A lot has been written on this website regarding medical care in Argentina, especially compared with the US. As I’m on vacation in the US, laid up with a painful problem, I thought I’d post something about my experience. Several days ago I began to feel pain in my right leg. I had been on a long flight and had carried heavy bags – maybe I strained myself. The pain grew worse and I finally decided to call my health insurance company in Buenos Aires. Part of my expensive Argentine medical plan, provided by one of the best companies in Argentina, includes coverage for travellers.
After a call to the emergency number on my “carnet”, I received a call from a company in Canada who handle travellers’ assistance on behalf of the Argentine provider. I explained the problem and was informed as to where I could go for treatment – to one of the leading hospitals on the East Coast of the US. To protect the innocent I’ll just say that at this time I am staying in a big city in the Northeastern US.
At 7:30 PM on Monday I entered the ER of this well-respected institution. A few people were sitting watching a large flat screen TV; others were chatting on cell phones or resting. Before being admitted to the inner sanctum of the ER I had to go through triage, an interview process regarding my medical problem. From there I was eventually sent to registration. Calls had to be made to the Canadian subcontractor and to Buenos Aires to assure that they would cover expenses. This initial process took about two hours.
At around 9:30 I was taken into the ER area and assigned a bed in the hallway.
At 12:10 AM the doctor arrived, took a look at my leg and ordered an ultrasound. He left and I continued to wait. Growing impatient, I asked the nurse how long it would take to see the technician. She informed me that there was no technician on duty and that one had been called. Though I was told that the Emergency Room was busy, it didn’t look anything like the TV show “ER” - no sign of any desperate people, no shouting, no sense of urgency. There were several other people resting on beds like mine. A couple of the patients looked underprivileged.
1:40 AM. An orderly took me to see the technician. The results were sent to the doctor. No sign of a blood clot, though the doctor said that the ultrasound is not foolproof and that I should return in 72 hours if I do not improve.
2:30 AM. The doctor returned with a prescription and instructions; I was discharged.
It’s now Wednesday and I am worse. My leg, primarily the area around the knee and calf, is stiff and painful. Walking is very difficult. I am not sure what to do next. I’m concerned about the expenses involved – the hospital could not give me any idea of what costs would be. “Depends on your insurance” one employee commented. No one seemed to have any idea of costs. In Buenos Aires, thanks to my comprehensive insurance, I would have many resources at my disposal. Here I feel helpless.
Now to the unavoidable issue of comparisons. I’ve been to the ER in Buenos Aires a number of times over the years. I’ve received the best treatment – never a wait of over an hour – at IADT (Instituto Argentino de Diagnostico y Tratamiento). Once at another leading clinic I arrived at a busy time. The ER was understaffed and there was confusion. By complaining I got better attention. Frankly I suspect that being a foreigner was an advantage in this case. Complaining and being insistent the other evening at the American hospital would not have made the slightest difference. No one was rude or unkind – they were businesslike.
I realize that one visit to an ER is not a fair basis for a comparison. As I said, I once had problems at a leading hospital in Buenos Aires. In many years of experience, however, I have experienced a pattern of efficiency, competence and consideration at the three major private hospitals I’ve used in Buenos Aires.
In talking to the staff at the US hospital and some friends in the medical field, I’ve gleaned that the American health system is beset with a number of problems: a litigious culture that hinders efficient treatment for fear that doctors and hospitals will be sued (often for capricious reasons), the growing number of uninsured people who rely on emergency rooms for treatment - some of these people are covered by the welfare system allowing hospitals to recover all or partial costs however others will never pay anything forcing the hospitals to pass losses on to the paying public; pharmaceutical companies notorious for charging exorbitant prices; doctors who receive generous compensation.
By contrast, the medical system in Argentina is divided into two categories: public hospitals that cater almost exclusively to the poor and private hospitals of varying levels of quality that cater to those who can pay for insurance. Though there is much criticism of the American system for its failure to offer universal coverage, the fact is that the poor actually do receive treatment – treatment at the very same hospitals that serve the insured middle and affluent classes. In Argentina those who can not pay for insurance have no option but to go to public hospitals. The result is that the emergency rooms at private hospitals in Buenos Aires are not crammed with welfare cases (there are none!) and the waits are shorter. In Argentina the culture of suing has not taken hold. Doctors are underpaid. The end result is that private coverage is relatively affordable; doctors spend more time with patients. Expats are usually happy with the care they receive.
I do not doubt that the US has some of the best surgeons and specialists in the world and that the technology in leading hospitals is state-of-the-art. What I have seen, however, is that the system functions well for those who are fully insured and adequately for those who are underprivileged, have no money or property and nothing to lose when they can not pay. Those who fall through the cracks are mostly middle class people who have lost jobs, can not afford to maintain insurance and run the risk of health problems that could lead to ruinous expenses that threaten their life savings or even homes. It’s clear that the system needs reform.
I sit here looking out over a glorious snow covered panorama, rather immobilized by a painful, rigid leg. The ER doctor advised me to return to the hospital if I do not improve in 72 hours. Seventy-two hours have not elapsed and I am not better – I’m worse! I’m scheduled to return to BA next week. I'm nervous about whether I'll be up to the long flight. I’ll be glad to return to Buenos Aires and a private medical system that can better deal with my “health issue”.
