A Spoonful of Azúcar

Navigating medical care in a new place can be confusing as fuck.

In Ecuador, there are a few different ways to go about it. There are public health centers in almost every city. You can google Centro de Salud to find the nearest one. We went there for our yellow fever shots. It was quick and painless. You show up. Get poked. And leave. Super easy. Free. Not to sure what else they offer or how other procedures work, but I believe it is the lowest cost and most widely available option.

Then there is the government-run IESS. With a price as low as $70 a month, you’ll have access to hospitals and doctors within the system. I hear that waits can be lengthy for non-emergency situations. But it’s inexpensive and gives access to comprehensive care.

Moving on to the private sector. For less than $300 a month we have 80% coverage for a family of three, though there are a variety of plans. We pay the doctor directly, which usually runs anywhere from $50-$70 for an appointment. This is on the higher end, but is very reasonable and worthwhile for us.

And then it’s time for reimbursement. The company we use, BMI, requires us to submit extensive documentation. It takes some getting used to, but once we had a better understanding of the process, it was actually quite simple. After we have all the bits, we schedule a courier, who picks up right from our house. And within a few weeks, we have a deposit in our bank account. Always a welcome surprise.

For residents, once you’ve established a rapport with a doctor, they’re pretty chill about consulting via WhatsApp or email. Instead of running through hoops getting referrals and appointment after appointment, you can send them a message directly. This is awesome. I can triage a situation without having to go in. Or even have test results analyzed. It’s a huge time and money saver.

If you’re visiting, here are a couple of tips. You can go to a pharmacy and purchase most things without a prescription, including antibiotics. If you need to visit an urgent care or the emergency room and you don’t have travel insurance, you can at least feel comfortable knowing that it won’t bankrupt you. I don’t know the exact cost, but I stayed in the hospital for five days with a kidney infection and the total cost was $4,000. This was for everything. The medication, my room, all the tests and the doctors fees. Everything. For five days!

Not only has the care we received been excellent. It’s enlightening to see a country operate so differently. Where you absorb the full and real costs up front instead of being dealt obscurity that has been finagled behind closed doors and bureaucracy.

With campaigns starting for the next election, health care will undoubtedly be a hot issue in the United States. One that I can now assuredly say having lived it firsthand. That taking care of people on your land in a reasonable manner is completely possible.

Undocumented immigrants. Those behind bars. Struggling with mental health issues. Addiction. Homelessness. Pre-existing conditions like having a baby.

And that these distinctions are bullshit.

Just another way for the rich to cover their asses and place the blame elsewhere.

Universal care is necessary. But even more so, the compassion to feel that towards each other. That each of us are deserving.

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