Why Some People Don’t Like the Public Health System

I’ve shared here before that I’ve had some very good experiences in the public health system with multiple specialists that I see (free if a legal resident), but when something is too slow from their overload of patients, I can, and occasionally do, choose the private healthcare system with many doctor choices and all expensive (though not as expensive as in the states!).

Last Wednesday evening my next door neighbor climbed up on a folding chair on his front porch to knock down a wasp nest and fell off on his hard tile floor and was calling out in pain. I went over to check on him and he did not want me to call a Red Cross ambulance, because they charge you and he has no funds for that, so I call a taxi and took him to our Atenas Clinic Emergency Room. The service there was very good (better than sometimes in the crowded Emergency Room!) with all his vitals checked and seeing a doctor within an hour and a half, it was no slower than any of my ER trips in Nashville! 🙂 The doctor called for a social security van ambulance to take him to the closest public hospital for an X-ray as he was acting like his arm was broken, maybe in two places. Within another 30-45 minutes he was in an ambulance on his way to Alajuela. So far, pretty good for not a penny of cost for him!

Then at Hospital San Rafael de Alajuela, he was seen quickly and x-rayed within about an hour. He has a broken shoulder and elbow! They scheduled him for the first available orthopedic surgeon which was 10 days away and said “we want you to stay in the hospital until after the surgery. But sorry, we have no available beds and you will have to wait in a chair in the hallway for a few days until a bed in the orthopedic ward becomes available.” 🙁 Saturday he was told he would probably have a bed on Sunday, the day I’m writing this and I haven’t communicated to see if he does.

THAT IS WHY MANY PEOPLE ARE UNHAPPY WITH CAJA (nickname for the Social Security Healthcare System): (1) A 10 day wait for surgery in an otherwise good system that is overloaded and under-staffed. (2) Like most public hospitals here, the government doesn’t provide enough money to expand and provide more beds and thus often there are no beds when needed. It was especially critical during Covid. He will survive but neither of the above two situations are good!

So, the next morning (Thursday), I took him some personal items from his house he will need in the hospital. Then I returned to my house a little after noon and started vomiting all over the place, followed by the expected diarrhea! No fun! And I did not want to deal with CAJA again, so I got an appointment with my private GP the next morning to be treated at my cost, which is always an option if you can afford to pay (my neighbor could not). So in some ways it is like the states, if you have money, you get quicker service (private room, etc.). But I am still not well, though no more vomiting or diarrhea. The private doc had me get all the lab work on blood and stool sample and I have 4 different medicine lasting 4 days to a week. (All costly!) Hoping I’m over it soon! 🙂

And how much different would my treatment have been at the public clinic? I don’t know, but was feeling so bad I did not want to find out! 🙂 And yes, I could get private healthcare insurance here, but at an unaffordable high price. And my local GP’s clinic has a “Membership” at $100 a month and I had it before I started using public, but I never needed that much service and it did not include the lab or pharmacy costs. So I dropped that. As you get older, medical services become more important and almost always depend on your income and available funds. If I every need another big cancer surgery & treatment, it will have to be with the public system, regardless how long I have to wait. I don’t have enough money to do it again. But at least Costa Rica has a basically very good public healthcare system, even if sometimes very slow. And 10 days is not near as long a wait as some people have for some surgeries.

Sorry! I got more long-winded than I intended! But maybe that partially explains why many people here don’t like the public health system, but remember that for the poorest person it is often a lifesaver! And though with a big overload of patients and work, they are extremely well-organized and with a computerized healthcare system that’s the envy of many countries!

So, I still like it! But will occasionally exercise my freedom to go private when I can afford it, as I did again this week.

¡Pura Vida!

Using Both Health Systems in Costa Rica

The public health system in Costa Rica is one of the best in the world, but as in other good systems there are occasionally delays for many reasons with an overload of patients and one always has the option to go to a private doctor at your own expense. Once Covid was over, when I had to use a private oncologist for my surgery and radiation treatment because our hospitals here were packed with Covid patients, I then moved all my medical treatment to the public system in 2022 and have been happy with everything done “for free” (really for a monthly Social Security fee you must pay whether used or not.) There are no co-pays, no insurance forms and everything is included, even my medications that I pick up monthly at my local “CAJA Costarricense Seguro Social Farmacia.” I’m pleased with the public health system here, even if sometimes slow.

