonzalo de la Guardia ( He is our agent for VUMI International Heath Coverage)
    He represents several companies.
    “International Health Insurance”
    Cel: 507-6671-3357
    Office: 507-393-5530
    gdelaguardia@gmail.com
    Skype: gedelaguardia
    Panama City, Republic of Panama

    http://www.detresnoinsurance.com/
    Gloria Detresno…..she is our agent for auto and property insurance and represents several Health Care companies. She has been in busieess over 20 years and her service is excellent as well as Gonzalo de la Guardia!

    VUMI, World Wide, and Bupa and the best of the companies out there. You can chose several different plans, deductibles, coverage to suit your budget.

    We have not had to use our insurance so we can not personally say how the claim process is but in doing our research VUMI has a great reputation for paying claims on time and it is all done through email. VUMI is Gonzalo’s Health Insurance Company for him and his family. We know friends here that have World Wide and have nothing but praise for them after having to file claims and getting reimbursed.
    Our VUMI policy went up $400 this past renewal and come next renewal we will look at World Wide.
    Something that was very important for us: Having coverage any where in the world (we plan on doing a lot of international traveling) including the US, for our occasional visits back with family.

    Here is a link to our insurance experience:
    https://latitudeadjustmentblog.com/2015/06/29/misadventures-in-health-insurance/#more-524

    If you have any other questions you can always contact us through our blog.

    Good luck!

  21. Hi Don ,

    Great post. You are a tremendous asset to David. The main reason my wife and I are not retiring to David is the poor quality healthcare. Over many years visiting Panama (30 plus) I have seen many Americans returning to the USA to get better and cheaper health care (cheaper if you have Medicare). It is not directly the fault of Panama that is to blame, a relatively poor country of 3-4 million people can not be expected to have the same health care system as a wealthy country of 350 million. It is the same as expecting the same quality hospital in rural Montana as you have available in Miami. Day to day medical care in Panama is OK but in a serious emergency situation you will have mayor problems. Also if you run out of money in Panama your medical treatment is more or less terminated, in the US we have Medicaid if you have limited funds. We love Panama and will continue to visit but only for a couple of weeks at a time and have insurance to fly us back to the U.S. if needed. The poor ambulance service outside the city as well as not having a blood bank should be considered by anyone thinking about retiring to Panama, especially us old coots. A large number of elderly folks eventually develop serious medical problems and should have a plan ready to deal with the situation before it occurs.
    Best wishes to you and your lovely wife.

    Len and Ping Rowland

  22. Boquete was paradise in the 1990’s. Now, honestly there are way too many “entitled” expats whining about customer service, medical care, and gov services. We are tired of seeing you loudly complain at Price Smart with the 6 words of Spanish you’ve learned. Go home.

  23. Joel, you should have seen it in the ’70’s and ’80’s. There were nothing but folks working hard to survive, no crime (aside from an occasional mango or blackberry theft), and everyone spoke to everyone on the streets; even to the funny-looking, pasty-white, blond-haired gringo. You could count the cars (trucks) parked in El Centro on both hands.

    It was a paradise then.
    jim

  24. I remember when i first came to Panama in the mid 90s it was still in the post military years and there was crime every where still. Every gas station and super market had a private guard with shot gun. It was a different world. I think things are a lot easier now. I once got returned away from the border because I didnt havent 500 cash on hand to show the agents at those times. It took me years and thousands of dollars to get my cedula and now they give cedulas to everyone basically. You couldnt even walk in a bank if you didnt have pants on back then either. I remember not being to leave the country once at the airport because I didnt get a multiple visa exit on my passport. Now I see people coming and complaining. It was a lot worse in the old days.

  25. “A lot worse in the old days” could be construed as more challenging, and paradoxically, made it a better place. Almost all the police, immigration, and authorities treat you with respect if you speak Spanish and drop your sense of entitlement. (As opposed to US law enforcement brainwashed to treat all as potential terrorists) “A lot worse in the old days” meant fewer entitled gringos loudly complaining about their chip debit cards not swiping. “A lot worse in the old days” meant no gringos living on disability loudly complaining in Boquete cafes about Obama and gun control, as if it matters here. But I do hear your point. Cheers.

  26. Don thank you for all your wife and you do for the expats in Panama. I know it can at times be a thank less job. But I do read your important info you provide. Becky W.

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