HeidiAllen.com

The United States Congress wants to pass some kind of healthcare reform this year. Unfortunately, most Senators and Congressman are refusing to consider the least complex, least expensive, most universal option… single payer healthcare. That means that help is probably NOT on its way.

If you’re dealing with a health issue now, and are struggling financially, you may want to consider medical tourism. This is true even if you have insurance. The cost will probably be less than your deductible.

This past September, I went to Costa Rica for a month to see a gastroenterologist and an opthamologist. Both speak English and are highly respected physicians. You won’t believe how little it cost me!

With the opthamologist, I had 4 or 5 office visits to fit one eye for a contact lens and adjust it properly. I also purchased 3 months worth of Acuvue daily use contact lenses.

With the gastroenterologist, I had an office visit, a gastroscopy, a colonoscopy, surgery and lab tissue analysis. (I was diagnosed with Crohn’s Disease, which is often missed.)

I also purchased a 2-3 month supply of a handful of medications, including Nexium.

While I was at the hospital, I started to go into a diabetic coma. The staff acted quickly, giving me a glucose IV and keeping me conscious until my levels returned to normal. My nurse spoke English.

The total cost for ALL of this was $1,855.34.

My air travel came to $745.02, including the Costa Rican airport tax.

I stayed with my mother, who lives in Costa Rica, so my lodging expenses were $0. However, there are many decent hotels with rooms for $35 a night. You can find hostels for even less. Most include breakfast.

Better yet, you could rent a room for a month from someone with a home. You should be able to find something for around $300. (Also check here.)

My food and miscellaneous expenses came to $181.61.

In the U.S., the average cost for just a colonoscopy is $3,081. My entire month-long vacation cost less than that, and I would still have had $300 left over for lodging.

(I’ve also had extensive dental work done in Costa Rica. My dentists had some equipment that even my US dentist didn’t have!)

It’s worth noting that my Tico (Costa Rican) doctors were much more accessible than my US doctors. They provided email addresses, and invited me to contact them at any time. (They’ve both responded promptly to emails since.)

My gastroenterologist had two copies of a full report including color photos ready for me when I regained consciousness after my surgery. My lab physician insisted on giving me my results personally so that he could tell me how sorry he was for my Crohn’s Disease diagnosis.

(UPDATE: The US Embassy in Costa Rica maintains a list of medical providers.)

If you decide to go to Costa Rica for medical tourism, here’s some tips:

* DO NOT rent or drive a car. Use taxis and buses, or hire a Tico driver. Costa Rica has one of the world’s highest accident rates, and people unfamiliar with the awful roads and bizarre traffic customs should not be driving.

* Learn some Spanish before you go. Yes, learning even the basics of another language can be tough, but it will be worth it… big time! Most Ticos do not speak English. (Why should they?)

* Arrive with at least $20 in colones in your pocket. At the very least, you’ll need to pay for a cab or bus to your hotel.

* Learn to count in colones… in Spanish!

* Buy a pocket translator / currency converter.

* Do not exchange money at the airport or through independent money exchangers. Do it at a bank. Also avoid ATM machines if at all possible.

* Make color photocopies of your passport, driver’s license and plane ticket as soon as you can after arriving. (You want a passport copy with the stamp that proves you entered Costa Rica legally.) Carry these with you rather than the originals. Keep the originals somewhere safe.

* Wear a money belt or other hiding place for valuables. If you’re carrying more than one item of luggage, break up your cash, credit cards and important documents so that the theft of one item won’t cause you to lose everything. Tourists are always targets, no matter where in the world you travel.

* Take a good look at the Costa Rica By Bus website and consider buying their guide. The website offers lots of excellent, free advice.

* Also thoroughly read the pertinent parts of Lonely Planet’s Costa Rica pages and consider buying their guide.

* Study a map of Costa Rica, especially San Jose.

* Stay away from bars. They’re trouble magnets, especially if you’re a male Gringo or a female alone. (Side note: I went to a club with a Tica friend and made the mistake of going out on the dance floor by myself. Within seconds, two men began grinding their bodies against me and a larger crowd of men gathered to await their turn!)

* Avoid US fast food chains, especially McDonald’s. My brother (for some reason I utterly fail to understand) went to McDonald’s on his first day in Costa Rica and got food poisoning. Tico food is better anyway! On the other hand, the Pizza Hut in San Jose is considered a fancy place to eat. (?!)

* Do yourself a favor and try Gallo Pinto (Painted Rooster) at least once while you’re visiting. I live on this stuff every time I go. (It’s usually vegan!) The dish is basically fried rice and beans with some red veggie bits and seasoning, but the description doesn’t really do it justice. Ask a Tico friend for a soda (casual restaurant) recommendation.

Gas prices are obviously impacting a lot of people and businesses here in the US, but we still have it easy compared to many other countries.