My latest cancer surgery was in November with my Public Provincial Dermatologist removing a cancer from my nose. Excellent surgery with absolutely no scar! But, that dermatologist in Hospital San Rafael de Alajuela gave me my next appointment to be in April 2026 and I had other non-cancer issues I really wanted to take care of earlier. So, I decided to exercise my freedom of going to a private doctor and my Public ENT Oncologist at Hospital Mexico de San Jose, who is monitoring any possible spread of my big cancer, agreed that the other issues would be better if handled earlier and he recommended Dr. Arturo Soto in the private Tabush Dermatologia Center in Escazu (feature photo of building). Here is my report with 3 before & after face photos . . .

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“I don’t know.”

That phrase, “I don’t know,” is becoming my old-age mantra as an 84-year-old who turns 85 in just a few more months.  Unlike the “Know-it-all” teen and young adult years, I continue to feel that “I don’t know” about more and more in life! 🙂

Like many my age, this old man walks into a room and asks himself, “What did I come in here for?”  “I don’t know.” Then a new pain comes in a different part of my body or some other part is not functioning properly. Why? “I don’t know.” Where did I put that? “I don’t know.” Is the doctor appointment tomorrow or next week? “I don’t know.”  What am I having for dinner?  “I don’t know.” 🙂

Followed by deeper thoughts, like when am I going to die? “I don’t know.”  When should I move to a Senior Adult home? “I don’t know.”  Why did half of my home country vote for a lying, immoral, convicted criminal to be their president? “I don’t know.”

With all of these doubts and multiple health problems I have now, why am I still happy? “I don’t know.” Maybe it is because of this mantra of accepting that in life there is so much that “I don’t know.”    🙂

Socrates famously observed, “I know one thing, that I know nothing.”

He also said, “The only true wisdom is in knowing you know nothing.”

And finally he said, “The secret of happiness, you see, is not found in seeking more, but in developing the capacity to enjoy less”

🙂

¡Pura Vida!

A Related earlier Post: Merton’s Prayer of Abandonment

Aren’t you glad that I don’t get philosophical too often? 🙂 Now back to nature!

Independence Day Special Report

My Health Update & The Culture Report

Sep 15 Independence Day Costa Rica

Every year the entire country flies flags and marches in parades to celebrate their independence from Spain and I’ve missed only 3 of the parades here in Atenas because I was in the Caribbean during this week. And was about to miss another for the same reason, but once I changed my trip this year to October, I thought I would again photograph the parade, but with the main part of the parade being from 10 to 12 during some of the hottest sunshine of the day and my right knee hurting, I decided to miss the parade on purpose this year. But I’ve posted links at the bottom of this post to the 6 parades I did photograph, plus I wore my Costa Rica National Soccer Team shirt (red, white & blue) to my usual breakfast out at Restaurant El Fogon Campesino and not only was the staff dressed patriotically but they had a marimba band playing on the terrace near where I always eat. So that was my celebration today! 🙂

Marimba Band at Restaurant El Fogon, September 15, 2024, Atenas, Costa Rica

For those who don’t know Spanish, “el fogon” is the Spanish word for “the kitchen wood stove” and “campesino” is “peasant” or “poor farmer.” Everything in this place is cooked on an old fashion wood-burning stove just like one of my grandmothers. They are mainly a lunch & dinner place, but have breakfast on Saturday & Sunday mornings and are the only place here with “Avocado Toast” and other breakfast dishes with guacamole! Yummy! 🙂 They of course have the traditional Costa Rica breakfast of eggs with Pico de Gallo (beans & rice), the best pancakes in town, a great omelette, and even a Breakfast Nachos for the young at heart! 🙂 But I’ve narrowed down my favorite to the Quesadilla with guacamole & picadillo on top and a side of bacon! 🙂 The only time I eat breakfast out other than on trips and a weekly treat for me!

Update on My Health

The public health system here is simply great and they are monitoring me in more ways than I ever would have on my own with private doctors, providing a specialist for nearly everything. Most of the specialists are in either San Jose or Alajuela and my driver, Walter, goes in with me as translator when needed, especially with the fast talkers! 🙂 “Hablo despacio por favor.” 🙂 But many speak English and nearly all the younger ones do, so no problem! But thankful for Walter!

Last week my geriatric doctor found that I had a little high blood pressure. She immediately put me on a blood pressure medicine and sent me back to my local clinic here in Atenas for my local GP doc to monitor me. There they wanted me to come in regularly to check the blood pressure or get a machine and check my own every day at home (or at a local farmacia that will check it daily for free). I chose the convenience of my own machine and will report back to Dr. Zuniga (my GP) with a month’s worth of BP numbers and it will tell if the current med is working or if I need something else. And I expect he will discuss my diet and exercise with me also. 🙂

Nothing alarming and I feel fine and the BP has already been back in the normal range one day. I think it was some little temporary thing, but we will see. And my oncologist says there is no trace of any cancer anywhere now. Plus I’m sleeping great with the new CPAP Machine the Costa Rica Social Security bought me! Costa Rica spends its money on its people and not on an army and constant wars! 🙂

¡Pura Vida!

