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Experience with Ecuador's national health care system was a big mess

Posted 12/7/16

When we first arrived in Cuenca in 2012, we were advised by gringos that the prudent thing to do was to get health insurance. Ed O'Connor

Being new, we took their recommendation and opted for coverage. The cost for both of us was $187 monthly …

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Experience with Ecuador's national health care system was a big mess

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When we first arrived in Cuenca in 2012, we were advised by gringos that the prudent thing to do was to get health insurance. oconnoredbw sizedEd O'Connor


Being new, we took their recommendation and opted for coverage. The cost for both of us was $187 monthly and since our monthly income was $1,293, It really put a burden on our budget.


I had serious doubts about its viability. Nothing was ever paid or reimbursed. There was always some mitigating factor that made us ineligible or we would be reimbursed “manana” (tomorrow). We would go to their insurance office every other day and after two months of “mananas,” I indicated to them into what orifice they could place their insurance. So, we went the self-insured route for three years.


Fortunately, we had the choice: We could choose to self-insure, get private insurance or subscribe to national health care. We were not coerced by government threats like you are with O’bummer care.


Was there an alternative? Yes – the Ecuadorean National Health Insurance, which is referred to here as IESS. The price was very attractive — $78.14 monthly total for the two of us. So we enrolled.


I have had degenerative discs since 1980. To relieve inflammation, I take Meloxicam. It was prescribed by my doctor in the United States. Until now I could go to the pharmacy 80 feet from my apartment and buy it over the counter. But now the government here in its infinite wisdom has made it necessary to have a prescription.


It turned in to a six-day odyssey of navigating the IESS system.


On a Monday, I arrived at the IESS doctor, explained the problem, showed him my X-rays and received the prescription. The doctor told me to go to the El Centro (center city) IESS pharmacy for the prescription and then go the main IESS office to schedule an appointment with an orthopedist (which I did not request or want). I was not examined.
We went to the El Centro IESS pharmacy and there I was told that they did not have Meloxicam and I must go to the pharmacy at the IESS hospital. Since I was already in El Centro, I went to the IESS main office to schedule an appointment with an orthopedist. After an hour of sitting around sick people coughing and sneezing, an appointment was made. Now we had to go to a clinic on the northeast side of town.


We get to the clinic, wait in line and get to the window. We are told the paperwork we were given has to be in triplicate, so off we go to find a nearby store to have copies made, then go back in line at the clinic. It is now 1:10 p.m. Finally, at 3 p.m., we get to see the doctor.
Now, he wants to see an MRI, so it is back to IESS El Centro. I am given paperwork to go to a large hospital so an MRI can be scheduled. After that an appointment has to be scheduled to have the MRI read back at the clinic in the northeast area of the city. After seven hours of running around today I still do not have the Meloxicam. Maybe tomorrow.


On Day 2, after spending/wasting another 4.5 hours going to four more IESS offices, doctors, clinics and hospitals, I still did not have the Meloxicam. There is none available at the main IESS hospital and they don’t know when they will have it. I will have to go to a pharmacy and buy the prescription. That is 11 IESS locations, two days and 11.5 hours of running around and have nothing to show for it.


On that Saturday, I had the MRI taken. On Monday, I go back across town again to have the MRI read. The doctor studied the MRI. His diagnosis? He told me to be careful when I walk, gave me a prescription for Flexaril and guess what else? Meloxicam!


With IESS you can get the prescriptions you need at no cost since one is a dues paying member of the system, right? Guess again. To get the medicine I was prescribed twice by IESS doctors and going to two IESS pharmacies which did not have the medication — that’s six days and 16 total hours running the IESS gauntlet — I had to pay for the medication myself.


Is this a great system or what?


I could have walked 15 minutes down the hill from our apartment, gone to my family doctor, gotten the prescription I needed and gone to the local pharmacy. Total time: about 50 minutes and I would have spent the same for a doctor call as I did the six days on taxis and bus fare.


I am really looking forward to my next IESS encounter.


Now my wife is experiencing the same type of running hither and yon with her IESS doctors. Two appointments with not as much as her blood pressure checked. Now the procedure she needs to have done has been finally scheduled — in three months! Her latest appointment was scheduled for 10:25 a.m. and she was not seen until two hours later. Patients who got there after her were seen before her. Not knowing that she understands some Spanish she heard the one nurse say, “The gringa can wait.”


Now we are back to self-insuring but we are keeping the IESS insurance for emergencies or for something catastrophic, just in case. We might need another tour of the city!
On the bright side: The private health care providers we use are great and I feel as confident in their care, if not more so, than I did in central Pennsylvania. And the prices of the office visits are extremely reasonable: family doctor is $20, specialist is $40 and dentist is $20.


They take their time and are very thorough. Olga recently had her yearly physical and the doctor spent 50 minutes checking her. He then sent her for blood work. The follow up visit to review the lab results was free.


Until later from beautiful Cuenca ... Eddy the Expat

Ed O’Connor, a former resident of Middletown and Lower Swatara Township, is an expatriate living in Cuenca, Ecuador.

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