We are proud at Montanita Estates to be active supporters of local youth athletes and surfers.  See below for some of our good friends.  

Often I get a number of questions about Health Care here in Ecuador and I thought I'd give our experience since we've been here in the last 2 years.  

Back in Los Angeles I worked in corporate America for 11 years and was always covered.  I was one of those people that while I signed up for a PPO or the best coverage my employer offered, I didn't even know the name of the provider or my doctor.  On a bad year I'd head to the doctor once a year for Surfer's Ear (ear infection) that I neglected too long.   I am young and healthy and never even thought about the doctor.  Was I glad I had the insurance, of course, did I need it, good question...

Since we've lived in Ecuador we have not had private insurance.  Insurance in general (car, health, home, rental, earthquake) is a discussion for another post, but not having private insurance here is quite common.  The primary reason is there is national coverage through your SOAT and private treatment is very inexpensive for an American (however expensive for an Ecuadorian).  

In our experience since we've been here, most Gringos opt to pay out of pocket for private treatment when treatment is needed.  When we've  visited the hospitals on both the coast and in Guayaquil the part of the hospital that treats those using there SOAT typically is hot, crowded and not very appealing.  After seeing this part of the hospital we went to the private treatment part and it has been incredible.

We have always opted to go to the hospitals in Guayaquil because you can seek out a specialist and they are all there.  There are no lines, you just walk in and typically within 30 minutes you are sitting with a doctor.  In the case of my ear problems I went strait to the ear specialist.  A consult cost $75 and antibiotics typically cost less than $20.  And this was for a major ear problem, I lost hearing in my ear for a week.  In the case of Holly when we were having our baby each appointment with our baby doctor cost $100 out of pocket.  Holly had a Parasite once and wanted a check up so we saw an Internal Medicine Doctor who had received his Med School Degree from Emory University (My alma-mater) and the CDC.  It doesn't get much better than that.  Grand cost $80.

There have been two instances when we/or friends needed X-Rays.  Typically what happens is you go to the specialist first and he tells he writes down instructions for X-Rays.  You then walk to the part of the hospital that does X-Rays and sit down at what appears to be a cash register.  You prepay for your treatment, in our case it was somewhere between $200-300 and then return to the doctor for a consult.  Again no lines, and very strait forward on the private treatment part of the hospital.  A couple of our friends needed major sugeries for broken bones and the cost was between $1500-3000 without insurance our of pocket.

Overall in these instances it was a very good experience. 

In the case of our baby, we decided to seek out the best doctor money could hire in Ecuador, and I think we found him, Dr Bernie Blum.  We were in a private hospital in Sambornodon.  The entire hospital had less than 14 rooms and when we had Maddox there were more nurses than patients.  At one point we needed to ask the nurses to stop checking on us b/c we just needed sleep.  We had a beautiful private room, with DirecTv, WIFI, a couch and private bathroom. We stayed for three nights.  We opted to have cesarean b/c when living 2 hours on the coast of Ecuador far from civilization, you really want to plan and make the experience as predictable as possible.  We just couldn't imagine how to handle going into labor and needing to travel 2 hours to the city.    Dr. Blum is the Chairman of the Samborndon Hospital, and his father is the Chairman of Policentro Kennedy, the largest hospital in Guayaquil a city of 3 mm people.  They were incredible to work with and both bi-lingual which was important to Holly.

Grand total for the surgery, stay, medicine and accessorials, $6000.   

Does that mean it cost $6000 to have a baby in Ecuador? no...  We have guests right now staying in our rentals that are having their baby for free at the local hospital in Manglaralto, but the option is there for either.

A couple more  items to think about is we are young and rarely use health care system here but for everyday illnesses there are clinics and pharmacies in every town.  In the case of Diaharrea (sp?) the flu or just general infections we head to the local clinic, or just strait to the pharmacy, 5 minutes away and tell them whats wrong and the doctor gives us medicine.  Typically takes less than 20 minutes and costs less than $20.  

Lastly the Gringo community here on the coast has organized and is enrolling in a private insurance plan.  Its new and I understand it costs less than $100 a month.

Because of our new son, I am going to look into it so once I research it and try it out I'll let you know.

Hope this was useful... Feel free to shoot me other topics and I'm happy to post.

"If you can provide a quality product or good value for a service you can make a stress free living in Ecuador, have a comfortable house and a 4 wheel drive truck, make your own hours, surf every day, eat fresh seafood and drink a cold beer with friends whenever you feel like it  and most importantly spend time with your family"

I suppose when I look back I started planning this move in 1999 when I first visited Costa Rica.  

I was a junior in college at this time and for Spring Break I went with 10 friends to Tamarindo where we rented a brand new beachfront 5 bedroom house with a pool for what I believe was about $200 a night.  I couldn't believe the luxury we were living in for what basically came out to $25 per night per person.  I was also drawn to the simplicity of the town, dirt roads, a number of outdoor bamboo cafes and bars with book exchanges, a surf shop on every corner, a couple dial up internet cafes, tiendas selling ice cream, fruits and veges,   and one chain hotel (The Best Western).  I felt like I had everything I needed.  It was also at this point where I caught the surf bug as well and knew no matter where I ended up after college surfing was going to play a big part. 

