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TCM: World Wide Medical

May 7, 2013 by 1 Comment

The presentation today was by World Wide Medical with some new health insurance offerings to the expat community. I am going to try to summarize and below my summary is their presentation.

They have a new option for Panama only health insurance that includes Hospital Chiriqui and Punta Pacifica in Panama City as the two in network providers. They want to be very clear this has nothing to do with the MS Chiriqui plan many people here use. The only common element is the hospital is a provider to both plans.

This Panama only plan requires you be under 64 years old at the time of enrollment; if enrolled you can continue coverage until age 100 with premium increases as you mature more.

If you are over 64 they have an international plan with three options that allows enrollment up to the day before you turn 75.

Please address any questions to Sr Bellisario, not me.

If you want more information the contact in David is
Belisario Centeno S.
telephone 775-9237
telephone 775-1615
FAX 775-8478
Cell 6672-4479
email minsl@yahoo.com

For more information and some idea of costs www.worldwidegroup.co

I tried to do an online quote, but alas, this is Panama. It did not work for me using Safari or Firefox, maybe IE but I don’t have it. Rates will vary with age, sex, health etc.


Filed Under: Featured, Health Care, Survival Kit Items

TCM: A Healthcare Forum

October 3, 2012 by 6 Comments

Yesterday at the Boquete Community Center we had a restrained but pointed discussion of healthcare issues in Chiriqui. I am extending the discussion beyond Boquete because most of the discussion was actually about hospitals and doctors in David, mostly Hospital Chiriqui.

Both Diane and I have requested Manuel from MS Chiriqui come to a meeting and discuss all the changes in their plan, he consistently defers to some future date. By a stroke of unplanned luck Magda Crespo was at the meeting and she was able to answer many questions about Health Insurance in Panama and reiterated that the MS Chiriqui Plan is not insurance.

I think an accurate summary of the meeting would be people are concerned about inconsistant billing from Hospital Chiriqui and either a lack of understanding or lack of payment criteria from MS Chiriqui.  The poll on the main page of this publications shows that 46% of the people who responded to my question about medical insurance here in Boquete use MS Chiriqui and that makes it important.

Last week I meet with the MS Chiriqui people and learned a few things. They have affiliated with an insurance company with deeper pockets than they have, Pan American Life. They have raised their maximum benefit from $18,000 a year to $25,000. They made it clear to me that they do not cover any hardware only services; this was raised as a question because they denied coverage for circulatory stents for one person in our discussion. They also have a two year waiting period for any pre-exisitng conditions and only cover 70% of services after that.

None of that explanation  explained why they had one speaker, while in the hospital, for surgery agree to a reduced payment of 50% for cardiac surgery. I now there are many people who have had good experiences with MS Chiriqui, but if any were at the meeting yesterday, they failed to speak.

It was noted that healthcare costs in Chiriqui have increased significantly in the past few years; but then so have all other costs. The question of use of MINSA and CSS clinics was raised and Magda confirmed they are available at very low cost to anyone who needs them, the same with Hospital Regional. If you do need to go to Regional please have an aggressive, Spanish speaking advocate with you or regardless of the emergency you may wait forever in the understaffed facility.

No one complained about the quality of doctors or care, just the issues on billing from the Hospital and questions about the quality of the MS Chiriqui coverage. One anecdotal story was about a person being billed some $13,000 for a single night in Hospital Chiriqui.

I was lucky or unlucky enough to have spent a couple of days there in June and dug out my bill. One night in ICU was billed at $300, less 20% jubilado discount a  second night in a private room was billed at $120, less the same discount. I am as gringo as the next gringo, so I am not sure why there is such a huge difference. Perhaps a copy of the bill would explain it all. I am linking to scans of my bill and a second of the the discount,  in anyone is interested.

One Cardiologist in particular was discussed and his huge variations in billing and changes between pre surgery quotations and post surgery billing. Rather than naming him without any written documentation I will point out that his name is not found on the medical resource list  posted on this site.

Bottom line, medical expenses have increased in Panama, there are serious questions from policy holders about MS Chiriqui and more about the Hospital and it’s billing practices. I am going to try to get a speaker from Hospital Chiriqui for a future meeting. Please do not confuse MS Chiriqui and Hospital Chiriqui, they are separate entities.

 


Filed Under: General Interest, Health Care, Survival Kit Items Tagged With: ,

My internet and I were off line for five days.

