Tag Archives: Healthcare

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. Continue reading Pardon my Rant

MC Update November 6

It has been about eight days since my last update.

For those just tuning in, this is a followup to THIS POST.

Let me start off by making something clear. This is a slow process. I went to the hospital yesterday morning and there were some visitors hoping to see Marion and had heard she was very much improved to the point that she might be released soon.

I had seen her the previous day, in the morning and the evening, and she was having a bad day. She was having difficulty breathing. Then, yesterday morning when I saw her, there had been no improvement. I could tell she was concerned.

I spoke with the doctor and he said they had found fluids in her lungs again. He said his plan was to drain the fluids. He called me about 1 PM yesterday and said he had talked to Marion and explained the situation. He explained the procedure to me, and said the procedure was scheduled for 3PM. Continue reading MC Update November 6

Healthcare Reality in Panama and The Cost of Living

No talk about the cost of living should exclude the topic of healthcare and planning for it. I have no problem with publications saying that healthcare is cheaper in Panama than the US, however, comparisons in quality are seldom mentioned.

If you live in Chiriquí, where I live, there are two reasonably large private hospitals. There are other private clinics and there are public clinics and hospitals. The availability of having places to go is not the problem. It is what is going to happen once you get there.

I volunteer as a Warden for the U.S. Embassy representing the David, Chiriqui area. This puts me in touch with many cases, usually at the public Regional Hospital (The Social Security Hospital).

That is because most accidents or other serious emergency cases are either taken there immediately or sent there when they are refused admittance at a private hospital. Continue reading Healthcare Reality in Panama and The Cost of Living

Lilliam Had Her 6 Month Cancer Checkup

Lilliam has her 6 month checkup with Dr. Bullen today. Doctor Bullen comes from Panama City once a month. For an appointment, you can see the first post I did announcing that he was coming to David.

I had a second post when the office opened.

Dr. Bullen invited me to be in the room for Lilliam’s examination. Since her cancer was a skin cancer, he inspected all of her skin. Literally from head to toe.

When he inspected the scalp, he moved all strands of hair looking for suspicious areas. He checked the bottom of the feet. He said different areas were susceptible to different types of cancer. Some cancers much more serious than others.

While he didn’t look at 100% of her body, he probably looked at 95%.. I was impressed at how thorough he was.

Lilliam got a clean bill of health and will return for next 6 month visit. It is really nice that she can see him in David and not have to go to Panama City.

Checkup Time 2015

A couple months ago, I went to see Dra. Marta Sánchez for the annual prostrate exam.

All went well, however, this year I also needed to see an internist to get a letter stating I am in good health and qualify to get a driver’s license. In Panama, this is required every two years following your 70th birthday. Prior to 70 it costs $40 for a 4 year license, i.e $10/year. After 70 it cost $40 for a 2 year license, i.e. $20/year.

Dra. Marta had recommended Dr, Héctor R. Caballero, who is an internist as well as a specialist in diabetes. My dad had diabetes, and I had asked her if she had an internist with experience in diabetes.

When Lilliam called, to set up an appointment, the admin asked if I spoke Spanish. My name had raised the red flag of a potentially Spanish challenged client.

Lilliam said my Spanish should suffice and she would be there as well. Apparently, Dr. Caballero wasn’t taking any more patients that only spoke English because of past communication problems.

This is why all people planning on living in Panama need to learn Spanish. While you can find doctors that speak English, you will be limiting your options.

I was extremely impressed with Dr. Caballero. It may have been the most thorough exam I have had, He asked me to get a special blood test, since my sugar level is borderline. I did that yesterday and will have the results for the next visit in a couple weeks.

He did provide the required letter for the transit authority. I will get that taken care of before the end of the month.

The office visit was $50. $40 with the jubilado discount. I got the blood test at Hospital Mae Lewis, since we are there every day and no need for a special trip to Hospital Chiriqui to get the results.The blood test was around $16.

My appointment yesterday was for 1:30 PM. We were told to be a little early. We arrived at 1:00PM. We entered the doctor office at about 2:45 PM..

We were entertained in the waiting room by a confused woodpecker. At least I think it was a woodpecker.