I’ll update this when I have news. Any serious advice will be appreciated.
After a call to the emergency number on my “carnet”, I received a call from a company in Canada who handle travellers’ assistance on behalf of the Argentine provider. I explained the problem and was informed as to where I could go for treatment – to one of the leading hospitals on the East Coast of the US. To protect the innocent I’ll just say that at this time I am staying in a big city in the Northeastern US.
At 7:30 PM on Monday I entered the ER of this well-respected institution. A few people were sitting watching a large flat screen TV; others were chatting on cell phones or resting. Before being admitted to the inner sanctum of the ER I had to go through triage, an interview process regarding my medical problem. From there I was eventually sent to registration. Calls had to be made to the Canadian subcontractor and to Buenos Aires to assure that they would cover expenses. This initial process took about two hours.
At around 9:30 I was taken into the ER area and assigned a bed in the hallway.
At 12:10 AM the doctor arrived, took a look at my leg and ordered an ultrasound. He left and I continued to wait. Growing impatient, I asked the nurse how long it would take to see the technician. She informed me that there was no technician on duty and that one had been called. Though I was told that the Emergency Room was busy, it didn’t look anything like the TV show “ER” - no sign of any desperate people, no shouting, no sense of urgency. There were several other people resting on beds like mine. A couple of the patients looked underprivileged.
1:40 AM. An orderly took me to see the technician. The results were sent to the doctor. No sign of a blood clot, though the doctor said that the ultrasound is not foolproof and that I should return in 72 hours if I do not improve.
2:30 AM. The doctor returned with a prescription and instructions; I was discharged.
It’s now Wednesday and I am worse. My leg, primarily the area around the knee and calf, is stiff and painful. Walking is very difficult. I am not sure what to do next. I’m concerned about the expenses involved – the hospital could not give me any idea of what costs would be. “Depends on your insurance” one employee commented. No one seemed to have any idea of costs. In Buenos Aires, thanks to my comprehensive insurance, I would have many resources at my disposal. Here I feel helpless.
Now to the unavoidable issue of comparisons. I’ve been to the ER in Buenos Aires a number of times over the years. I’ve received the best treatment – never a wait of over an hour – at IADT (Instituto Argentino de Diagnostico y Tratamiento). Once at another leading clinic I arrived at a busy time. The ER was understaffed and there was confusion. By complaining I got better attention. Frankly I suspect that being a foreigner was an advantage in this case. Complaining and being insistent the other evening at the American hospital would not have made the slightest difference. No one was rude or unkind – they were businesslike.
I realize that one visit to an ER is not a fair basis for a comparison. As I said, I once had problems at a leading hospital in Buenos Aires. In many years of experience, however, I have experienced a pattern of efficiency, competence and consideration at the three major private hospitals I’ve used in Buenos Aires.
In talking to the staff at the US hospital and some friends in the medical field, I’ve gleaned that the American health system is beset with a number of problems: a litigious culture that hinders efficient treatment for fear that doctors and hospitals will be sued (often for capricious reasons), the growing number of uninsured people who rely on emergency rooms for treatment - some of these people are covered by the welfare system allowing hospitals to recover all or partial costs however others will never pay anything forcing the hospitals to pass losses on to the paying public; pharmaceutical companies notorious for charging exorbitant prices; doctors who receive generous compensation.
By contrast, the medical system in Argentina is divided into two categories: public hospitals that cater almost exclusively to the poor and private hospitals of varying levels of quality that cater to those who can pay for insurance. Though there is much criticism of the American system for its failure to offer universal coverage, the fact is that the poor actually do receive treatment – treatment at the very same hospitals that serve the insured middle and affluent classes. In Argentina those who can not pay for insurance have no option but to go to public hospitals. The result is that the emergency rooms at private hospitals in Buenos Aires are not crammed with welfare cases (there are none!) and the waits are shorter. In Argentina the culture of suing has not taken hold. Doctors are underpaid. The end result is that private coverage is relatively affordable; doctors spend more time with patients. Expats are usually happy with the care they receive.
I do not doubt that the US has some of the best surgeons and specialists in the world and that the technology in leading hospitals is state-of-the-art. What I have seen, however, is that the system functions well for those who are fully insured and adequately for those who are underprivileged, have no money or property and nothing to lose when they can not pay. Those who fall through the cracks are mostly middle class people who have lost jobs, can not afford to maintain insurance and run the risk of health problems that could lead to ruinous expenses that threaten their life savings or even homes. It’s clear that the system needs reform.
I sit here looking out over a glorious snow covered panorama, rather immobilized by a painful, rigid leg. The ER doctor advised me to return to the hospital if I do not improve in 72 hours. Seventy-two hours have not elapsed and I am not better – I’m worse! I’m scheduled to return to BA next week. I'm nervous about whether I'll be up to the long flight. I’ll be glad to return to Buenos Aires and a private medical system that can better deal with my “health issue”.
I’ll update this when I have news. Any serious advice will be appreciated.
