Go To Health

This is a recap of a friend’s experience with medical care (and costs) in Panama compared to what it would cost him in New Jersey.

No healthcare insurance, so what.  I have only had health insurance for maybe three years in my adult life. In todays’ dollars, insurance for all of that time would have cost me over $600,000 to be totally ‘protected.’  I am normally healthy and do see a doctor once every four to five years. Those visits are for things that are not recurring problems.  My full time real estate career started in the 70”s and I am not yet old enough for Medicare.  I did take care of my parents from their mid-70’s on, shuffling them from doctors to tests to hospitals for fifteen +  years, so that gave me experience with doctors, labs, hospitals and costs.

Until this week, I never had an EKG and the last blood work that was done was in the 80’s or 90’s, I don’t remember.  I have had an umbilical hernia for a year and a half and it started to get annoyingly larger during the last six months.  I broke a crown six weeks ago. The crown was twenty years old. The locals here wanted about $3,000 to ‘fix it.” Time to go to Panama.

I did have a tooth implant two years ago in NJ and it was around $4,000+ for one implant.  I will be going back to Panama soon just to have two or three implants for $1,200 each. This will save $5,000 to $9,000 even after air and hotel. There is an additional 15% discount for passionate status.

My family history includes basil cell skin cancer. I did have a large spot taken off of by back in 2000 on a vacation trip to Singapore. On the flight from Hong Kong, there was an article in one of the inflight magazines recounting how more and more people were becoming medical tourists. The dermatologist I went to was a Chinese woman doctor born in Malaysia, living in Singapore and did her residency at NYU medical center in New York. The procedure was efficient and she sent off the biopsy to the local lab for testing. Her fee was $200 and the lab was $40. The results were mailed to me in the States with her comments. I did need follow up and went to a local NJ doctor. That on charged me $1,200 including lab fees. There was another visit in NJ to freeze off some basil cell spots. Eight spots were frozen on one visit and the bill for the less than two minutes with an aerosol can of liquid nitrogen cost and additional $250.  Relatives tell me that the rate for freezing one basal cell is $100 now.  Just one of those cans of liquid nitrogen probable brings a dermatologist $10,000 in billings here. I tried to buy a can 12 years ago but was unsuccessful.

The hernia operation that I had in 1983 was without health insurance. I had a surgeon recommended. He was told of no insurance so he modified the procedure. Sitting in his office, he called the hospital and ordered an operating room for outpatient surgery.  I could only hear the conversation from his side. He told the administrator that “no” for each and every test and add on that the administrator rattled off. The cost was under $1,000 for everything, including the anesthesiologist.  So much for routine tests.

So what is the point to all of this? Jackie extolled the virtues of Panama including low cost health care. During the trip with Jackie in 2011, I did see firsthand what the country has to offer.  Panama City is not much different than San Diego, Miami, Hong Kong or Singapore. Drop you in downtown and with no street signs they look the same, beautiful modern buildings with people scurrying about their business.  The only difference is that the cost of living is much less than those other cities.

I made arrangement to have the hernia taken care of and a dentist appointment for the broken crown and implant consultation over the phone and internet.  Bob Adams of “Retirement Wave.com” had touted Dr. Charly Garcia, a duel citizen dentist, and Punta Pacificia Hospital. Punta Pacifica Hospital is part of the  Johns Hopkins Hospital system. The hospital led me to the surgeon for the hernia operation. The schedule was to go to Panama during Thanksgiving week. Panama does not celebrate Thanksgiving and the US is slowed down during that time. While friends and relatives were carving up the turkey, the Panamanian doctor was carving me up.  My schedule in NJ is very busy with five major rehab real estate projects in process. I did not have the time to take off during regular hours.

Here are the results of my six day trip: leave Newark Airport 5PM on Tuesday the 20th. Dentist appointment at 9 AM Wed.  X-rays, filling one cavity, fluoride treatment and an additional periodontal consultation, $180. The dentist made an appointment for a full panorama x-ray and CT scan at a local x-ray lab in preparation for implant surgery.  I also requested a recommendation for a dermatologist. At ten AM lab x-rays ( Panarama x-rays and a full CT scan $97.75) and 1PM dermatologist appointment.

The dermatologist did a full body check and the liquid nitrogen trick, zapping 25 dime to nickel sized spots. Total cost $100. He is an internist who had worked for the Canal Zone Authority (US Military) until he saw that his services would not be needed as much when the canal was turned back to Panama, and he should get a specialty. He trained in dermatology at Johns Hopkins Medical School  in Maryland. After getting his certification, they hired him as a professor in Medicine where he taught for ten years until returning to Panama to set up his practice.
The dermatologist sent me to an internist in the same building. He wanted me to have a checkup prior to surgery since it had been at least a decade.  The internists examined me, gave me an EKG, and wrote up the prescription for immediate results blood work and reviewed them the next morning. Total costs $70.00. When my dad had the same work done from his NYC doctor, it was $547 not $70.

The Hospital assigned an English speaking case worker to assist me. She had a driver waiting at the airport to pick me up. She sent me the names and prices of two hotel choices that they have an arrangement for lower room rates that are close to the hospital. She met me at the surgeon’s office for my appointment and at the admissions office the next day to make things go smooth.  She offered to arrange car service back and forth, but it is only a two dollar cab ride, so it was not necessary.

The hospital and surgery were more expensive than anticipated but WAY below US metropolitan rates, $4,600 total.  I felt safe and secure that the treatment would be first class. When telling people that the surgery was going to be in Panama, the reaction was as if the procedures were being done the middle of the Amazon River by voodoo doctors. This was top drawer in Panama. It could have been less money at one of the other hospitals but this was the best. I did not have a personal recommendation for the surgeon or another hospital so Punta Pacificia was my choice since they were affiliated with Johns Hopkins. The expat community is large and informed.  If I was living down there or visiting more often, the personal network could have provided a lower price alternative.

I am not recommending that anyone else go uninsured. Since I am not responsible for anyone else and am healthy, it has been my choice. The cost of living here, N.J., 12 miles from Manhattan, is so much more and the caution that the medical professionals take to avoid lawsuits has driven up the costs for simple things out of control. There are more attorneys per capita in NJ than any other state. Oh, what a comfort!
I am very happy with the results of my six day trip to Panama.  It saved at least $5,000, even after airfare and hotel expenses. I have made connections with Panama health professionals which will be used in the future.   All of the major players spoke English well and others that did not found someone to help out. I use the holiday time differential to my advantage.

Should I decide to get major medical outside the US later, the premiums will be lower than today’s rates for Medicare Part “B” suppliment alone not counting the premium for Medicare Part A.  Who knows what the ‘Affordable Health Care Act’ will bring us lucky citizens in the next few years.

The bottom line is that Panama is a dynamic country with a stable government, lower cost of living and a booming economy drawing on the Americas and Asia. The technology, commerce and laws are in place for an active lifestyle and the country offers very, very inexpensive living for those choosing to live a slower life outside of Panama City. This is not a backwater third world country. It was controlled by the US for 100 years and has systems set up for modern living.  Just like Hong Kong controlled by the Brits, high civilization is the norm.

Best of health, wealth and happiness , Brian.