September 20, 2012 by 10 Comments

The thunderstorm of last Friday scored a hit close too to my internet tower, it took five days for the parts and technicians to arrive and put me and others connected to this tower back online. If I had been on line this week I would have told you that CUSA has slowed work on the highway to David until the government resolves some issues in Los Algarrobos and pays some past due bills to CUSA. But since I was offline you can read much more about this from roving reporter Keith Woolford on BoqueteNing.com.

My past few weeks were curbed by a litany of now resolved health issues and because health issues and appropriate responses are important here in Boquete, I will share some of medical resources and how they responded.

My first call was to the office of Dr Chen in Boquete I was having trouble breathing. Dr Chen was not there, but a young doctor, Dr. Michael Pimentel saw me in a few minutes. He poked, he probed and he asked a bunch of questions. Eventually he said, bronchitis, something new too me. He prescribed a antibiotics, acetaminophen for fever and a cough syrup, despite the fact I was not coughing.

I had my doubts about the diagnosis, the cough syrup made me wonder, and sadly a doctor younger than my children made me wonder; maybe I am prejudiced in favor of gray hair and experience. My reaction was to visit a specialist at Hospital Chiriqui,  Dr Alcibiades Arosemena, Neumologia, a lung man. He did a history, listened to my description of the Boquete office visit, did not poke, did not probe, did not even look down my throat. He did listen to my breathing and said your lungs are clear, but all is not right in Lee’s lungs. He wrote a script for a chest  xray and suggested I might be having a reaction to the meds I have been taking for cardiac issues. His advice, X-ray, stay on the antibiotics and give a rather detailed note he wrote to my cardiologist.

So on Saturday morning I called Dr Correa, my cardiologist  at Hospital Chiriqui. He said, get into the car and come to my office; now. He poked, he probed, he read the note from Dr Arosemena. He doubted the drug interaction but regardless, changed the mix. He also said finish the antibiotics then get some blood work done.

I returned to Hospital Chiriqui on the following Monday, feeling much better, met a lovely vampire in the lab and took the results of her blood extraction and chest x-ray to Dr Correa. Final analysis, I am breathing better, we might never know if it was Bronchitis cured by the antibiotics or a drug interaction, but I do know I have a responsive cardiologist.

It does not take grey hair to make a good doctor, it does take knowledge, the ability to listen and communicate and the willingness to respond.

 

 


Filed Under: Health Care, Survival Kit Items

TCM: Dra. Karen Zapata, Dermatologist

September 5, 2012 by 2 Comments

Dra. Zapata gave an excellent presentation skin diseases and in particular dangers of sun exposure. We had a technical difficulty with her computer so she was not able to show her Powerpoint presentation.

She has sent it to me for presentation here.

Contact information for Dra. Karen Zapata
777-8091
774-0128 ext 3225
Hospital Chiriqui


Filed Under: Health Care, Survival Kit Items

TCM: MINSA on Mosquitos, take off those shorts

August 28, 2012 by 6 Comments

This Tuesday we had a excellent presentation by a Public Health professional for the Ministry of Health. She did a presentation on mosquito born diseases in Panama. To my surprise we learned that Dengue although rare in the Boquete area does happen here.

Dengue is a viral infection carried by the female Aedes mosquito which has been slowly moving from the urban areas at sea level up into the cooler areas. The Aedes mosquito is an urban dweller and prefers fresh water to stagnant and can live in moving water including fountains. Dengue comes in two forms, the very painful Dengue fever, which can appear to be a severe flu and the occasionally fatal severe or hemmoragic dengue. There is no cure just treatment for the symptoms. Severe Dengue requires intensive care hospitalization and can be fatal. MINSA says do not self medicate for Dengue go to a hospital. The best defense is eliminating anyplace mosquitos can breed.

Symptoms of Dengue, Wikipedia

Malaria was also discussed and MINSA reports no cases in Chiriqui. The mosquito that carries the malaria parasite is a rural dweller and likes stagnant water for it’s eggs and larva. More on Malaria here at Wikipedia.

The third insect born disease discussed was Leishmaniasis is a disease caused by protozoan parasites that belong to the genus Leishmania and is transmitted by the bite of certain species of sand fly (subfamily Phlebotominae).

Life cycle of Sand Fly, Wikipedia

Of the three diseases this is the most common in Boquete with a handful of cases each year.

