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Heath Care in a “Third World Country”

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A foreigner here in Ecuador recently had a fall and needed medical attention, the story of which makes me smile.

My Ecuadorian friends couldn’t understand why I was asking how much emergency care might cost, simply shrugging their shoulders and saying “Medical care is always free, you just have to pay for the medicine”.
Surely this can’t apply to a foreigner, we all reasoned.

With no idea what might be required, patient, passport, travel insurance paperwork and a small fortune in cash were loaded into the 4×4 and driven down to the small town about an hour away.

Upon arrival at the emergency department of the hospital, he was greeted by extremely friendly staff who apologized for his four minute wait due to another patient being seen. A very friendly and professional doctor sized up the situation and after some local anesthetic, had the cut cleaned out and stitched up with eight neat little lines of thread, eagerly asking questions about foreign lands the whole time.

The doctor wrote out a prescription for a week-long course of antibiotics and wished his new friend well as they walked to the door of the hospital. A little confused about the need for payment, the patient tried to show his insurance and passport, to which the doctor said with a broad grin, “You don’t need that here, everything is free”.

At the local pharmacy (drug store), the prescription was filled in thirty seconds and the total bill rung up – $7 (USD) including tax.

Raise your hand if you wish health care worked like that in your country.

Sitting around the dinner table that night while the story was relayed were looks of surprise, shock and outright disbelief. Stories about healthcare in homelands were told by people from all over the world, from similar accounts, to people declaring bankruptcy due to nothing more than a broken arm, an injury that will probably happen to most of us in our lifetimes. After some rough translation, the Ecuadorians couldn’t believe the cost of health care in some countries, and were downright scared when told how much one couple had paid in medical expenses just to have a baby.

I think it’s pretty clear those of us living in the “First World” have a lot to learn from those in the “Third World”.

-Dan

P.S. No, mum. This story is not about me. You can stop worrying now simple smile

29 Responses

  1. O'Shea 12566 says:

    Dan,
    As much as it would be nice to have a Utopian society where everyone has free or low cost health care, it is not possible here. Ecuador’s population 13,481,424 – 2008 (Source: World Bank )versus that of the U.S. 307,006,550 (Source: U.S. Census Bureau). 13 million vs 307 million. I wish it would work, I really do. Be so awesome to go to the ER or your doctor and get treated and walk out. How awesome would that be? But who is going to pay for it? How often would one see a doctor?
    “everything here is free” is a nieve statement. It is not free. It is paid for those who get up at 4 am dig ditches, weld metal, trade stocks, put out fires, arrest the bad guy, fly planes, climb telephone poles, make widgets, you get the idea. It is far from “free”

    • Dan says:

      Brian,
      Yep, you are exactly right – there is no such thing as a free lunch, someone is absolutely paying for it.
      Though I completely disagree that the system can not work simply because of scale. Obviously the USA is a lot bigger, but that’s no reason it can’t work just as well, if not better.
      In fact, I would argue if you looked a GDP per person the USA is many many times richer than Ecuador, and so the system could work many times better.
      Just a thought, anyway.
      -Dan

    • Enginerd says:

      Unless there is some outside benefactor giving Ecuador all the funds they need for medical care your argument is false. The US has a much higher GDP per capita than Ecuador, hence they have more resources to provide the same care. You are correct that nothing is “free”, and it would need to be paid for in taxes, but the US ALREADY spends more per capita in healthcare (when including both private and public spendig) than every other country in the world. And people still declare bankruptcy the moment they actually need care.

    • the commentator says:

      its spelled naive. think native without the “t”.

    • Mark says:

      Yup, in the third world, we pay taxes and get free healthcare…. while you schmucks in the US let your government use all your money (trillions) for “defense” against the bogeymen.

    • Mob says:

      O’Shea,

      Interesting point, however I have had very similar experiences to this in the country I live in, where? China population 1.3billion. You pay for the medicine at wholesale rates.

      Actually cost of health care in the US comes from the cartel situation enjoyed by the medical industry there, people have no alternative but to pay and the government just doesn’t have the balls to do anything about it.

