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.