Leishmaniasis Skin ulcer

If you discover an ulcerated bit on your skin you should go to a MINSA clinic, the government has treatment at no cost for this parasite.  Much more information here at Wikipedia

Our final insect born disease of the day was Chagras disease. It is carried by this inspect common in this region.

Triatomid, the kissing bug, can carry Chagas’ disease (American trypanosomiasis). (Image courtesy of the Centers for Disease Control and Prevention.)

Chagas disease is caused by Trypanosoma cruzi, a parasite related to the African trypanosome that causes sleeping sickness. It is spread by reduvid bugs and is one of the major health problems in South America.

Risk factors for Chagas disease include:

  • Living in a hut where reduvid bugs live in the walls

    Living in Central or South America

  • Poverty
  • Receiving a blood transfusion from a person who carries the parasite but does not have active Chagas disease

Symptoms

Chagas disease has two phases: acute and chronic. The acute phase may have no symptoms or very mild symptoms. Symptoms include:

  • Fever
  • General ill feeling (malaise)
  • Swelling of one eye
  • Swollen red area at site of insect bite

After the acute phase, the disease goes into remission. No other symptoms may appear for many years. When symptoms finally develop, they may include:

  • Constipation
  • Digestive problems
  • Pain in the abdomen
  • Swallowing difficulties

The acute phase and reactivated Chagas disease should be treated. Infants born with the infection should also be treated. Treating the chronic phase is recommended for both children and adults. Adult patients should talk to their doctor about whether to treat chronic Chagas disease. Two drugs are used to treat this infection: benznidazole and nifurtimox.  Source and for more information   US NIH .

All said, the suggestions are keep a clean home, eliminate breeding places for the insects, all standing water. A point was made that ponds, fountains, vases with water for flowers are all risk areas for mosquito breeding. Also wear logn pants and long sleeves and use insect repellant when outdoors.


Filed Under: Featured, General Interest, Health Care, Survival Kit Items

ObamaCare what is the impact on you?

July 2, 2012 by 31 Comments

I am from a generation that lived without the need for health insurance. I remember when a doctor’s visit was affordable. I remember when hospitalization did not bankrupt a family. I remember when health care in the US was priced as it is in Panama now. Those memories are distant, because it is no longer that way in the US, and, even in Panama it is changing rapidly.

Years ago, in a land far away, I had a small business. I also had four children, and a wife with a health problem. As a small business owner, I wanted to provide health insurance for my employees; and, as the head of a family, I wanted to provide for my wife and children. Under the laws of the great State of Arizona, our company, at that time, was considered a small business; so small that no insurance company would insure anyone if they had a pre-existing condition. We needed to become part of a larger risk pool. We ended up paying a monthly fee (on top of insurance premiums) to an employee leasing company so that we could be part of their much larger pool. If not for this larger pool, we would have been uninsured in a country that provides healthcare for the poor, the elderly, government employees, and the military, but not for the small businesses and individuals that pay the taxes to cover all of those above.

That has now all changed.  If you are an American citizen, or a resident of the United States, you will be affected by the PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010. Whether you agree with the law or not, the US Supreme Court has upheld the law against constructional challenge (surprising many, including myself. I believed, as did the Court, that the individual mandate was a stretch of the Commerce Clause. I never thought of the argument that won the day: it is within the taxing authority of the government. It seems, in retrospect, that if the government can tax for Medicare and Social Security, it can join the rest of the world for health care.

I have read the law, all 974 pages and admit that some of it is cryptic enough that I am sure portions will be back in court over and over. If you want to read the act as passed it is available for download as a PDF file at http://housedocs.house.gov/energycommerce/ppacacon.pdf .

Grab a bottle of rum and prepare to need it.  The law is long, tedious, and in parts indecipherable, due to references to other laws on the books.

For those who object to the law, I would like to quote few items, and provoke some thought. This law may upset people because they are being forced to purchase insurance. It will however benefit many who cannot now obtain insurance. By forcing all to have insurance the pool of those insured will include more young healthy people, as well as people who really need insurance because of health issues.

According the the World Health Organization 2000 report the US had not the best healthcare in the world as propaganda might make you believe, but was number thirty-seventh in overall system performance and found to be the most expensive. WHO Report this is a PDF download.

