Some of you may have seen this article before in our newsletter but it got so many comments we thought we should put it in the blog. Let me also mention that the "executive check up" that I had at Clinica Biblica now has the cost of the check up listed in the article. (you'll have to read a bit to find it). This is the second article we have written on Health Tourism in Costa Rica because the subject seems to get a lot of interest from readers from the US and Canada.
Background: Costa Rica has a nationalized health care system that is nearly free for all residents. Quality of care ranks #36 worldwide by the World Heath Organization (the US is #37) and yet the cost per capita of healthcare in Costa Rica is less than 1/10th the cost of comparable care in the US. Many procedures cost even less, in fact many procedures cost as little as a tenth the cost of comparable care in the US.
What is their secret? With cost of living expenses in Costa Rica significantly lower than the US, the cost of doing business is less. Average per capita income in the country averages less than $12,000 per year, so labor costs are significantly lower than many other countries. Furthermore, Costa Rica has basically eliminated malpractice expenses, a primary reason why health care costs are so expensive in the US.
It's an attitude. Costa Rica operates their health care system with the acceptance that health care providers do occasionally make mistakes. The difference in their system is that if a mistake occurs by a doctor, nurse or other party involved in providing health care services, legal claims are limited by the injured party to the actual cost of the procedure and nothing more. By taking out the cost of malpractice insurance, huge awards, litigation and compensation to these unfortunate few, their health care system is not supporting huge expenses paid through litigation. This eliminates a number of costs that we incur in the US, attorney fees, malpractice insurance costs, awards paid to injured parties for pain, lost wages and survivor benefits, etc. It also discourages the need to over test; over administer drugs and remedies, i.e. testing to find every possible malady, again out of fear of malpractice in the event some rare issue gets missed. Doctors in the US are so afraid of malpractice that they test for everything, exposing patients to unneeded surgeries, potentially lethal drugs and unnecessary expenses. This cost is passed on throughout our health care system by the hospitals, the staff, the increased use of equipment, over prescription of potentially lethal medications and the hectic pace that this over testing and fear based system requires.
How safe is health care in Costa Rica? The truth of the matter is that Costa Ricans have a life expectancy of longer than the US yet they pay roughly one tenth the cost per capita of health care services. Let me repeat that. They pay a tenth of what we do yet they are expected to live longer than us. How can that be? As a result of the huge cost of healthcare in the US, many of us are uninsured or underinsured. Many of us don't get the routine care we should be getting and skip recommended procedures designed to find issues in early stages. This results in undetected issues that if treated early are typically not costly to deal with. Instead we wait until these issues are a true emergency and often with life threatening results. Those of us who are insured bear the cost of those who are not. In reality we all pay for the uninsured since everyone is entitled to some free care in emergency situations.
Nationalized health care: Now with nationalized health care on the horizon from the Obama Administration, these costs will be mandated and spread among tax payers in the US. However until the system is fixed and doctors continue to base their care on potential malpractice exposure rather than sound health practice, them cost of healthcare in the US will still be unnecessarily out of balance.
My recent experience: Two days after our July real estate property tour ended, I went to the Clinica Biblica in San Jose, a large private hospital in Costa Rica for an "Executive Check Up". I arrived at 7:30 am and was checked in. Within a few minutes after arrival I was already being seen. My day started at the lab giving blood for analysis as well as urine, followed by a general physical exam. Minutes later I was having a chest plate X-Ray as well as a bone density scan. The equipment used was all the same as we'd use in the states, Ultrasound equipment by Siemens, X-Ray machines by GE, everything I was used to. Many of the doctors and lab assistants spoke multiple languages and I was escorted throughout the day by a translator for the few instances when the doctor did not speak English. Next I had a number of ultrasounds done to view all my vital organs, then off to the Endoscopy clinic. I opted for full anesthesia for both the Endoscopy and Colonoscopy. Next they fed me a great chicken dinner and then I was off to a sound proof room for the most extensive hearing test I've ever had in my life, followed by a complete eye exam. Next I met with a nutritionist, who by then had the results of my blood work and urine, as well as a complete medical record with my chest X-Ray, bone density results, a complete set of color photos of the inside of my colon, stomach, esophagus, photos of nearly all of my organs. He reviewed the results of all and reviewed my diet and exercise routine, with suggestions on where I could improve. I then visited with the chief resident doctor of the program who again reviewed my completed results. I learned that I suffer from osteoporosis as well as small ulcers in my upper GI tract from acid reflux. He prescribed medications as well as suggestions on how to treat these issues holistically. I walked out of the hospital before 3:00 pm on the same day with all results in hand, a medical history summary, all lab results, X-Rays and full color images. In summary: My experience was incredible. The entire set of procedures including all lab work and lunch and parking included cost me $1100. I did not wait more than 5 minutes between each test or procedure. The equivalent tests, lab work and procedures in the US would have cost over $7000. I have no insurance in Costa Rica and paid "full price" for these procedures. My experience with doctors in the US is that we are treated by them as an enemy who they must guard themselves against due to the risk of malpractice and litigation. On the contrary however on this day in Costa Rica the doctors all explained to me what they were doing and why. They talked to me like a friend, were very thorough and I did not feel rushed. What I realized most was how broken our health care system really is in the United States.