In Costa Rica, gas is currently $4.72 a gallon. In the capital of San Jose, that nation’s most populous city, emergency services will be cutting back from 3 ambulances to 2, because they can’t afford the gas. Emergency calls to EMS will now be prioritized, and ambulances will only be dispatched to the most serious cases.

Taxis are no longer driving around the city looking for customers. Instead, they line up at various locations, waiting for the customers to come to them. When the taxi at the front of the line gets a fare, the rest of the drivers get out and PUSH their cars forward.

All this is going on at a time when Costa Rican president and Nobel Prize winner Oscar Arias has been caught red-handed with a 2 million dollar slush fund made up of government money. Sigh.

And what are we, the world’s biggest consumers, doing about the gas price issue? Apparently, falling for the bull that drilling in environmentally sensitive areas will bring down prices.

This simply isn’t true. See the actual Department of Energy analysis at the end of this post for the facts.

Meanwhile, when I called a senator’s office recently and asked his aide to tell the senator that I support reigning in oil market speculators, he responded, “Oh, so you want to REGULATE the free market?!!!”

“No,”, I replied. “I want to protect the free market and the American people from what the speculators are doing to them. Wouldn’t that be a less costly and faster way to deal with high gas prices?”

He spouted a bunch of talking points that supposedly “proved” me wrong. I researched them after I hung up and discovered that he didn’t have a leg to stand on.

And that’s where we’re at. Talking points versus facts. Given our recent history, don’t expect facts to win out.

US Department of Energy, Energy Information Administration
“Official Energy Statistics from the US Government”

May 2008: Analysis of Crude Oil Production in the Arctic National Wildlife Refuge

“With respect to the world oil price impact, projected ANWR oil production constitutes between 0.4 and 1.2 percent of total world oil consumption in 2030, based on the low and high resource cases, respectively. Consequently, ANWR oil production is not projected to have a large impact on world oil prices. Relative to the AEO2008 reference case, ANWR oil production is projected to have its largest oil price reduction impacts as follows: a reduction in low-sulfur, light (LSL) crude oil¹⁸ prices of $0.41 per barrel (2006 dollars) in 2026 in the low oil resource case, $0.75 per barrel in 2025 in the mean oil resource case, and $1.44 per barrel in 2027 in the high oil resource case. Assuming that world oil markets continue to work as they do today, the Organization of Petroleum Exporting Countries (OPEC) could neutralize any potential price impact of ANWR oil production by reducing its oil exports by an equal amount.”

2007: Impacts of Increased Access to Oil and Natural Gas Resources in the Lower 48 Federal Outer Continental Shelf

“The projections in the OCS access case indicate that access to the Pacific, Atlantic, and eastern Gulf regions would not have a significant impact on domestic crude oil and natural gas production or prices before 2030. Leasing would begin no sooner than 2012, and production would not be expected to start before 2017.”

I haven’t done a very good job of covering what’s going on in Costa Rica. In a nutshell, President Pacheco quelled the strikes with the old bait and switch. He changed the focus to a corruption investigation of former presidents. And whaddya know?

After all was said and done (and if my scorecard is still up to date), 2 former presidents landed in jail and one is afraid to re-enter the country for fear of arrest. Can you imagine the damage to the national psyche that would occur if this were to happen in the US?

The unrest of last year was due to an overall hostility towards foreign intervention. One of the primary targets was CAFTA, called TLC in Costa Rica. It looks now as if Pacheco will use various stalling tactics to put off the final vote on CAFTA until after he’s left office. As it is, he’s battling new corruption charges every week, and his position is tenuous.

I can’t say that I blame him. If CAFTA is voted into effect, the country is sure to be rocked by another series of strikes and protests. In all likelihood, they’ll be worse than those of last year. In the meantime, I’m heartened that the US Congressional Hispanic Caucus voted 14-1 against CAFTA. (Shame on you, Rep. Henry Cuellar!)

For those of you interested in keeping up with the goings on in Costa Rica, here’s your best sources:

The Tico Times:
Long-running English language paper catering to foreigners living in Costa Rica

A.M. Costa Rica:
New English language paper with a more informal tone, but strong on opinions. Sometimes reports on stories that the Tico Times would rather stay away from.

La Nacion:
Costa Rica’s most popular newspaper. Publishes a weekly news roundup available online in English.

For those of you who are bi-lingual, here’s some other major Tico newspapers:

El Dia

La Prensa Libre

La Republica: “Costa Rica’s Business Daily”

Thank Goodness for OneWorld.net. I have loved ones in Costa Rica. The current national crisis there would have escaped my notice if I’d relied on the mainstream media.

Most Americans don’t know that Costa Rica has a long history as a peaceful, constitutional democracy, with the highest standard of living in Central America. Unfortunately, US-friendly business interests have been infiltrating the Costa Rican government, culminating in the election of the current president, Abel Pacheco.

Right now, a massive general strike and protests are spreading across the country. Ticos, as Costa Ricans call themselves, are usually very passive, but with their parliament set to pass the Central American Free Trade Agreement (CAFTA) and some of their government’s duties now contracted out to corporations in other countries, Ticos have had about enough.