According to a 2009 Article in Business Week, 62% of personal Bankruptcies in the US in 2007 were Health Care related, Business Week . The cost of healthcare and health insurance has grown to be a massive cost for the entire country. When an indigent person goes to a hospital and cannot pay for services the hospital needs to find the money someplace: higher bills for you, more taxes to subsidize the indigent. If you have health insurance in the US, you can read insurance statements and see the difference between what you would have paid and what the insurance company rate was — vastly different numbers.

This law will shift some of that burden. Under this law people pay for insurance based upon ability to pay, the government is subsidizing with some tax credits based on income. Under this law hospitals will get paid by insurance for bills that were un-collectable.  Maybe in time this will slow the increasing costs of insurance and healthcare.

For this who think Mitt Romney will remove the law, he cannot unless Congress also votes to rescind it and I hope they do not. It was Mitt’s Medical Reform in Massachusetts that helped to create a model Federal law possible; he understands that affordable healthcare is essential.

“The Massachusetts health care insurance reform law, St. 2006, c.58,[1][2], enacted in 2006, mandates that nearly every resident of Massachusetts obtain a state-government-regulated minimum level of healthcare insurance coverage and provides free health care insurance for residents earning less than 150% of the federal poverty level (FPL).[3] The law was amended significantly in 2008 and twice in 2010 and major revisions related to health care industry price controls were introduced in the Massachusetts legislature in May 2012 with expectation that some version of these controls will pass by July 2012.” http://en.wikipedia.org/wiki/Massachusetts_health_care_reform

Blue Cross of Oregon has posted a good summary of how the new law will impact some areas. LINK . This summary shows how this law will help people. The law itself may not be perfect but most people who are negative about the law, will benefit from the law. Stop believing the thirty second sound bites, read the law.

Under this Federal act many of the same elements are covered.

People who could not buy health insurance before can.

SEC. 1101 ø42 U.S.C. 18001. IMMEDIATE ACCESS TO INSURANCE FOR UNINSURED INDIVIDUALS WITH A PREEXISTING CONDITION.

(a) IN GENERAL.—Not later than 90 days after the date of enactment of this Act, the Secretary shall establish a temporary high risk health insurance pool program to provide health insurance coverage for eligible individuals during the period beginning on the date on which such program is established and ending on January 1, 2014.

Pre-exisitng conditions are no longer a bar for obtaining coverage.

‘‘SEC. 2704 ø42 U.S.C. 300gg–3¿. PROHIBITION OF PREEXISTING CONDI- TION EXCLUSIONS OR OTHER DISCRIMINATION BASED ON HEALTH STATUS.

‘‘(a) IN GENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage may not impose any preexisting condition exclusion with respect to such plan or coverage.’’; and …

The law does not require you to leave your current insurer.

SEC. 1251 ø42 U.S.C. 18011¿. PRESERVATION OF RIGHT TO MAINTAIN EXISTING COVERAGE.

(a) NO CHANGES TO EXISTING COVERAGE.—
(1) IN GENERAL.—Nothing in this Act (or an amendment made by this Act) shall be construed to require that an indi- vidual terminate coverage under a group health plan or health insurance coverage in which such individual was enrolled on the date of enactment of this Act.

An insurance company can no longer cancel a customer when they have a claim.

‘‘SEC. 2712 ø42 U.S.C. 300gg–12¿. PROHIBITION ON RESCISSIONS.
‘‘A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not rescind such plan or coverage with respect to an enrollee once the enrollee is covered under such plan or coverage involved, except that this section shall not apply to a covered individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation of material fact as prohibited by the terms of the plan or coverage. Such plan or coverage may not be cancelled except with prior notice to the enrollee, and only as permitted under section 2702(c) or 2742(b).

So what does Obama care do? It makes health care affordable to those who could not afford it but were not so poor that they already received it free. In the past the poor had Medicaid or some State equivalent.  The working might have had insurance from their job and those who were not part of a large group, or healthy had to pay the increasingly unaffordable costs of medical care in the US. The US has now joined the rest of the developed world in providing a path for it’s citizens to have affordable healthcare.

For Expats, this is how you will be affected.