In 2002 the consulting company I was working for had been clobbered by the tech bubble and I  had literally been "on the beach" (consultant speak for between engagements but literal for me b/c I lived in LA and just surfed all day) for 6 months.  I knew my days were numbered and wasn't ready for another desk  job so my best friend and I got the crazy (likely inebriated) idea to drive to Chile.  The next day we got out a map to start plotting our course when we saw Colombia in our path and decided we better just aim for Panama as Colombia hadn't turn the corner just yet. 

Over the next 2 months while I waited for my pink slip and subsequent severane package that was going to fund our trip we looked for a car to drive and found it in Mr. Bernardy.   Mr. Bernardy was a 1978 Green Volkswagon Van that we bought for $750 in the OC.   We heard they were easy to fix and bought a dummies guide to repairing your VW bus and were on our way severance package in hand.  The story of that trip is for another entry but we spent 6 months in every surf destination between LA and Panama.  Our trip highlights were the East Cape of Cabo ,  Mainland Mexico Sayulita, Punta Mita, Troncones, Escondido, Barra (Huatulco), Nexpa, Ticla, the Ranch, El Salvador East and West, Nicaragua Popoyo, Colorados, San Juan Del Sur, Mahagua, Costa Rica Tamarindo, Santa Teresa, Dominical, Manuel Antonio, Pavones.  

3 years later after a similiar corporate foray I spent 6 weeks between jobs in Peru and Ecuador surfing where I stumbled onto Montanita in 2006 and had  a blast.  

I suppose the point of this brief history is to show that I feel like I'm as close to an expert on surf towns in Central and South America as they come and have seen a number of these towns grow up over the last 14 years as I took every chance I had to visit over and over again my favorite spots. 

So having finally had a couple successful years in Corporate America I was able to save enough money to make the leap I started planning my exit.  My criteria were as follow:

• Consistent uncrowded Surf  (this ruled out places like the Carribean, Belize and Honduras and put Mexico, Peru, Costa Rica, El Salvador and Nicaragua high on the list)
• Warm Water (ruled out Peru and south)
  
• Cost of Living (by 2006 when I visited Costa it had already gotten expensive and today the prices are not much different than the US, no on costa and no on Panama b/c of the amount of money flooding into the country due to the canal.  There's a Trump tower there now....)
  
• Proximity to the US (while I was ready to leave the US I like being close to family and friends, so Asia was just too far, I had visited Indo, Thailand, China, and India on other trips at other times)
• Town (this is where Montanita won out over El Salvador and Nicaragua as Montanita is the best little surf town you will ever visit in terms of vibe, locals and fun)
• Property Rights (as an investor here now this is important but was lower on my criteria b/c I didn't know what I was going to do when I moved, this always made me rule out Mexico b/c of the long history of Californians losing property)
• Safety (having been to as many places as I've been, I've learned this is primarily under your own control, there are bad apples everywhere you just need to be smart to avoid the places they hang out the best you can, however the problems in Mexico and the petty crime in Costa Rica really turned me off to both places)
• Investment (Ecuador has ranked highly with IL and its driving a lot of retiree traffic versus other locations that do not get the coverage or have already run up)

In the end for me Montanita was the perfect balance of my criteria:

• Surf - Warm uncrowded, consistent surf year round.  
  
• Cost of Living - Ecuador really is inexpensive.  Once you take out housing out of the equation our expenses are 10% of what they were in the US and from what I've heard probably about 60% less than a Costa Rica these days.  
• Proximity to the US - While I rarely head back or miss  the US, Holly visits 2-4x per year mainly to see family, eat some good meals and shop.....  
• Town - Montanita has become our home and we love our little pueblo and its people.  We look forward to spending many more years here and Maddox to grow old with the local children.  There are a few thousand people that live in the area and its one of those towns where you can walk through and every 10 yards you are saying hi to friends.  There is also a heavy tourism/backpacker culture so there are always new people, personalities fueling a lively bar, restaurant, party scene that keeps the town feeling new
  
• Property Rights - Since I've been here I've never met or heard of someone that has lost a property.  There are intricacies to the Ecuadorian law that you need to understand in order to buy the right properties that wont have problems but once you understand the law my experience has been good
• Safety - We didn't lock our doors for the first 1.5 years here and the only reason that changed is b/c we finally got a new door.  We also leave towels, flip flops on the beach and car doors unlocked and have never been robbed.  In other locations i've been to its felt like you are being watched and they break into your car as soon as you walk away... Costa Rica
• Investment  - Ecuador is booming right now and investing is cheap and low risk.  

Whether you are buying a property or starting a restaurant the start up costs are low and the foot traffic in the right locations is high.  If you can provide a quality product or good value for a service you can make a stress free living in Ecuador, have a comfortable house and a 4 wheel drive truck, make your own hours, surf every day, eat fresh seafood and drink a cold beer with friends whenever you feel like it  and most importantly spend time with your family


That's what we are doing, whats your criteria?