I kept hearing this noise. For a while I thought someone was working outside. It continued and I finally noticed this bird pecking at the corner of the windows. He would leave and return. I am not sure what he thought he was going to accomplish by tapping on the window, but he did keep me amused. As you can see, it doesn’t take much to amused.

Rude Awakening

I received the following email this morning. Maybe it is time to put out another advisory, that retirement in Panama is not for everyone.

Hi Don Ray,
I visited with Peter yesterday. He said he had found John on the floor at the Occidental apartment. Peter said it was a hard fall but nothing was broken. It looked like someone had taken a bat to John. Peter had him transported to Regional. When they checked in at ER no one asked who would be responsible for the bill.

Regional kept him for 4 nights. Peter purchased a wheelchair. He went out there to pick him up. They unhooked the tubes, put John in the chair and off they go. The hospital did not present Peter with a bill. or ask for payment.

Peter is trying to get John checked into El Hogar de los Ancianos. John is #4 on the waiting list. Peter said they were going to charge $700/month. Peter said there is a place in Dolega but that is too far for him to go.

Peter was very impressed that you had made the trip to the Occidental and that a lady from the embassy called.

I just thought I’d update you. Some Americans are in for a rude awakening when they learn they can’t find a care home.

Cheers,

Last month I visited another U.S. Citizen in Algorrobos that is also on the waiting list. He had recently had a stroke and his neighbor’s are taking care of him until a vacancy is open. Continue reading Rude Awakening

Another HealthCare Observation

I have another healthcare case, which is providing more experience, that I feel I should share.

This individual came to Panama with no insurance, only social security income, and has developed significant healthcare issues. He was taken to one of the public healthcare facilities and was seen by the resident doctor.

The doctor was very vocal in stating that he did not understand why elder American citizens, with medical problems, are allowed in Panama and why the U.S. Embassy does not provide assistance to them. He ended the conversation saying that he would limit his service, for this patient, to just writing a report on his condition and no more.

He explained that there are no beds in the public hospitals and that a Panamanian needs to wait almost seven days for a bed.

I know this doctor, as he is the doctor that Hogar Santa Catalina took Robert (the stroke victim) for a checkup. In that meeting, he accused all U.S. Citizens of being insolvent and if he needed treatment that he would have to be taken to his private practice in Hospital Chiriqui where he would bet paid his specialist fee.

Needless to say, this doctor was removed from my list of doctors receiving a recommendation by me. His attitude is a discredit to the medical profession and he is a poor representation of Panamanian physicians. He was extremely rude to me when I was was with Robert in his office.

That being said, it should be noted that his sentiments are shared by others. Luckily, they are the minority. I will admit, that while this doctor’s deportment is deplorable, he has some valid points behind his statements.

If this individual goes to the Regional Hospital and has the proscribed CAT scans, x-rays and other tests, he may not have the ability to pay. If that happens, it will put more more burden on the already overburdened Panama system.

Most private hospitals will not admit patients without proof of payment. The public hospitals are crowed and understaffed. Walk-ins to the public hospital will most likely be placed on the same 7 day waiting list mentioned by the doctor.

I had another case where the Regional Hospital asked a U.S. citizen to leave because they said he was in good enough condition and they hospital needed the bed. I received a call from his landlady about 6 hours after his release telling me that he was not doing well. He died about 2 hours after the 911 services arrived. It was obvious that it was an error by the hospital to release the patient.

Bottom line is that if you are moving to Panama, with a problematic medical history or the probability that medical care will be needed, be prepared to pay. I took a physical prior to moving to Panama and found that I needed surgery and didn’t know it. The rumors of cheap health care in Panama is always relative.

I can visit a clinic for a cold or infection or minor office visit. The cost will be $6 for the visit and I have always been treated with respect. However, if I need to see a specialist, the office visit will be from $35 to $80 or so after the jubilado discount. In all of my specialist doctor visits, I have always been treated with resect.

I always advise any person making an exploratory trip, for viewing Panama as a retirement location, to visit the hospitals. You should also visit the Regional Hospital (public) even though you think you would only use a private hospital, because the public hospital is most likely where you will be taken, if you are in a serious accident.

If you do move here, you should immediately determine what doctors you want to use as your primary care physicians. Finding one in an emergency may put you with one doesn’t like foreigners.