Section 1501

‘‘(f) MINIMUM ESSENTIAL COVERAGE.—For purposes of this section—

‘‘(1) IN GENERAL.—The term ‘minimum essential coverage’ means any of the following:

‘‘(A) GOVERNMENT SPONSORED PROGRAMS.—Coverage under—

‘‘(i) the Medicare program under part A of title XVIII of the Social Security Act,

‘‘(ii) the Medicaid program under title XIX of the Social Security Act,

‘‘(iii) the CHIP program under title XXI of the Social Security Act,

‘‘(iv) the TRICARE for Life program,

‘‘(v) the veteran’s health care program under chap- ter 17 of title 38, United States Code, or

‘‘(vi) a health plan under section 2504(e) of title 22, United States Code (relating to Peace Corps volunteers).
‘‘(B) EMPLOYER-SPONSORED PLAN.—Coverage under an eligible employer-sponsored plan.

‘‘(C) PLANS IN THE INDIVIDUAL MARKET.—Coverage under a health plan offered in the individual market within a State.

‘‘(D) GRANDFATHERED HEALTH PLAN.—Coverage under a grandfathered health plan.

‘‘(E) OTHER COVERAGE.—Such other health benefits coverage, such as a State health benefits risk pool, as the Secretary of Health and Human Services, in coordination with the Secretary, recognizes for purposes of this sub- section.

and this section relevant to those who live out of the Uniied States.

Section 1501

‘‘(4) INDIVIDUALS RESIDING OUTSIDE UNITED STATES OR RESIDENTS OF TERRITORIES.—Any applicable individual shall be treated as having minimum essential coverage for any month—

‘‘(A) if such month occurs during any period described in subparagraph (A) or (B) of section 911(d)(1) which is applicable to the individual, or

‘‘(B) if such individual is a bona fide resident of any possession of the United States (as determined under sec- tion 937(a)) for such month.

Section 911(d)(1) is part of the Internal Revenue Code

“(d) Definitions and special rules

For purposes of this section—
(1) Qualified individual

The term “qualified individual” means an individual whose tax home is in a foreign country and who is—
(A) a citizen of the United States and establishes to the satisfaction of the Secretary that he has been a bona fide resident of a foreign country or countries for an uninterrupted period which includes an entire taxable year, or
(B) a citizen or resident of the United States and who, during any period of 12 consecutive months, is present in a foreign country or countries during at least 330 full days in such period”
I was asked about the provision requiring a RFI chip implant, I cannot find any such provision in the law. If it is there please provide a section.
I urge Americans to realize that health care in the United States is currently run by the insurance companies. This law will require those insurance companies to provide better service to the population and will regulate how much they can charge for services.
It is a comprimise law, although the idea is repugnant  to many Americans it would probably cost us all less if there was one insurance pool like medicare and one government agency running things.  Alas without understanding that Capitalism is defined by profits not service, people in the the US blindly follow the need to allow the insurance companies to grow and profit at their expense. Too many people are against this law without understanding the need.  Most opposed to the law will benefit in both the long and short run.
For much more information on the law and how it will impact you read. http://www.healthcare.gov/index.html
If you live in Panama you might wish the law extended here so that you could buy health insurance here from all those companies that will not insure you now.
The Clintons tried in 2003 to do what would have been better, but as in all things governmental it took seven more years, another  President and rolling over to the interests of those lobbies that will profit from the new law. Clinton Proposal Link

 


Filed Under: Featured, Government, Health Care, Survival Kit Items, Taxes Tagged With: , ,

Wedding to Hospital Chiriqui, Mr. Lee’s wild ride

June 5, 2012 by 11 Comments

It might have been stress relief or perhaps the disappointing wedding cake, I am not sure but after eating some of the cake my heart started to explode. I sat on a plastic chair and the beating of my heart shook the chair. My first reaction was to find a quiet spot and lie down hoping things would return to normal; they did not.

After some time Elizabeth recommended a trip down the hill to see Dr Chen. As I entered his office he was leaving to another urgent call and my friend Vincent who was driving, Mayra, Mr Daughter and I headed to Hospital Chiriqui.

The infinitely long ride to the emergency room made me wish the road was finished. On arrival I was moved quickly  into the ER and a doctor listened and agreed withy diagnosis, Arrhythmia (tachcardia) my heart was racing and out of rhythm.

It was Saturday night, we tried contacting my cardiologist, he was not accessible. The ER called in a Cardiologist who arrived in about an hour, not good.  The Cardiologist said they needed me on an IV with some drugs for twenty four hours to normalize my heart and then another twenty four hours for observation.

