Imagine how concerned I was when I received an email from my video guy when he was down shooting some film recently. The subject line of his email was “Mugged in Cabrera” and it contained a collage of pictures showing black eyes, egg-sized goose eggs and bleeding slices on both arms. Needless to say I was shocked. That is not the Cabrera I know and love. Below is one of the pictures he sent me.
So what gives? When I called him back I learned that it was just a cruel joke. Well, at least part of it. Of course he was not mugged in Cabrera, but he did suffer an accident while shooting pictures in one of the larger stores in Nagua. Banged up pretty bad.
But what is REALLY interesting about this story is the comparison he made between the care he received in the emergency room in the Nagua public hospital and the care he received in a small US hospital as a result of a car accident just a few months later. I will let you read his own words below as he described both experiences.
But first let me give you the punch line of the story. He received more treatment in the Nagua hospital for $170 than he did in the US hospital for over $10,000. (actually $12,000, but who’s counting).
This is a story you may want to read. This is a story of a healthcare system run amuck in the US and further evidence that an expat can do pretty well in keeping his healthcare costs to a minimum in the Dominican Republic…..
As you can see from the pictures, the doctors at the Nagua hospital did have something to keep themselves busy with for a couple hours. Now here is the email from my video guy.
It’s been a pretty interesting couple months since I was down there. As you know, one of the things I have always been a bit hesitant about in relocating down there was healthcare. No Longer. As you know, I had the “opportunity” to check out emergency room care at the public hospital in Nagua on my last trip down. I took a tumble in a large Ceramica (tiles, sinks, toilets, etc) store in Nagua. I landed on a pedestal sink that of course was on display and not fastened to the floor. Down I went, arm in the air trying to save the camera. Unfortunately the pedestal sink broke into a million sharp shards, some of which ended up embeded in my arms as my head hit the concrete HARD along with my eye. After getting over my embarrassment, I realized that I was about half aware and that I was bleeding all over the floor. What a mess.
The store owner rushed her first aid kit to my side to apply some temporary bandages and tourniquets to stop the bleeding. Then she told her teenage son to get me down to the emergency room in the public hospital only a couple blocks away. Not only did she send her son down to translate for us, she also closed her store and came down and stayed with us translating until I was discharged almost three hours later. So my first lesson was that these people were the most caring and concerned strangers I have ever met. That is encouraging and consistent with everything you have said about the people living there.
My Experience In A Dominican ER
The second lesson I learned was that these care givers were quite competent. I saw two doctors, the first was focused on my head to make sure I had no concussion or permanent damage to my head or neck. This involved immediate triage as well as xrays of my head and neck. Once a concussion was ruled out, they called in a surgeon from off duty to suture me up on all the cuts on both arms. That took the surgeon and his assistant almost 2 hours to perform xrays of both arms and apply about 30 hand tied sutures on both arms.
Finally, after they finished stitching me back together it was time to check out. This whole time, that gracious store owner and her son stayed with us translating and just being supportive. I had no idea what to expect. Obviously I don’t have Dominican insurance so I was little apprehensive paying cash, but grateful to be back in one piece. The hospital business office person cranked away on an adding machine for what seemed like a few minutes. Then she handed me the bill…. 8,170. Ouch! But wait, that is pesos…. $190 US dollars. Relief.
Now the funny part of that story…. remember that sweet little business owner. She thought the bill was outrageous. She went nose to nose with the surgeon talking Spanish about a million miles an hour. End result, the hospital reduced the bill to only $170. That is $170 total for the triage doctor, almost two hours with the surgeon and surgeon’s assistant, 2 head xrays, 2 arm xrays, 30+ hand tied sutures, wound cleaning, bandages, antibiotics, pain meds, and a bloody mess of the linens and floor in the treatment room.
Now up until that time, I have never even been in an ER for any kind of trauma, but I am pretty sure that $170 total was a pretty darn good deal.
My Experience In An American ER
Well it just so happens that I had another “opportunity” to visit another ER at home in America only a month later. A car accident that resulted only in about a one and one half inch gash in my head and a sore neck. I spent the same 2 1/2 to 3 hours in the ER, a lot of waiting. They sutured my head back up with 8 little staples. They did 2 xrays of my neck. They did do a cat scan of my neck just to make sure nothing was damaged and that is pretty much it.
Two very similar courses of treatment. In fact they did a good deal more in the hospital in the Dominican Republic than they did in the American Hospital. It is hard to say exactly what the total American hospital experience cost, because I am still getting bills from all sorts of people, including labs, doctors, the hospital and god knows who else. So far, the bills have totaled to more than $12,000 dollars in the American hospital. Even if you take out the cat scan it is still over $10,000.
So to sum it up…. more care in the Dominican ER for $170 than I received in the US hospital for $10,000+.
Now there is something bad wrong with this. Or maybe I should look at it another way. There is something amazingly good about this for anyone considering a move or extended stay in Cabrera.
Yes I do feel that the quality of care was comparable. Sure the American hospital is fancier and they have more gadgets and the paint is newer and perhaps the floors a little shinier…. but when it comes down to handling a basic trauma like these two events, the care was comparable. I did not have any complications with either course of treatment. I am just glad some insurance company was there to pick up a large part of the bill in the American hospital. But even with the insurance coverage in the US, my out of pocket was almost $2,000 compared to an out of pocket total bill of $170 in the Dominican hospital.
Yeah Barry, I am feeling pretty good about the people and the healthcare down in Cabrera. Can’t wait to get down there again.”
Well, there you have it. Another convert to an alternative way of life. For now, it’s Barry in the DR off on a hectic but fun few weeks of touring families through the North Coast in our DYD Discovery Tours.