While it’s true that most Americans are not happy with their health care, in sharp contrast, a very small subset is very happy with the care they receive.
Here are the numbers.
In August 2017, Gallup asked Americans their view of the health care industry.
Here are the results:
- Very positive: 9%
- Somewhat positive: 29%
- Neutral: 18%
- Somewhat negative: 26%
- Very negative: 19%
In the study “Expat Report: How is Healthcare Abroad?” released May 2016, our company, Best Places in the World to Retire, reported the results of the survey we did of expats in Panama, Nicaragua and Belize. One of the questions we asked was: “Overall, how satisfied are you with the health care you receive in your home abroad?”
Here are the results, segmented out just for American expats:
- Very satisfied: 45.1%
- Somewhat satisfied: 27.1%
- Neither satisfied dissatisfied: 14.7%
- Very dissatisfied: 4.1%
- No opinion: 3.0%
In an upcoming study we concluded earlier this year that we will publish in a few months, we asked the same question of US expats living in Mexico.
The results were even more lopsided:
- Very satisfied: 59.2%
- Somewhat satisfied: 20.2%
- Neither satisfied dissatisfied: 7.4%
- Very dissatisfied: 2.6%
- No opinion: 0.9%
Because it is very likely that the health care received in the US is more uniform among economic classes than it is in the countries we cover, we should remember that expats are responding to experiences with their own care, as opposed to the general health care system provided to everyone (locals included) where they’re living. For example, the health care provided to a typical American expat in Mexico, Panama or Nicaragua will be quite different than the typical health care provided to an average Mexican, Panamanian, or Nicaraguan in their home countries.
With that stipulation, the huge differences in the results above are eye opening. I’ve spoken directly with more than 500 expats, who almost uniformly rave about health care cost, access, quality and the overall care they receive abroad. In July 29, 2017 I wrote an article for Newsmax titled “4 Reasons Healthcare is Lower in Mexico, Panama, than US”, in which I offered some reasons for these differences, and I’ve documented what happened with my own health care situation in “My Personal Experience Comparing Healthcare in the US vs. Mexico.” Here is what other expats we talked with say.
Mike Cobb is an international businessman who comes from Pennsylvania. Here’s what he says this about health care in Nicaragua: “Metropolitano Vivian Pellas, in Managua, has Joint Commission International accreditation, which is difficult to receive and is a very good indication that the facility receiving the accreditation is up to the highest international standards. My daughter had surgery there and I go for general checkups and executive physicals. Metropolitano provides top notch care at a fraction of the price in the US.”
In most of the more significant expat areas we cover, excellent, low cost medical care can be provided in English. Mike Cobb speaks very little Spanish. Melissa Darnay moved to Panama from Dallas, Texas, to Panama, when she spoke less than a dozen words of Spanish. She told us, “Earlier this week, I had chest pain and numbness in my left arm and was convinced I was having a heart attack. I went to a little medical clinic similar to an urgent care clinic in the US, where I was seen within 30 seconds. Within an hour, I had been completely tested and checked out, including my oxygen level, pulse, blood pressure and I even had an EKG. They provided competent medical care, spoke English, and the entire bill was US $60, out of pocket, with no insurance. How much would that cost in the US?”
Spencer McMullen, originally from Santa Barbara, California, now practices law in the well-known expat destination Ajijic, in the Mexican Highlands. McMullen told us, “In the private hospitals in nearby Guadalajara, you almost have what looks like a mini hotel room with a reclining chair so your family members can sleep next to you.”
Former South Carolinian Marla Diaz now lives with her husband and child in the beach town of Coronado, Panama, another well-known expat destination about 45 minutes to an hour from the capital, Panama City. Diaz reported her firsthand experience. “I was living in Panama less than 6 months when an accident had me in need of an emergency back surgery. Being an American I knew very little Spanish and was really worried about my ability to communicate my needs in this critical situation. I was so surprised that every one of my doctors spoke great English.”
Diaz then told us about the quality of the care she received. “The hospitals had state-of-the-art equipment. I felt very well taken care of and had an extremely positive experience in a very stressful situation.”
Janice Gallagher used to live in Dallas, Texas. Now, she lives in Granada, Nicaragua, a colonial city. Gallagher told us, “Although small, Granada does have some very good doctors on all levels. There are good dentists, eye doctors, pediatricians and general practitioners in Granada for your basic needs. And, believe it or not, they make house calls!”
Yet another former Texan, Ron Morgan, has been living in Puerto Vallarta for 17 years, and visits the US frequently. When he compares the health care he receives in his expat home with the health care his friends receive in the US, Ron is extremely impressed with the health care he receives in Mexico. “Private hospitals in Puerto Vallarta have state-of-the-art equipment and a nearly equivalent ratio of doctors to nurses,” reported Morgan. “You don't wait in the emergency room; you will be immediately seen by a doctor and nurse. I broke my foot two years ago and was out within an hour-and-a-half with a bill of US $160.”
Several expats told me about how the physicians they saw had practiced in the US. Roger Pentecost lives in the somewhat remote, small town expat hamlet of Boquete, which did not have sufficient medical services for his needs. “We chose to go to a hospital in Panama City, where we could use the services of Dr. Fabrega, head of his specialty of surgery for 16 years at Sloan Kettering in the US, and looked upon as a world expert,” Pentecost told us. “You can’t believe the modern equipment and techniques they have in Panama City and how fast and efficient the service is.”
Until a few years ago, Terry Bradford lived in Southern California. Bradford commented on the differences in the quality of care she received in her new home in Panama. “Here in Panama, the doctors are with you for one full hour. They do not rush the patients through like a bunch of cattle.”
“In addition,” Bradford continued, “doctors give their phone numbers to their patients, so you could call a doctor at any time and ask him a question. You do not have to wait several days for a return phone call like you do in the US.”
Many times, the cost differential is shocking, even for sophisticated care. Wade Yarchan used to live in Sarasota, Florida, and now lives in the Yucatan, in Mexico, in large part, because of the health care he could receive there. Yarchan told us, “I have a blood condition for which I needed specialized treatment. We looked all over the world and finally chose Mexico. Treatments in the US that cost $17,000 a week only cost a couple hundred dollars a week here in Mexico. The medical here in unbelievable. Oncologists in the US would be $600 per visit, yet here in Merida, you can go to one of the best oncologists and pay only $35.”
Just like in the US, the health care you receive in small towns abroad will be more rudimentary than in large cities, which have the population and wealth concentration to support larger hospitals with more sophisticated equipment.
Just like you would not expect the small island of Catalina, near Los Angeles, to have a 1,000-bed hospital, you should not expect an island in the Caribbean at Bocas del Toro, Panama, to have the same facilities as Panama City, which has at least three state-of-the-art hospitals, one of which is managed in conjunction with Johns Hopkins. Also, for extremely unusual cases that require very specialized care or if you have an unlimited amount of money (think: fleeing dictators), the US will probably be the better option. For the rest of us, however, the results above can be quite compelling. They were for me.
Chuck Bolotin is the founder of Best Places in the World to Retire (click on: https://bestplacesintheworldtoretire.com/), a website that provides credible information to those researching moving, visiting, or doing business abroad. Prior to that, Chuck founded, funded, ran and sold two companies. He is a frequent guest lecturer at the Eller College of Management MBA Program, mentored at the Arizona Center for Innovation, and frequently sat on the Desert Angels Screening Panel in Tucson, Arizona. After selling his home in Arizona and completing a one year road trip through Mexico, Chuck now lives in Ajijic, Mexico, with his wife, Jet, and their two dogs.
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