It has been more than 17 years since I was last covered by health insurance. Because of the brain tumor I had removed in 1990, I was considered “uninsurable”.
Providentially for me, I enjoyed decent health until the accidents that crippled me in 1998. By that time I was living outside the United States, so I was able to afford health care even without insurance. (Admittedly, some of the health care was provided by practitioners whose credentials might be considered by some–anyone with an IQ above 30 –as suspect. I remember that on the island of Nevis they only had one class of physicians, and consequently even Chiropractors could prescribe drugs- “take two of these pills daily, and return three times a week forever”. The the university degree of the chief health officer of the island, a doctor whose name I do not remember, was R.N.)
But all of that changed when I came to Uruguay! Every legal resident who pays Social Security is entitled to choose from among several HMOs which are totally paid for by one’s Social Security contribution. In addition, there is also a government health service to care for the needs of the poor, and private health insurance as well (for which I could not qualify because of my pre-existing conditions).
Since I am working and paying social security I now have health insurance. Santiago researched the various plans and chose COSEM because it was reputed to have the best doctors and the newest facilities.
Eight days ago I went to COSEM for the first time to see a general practitioner in order to get a referral for a specialist. I was impressed with the modern facility. I did have to wait about an hour to see the doctor, but I have waited longer than that in the US and then had to pay $120 for the privilege. This visit cost me nothing. The doctor gave me a referral to a dermatologist to deal with the skin on my left leg which had been ravaged by a seven-year long staph infection.
Perhaps the most impressive thing was that the doctor did not tell me to put Dr. Selby ointment on my leg–in Uruguay Dr. Selby is the equivalent of “take two aspirin and call me in the morning”.
Santiago went to the front desk to make the appointment for me. He was told that there were no dermatologist appointments available for more than a month. However, the general practitioner had marked my need as “urgent”, so the scheduler told Santiago he would find an appointment for me quickly and call us with the time and day. That was Friday, March 7.
My appointment with the dermatologist was on Tuesday, March 11. I don’t think I could’ve gotten in that quickly in the US under any circumstances short of third-degree burns covering 80% of my body.
When the day came for the dermatologist appointment I cleared my calendar just in case there would be a long wait. To my pleasant surprise, there wasn’t. I was the second person on the list, and don’t think I waited more than 10 minutes. The dermatologist was knowledgeable, and gave me some prescriptions that have helped me tremendously. I started seeing improvements very next day. Some of the things the doctor prescribed were available right there at COSEM’s pharmacy and were extremely inexpensive. The rest we had to buy at a local pharmacy, but the price there was discounted as well because of my COSEM membership.
The whole process was easy, and frankly, encouraging. Virtually every encounter I have had with physicians in Uruguay has been positive.
I say virtually because there was one doctor that I had to endure who started out with the tired old litany of “you’re overweight”. Gee, really? I didn’t know that: I thought I was the perfect weight for someone 7′6″ (2.25 m). That encounter was actually pretty funny because, as she was talking, in Spanish of course, Santiago became visibly upset. He told it was because he knew I would not like what she said. I told him that I would absolutely not be angry or upset because I intended to ignore her completely.
Those who know me even casually know that I am a libertarian/right-wing nut. By rights, I should hate the medical system here. But I can’t, because even before I am a libertarian, I am a utilitarian; and Uruguay’s medical system WORKS!
David,
How is your leg doing? It was a shame that you had to wait so long to find the right help.
I really enjoy reading your posts. Thanks for the effort.
Loggy
>>It is doing much better. The wound has healed and the dermatologist is really helping the remaining skin problems. The biggest remaining issue is swelling, but we are working on that. Thanks for your kind concern.
The Southron
Left by Loggy on March 25th, 2008