Our journey into American health care system was the first time we have visited an MD in the US in many years. We have been through a similar exam in Ecuador. The dermatologist there has some form of light he placed on each blemish, quickly saying “no”, “no” “no”. The nos were good. No meant “no malignancy”. We stepped out of the office, paid $25 each for the exam and were on our way.
Mount Ibarra. Ecuador offers more that just beauty and fun. See details about Ecuador Medical tourism
I did not expect the exam would be as good or as easy in Florida, so was pleased when we received an advance courtesy call from the dermatology office. Ugh, I was impressed that is, until I understood the purpose of the call. There were no medical questions but a rather harsh “How are you going to pay? What type of insurance?” They seemed surprised and confused when I explained we would pay since we do not like an insurance company to interfere in our relations with our doctor. I now realize of course that this was under the mistaken idea that the doctor would actually engage in a conversation with us, beyond “Do not question the system”.
On the day of the exam we arrived early and were told to sign in and wait. Around 30 people were seated, I had some other issues to attend to and thought, “Maybe I can run out and deal with them”. I went to the empty counter to ask… “How long?” The reply was “Wait your turn.”
About an hour later our turn arrived. A trainee first looked at us and fed data into a computer. Then a technician came. The tech spent her time explaining how the trainee was new, temporary and did not know anything. Finally an MD (I think) came. There was no introduction and I still do not have a name. After one quick look the result was. “We’ll need to take biopsies.” Then after a short procedure we were told we would have results in three weeks. Nearly many hours and $900 later, we have no clue about anything except in three weeks I am pretty willing to bet we’ll have the same results that cost us an hour and $25 in Ecuador a few years ago.
In Ecuador dermatologists and many other doctors and dentists in the province of Imbabura province have been helping us and our readers create wonderful treatments and huge medical savings over many years.
One reader wrote about the dermatologist: (bolds are mine). “Dear Gary and Merri, I have been in Cotacachi for several weeks and have watched many happy travelers come and go. After hearing the exclamations of a few who had wonderful, therapeutic dermatological facials from Dr. Alquilerra in Ibarra, I decided to try one for myself. My intention was to simply get the facial, but after arriving and meeting the doctor, I was so impressed with his professional demeanor and his spotless, modern office that I mentioned a cyst that had been bothering me for several years. Imaging my surprise when he said, ‘Of course, let’s take care of it right now.’ In less than half an hour I had the cyst excised painlessly and was bandaged and ready to go. After asking me about any allergies to drugs that I might have, I was handed instructions and a prescription. My total so far – a remarkable $40.00. Our wonderful driver stopped at the “farmacia” (pharmacy) and took my prescriptions to be filled. For a Z-Pak of zithromycin I paid a whopping $14.00. Along with a prescription for a pain medication, an antiseptic wash and bandages, my farmacia total was $27.00 and some change. Before traveling to Ecuador I had checked on having the cyst removed by a dermatologist in Texas. “Here are my savings – both doctors, in the US and in Ecuador, are specialists.”
Low Cost Health Care Comparison
“The San Antonio Dermatologist quoted $1500 – for simple surgery plus $ 125 – antibiotics and pain medication or a total of $1625. The Ecuador Dermatologist charged $40.00 plus $27.35 antibiotics and pain meds for a total $67.35. “Even factoring in my trip to Ecuador and a hotel bill, I am way ahead. My doctor was polite, efficient and well trained. His office was clean, bright and had the latest medical equipment. I was not asked for any insurance or any money prior to the procedure.”
This leaves me feeling increasingly cynical about the US health care system. How many procedures are American patients subjected to that do not mean a thing but cost a lot?
Take for example the annual checkup. A recent New York Times article “Skip Your Annual Physical” Ezekiel J. Emanuel (1) says: Not having my annual physical is one small way I can help reduce health care costs — and save myself time, worry and a worthless exam.
Around 45 million Americans are likely to have a routine physical this year — just as they have for many years running.
There is only one problem: From a health perspective, the annual physical exam is basically worthless.
In 2012, the Cochrane Collaboration, an international group of medical researchers who systematically review the world’s biomedical research, analyzed 14 randomized controlled trials with over 182,000 people followed for a median of nine years that sought to evaluate the benefits of routine, general health checkups — that is, visits to the physician for general health and not prompted by any particular symptom or complaint.
The unequivocal conclusion: the appointments are unlikely to be beneficial. Regardless of which screenings and tests were administered, studies of annual health exams dating from 1963 to 1999 show that the annual physicals did not reduce mortality overall or for specific causes of death from cancer or heart disease. And the checkups consume billions, although no one is sure exactly how many billions because of the challenge of measuring the additional screenings and follow-up tests.
Spend your time and money on fun instead. Get rid of activity that others have fooled you into taking for their benefit not yours. Observe nature’s way and let this more powerful intelligence educate you.
Take for example the power of fun. Have you ever noticed how young children are so curious and always want to play? Playfulness turns them into dynamic learners. Learning is fun.
Western culture tends to compartmentalize life into separate spheres: work, family, education, politics, religion, recreation and entertainment. Most spheres are seen as being serious. These assumptions of division are not natural and they certainly are not fun! Work becomes pressure. Education creates tension… politics… anger… exercise… work. This compartmentalization separates work from play. This is an error. Play is nature’s way of motivating us and helping us learn. Joy is the most powerful motivational force. Fun and games are God’s great teachers!
Society can beat the playfulness out of you. A myriad of rules and responsibilities make you serious. This creates stagnation, rigidity and fear of change at a time when flexibility can be your most valuable asset and embracing change your most profitable and enjoyable activity.
Reverse the process. If youth encourages play, then play encourages youthfulness. Start to play in your work and exercise and your business and your investing. Your health can improve if you add play to your exercise programs.
Have an adventure. Take a trip. For example a trip to Ecuador can be free.
One reader wrote to me: “Hi Gary, I would recommend medical care in Ecuador any day. I went to Dr. Alquilerra in Ibarra to have 22 cysts removed. It took one-hour 10-mins. and he was thorough and gentle and charged: $200.
Six months prior I had ONE removed in Waynesville, N.C. from a P.A. It was obvious she didn’t get all of it as Dr. Alquielerra noticed, so he removed the rest. The P.A. charged $120.00 at their medical practice that I have to say looks like something back in the ’50’s. Dr. Alquilerra’s “State of the Art” facility was unbelievable. Never have I seen any here in N.C. as clean, as well run as his.
“I would recommend medical care in Ecuador over N.C. I cannot speak for the other states, but people I know across the U.S. are complaining that, if they lived after a particular procedure, the hospitals were not State-of-The-Art”. They were not as clean as they should have been. They had infections afterwards that put many back in the hospital, and that the nursing care was not adequate but hostile. Is this where this country is heading?”
Another reader wrote: “I have just been to Dr.Roberto E. Alicivar Viteri —an Oftalmologo in Manta (Opthamologist) in Manta who also goes to Portaviejo. He speaks English and trained for 5 years in Mexico. His exam to check for a detached retina was $25.00.”
Which would you rather spend, a day in a clinic waiting for impersonal treatment at a high cost, or a trip to Ecuador? In many instances the trip and better treatment will cost you less in Ecuador. Plus taking a trip is fun!
Figure out how to have some fun. This really is the best medicine.