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US Health Care Ranks Below Costa Rica?

Posted on Monday Aug 24, 2009

Words (1145)

(Warning:  Eric rants!)


I don’t normally pay much attention to the latest in US news.  But for us who know 3rd world health care very personally I can’t stand not saying something.  So I thought I would post it here where no one really reads it.


The WHO ranked Costa Rica’s health care above that of the US and many people in the US were shocked and upset.  Well, I can tell you the health care here is better, faster and cheaper.  In the capital, San Jose, they have all of the latest high tech equipment from MRI and 3d TAC to bone scan machines.  You can walk in without an appointment get a scan, pay $20-$150 and walk out with your results usually inside 2-3 hours.


So I was a bit offended by the people who were offended that even Costa Rica ranked higher.  Well, I would definitely rank Mexico higher than the US too and I found Mexico was way down on the list at #61 (http://www.photius.com/rankings/healthranks.html).  But I looked closer at the requirements and I think if you look at the health performance rankings by country it provides a better picture (http://www.photius.com/rankings/world_health_performance_ranks.html) with Costa Rica #25, Mexico #63 and US #72. 


My real problem is with all these people on TV screaming about health care.  (Keep in mind I can only see Internet news and for TV it’s Fox News and CNN International and CNN International isn’t at all interested in the subject).  Please, the system is broken and the insurance companies, pharmaceutical companies and lawyers broke it.  Let’s not try to defend the current system.  I see it has gotten to the point where some people show up with guns to the political rallies.  What the hell?!  People are not getting proper medical treatment or going bankrupt trying (about 50% of bankruptcies are as a result of medical expenses) should be the focus of anger.


It is crazy.  Medicare and Medicaid are social programs.  So are the police and fire services, big deal.  The bulk of the non-war related deficit is in Medicare/Medicaid so there is a lot of room for “social” improvement.  Why are so many people afraid of trying to fix some that is broken for most Americans?  And I say “most” Americans because after experiencing health care of other countries I didn’t realize how bad I had it.


I can empathize with people who have steady jobs, employer covered insurance with reasonable co-pays not being interested in change.  However having had major health care issues in Mexico and Nicaragua and smaller but non-trivial check-up type exams in Costa Rica, Panama and Ecuador, even that insured service isn’t great in the US.  (Sherrell would be denied insurance coverage in the US because of pre-existing conditions, making coverage unattainable in the US for us).


As an uninsured foreigner, for example, I can walk into a clinic, see a doctor ($4.18 in Ecuador to $50 in Mexico), discuss my problems (no time limit), and get recommendations for tests.  I can then walk into a testing facility, either independent or associated with a hospital and get my testing done that day (assuming I don’t need to fast or something unique for that specific test).  I pay less than $200 (even for complex tests) and walk out with my results in my hands.  I can then choose to go back to the previous doctor (the follow up is often free), or take my results to other doctors and shop around for opinions.


If I need hospitalization the costs run between $15 (Ecuador) and $200 /night (Mexico), with $100 (Nicaragua) being more common.  These prices are all inclusive of care and medication at high-end modern facilities designed to US standards and there are cheaper options of course.  They are fully staffed and are often certified by American Quality Assurance companies for safety, cleanliness and training.  The same goes for the medical labs with certifications for both equipment and training from international organizations (usually US).


I don’t claim to know all the ins and outs of the finances behind each country’s system.  However looking at the WHO rankings I see these countries are no where near the high US costs and yet doctors are still paid well which I think is very important.  For people who need special high cost operations and have to go through the fully covered insurance of a socialized program, progress can be frustrating and slow, but at least they can get help.


While I don’t trust politicians, I do think a new approach is needed to health care and trying just about anything is worth the risk.  The worst that could happen is we could increase the deficit and the same people don’t get health care.  It’s not like we are going to war where people will die and trillions of dollars will be lost.  I really don’t think the hostility shown against the new plan is warranted at all.


In Costa Rica employers pay 9.25% and workers pay 5.5% to the health care system.  The overall amount is much less than is spent in the US and yet not everyone is even close to being covered in the US.  People like Sherrell are SOL for coverage in the US and the costs are so high forget paying it out of pocket.


Health Care is like dealing with cancer, there is no good solution.  No one is going to be jumping for joy but I think the US can do a lot better if they suck it up and try something new rather than complaining.


The history of Costa Rica’s system which is 68 years old and has both public and private option for full coverage.  The system is very interesting and mirrors the US debate, only in 1941 when it started, not 2009.  Looking at the history shows me why there are a lot of dollars being spent to lobby congress as the public option helped keep the private sector from reaping billions in profits.  http://www.ticotimes.net/topstoryarchive/2009_08/082109.htm  However it is a system similar to Canada, which the US is not going to adopt, but many of the arguments in 1940’s were the same as today in the US and were proven to be invalid.


Unfortunately I feel the US health care plan will probably be whittled down by big money and be too little too late.  And people like Sherrell will still be un-insurable.