Aug 19 2015

In the Mailbag – August 17, 2015: Healthcare in Costa Rica

emaildelivery-200pxOur newsletters and posts generate lots of discussion, on our website, in emails, and on facebook.

Here’s a glimpse into our mailbag about our recent issue concerning healthcare in Costa Rica.

From paddicakes:

Just to let your readers know there are private medical options in Canada. This includes shoulder replacement surgery. However I personally canada_leafdo not know anyone who has used it. I know Americans often hear of people on long waiting lists in Canada, but sometimes there are reasons for the delay. For example a co-worker waited a while to have knee replacement surgery. She also was a diabetic, and did not follow her doctors orders. She was told her diabetes had to be stable before they would operate. I myself have never experienced any delay in surgery unless you consider twelve weeks for an elective surgery is long. Even for test such as a MRI, I have always gotten in, within a reasonable time. You may get an odd time for the appointment, they run 24 hours a day. The items that make it to the media are exceptions and often like media everywhere they leave out information that takes away from the drama of the article.

From Diego:

From Bob and Linda Beavis’s story regarding their experiences with the CAJA-

“In essence they told Linda (after 12 days), “You’re a Gringo. You should go to a private hospital or you may be waiting 2 months here for this surgery.” We were appalled and immediately moved to get her into a private hospital yesterday.

The fault totally lies with the CAJA doctors who are apparently very arrogant and could care less about Gringo patients. The other hospital staff at the CAJA hospital were generally good service, but a patient is expected to tend to themselves far more than the North American standard.
Much as we are very much not the “Rich Gringos” the doctor implied, we immediately took my wife to Hospital Metropolitano where we received immediate & excellent treatment.”

First, I want to be very clear that I am very happy for Linda’s outcome and wish her continued good health. Without having met them, they seem like very nice people that would not have behaved in a way to evoke harsh feelings from anyone. I very much appreciate them sharing their experience.

Why might they have been treated the way they were for Linda’s injury by the physicians? How much are expats paying for CAJA? Less than $1,000 per year? What is the value of the treatments received? Often, considerably more. Who is paying for the difference? Costa Ricans.

As an American I do not appreciate knowing that my tax dollars often go to people who misuse social services. No matter who they are or where they are from. Why would Costa Ricans feel any differently? Many expats move here when they are older and retired. All of us will require more medical care as we age. I do not feel it is responsible to have the expectation that we will utilize a system that we have contributed very little towards.

tax1I view CAJA as an additional tax of which there are many. It can be avoided by being a perpetual tourist and making a border run every 90 days and staying out of the country for 3 days or you can just pay it. All expats should have private insurance. It’s expensive compared to the CAJA, but now the risk is shifted to a company and away from the Ticos. The CAJA system is already struggling, so we should not add to the problem. Physicians are the most aware of this which may explain the harsh feelings towards Gringos by some of them.

The fact that the quality of healthcare in Costa Rica is relatively high is important. How we access the system is also very important.

Tico’s have a very unflattering slang expression, “Pinche Gringo.” It basically translates to “Cheap Gringo”. It is not specific to healthcare, but a general characterization. I hate it…

BigMacThe Big Mac index was invented by The Economist in 1986 as a lighthearted guide to compare purchasing-power in different countries. The cost of a Big Mac in Costa Rica is very close to that of the United States which means the cost of living is also very close. If you choose to live frugally in Costa Rica or the United States it is a personal choice which I support. Take a look at the large number of drivers of Porches, BMWs and Land Rovers flying down Ruta 27 and you will see that they are nearly all Ticos. They are chasing, “The American Dream” which is why there is close parity with the US in the cost of living.

I realize I may be offending many people who have a different view. I do not feel I have the right to tell anyone how they should live. All I ask is that people try to see it from the other side and fight to perpetuate the negative stereotype that exists. I realize generosity can be expressed in many ways and not just financially. It is important to me to be considered a generous expat and I still have a lot of room to improve.


From David F:

Love how the posts here are never sugar-coated. We always get to hear the good and the bad!

Thanks David. We try to paint a balanced picture. It’s hard sometimes since we love it here so much. But as we always say “we want people to come here with their eyes wide open.”

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