Considering all things, I was reluctant, still hoping things would stabilize on their own. Finally I relented and was moved to intensive care where I stayed for almost twenty four hours. Then I had about twelve hours in a private room before discharge.

The reason I share this is that is was my first experience with a personal crisis that had the potential to be fatal in Boquete. If this had been a serious heart attack I would have died before ever seeing a doctor.

Since I did make it the hospital without being able to contact a specialist the wait there might have also been lethal. The ER doctor did nothing except confirm the need for a specialist.

Hospital Chiriqui would not admit me without a credit card deposit, despite my International insurance coverage. They prebilled me $2,100.00

The final billing might be of interest to some people, I have no basis to compare it to the US. So here are some raw numbers.

ER charge was $10

Each EKG was $35

The Intensive care unit cost was $800

The Private room was $120

The all the lab charges, hospital charges, medicines etc totalled $1,635.83 less 20% jubilado discount

The Cardiologist charged $100 for the ER visit and another $875 , also less 20% for his services.

In total it cost me $2,106.66 to leave the hospital in thirty six hours.

The patient care was very good, particularly in ICU.

What I do not know is if any ER would have treated this differently. I do not think it was life threatening, if not waiting for the specialist was probably normal procedure. I know a lot of experts read this blog so I would love to hear some reaction to the service and costs.


Filed Under: Health Care, Survival Kit Items

TCM: Hospital acquired infection presentation

May 29, 2012 by 1 Comment

I missed the Tuesday Community Meeting today in Boquete Panama. Donna O’Toole was kind enough to let me upload her Power Point Presentation. I cannot make much of a comment beyond saying in Panama and everyplace else this is a serious issue to be considered before surgery.

Hospital acquired infection presentation
View more PowerPoint from lzeltzer


Filed Under: Health Care, Survival Kit Items, Tuesday Mornings Tagged With: , ,

TCM: The 6 Million Dollar Man

May 15, 2012 by 2 Comments

Perhaps if I had not called this meeting “Hybrid Operating Rooms” but how you can be kept alive by new technologies in medicine more than twenty people would have come to the meeting. Our speaker Bruce Landau from the University of Pennsylvania was excellent.  We are often lucky that very talented visitors to Boquete offer us their time when they are here.

Bruce discussed some of the changes in modern surgery and how computer and imaging technology is remaking the operating room. The cost  of these new high tech operating rooms can exceed the six million but the outcome to patients is worth the investment.

The bottom line message was that the practice of medicine is changing, rapidly. The use of new technology is allowing for less invasive surgery and lower risk of infection. Although these new techniques are now being used in Canada, Europe and the USA, as of now they are not available in Panama. That might be changing soon and based upon what I saw today if I needed surgery that can be done in a hybrid operating room I would without a doubt travel to a location that has the technology.

This link to an article in USA Today might be of interest to those who missed the presentation. LINK

Sorry if you missed the meeting because many of us will face these life altering decisions in the future  for either ourselves or loved ones.

 


Filed Under: Featured, Health Care, Survival Kit Items, Tuesday Mornings Tagged With:

Healthy Living in Panama, or Kansas

April 25, 2012 by 6 Comments

I read a lot of online discussions about Panama. There is a Yahoo Group called Gringos in David,  it encompasses discussion relevant to Boquete. Today I opened an email called “Looking for Doctor Gruber” a person looking for Frank Gruber and a cure for cancer. I read the discussion with interest, I know Frank Gruber, if he is a doctor of anything I am not aware of it, however since the doctorate does not make the man I will discount that error. Frank does sell some herbal cures, one claims to cure skin cancer. I can attest his Jungle Oil is a good insect repellent but that is my anecdotal experience not a proven fact. For something more significant than repelling insects I would fall to my scientific background and want to see some studies to prove anything works before I ingest it.

I can guarantee all those living today are going to die. How and why we die is to a limited extent based upon how we choose to live life. Life insurance companies have actuarial tables to limit their risk when writing life insurance policies, they will assure you that a person working on a fishing boat has on average a shorter lifespan than a milkman, if they still exist. Health insurance companies do the same type of analysis and they will be more reluctant to write a policy for someone obese or with diabetes than some one of normal weight and no health issues.