Inflation is rising far more quickly than the cost of living. Privatization of formally government held industries is causing rising unemployment. The huge influx of foreign nationals retiring to Costa Rica has driven up housing prices in some areas beyond the reach of all but the wealthiest Costa Ricans.

The coffee growing regions are suffering terribly due to the global coffee crisis. Farmers are often offered less for their coffee than it cost them to grow it. Many Ticos blame the crisis on the policies of the World Bank and the International Monetary Fund.

Ticos also feel that their safety has been endangered by the US invasion of Iraq. They’re the main US ally in Central America, making them a target. Costa Rica’s own Supreme Court has issued a report saying that the Pacheco administration violated the country’s constitution by supporting the US invasion of Iraq. The average Tico is strongly against the invasion.

As for CAFTA, representatives of the United States used some very questionable tactics to force Costa Rica’s negotiators to sign on to the agreement. For example, US-based Harken energy, the oil company once run by George W. Bush, suddenly wanted the Costa Rican government to cough up $57 billion, three times Costa Rica’s gross domestic product.

The amount, they claimed, was due to them as reimbursement for a drilling project that was halted due to environmental concerns. Harken’s own website estimated the actual amount lost at $10 million.

When CAFTA negotiations ended favorably for the US, the new Harken settlement offer dropped to between $3 and $11 million. Harken stands to gain substantially if Costa Rica passes CAFTA, which may force Ticos to allow oil drilling, regardless of their no-drill laws.

So I’m torn. On the one hand, I and my loved ones are glad that our Tico friends have finally decided to stand up to a government that is selling them down the river. On the other hand, I fear for those I love. They’ll soon be without electricity, water, telephone or internet service if the strike continues. And they’re obviously Americans. That is no longer a good thing.

I received an email from one of my loved ones in Costa Rica today, and will include an excerpt here.

First, note that the term “Nicos” refers to Nicaraguans. It’s pronounced “NEE-coes”. The Tico (Costa Rican) police force now includes many Nicos. Tico police aren’t issued firearms, but Nico police officers tend to carry the weapons that they used as soldiers in their homeland. There’s been growing tension between Ticos and Nicos for decades. This adds yet more fodder to a situation that could easily become explosive. My loved one writes:

“President Pacheco is acting like a fool. He was filmed laughing at workers’ demands. There is a lot of anger out there. And TV coverage of Gestapo-like police breaking truck windows and lobbing tear gas into the trucks to get the drivers out inflamed the situation. A lot of innocents were beaten up by police thugs.

After that students and teachers and hospital workers joined the protests. Of course, nobody really wants the TLC (CAFTA) because Bush is demanding that Costa Rica dismantle its constitution in order to join. Bush wants US big business to run the country’s infrastructure. Now things are pretty much a government monopoly. But the Costa Ricans are willing to try free trade as long as the decision and manner of doing so is theirs.

“Ticos are generally pretty passive. They don’t like confrontations. It’s a different thing with the Nicos. They have had nothing BUT violence forever. And Costa Rica has been pushed to the limit with Nicuaraguan refugees crossing the border by the thousands every week. They come because they are starving in Nicuaragua. They come with nothing but their weapons and disease. It’s pretty sad. You can’t eat guns!”

I was also forwarded a note from another American (whom I don’t know) who lives near San Jose, the Costa Rican capital. His name is Mark John Allen and he writes:

“As I speculated earlier, events at present are surreal and simillar to events leading up to this country’s Civil War in the 1940s, in that you have a government totally out of touch and alientated for quite some time from the people. Instead of working for the benefit of the people, the people perceive that it is working for special interests, the elite in the country, the IMF and their ilk, and doing what it is told by the US government, whose ridiculous policies the majority of the people hate and despise.

“They can see that this outside, alien power is attempting to subvert their national sovereignty, and has talked or coerced Pacheco into doing things that are damaging to the country and contrary to the wishes of the people.

“Pacheco could send out an olive branch by immediately taking his signature off of George Bush’s ludicrous so called “coalition” but instead, even on this minor point, he remains stubbornly opposed to what the people wish. He is a proud, arrogant, stupid man without understanding. Everything he does serves only to escalate this crisis more.

“What started out small on Monday has cascaded into a potential national disaster and civil war. He had better start acting like the President of the people of Costa Rica rather than the lackey of special interests and the US government if he wants to remain in power for the remainder of his term. Otherwise, the ugly mood of the people will grab him by the neck, and forcibly show him to the door post haste.

“And by the way, UnAbel, sending in your goon squads [police] dressed in black like Mutant Ninja Turtles as you have been taught by the Yankees to smash people’s heads, windshields, etc., is not just un Costa Rican, but won’t cut it here and is not an act of reconcilliation.”

I pray that the Costa Rican government heeds the will of the people before it’s too late.