    • ST says:

      As Dan says, pure population numbers don’t have any meaning. Lets look at some meaningful figures:

      Physicians per 1,000 people
      #51 – United States: 2.3 per 1000 people
      #81 – Ecuador: 1.48 per 1000 people
      Source: http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physicians-per-1-000-people

      So you can see, even with less doctors per capita, a 3rd world country is better at providing one of the most fundamental services humans require. It’s not about who pays for what, ultimately, as you seem to be well aware, it is the “working people” that pay whatever needs to be done. How these funds are allocated, however, is at the sole discretion of the governing body.

  2. Hey dan, first off id like to say wow! you have an amazing life. i can only amagine all the great people and cool places you get to see along your way. keep up the great work and dont forget to have some fun! ive traveled all over the us but one of my favorite memories was when i was in williamsport pa. we went on a 3 hour hike up the side of a small mountain. (ya i said mountain, im from florida so they were mountains to me lol)this trip was truly breath taking! It was so nice to be away from the sounds of the city and just the fact of making it to the top was a great accomplishment for me. i can somewhat relate to what your doing and im happy to see you out exploring the world. believe it or not you inspire me alot. i wish i had more time to travel and see more of the world. thats why im going to be donating money to you.it wont be much but hey every little bit helps right.. all i ask is that you buy yourself a beer with it and post the name of the beer and place you bought it at. god knows i would love to be there. so have a drink on me! i will try to donate more soon. i look forward to hearing from you and following your cool adventures. yours truly carl henderson.

    • Dan says:

      Carl,
      Thank you so much – hearing that I can give even a little inspiration to you is huge for me – I really hope I’m showing people out there what really is possible if you want to do it.
      You DO have more time to travel, it’s just a question of priorities.
      I know exactly what you mean about hiking to the top of a mountain and soaking in the silence – I just did that two days ago and loved it. It was my 18th time to the top of the mountain at 4200meters, about 6 hours round trip :)
      Good luck Carl, let me know your plans for some big adventures in the future :)
      -Dan

  3. Erik says:

    Hey Dan,

    I’ve been following you’re blog for a while now (found it when I was reading about Chris McCandless).
    I think you’re an awesome person with an awesome webbsite, You’re a great source of inspiration for me and I’m looking forward to read about your future adventures. Are You planning anything after south america?
    Thanks for the great webbsite
    -erik

    • Dan says:

      Erik,
      Great to hear from you man and I’m really happy you love the website. I hope you’re dreaming big and we’ll hear about some adventure of yours to come :)
      There certainly are plans forming for post South America, though I change my mind pretty often :)
      Something big is coming for sure.
      -Dan

  4. Steven Mueller says:

    The costs of medication are cheaper, because third world countries get discounts and whatnot when it comes to the use of pharmaceutical patents.

    Don’t think this would be possible in the U.S.

    A great story, nonetheless.

  5. Lynne says:

    First world countries have that- it’s called Canada, France, the United Kingdom, Sweden, and almost everywhere else in Europe.

    Seriously, why do Americans think it’s so impossible with their “huge” population? Most people wouldn’t even notice if a few billion were diverted from the military towards health care, until they suddenly realised that they HAD health care.

    • Dan says:

      Lynne – (my personal opinion here)
      I honestly think citizens of the US think it can’t be done simply because they don’t know about other countries and what they are doing. In my year living on both the East and West coast of the US, asking the average man on the street about health care in other countries, they simply have no idea. Even college educated ‘intellectuals’ believe that Canada’s health care sucks – though when you ask them why exactly they have absolutely no idea.
      It’s not in their culture to lean about other countries or (god forbid) compare themselves to them as if they are in the same league or something.
      I find it all very very fascinating.

  6. Jason says:

    Dan, just found your site, and although it’s been said before, you are an inspiration to many who wouldn’t mind dropping it all and adventuring. I just ran into one of your fellow travelers in Omaha, Ne. and just want to share his website with you. His plan is similar to your biking friends.
    http://www.jessesteiner.com/
    Enjoy your travels, and you’ve got another follower on your blog!

  7. Hank says:

    “it is not possible here.”