Many people I have met in Boquete in their “golden years” have become preoccupied with diet and natural cures for all things. I am not going to discount their beliefs, a healthy diet is easy here. Most locals do not eat well. In Panama the diet is rice and fried anything. Still on the average Panamanians live to an average age of 77.96 years, in the US the average is 78.29, source CIA World Fact book.  In Monaco the average age at death is 89.68, does that mean we should move there for long life, maybe, but I doubt moving will help.

We cannot predict our death, you can eat well, exercise daily, never become ill and be hit by a bus. You can do the same thing and add to the same statistics if you eat only a diet of Big Macs and french fries.

The question becomes how to we try to maintain good health while we are alive, not how long we will live. Most of us grew up in a world of professionally trained doctors. If we were ill we went to a doctor with a degree, with practice and hopefully with a heart. Western medicine is symptom based medicine and has evolved into reactionary medicine. In the US it is driven by what solutions insurance companies are willing cover; that means little proactivity and lots of pill pushing. Panama is still a little better, doctors are not as focused on insurance but they are still trained in the same schools and hospitals. In general I have found doctors here better than in the US.

The natural practitioner might have some education, there are schools that educate in non traditional techniques, some natural cures work, some do not; just like in western medicine. I my life I have experienced that acupuncture resolved problems for me that western medicine could not. However I would not go to an Acupuncturist for a cancer cure. I have experienced that a Chiropractor resolved problems with my back that a doctor could not, still I would not go to a Chiropractor for a cancer cure. I am a cancer survivor, I was diagnosed with prostate cancer more than ten years ago. I went to several specialists in prostate cancer, medical doctors, I listened to them, consulted with others who survived the surgery, they all made recommendations and I selected the doctor I though would be best. The cure worked, I am here more than ten years later to write about it.

If the doctors had said it is incurable. I would have looked at other options. When there is life there is hope. There are so many people selling natural solutions that sorting the wheat from the chaff is nearly impossible for anyone; even someone with education and experience. There are however some misconceptions to be dashed.

There are many who do not trust big pharmaceutical companies because, as stated in the Gringos thread, they are profit motivated. Yes they are, that is capitalism, make money regardless of the means. That is the reason that governments usually have agencies that require testing of medicines and other solutions before allowing the marketing. It is true that the FDA in the US is funded by the same companies who want to sell the drugs; that is a consequence of funding and politics. Still other things are less regulated and that includes “natural supplements”.

In the US this is the current state of the law.

“FDA regulates both finished dietary supplement products and dietary ingredients under a different set of regulations than those covering “conventional” foods and drug products (prescription and Over-the-Counter). Under the Dietary Supplement Health and Education Act of 1994 (DSHEA), the dietary supplement or dietary ingredient manufacturer is responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed. FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market. Generally, manufacturers do not need to register their products with FDA nor get FDA approval before producing or selling dietary supplements.*”

FDA  Bolding is mine, not theirs.

The contrast is dramatic, no studies, no testing until after the product is released and sold to anyone. Then and only then, if there is a problem can the government step in.

So now we have the next argument that big pharmaceutical companies do not want to cure cancer, that the cure is there but it is natural and they cannot patent it so they do not want to sell it. The argument is bogus, if they can find it they can purify a natural drug, patent it, sell it and gain megabucks.

“( The US) Congress eventually revised the patent laws in 1952, to permit patenting of “anything new under the sun made by man.” While Congress intended this to be expansive, the U.S. Patent Office was more restrictive. The courts were more reasonable, agreeing that natural products might still be patentable. ”

“… don’t assume that because a product is based on naturally occurring substances, it won’t qualify for patent protection.”

Natural product insider 

So now time for two plus two plus two equals six. Good health is a combination of luck, genes and how you choose to live. If you do decide to eat only McDonalds daily you will likely tend toward obesity and a shorter life than if you eat well but maybe not. If you use natural practitioners and food supplements you might live better, or not. If you choose to avoid doctors and big pharma I hope you never have a crisis that needs them.

As for me, here in Panama. I eat more fish and great pork, still enjoy an occasional visit to the Golden Arches in David, take a multivitamin and fish oil daily. Recently I rediscovered some green vegetables and thanks to Rodrigo Marciacq and Ron Miller eat great hydroponic salads. Oh and yes I do like Rum Abuelo with some cheese too. The outcome is I am happy, healthy and living a good life. Variety is indeed the spice of life and fanaticism of any type is to be avoided, have an open mind but learn the facts.

 


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