Out cruising-may need surgery

[Dave22q]

It has been a while since the US had the best medical care. If you have no doctor and only medicare you would be far better off paying cash locally. I would investigate Cuba, Guatemala, Panama and Costa Rica as possibilities. Your fear of the US system is well founded. By the time you find a qualified doc with privileges at an good hospital who will accept your medicare, months could go by. Also your expenses and co-pays will probably exceed the total cost of operating overseas. Whatever you decide, I hope the results are good.

[Russ]

I am retired surgeon. All replies valid except an acute attack in ER won't guarantee a next day operation. If they really thought or you really are having an attack they will usually treat and try to do surgery electively later. A lot of variables.
Yes foreign countries are cheaper maybe okay surgeons but like in USA you can get really sick from this operation if not done well. Think bike leak from poor closure and long recovery and second operation
Do what the patient wants. It's his risk.

Russ Davignon MD

[johnmcntsh]

Originally Posted by ArmyDaveNY

I'm not sure that this is a political statement. I know a few who have used and they are ruing the day they used it. He makes a valid point about the IRS and penalties. It is sadly a valid consideration.

I do no know why Obamacare would have anything to do with a medicare procedure and what the hell would the IRS have to do with it?

I question whether you have any idea what you are talking about because your statement makes no sense with regards to the OP's question.

I would agree with the poster who suggested flying in and getting it done in US., especially if you carry supplemental.

[Olde Chief]

You might get a referrals at the US Embassy or Consulate. Many of the major cities have US trained surgeons that can do that procedure.

[s/v Beth]

As a physician who has practiced and taught medical school in the US and in central and south America I would advise caution. I had my gal bladder out in Wyoming and was back to work in less than a week. I paid cash and the government was not involved. You can have the same standard of care in central and south America, but those clinics are not the norm. PM me if I can help you in any way.

[craftconn]

I don't understand the ranting about Obamacare. I have had Medicare for 2-1/2 years and have had numerous very expensive tests and two surgeries with no problems of any sort. I guess if you don't pay your bills, someone may hound you, but I don't think you get to drag politics into that. And certainly, it's no reason to tell someone else to avoid US medical care. (Costs are outrageous, and get worse every year, and have for the last 20 years, but Medicare does cover most of it, so I don't hesitate to get the care I need.). As for the concern that it will drag out for months, you are so right! It will! Go to an ER. Tell them you have no primary care doctor--they see it all the time, and won't look at you sideways.

[chebba]

The respondent correctly labeled the system in the USA as "the American Health System" or aka the American Health Care System. The further reference "read Obamacare" was political and unnecessary. I am not going to get political and discuss the merits of Obamacare or the American Health Care System. I wish it wouldn't be pointedly labeled as "Obamacare" in a negative diatribe about the American Health Care System. It is the American Health Care System created using the American political system which I am proud to say I have fought for in foreign lands.

[Bulawayo]

Costa Rica every time.......inexpensive and decent care.

Originally Posted by Svdestiny

Okay we are currently in Guatemala and my husband MAY need Gallbladder surgery. It can be done inGuatemala, but Considering returning to USA to get it done there . we no longer have a real home there (cruising on and off since 1999) but do have family, inland.

My concern is, if we return to states, how long to get the surgery? We no longer have a primary doctor and are covered under social security/Medicare. I fear that when We get there it will take for ever to get an appointment, (if we can even find a doctor who will accept a new medicare pt) . Then we will have to hang around around a while to take tests, then have to wait for surgery. All a lot of hanging around. Or we could go to ER but I'm sure they wouldn't like that unless he was in the middle of an attack (god help me we have thought of inducing an attack to get the Emergency rooms attention, but that feels dumb and painful!)


Any advice from those familiar with todays US health care system? Ideally I would love to have him Fly in, see a dr, get the surgery, then fly back, but I fear it will be a long drawn out affair, (which im not sure we could handle financially re housing etc.) We could go back on the boat, but as we are in the middle of replacing port lights and the sole, it could be a while.

Thoughts?

