Medical Care


Since we’re talking about retirement, we’re also talking about health care, and concerns about the quality of that care are usually exaggerated or simply unfounded. Most developing nations have two distinct levels of health care available, private care for those who can afford it, and public care for anyone else.

You’ll want to choose the private care option. Even at the nicest facility, it will not cost you anywhere near what such treatment would cost in the States. You can buy hospitalization insurance, but if you do, you should remember that you might do just as well to pay as you go. Accident insurance might make more sense, as unfamiliar driving habits are probably the greatest risk to foreign pedestrians and drivers.

I’ll start with a story about my first foreign medical experience. This happened in Argentina.

I was using a very sharp knife to open the back of a pocket watch when the blade slipped off the watch case and almost removed the top of my left index finger. I immediately went into shock and began worrying about cleaning up the blood rather than taking care of the problem itself. Finally, I wrapped my hand in a towel and went out to the street to hail a cab.

I asked to be taken to a doctor, but when the cab driver saw my hand wrapped in a blood-soaked towel, he took me to the nearest hospital. This was in Palermo, a super-fashionable neighborhood in Buenos Aires. Beautiful people were sunbathing in the park nearby. Cafes were full. Everyone seemed young and rich.

The hospital was a public hospital, and was shockingly dumpy. It was as if I had stepped from one movie set to another. Fortunately, the doctor who waited on me spoke good English, and he stitched my finger back together. He said I was lucky to arrive on a day when they had sutures. He was also able to give me a lidocaine shot before he began sewing.

When he was done, he told me that I should get a tetanus shot, but that the hospital had no tetanus serum, because it was prohibitively expensive. I could, however, purchase such a shot at the local pharmacy. I thanked him and asked him for the bill. He said “there is no bill. Healthcare is free in Argentina.”

I walked back out into the sunshine and the swarms of beautiful sunbathers and went to a pharmacy on the corner. A woman in a white smock (all the places I like are crazy about uniforms) was standing behind the perfume counter. I told her I needed a tetanus shot. She nodded and motioned for me to step behind a curtained changing room, and to drop my pants. I did, and then she entered with a hypodermic syringe and needle. She told me to bend over.

Just inches away, people were trying on sunglasses and spraying samples of cologne.

The shot cost fourteen dollars, which was a lot of money, comparatively in those days, but that’s because they had to import the serum from a manufacturer in the States.

Ten years later, in Nicaragua, I woke in the middle of the night with a pain in my upper chest. I’ve never had any history of heart trouble, but I was afraid, and so I repeated step one from my previous experience, and took a cab to the local public hospital. It was 2 in the morning.

The waiting room was crowded. A few dim energy saving bulbs barely lit the expanse of concerned parents, crying children and bewildered looking older people all waiting to see the one doctor. After about half an hour of waiting I realized this wasn’t going to work, so I went outside and asked if there was another hospital or clinic I could go to. Somebody said “yes, that clinic over there, but it’s private, it will cost you.”

So I went to the clinic, which was air-conditioned, and asked to see a doctor. They admitted me, took an EKG, put me on an IV of some kind, fed me breakfast in the morning before a specialist who had studied at Johns Hopkins examined me in the morning, studied the EKG and told me that he saw no indication of heart irregularity and that I had most probably been suffering from acid reflux. I paid the bill of one hundred dollars and felt it was money well spent.

Public health care in Thailand is much higher quality than in the two Latin countries, but still, if you can afford it you’d probably be more comfortable in a private hospital, where you’d be treated like royalty. In fact, private Thai hospitals are so good that people from other countries journey to Thailand for medical care. The most famous of these is Bumrungrand in Bangkok, but it is by no means the only one.

After a motorcycle spill in Chiang Mai we visited Chiang Mai Ram hospital, and although it was considerably more expensive than the competition, we didn’t feel ripped off. Everyone from attending doctor to nurses’ aide spoke English.

In conclusion, fear about the level of health care available is misplaced. The situation regarding health care we’re de-evolving towards in the States is the one they already experience in these emerging economies. Someday, maybe someday soon, we will all meet in the middle.




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