My post comparing hospitals and care in Washington [US] and Panama as expected generated a number of comments.

From Carmen Rodriguez . . .

Always enjoy your blog.  I do not think that comparing Chiriqui Hospital to Mae West is comparing apples to apples. If you are thinking about moving to Panama as an older expat (at this stage of your life, everything seems to hurt), it is very important to set your priorities.

You can move to Seattle and have Mae West and the cold, the snow and the gray days or you can move to Panama City, have Hospital Punta Pacifica, have sun, a lot of rain but no cold or snow. You can also move to Boquete, which may be everything you are looking for except for the medical aspect.

If you are looking for the perfect place you may need to wait for the next step in your journey, that would be Heaven.

Our last experience in Hospital Punta Pacifica was a colonoscopy. I will start by saying that the total cost of the procedure was $1079.00. No insurance. A friend of ours in Gainesville, Ga had one six months ago and his bill was for $6000. As I had mentioned before, what impresses me the most here in Panama is that doctors give you their cell phone numbers and actually answer the phone. My husband called a friend to get a recommendation to have the procedure done. He gave my husband the doctors name and number and told him to call the doctor in five minutes. When my husband called, the doctor was already waiting for the call. Gave him an appointment for the next day. Had the procedure done within a week and when we went for the results, the doctor greeted us at the counter where the receptionist sits. Spent half an hour going over the video of the procedure and just chatting. No pressure, no rush. Talk about two minutes with actual face to face in a doctor’s visit in the US, unless you are friends. I know. I am a pharmacist and the worst part is that patients come to discharge all their frustrations on us. Don’t worry. We are used to it.

Carmen, Just to clarify:

While I am certainly looking forward to heaven, I’m not ready for it yet.

Mae Lewis and Hospital Chiriqui are both hospitals in David, Panama. Virginia Mason Medical Center is in Seattle, WA. Punta Pacifica is a hospital in Panama City, Panama. Regards, Richard

Carmen got back to me . . .

Sorry, Richard. I meant to say comparison between Chiriqui Hospital and Virginia Mason.
I want to clarify that I am not Panamanian and I do not promote relocating to Panama. My opinion is that if you are thinking about relocating anywhere out of your comfort zone, you should move and rent for a year.

Regarding medical care, first of all, the doctors I see here are Board Certified in the USA.
Second, the world is over-populated because people are living longer due to better medical care and they do not all live in the USA.

And third, people in Panama that can afford Hospital Punta Pacifica have better sense than thinking that it is Johns Hopkins. Not that at Johns Hopkins and in the hospitals in the USA more people die of nosocomial infections that in Panama. But again, the beauty of Panama is that in 2 and 1/2 hours you are in Florida.

Punta Pacifica is affiliated with Johns Hopkins although I’m not sure what “affiliated” means.  And I absolutely agree with your advice to try out any new country for six months to a year before making a permanent move.  To visit on vacation or for a few weeks is one thing, to live in a place is another.

David Lane who is a faithful reader commented,

I appreciate your honesty and frankness in discussing the healthcare situation in both Panama and the state of Washington. So many people promoting Panama as a place to relocate and retire have not presented a realistic comparison of U.S. healthcare vs. Panama health care. As we age our systems tend to require more attention including the need for sometimes more than one specialist. If we have chronic issues such as diabetes, heart disease, COPD etc. we require carefully coordinated care. While hospitals in all parts of the world may be able to purchase sophisticated equipment for diagnosis it really boils down to the expertise and skill in the interpretation of the testing results and being able to determine the course of action needed for a particular person. Third world countries have not demonstrated that they have all of this available currently. Sure you can say in Panama City you have a somewhat developed hospital that has an affiliation (consultancy with a highly acclaimed medical center in the U.S.) but that does not mean that it has all the resources and staff that the U.S. hospital has. The hospital in Panama City is NOT Johns Hopkins. Some people seem to misunderstand this concept. We travel frequently to Latin America including Panama. We are in our early 70s and have complex health issues including heart related issues. We both require coordinated care for our conditions. Should we ever need to be hospitalized we would want our care to be provided in the United States and particularly at Winter Haven Hospital, Winter Haven FL. All our records are available in one place (the hospital and Bond Clinic) where all our physicians have an affiliation. We subscribe to a program called Medjet Assist which provides medical transport service including care all over the world. In an emergency requiring hospitalization we would be flown back to the U.S. and even to our hospital in Winter Haven promptly and with expenses and arrangements made by Medjet Assist. I feel anyone traveling should have this particular coverage. I can remember a number of months ago maybe last year you had a blog on emergency transfer from Boquete to David hospitals. Your presentation did not present a picture of coordinated care or rational approach. Perhaps you should share that blog with your readers again. Thanks again for your frankness and honesty. Good healthcare costs money and there is no alternative to that if we truly want and need 21st century care. Things will cost more in Panama for medical services as you point out. If prices do not go up there is no way they will ever be able to provide top-notch care. Physicians are a profession and simply will not remain in countries where they are not able to earn money. They will relocate to where the financial opportunities exist. Obamacare is on the way. There will be many opportunities for bilingual physicians in the U.S.

Sharon Oaks wrote,

This is a great post. We keep reading about the excellent and affordable medical care in Central America but I’ve never read a comparison dealing with anything more than costs and the fact that the doctors don’t rush. This is very helpful and tells me that keeping our Medicare supplements might be a good idea so we can take care of certain things when we visit the US.

Along that line, keeping your Medicare supplements if you are US retired,  Robert Berding, another US expat living elsewhere in the region suggests . . .

Richard. Might be an idea for people who have Medicare. It is just 3 hours flight from Tocumen.  Cardiovascular Center of Puerto Rico  Robert Berding

Continuing from Sharon . . .

I also want to say that I love your book. We aren’t sure if Panama is for us, my husband is a beach fanatic and I would love Boquette, but your book has so many things that will apply to other countries as well. I am currently reading it for the second time and will write my Amazon review after that. The first time I went through quickly without making use of the questions and tools, this time I am doing that. Thank you for providing us with your honest information about Paradise. I hope to at least visit Boquette one day and hope I will meet you then so I can thank you in person.