[undercutter]

Fly to Switzerland. Much cheaper than you may think and some of the best Doctors in the world. When my wife got sick (told her she had a year to live in Canada without Liver Transplant) took her there and in 3 days completely different diagnosis and prescribed treatment which has led to a remarkable recovery. It was actually an amazing experience as they would conduct a test and during the time it took to return to the Doctors office they would have all the results sent back and the Doctor would already have conferred with the specialist (usually a Professor).

Healthcare system in NA is archaic and I wouldn't voluntarily go anywhere near the place again.

Australia is pretty good as well as long as you are paying privately.

[secrabtree]

A friend with Blue Cross found that the cost of a trip to Guadalajara for him and his wife, two weeks in Guadalajara for both - including meals and hotel for his wife while he was in the hospital and both after he was discharged cost less than his Blue Cross copay if he had the operation in the US. His assessment wqas that the medical care was better than he'd have received in the US. My experience from 4 years cruising Mexico and having a couple hospital visits myself and having my wife's knees replaced there I can definatly say that care is MUCH more personal in Mexico and the quality (as assessed by this layman) is every bit as good as the best care I've received in the US in the last 60 years of my 80 year life.
,

[kkotsur]

As you are aware there is a huge ex pat community in Costa Rica and therefore all the services to support them are there as well. Head there, save money and get the procedure done.

When I had my surgery it took me a few weeks to feel able to move freely and a month or so to be back to normal in terms of movement. On a side note, his BM will be different depending on the foods consumed do that takes a little getting used to. 😀

[mauser]

Me thinks more clinical intel is necessary on the current status of the patient. If he is stable - the delay in care is appropriate and future OR location is irrelevant. If clinical picture is worsening (AKA R. upper quadrant continuous pain radiating to neck/shoulder, nausea, vomiting ) delay in care may lead to necrosis/perforation/peritonitis. At that point odds for recovery are decreasing and immediate medical care is necessary. Cost becomes no issue - survival is.
Mauser

[dgarces]

As a physician I concurr with the comments provided by the other physicians in this thread. I would add that you must obtain a medicare supplement to your current medicare and it is likely your cost will be minimal if any in the US. There is no emergency to do your procedure and it is wise to allow the inflamatory process that developed during your attack to resolve completely. The many detractors to Obamacare are based on political motives. Alot needs to be done to improve the current healthcare system and Obamacare was a step forward! An uncomplicated Laparascopic Cholecystectomy will have you eating barbecue the next day in your cockpit.

[Kevin W]

My wife had this surgery 10 years ago. It is day surgery. In and out same day. My father lived on his boat in Quatemala for 20 years. Their medical is very good and U.S. trained. Costa Rica is also good.

[Sailing55]

Originally Posted by Svdestiny

Okay we are currently in Guatemala and my husband MAY need Gallbladder surgery. It can be done inGuatemala, but Considering returning to USA to get it done there . we no longer have a real home there (cruising on and off since 1999) but do have family, inland.

My concern is, if we return to states, how long to get the surgery? We no longer have a primary doctor and are covered under social security/Medicare. I fear that when We get there it will take for ever to get an appointment, (if we can even find a doctor who will accept a new medicare pt) . Then we will have to hang around around a while to take tests, then have to wait for surgery. All a lot of hanging around. Or we could go to ER but I'm sure they wouldn't like that unless he was in the middle of an attack (god help me we have thought of inducing an attack to get the Emergency rooms attention, but that feels dumb and painful!)


Any advice from those familiar with todays US health care system? Ideally I would love to have him Fly in, see a dr, get the surgery, then fly back, but I fear it will be a long drawn out affair, (which im not sure we could handle financially re housing etc.) We could go back on the boat, but as we are in the middle of replacing port lights and the sole, it could be a while.

Thoughts?

Port lights, cabin sole, dead husband...hmmm...do you have an insurance policy on him? What are your priorities?

My personal experience with the US health care system is nothing but positive. And on Medicare to boot. Couldn't possibly be any more professional or competent. Period. Major surgery, follow up care, all 100%.

Have family in the States make some calls and find a PCP that is accepting Medicare, and get the facts from the health care folks rather than speculating and worrying...not good for your nerves and not good for the husband.

Or get it done where you are and accept your circumstances...you are there because that is where you choose to be.

But please, don't delay for lack of information.