¡Feliz Día de la Independencia!

Photo Galleries of Earlier September 15 Parades

¡Pura Vida!

#1 Best Travel Destination AND #1 Best Place to Retire!

No big surprise for those of us who live here, but Costa Rica was named as the #1 Travel Destination for 2024 by Travel & Leisure Magazine AND the International Living Magazine and organization simultaneously named Costa Rica as the #1 Best Place to Retire in 2024! Read about it in Travel & Leisure. Or on International Living website.

View from my cabin at Playa Cativo Lodge, Piedras Blancas NP, Costa Rica. And feature photo is a Keel-billed Toucan in my garden in Atenas, Alajuela, Costa Rica.

For someone who made what a few American friends back in Nashville thought was a radical or crazy decision to move here in 2014, these announcements confirm the good decision I made back then! :-)

And these rankings are a good celebration of my 9 years of living in Costa Rica (as of December 24, 2023 — 2+ weeks ago). And my survival of cancer a celebration of the excellent healthcare here! Plus there is no better place for a nature lover and nature photographer like me! Tell your nature-lover friends to follow my blog to see what it is like to be “Retired in Costa Rica!” :-)

¡Pura Vida!

Birds, Rainy Season, and Personal Catch-up

Finally! Rainy Season seems to have started with rains every afternoon for 4 days straight now, but oh so much later than usual and from what I’ve read, we may still have a drier rainy season than usual. It is amazing how much greener it gets here after even one rain! And how many more birds! Below are photos of 4 birds I managed to snap this week. I love the rainy season, my favorite time of year here! And most days it rains only 2 or 3 hours in the late afternoon or early evening.

Rufous-naped Wren Eating an Insect, Atenas, Costa Rica
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Blooming Cactus?

No – though the first time I saw these bright pink flowers on top of the cactus plant at a house I walk by frequently on my way to town, I thought is was going to be a beautiful cactus! But it seems that the owner of that house has allowed his Bougainvillea to climb over from the wall to the cactus and from a distance, the second photo, it looks like it’s blooming. And some cactus here do bloom, but I’ve not seen that one bloom yets.

Bougainvillea on a cactus makes it look like the cactus is blooming.

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Today is HUG Day!

I learned about the fun and silly holidays from a Washington Post article, including February 12 as Hug Day!

This celebration is part of someone’s idea to stretch Valentine’s Day into a week. No need to buy flowers or candy for this day, thankfully. Just offer friends and family something that has been scientifically shown to lift their mood: a hug.

February 12 – National Hug Day!

¡Pura Vida!

🙂

New Trip Blog Posts Start Tonight!

Also TODAY is the day that I fly on a little Sansa Airlines 12 passenger plane to one of my favorite wilderness places in Costa Rica, Tortuguero National Park, as mentioned yesterday. So most likely you will get a post from there tonight, assuming that their internet WiFi is as good at this most expensive lodge in Tortuguero as they claims it is.  🙂   Tortuga Lodge & Gardens

Much wildlife spotting is done from a boat at Tortuguero.

So expect a week or more of photos and comments from what travel magazines call “The Amazon of Costa Rica” and one of the few places in the country where travelers have actually seen a Jaguar (from a boat) though they are mostly nocturnal like all the wild cats here. Plus I expect a lot of birds, some butterflies and several other animals, along with the tropical rainforest and rivers/canals and of course some great Caribbean food and 4 good nights of sleep!  🙂

And to read more about Tortuguero, see this interesting little article on CR Travel Life:  14 EPIC Things to do in Tortuguero, Costa Rica & Guide to Visiting though not necessarily what I will be doing!  🙂

My Garden Peacock & Health Update

And of course you do know that I mean Peacock BUTTERFLY!  🙂

There are two species that I see here, the more common is the Banded Peacock that I see all over Costa Rica and shared one from last week’s visit to Xandari, but maybe my preferred is the simpler but elegant  White Peacock Butterfly, Anartia jatrophae. Click that link for my gallery photos of them. They are also found all over Costa Rica, though not in the abundance of the Banded Peacock. These are the only 2 “Peacock” butterflies in Costa Rica, while Panama and south into South America there is also a Red Peacock Butterfly which is similar to the Banded but with thicker bands of red where the Banded has thinner white bands.

White Peacock Butterfly, Atenas, Alajuela, Costa Rica

Continue reading “My Garden Peacock & Health Update”