Medical care : US vs Argentina

[sergio]

A lot has been written about this. I just want to say that I was just in the US and consulted a specialist I used to see when I was living there. A problem I've been having was not dealt with successfully by several leading specialists in Argentina. The American doctor introduced me to new medications that so far seem very effective. What I am saying is that despite having one of the best medical plans in Argentina, I don't think doctors are as informed as their American counterparts, at least those at the top of their profession. I have another experience to relate about superior dental care in the US (I had to have work redone that was done in Argentina). I know this will spark controversy -- that's fine. I am just telling you my experience. I am not saying that medical/dental care is not good in Argentina but I don't think it is nearly as advanced as in the US. And let's not get into cost. I am talking about what is available if you can pay.

 

[marksoc]

Dental care can be good in Argentina as in any advanced economy. The problem I find with Argentinian doctors is that maybe they tend to use the cheapest possible solution for a problem. I put maybe, because I don´t know if it is exactly true. It is true that most of the population cannot pay for state-of-the-art drugs, and that maybe local hospitals cannot offer the last technology available (in the US). Thus for most of people the solutions offered by local doctors are the most effective ones given the resources at hand, since a marginal increase in effectiveness would come at a high cost that it is not necessary to affront. About not being up to date with advancements in medicine, I don´t know if this applies to specific doctors in every country, or if this is the case for argentinian doctors in general. It would be useful to have the input of a local doctor here.

In my case, I had a test in Argentina that yielded no results, against a test in Israel that I think correctly identified a medical problem. The difficulty to get complex tests in Argentina derives from the bureaucracy of the system and the lack of equipment and personnel. Btw, both systems are "socialized", being the Israeli more comprehensive and "socialist" (to use a teaparty denomination) than the Argentinean one.

I find local doctors to be very knowledgeable and having a better rapport with patients than the Israeli ones, maybe because they depend more on the personal interview than on tests.

Of course if you can pay anything probably the US has the best care available (is this a myth or is it an objective truth?), but money is always an issue, especially if we talk about the entire population and not about individual cases. Policy must take into account if possible all the people, not only the rich individuals. When you modify health policy, you are choosing in a way who will live and who will die, since resources for care are limited. The trick is to enhance care for the maximum quantity of people possible for the maximum amount of years possible for each individual, isn´t? But tough choices must be made every year, regarding the drugs to be subsidized, the machines to be bought, etc.

Yes, I have a lot of free time today.

What do you think?

 

[jenh]

Many medications are approved first in the US or Europe and get to this market a little later. Also, the quality of generic medications here is not always equivalent to the quality of generics in the US. If your treatment involved a new medicine, it might not have been on the market here yet.

Generally, I find the medical care here pretty good except when it comes to using the newest medicines or newest protocols of treatment. In specialist centers, though, I have spoken with doctors (for my work as I work in health care) that are as much on top of things as the top docs in the US.

 

[sergio]

One other difference that I noted is that in the US, even at the dentist's, they ask you to complete a detailed information sheet about medical history, drugs you are taking etc. I have seldom, if ever, done this in Argentina -- and never for a dentist. This is not high tech but common sense and does not cost much -- just the price of a piece of paper. In my case, up-to-date treatments were not available in Argentina and when I asked a couple of doctors if there weren't something new, they said "no". They did not volunteer that there were options elsewhere, something they might easily have said to a foreigner who is more likely to travel abroad. As for the high cost of a drug that was prescribed for me, if I were working in the US I would probably have had insurance that would pay for all or most of it. At least that is the case with my working American friends. Anyway, my observations were personal and not philosophical. I just found care in the US more up-to-date and more professional than in Argentina. In Argentina you get more time with the doctor but what good is it if s/he can't help you?

 

[clooz]

Many medications are approved first in the US or Europe and get to this market a little later. Also, the quality of generic medications here is not always equivalent to the quality of generics in the US. If your treatment involved a new medicine, it might not have been on the market here yet.