    Darn right, O’Shea. We’re too busy paying for two wars and the most bloated military apparatus in the history of mankind to do something as outrageously utopian as, get this, affordable health care for the rest of us.

    Because you know, everything has to be cheaper, faster, better all the time. Just not when it comes to medical attention and the military. The idea that ‘the best country in the world [TM]’ could actually make medical care routinely cost-effective and cheap for all of its citizens is beyond laughably insane. Imagine if that happened one day. you go to a doctor and you’re not ruined?! Where would that end? Seriously, the dreams of some people.

  8. Cindy says:

    I’m glad you liked Ecuador, I grew up there and have lived there for about 11 years. Unfortunately, public healthcare is free when they want it to be, the country has been labeled third most corrupt in S. America. My mom took one of our employees to the ER once and they charged her because my mom did not look “poor” or “in need”. That is discrimination! I personally wouldn’t trust a public hospital for anything serious and private hospitals can get very expensive, I came back from a consultation with a gyno and it cost $45 (that just for seeing the doc, exams not included), that is in a country where the average full time monthly salary for let’s say an office assistant or cashier is $350. Hope this doesn’t dis-encourage you from all the other awesome things that Ecuador has to offer, the country is beautiful and they have the best weather in the world, it’s perfect all year around :)

    • Dan says:

      Cindy, corruption is obviously a big problem here and certainly can have an effect on all aspects of life, including Health Care. I hope that over the coming years a president can be found to seriously stamp it out.

  9. Josh Howard says:

    All I can say is gogo gadget Canadian Healthcare! Albeit we’ve got kinda long delays sometimes

  10. Chris says:

    Glad the travels are going well Dan!

    This story reminds me of the recent attacks on our health service (the National Health Service in the UK), we have a similar free healthcare system to ecuador, but obviously on a bit of a larger scale. I think it can and would work for places like the US, but as it’s been shown recently, it’ll be a long hard fight as there are many companies in the US who would lose a hell of a lot of money if people got more care for free.

    I’ve always considered moving to the US for a while as it looks like it could be an adventure (as you showed a few months ago!), but the paying for healthcare thing has always worried me.

    • Dan says:

      Chris, I agree 100%. Being Australian we have health care more-or-less similar to the UK and Canada, and it’s always fascinated me the USA has no such system. You are absolutely right there are a lot of enormous companies that will lose unimaginable sums of money if anything seriously changes, which makes me think it may never happen.
      Who knows?

  11. oscar says:

    Hello !! Dan
    This is not just in Ecuador with a population of 13 millions plus.
    Brazil is getting close to 200 millions and they have free health care so is Venezuela, Colombia, Peru, Argentina, even Bolivia the poorest country is south America has free health care, this just to name a few, no only the health care system, but also on many others things for example, the gas in Venezuela, it is so cheap that you can fill your tank on your jeep for less that $4. do your research and you will see.

    Keep the good work and remember stay safe.

    • Dan says:

      Oscar, yep – there are many countries in the world that have it sorted out :)

    • mano says:

      true…but coins has two sides…. while you fill up your tank for 4 $ ..u gotta say u will pay lot more for renting the car, or if you live there, did u see the prices of the cars ? Old used junks for hell tons of money…. healthcare is for free..sure as long u have flue, or some feawer… if you are facing the kidney transplantation (God forbid) or some cancer disease, im not sure if you will not look for help in the U$A…i know pesonaly one ecuadorian, succesfull biznisman in ecuador, who after he got cancer, was treated succesfully in MGH Boston.

  12. jlcollinsnh says:

    Hi Dan….

    just stumbled on your site.

    we spent last summer in Ecuador and loved it. fortunately we didn’t need health care but the stories we heard left us impressed. We’ll be returning for a longer stay.

    later this year will find us in Peru and Bolivia, but firsts for us. but for now I’m going to tour around your site here some more….

    • Dan says:

      Hey there,
      I’m happy you stumbled across my site. Ecuador is a beautiful place and I look forward to returning some day.
      Let me know if you have any questions about my site or the trip.

      You’re going to love Peru and Bolivia. Be sure to checkout The Uyuni Salt Flats in Bolivia!

      -Dan

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