Healthcare in Ecuador

A recent, very extensive healthcare study was conducted utilizing largely World Health Organization (WHO) and World Bank data, in order to determine the relative efficiency and value of medical care world-wide.  The methodology used focused on three critical facts: 1) Life Expectancy data; 2) Relative per-capita healthcare costs; and 3) Absolute healthcare monetary expenditures.  A weighted sum of each was used to arrive at a value/efficiency score.  Countries with populations under 5 million, were excluded from the study. The results were rather surprising, with regard to global statistics and certainly, with regards to health care in Ecuador.

The report released findings showing that Hong Kong had the most efficient healthcare program in the world, closely followed by Singapore and Japan, rounding out the top 3.  Ecuador, amongst all report nations, ranked #20 on the list, only one spot lower than France (#19) and only three spots below the oft vaunted Canadian healthcare system (#17).

Perhaps surprisingly to some, Ecuador’s healthcare efficiency ranked well ahead of Cuba (#28), Germany (#30), Argentina (#32) and the USA at #46.  This serves as a sobering analysis of the efficiency and value of healthcare across the globe.

I am a firm believer in statistical models and facts, because they wipe away subjectivity and human bias, at least as much as anything can that is “man-made”.  However, to me the key is always whether the results of objective, logical and pure statistical analysis can also be reflected in real world experiences.  In this case, real world experiences are with the Ecuador healthcare system.

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Case Study #1:  A recent client of mine required medical attention while in Guayaquil.  It was a quick onset and the onset occurred post 5:00 PM.  Most times in the USA, for example, try getting a last minute appointment, post 5:00 PM.  Most doctors are gone for the day and the few left working, are just trying to fit in the patient overload for the day, as they try to meet minimums to cover insurance premiums and liability costs.  Not an iota of an exaggeration, if like me, you have many friends that are USA physicians willing to candidly discuss their realities privately.

My client had attempted to make the appointment, in somewhat broken Spanish.  No  luck.  The key, very specialized physician needed was gone for the day.  I offered to call and see if an alternative option existed.  None.  The one key specialist was by far the best option and they had left.  However, here is where the change began.  I was offered the doctor’s private cell phone number to call and schedule an appointment for early the next day.

I called.  The doctor answered, promptly.  I explained the situation.  The clients need to travel soon and they had a llack of perfect Spanish on the client’s part.  Sure enough, the doctor offered to see the client as patient – not the next day, but that very evening.  The doctor would return to his office to meet with my client.

From there, my client spent the next 4 hours between discussing the symptoms with the doctor and getting a battery of exams/tests.  The result?  The client was cleared as ok.  His assessment of this medical experience was deemed top-notch and more attentive than in the USA.  The cost?  Well, my client defined the cost as, “Easily one-third of what I would have spent in the USA.”  That whole efficiency and value analysis seems to hold up.

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Case Study #2:  A friend also recently needed to visit a physician.  They did.  They also needed some tests.  Results were returned.  They wanted a second opinion.  They showed up same day to the office of a physician in the required area of specialization.  The doctor ushered them into a waiting room, sans appointment and was with them within 15 minutes.  After making observations, the doctor suggested another specialist be consulted.  There was no, “call them and set up an appointment for next week”, but rather the doctor picked up his cell phone, dialed the other physician and asked if they could see the patient immediately.

Another 15 minutes later, the patient was visiting with specialist #2.  Again, opinions were offered and, again, the physician suggested that one more specialist be consulted.  The result this time was the same as before. Out comes the cellphone…another personal one-on-one doctor to doctor call…and another instant same day appointment for the patient.  At the end of the third and, happily, final doctor visit, the client was given a clear bill of health, with some minor treatment options.  What were the costs? They were approximately 20% of USA equivalents.  Satisfaction rating? The patient was ecstatic with the quality of healthcare.

I could cite additionally examples of which I have personal knowledge.  However, they would all sound roughly the same.  The statistical report findings and real world experiences seem to mesh well here in Ecuador in Ecuador.  The study findings hold up in the real world and Ecuador’s #20 ranking in efficiency/value seems warranted.

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Two points of note, however, for balance and credibility.  One factor that consistently gets raised by friends and clients is that not enough doctors in Ecuador are bilingual. Of course, my Ecuadorean doctor friends would likely claim that not enough expats come prepared to speak Spanish or to have a standby translator for times of urgency.  I am not going to get into the whole chicken vs. egg debate, although I definitely have strong opinions.  The point is, the chief “efficiency” barrier seems to consistently turn out to be one of language, where precise medical communication is key.  I beg folks to consider the next time one of my brethren in the real estate arena, finds you that perfect house in the “middle of nowhere” Ecuador, the impacts of such isolation on the elderly, children and anyone in need of urgent healthcare. We so advise our clients.  Some listen, some don’t.

Secondly, there is no doubt that the quality of healthcare in Ecuador, its value and its efficiency, may vary greatly from locale-to-locale and from medical professional to medical professional.  Like anything else, one needs to shop around.  The critical consideration in “healthcare shopping” is that it is not best done at the last minute, when an emergency has arisen.  It should be one of the first items anyone considers.  Sadly, my experience in 30 years of real estate is that it is one of the last items ever considered.  Most of the time, no worries.  Some of the exceptions have ended in tragedy.  Word to the wise, your medical care matters, especially in a foreign country, where language skills may not be perfect.

In closing, I was very proud of Ecuador, though not so surprised, by the results of this global healthcare study.  The Correa Administration has done some great things and continues to do some great things, to dramatically improve healthcare in Ecuador.