How do we find out which specific generics here are of equivalent quality to European/ISO regulated standards? Since the FDA is part of the big-pharma funded USG, as an organic chemist, I don't put much reliance on their oversight of anything including manufacturing quality.

 

[jenh]

It is pretty tough to find out. I had an experience here with having a serious adverse reaction to a generic medication because of the inactive ingredients it contained - not the drug per se but the fillers etc. in the formulation. It was a topical medication.

Many people here stick with the "branded generics" as they say - one of the reasons that brands don't lose as much power when generics enter the market. If you are taking something that your life depends on, I would bring the medication from the US or make sure it is manufactured here by one of the major Pharma companies and not a small lab. But then again maybe I am just paranoid and cynical about being in the health care industry too long.

 

[syngirl]

The problem I find with Argentinian doctors is that maybe they tend to use the cheapest possible solution for a problem. I put maybe, because I don´t know if it is exactly true. It is true that most of the population cannot pay for state-of-the-art drugs, and that maybe local hospitals cannot offer the last technology available (in the US). Thus for most of people the solutions offered by local doctors are the most effective ones given the resources at hand, since a marginal increase in effectiveness would come at a high cost that it is not necessary to affront. About not being up to date with advancements in medicine, I don´t know if this applies to specific doctors in every country, or if this is the case for argentinian doctors in general. It would be useful to have the input of a local doctor here.

Actually a lot of this is pressure put on them by the seguro companies -- for instance, when my husband had his knee surgery, OSDE was only willing to pay for locally made screws. His doctor said "look, I can do the surgery with them, but I don't like to". He only liked to use the American-produced titanium screws -- this came at a cost of $600 USD to us -- if we couldn't afford it, the surgeon would have used the OSDE-covered screws. We paid the extra.

Same with my obstetra-ginecologa now -- they have all the latest tests available if you want them, but they aren't necessarily going to be covered by OSDE (this is the same if you go to private radiology clinics etc -- you can get a tonne of the latest scans, but at a price). We're fortunate enough to have the financial means to pay for tests -- we did look into upgrading our OSDE plan, but when we found out the tests still wouldn't be covered, we decided that it made more financial sense to stick with what we have and just pay additionals out of pocket.

 

[gouchobob]

Actually a lot of this is pressure put on them by the seguro companies -- for instance, when my husband had his knee surgery, OSDE was only willing to pay for locally made screws. His doctor said "look, I can do the surgery with them, but I don't like to". He only liked to use the American-produced titanium screws -- this came at a cost of $600 USD to us -- if we couldn't afford it, the surgeon would have used the OSDE-covered screws. We paid the extra.

Same with my obstetra-ginecologa now -- they have all the latest tests available if you want them, but they aren't necessarily going to be covered by OSDE (this is the same if you go to private radiology clinics etc -- you can get a tonne of the latest scans, but at a price). We're fortunate enough to have the financial means to pay for tests -- we did look into upgrading our OSDE plan, but when we found out the tests still wouldn't be covered, we decided that it made more financial sense to stick with what we have and just pay additionals out of pocket.

I had a similar situation with an orthopedic device I needed. The insurance company was willing only to pay for the locally produced materials. I went ahead with the locally produced one and it only lasted a few weeks. I went back and paid for one made from imported materials(U.S.) and still use it 3 years later.

Overall I was quite happy with the medical care we received in Argentina through the private insurance plan we had. For some reason the general poor level of service, overly cumbersome bureaucracy, you find in other parts of the society have not impacted medical care. Dentists on the other hand I wasn't to impressed with and I tried several, I am sure there must be some good ones.

 

[jago25_98]

My experiences agree here. I wanted a simple hormone test but it's not available in the 3 hospitals I tried. What with the beefed up guys walking around everywhere I though hormones would be well covered... well perhaps it's only Testostrone that is well covered and not the other ones!

Compare this to the US, you just piss in a pot and mail it back.