From Panama, a Different Perspective on Health Care

IV. Personal experiences

I have had several experiences here with insurance-covered medical care, all of them good. Four years ago, I awoke with two large welts on my forehead. Spider bites had caused an allergic reaction. I became both weak and disoriented. My wife drove me to the emergency room at Hospital Chiriquí in David.

There was no crowd of sick or injured people and I was seen immediately. A nurse promptly contacted the on-call physician, began limited treatment, and got lab tests and an IV drip started. The on-call physician arrived quickly, examined me, and after reviewing the various lab results added something to the IV drip. The entire experience was successful and lasted roughly three hours. I paid only $33.00 -- that's not a typo either. The balance (I did not bother to find out how much, but I suspect it was about $60.00) was covered by our medical insurance.

Two years ago, a spinal compression caused my left leg to cease to function properly. I went to a highly regarded (and properly so) neurosurgeon at Hospital Chiriquí. It was after 6:00 p.m., so following an hour-long examination he telephoned the head of the insurance company at home and received immediate authorization for an emergency MRI. I had the MRI the next morning and had surgery the following day.

The surgery took over five hours, and I was hospitalized for four days following surgery. While hospitalized, I received physical therapy to help restore leg function, lots of medication, frequent visits from my physician, etc. The food, by the way, was excellent, although the filet mignon was a tad overdone for my tastes. The nursing staff appeared to be more numerous than the patients in the post-operation rooms; all were extremely attentive and seemed to know what they were doing.

The total cost for everything was approximately $14,000. The insurance company paid half, and I paid half. Checking into the hospital took all of ten minutes. About a week after the surgery (I had been advised not to drive for a while), the neurosurgeon drove to our home (about 35 minutes by car) one evening to check on me and to deliver various medications, some related to the surgery and some I needed for other reasons. Follow-up visits to the neurosurgeon at his office were included in the cost of the surgery.

Immediately following my surgery, and on other occasions, he told me to telephone him any time I felt the need to do so. His business card, as is customary here, includes his office phone number, his home phone number, and his cell phone number.

Our maximum insurance coverage per year is only $15,000 per person (not including my wife's cancer coverage, which has a substantially higher cap) -- a mere pittance in the United States. Here, it seems entirely adequate.

V. Deficiencies

Some cutting edge medical care available in the United States is not available here. I do not think that some organ transplants, for example, are available. Since we no longer live in the United States, we have no medical insurance there. Should I require very expensive treatment not available inPanamá, I would most likely do without it and rely on whatever palliative care might be available. Were that to mean my death, so be it. We all die, and I have no interest in postponing the inevitable for a few months of intensive, invasive, unpleasant, and expensive treatment. I cherish the freedom to make that sort of decision myself and don't think that anyone else -- particularly the government -- should have the power to make it for me.

For most people, even those who live in far more remote rural areas than we do, it is possible to get to a social security clinic. Relatively few cannot do so. If bitten by a highly venomous snake, the chances of death are substantial. The same is likely true in comparable areas of the United States. "Rich" people can get better medical care than very poor people. That is also true in the United States. Nevertheless, I think the care provided even to the very poor here is generally better than that available to them in the United States.

VI. Dreams

The very best cutting edge medical care free for everyone, with no waiting and the right to sue for enormous damages should something go wrong, might be nice. It would also be great if everyone could live in luxurious homes maintained by loyal servants, have enjoyable high-paying jobs with three months paid vacation per year, and not have to worry about gasoline costs or mortgages. Discovery of the Fountain of Youth, with whatever miraculous substances it might contain available free for everyone, might also be good.

The problem, obviously, is that many of these dreams are impossible. As to the others, somebody would have to pay through the nose. Our "friends" in China are already becoming upset about financing the current lifestyle in the United States. According to the Obama administration, federal borrowing will account for 39.9 percent of expenditures during the fiscal year beginning in September; personal income tax returns will amount to 27.3 percent.

The government will be borrowing the largest share of federal spending since World War II, when the federal government borrowed 62 percent of the budget in 1943.

The estimated national deficit for the next ten years is already over nine trillion dollars, more than the sum of all deficits since America's founding. By the next decade's end, it is estimated that the "the national debt will equal three-quarters of the entire U.S. economy." In these circumstances, China and other countries seem quite likely to do less rather than more to help perpetuate our lifestyle -- they may even own us.

Many here think that Americans have a four-part mentality: 1) I like it, 2) so I want it, 3) so I need it, 4) so I am entitled to it. That may be an exaggeration, but is not too far off the mark. Use of ObamaCare (whatever that might be) to perpetuate this conception in the United States and abroad would be delusional and foolish.