Tomorrow a nurse will remove three stitches from my forehead that were placed there a week ago by a doctor in the hospital about four blocks from where I live in Costa Rica. I fell while taking my dog for its early morning walk and consequently had a close encounter of the worse kind with the sidewalk. I was bleeding from where my forehead got to know quite well the cement sidewalk. It was about about 5 a.m. in the morning.
As always with such accidents you don't feel that bad right afterwards, so I decided I could walk the four blocks to the city's hospital. I did and went straight to urgent care. There they checked me in on the computer with my identification document. Nurses then took my blood pressure and temperature, and I was then told to wait in the waiting lounge for my name to be called.
My name was called about ten minutes later, and I saw a doctor who spoke English. She took some information about any allergies to medications and then took me into what looked like an operating room. I got up on an operating table and a circular apparatus of bright lights was moved down from the ceiling and was turned on. Several others in hospital greens and Crocs moved into the room but I didn't see their faces. The door was shut. The room was air-conditioned.
My first doctor washed the cut above my left eye and injected anesthesia around the cut. Then three stitches were put in; I didn't feel anything. I really didn't see who did the stitches because the light was so bright. I was asked if I had pain any other place or if I had lost consciouness. Then I was escorted to an infirmary where I got a pain shot in one buttock and then two other meds, one for pain and one for my increasing shakiness, were administered by IV while I sat in a chair. That took about an hour.
Then I was taken to X-ray for pictures of my head and thorax. I was given the X-rays in a manilla envelope and took them to a bilingual doctor who looked at them. He said everything looked good, but I would still have pain from the trauma. He gave me a prescription for pain meds—all at no cost. All of this took about two hours.
The takeaway here in terms of price? In order to stay in Costa Rica as a permanent resident, I have to pay into their healthcare system whether I use it or not. Because I am retired and on a pension, my cost is $77 a month to the Costa Rican government. (The cost would be a lot higher for a wealthy expat.) For that $77 month I get emergency care, such as just described, whenever I need it--without any extra cost above the $77. Also available are vaccinations, medications, blood tests, and regular check-ups—all without extra cost. If I need to see a specialist, that is available too, but on a first-need, not first-come basis.
Costa Rica is not a rich country; it is a third world country. They have financial problems. But they do try to give basic care to their citizens. For example, all mothers get free pre-natal care and children receive free care until the age of 18.
As much as possible I try to use Costa Rica's healthcare. I do have to buy a couple medications not on the government formulary in private pharmacies. I also end up seeing a private specialist here once in a while at the government regulated cost of about 50,000 colones (about $87) per visit. I have private insurance in the States but it doesn't pay anything in Costa Rica. I also have Medicare, but it too doesn't pay for anything in Costa Rica.
Some expats here do go back to the States temporarily or permanently for special treatment. But if you can stay here, there are no surpises, no unexpected bills from anesthesiologists or emergency room doctors. No medical bankrupcies. It is very basic, but more often than not for me, it is good enough.