Hospital from the other view.

DR Solar

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The thread that AE started closed fast and perhaps needed to be. But I'd like to talk about some of the better moments that saved someone and those that helped.

Major brain surgery for a tumor paid for by a friend. It took weeks to study and put together a team. Gringos AND Dominicans contributed to pay the costs. Insurance did not.

Metal leg rod became disconnected and started to protrude out the leg with infection. Dominican Insurance would not cover the correction and would not do anything. A local gringo helped and surgery was done the next day. $70K pesos. He would have lost his leg if untreated for a couple more days and would have died if not.

Truck pulls out in front of a man on a moto. Head on. Both arms shattered. Forehead skull shattered. The list is too long. Taken to Hospital in POP where insurance would cover BUT... THEY REFUSED due to the extensive injuries thou they did stop some bleeding. Back of pick-up to another Hospital and did the major work. They would not take his Dominican insurance but he was stable. They would not do anything more until bill was up to date.... US... $10,000. He needed more work and it got done. A gringo sent the money.

These 3 examples of need and done should be examples! I have many more. All 3 went back to work and are productive people that work hard for their families and a spirit to their communities.

I must commend those people that saw a need and raised/donated the funds to keep a brain working, save a leg/life and rebuilt a young man with a family almost in total.


The system is crude but it's all they have. Sometimes a little help is needed.

What's the cost of a leg?
 

La Profe_1

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Oct 15, 2003
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What's the cost of a leg?

In my case, over $100,000 US to save my leg when I developed gangrene after a Dominican taxi driver hit me and ran over it with a minivan.
 

SantiagoDR

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Jan 12, 2006
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... Gringos AND Dominicans contributed to pay the costs.

... A local gringo helped and surgery was done the next day. $70K pesos.

... They would not do anything more until bill was up to date.... US... $10,000.

... These 3 examples of need and done should be examples! I have many more.


Your post DR Solar just points out the same problem as the other thread.
No money, no medical treatment, die or lose a limb, they don?t care.

Why are there so many amputees in the D.R?
Because the doctors know they will not be paid to take the time to save the limb?
So they just cut it off?
 

dv8

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if you have a dominican health insurance (a good one) and have friends/family in medical field, DR does a neat job in terms of health services. i appreciate that i can see any specialist, any time, without referral from a GP. and private hospitals are pretty nice.
 

DR Solar

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In the brain surgery case. The lead Doc. did not charge. The 2 assisting Docs. charged for expenses only. Everyone else paid in full. I think that some needed medical equipment was reduced.

So a leg in the US is over $100K. I'm sorry that La Profe 1 had to go thru that. I hope that you are doing well. What I was impressed with at the Hospital here in the DR is that the infection and situation was noted and taken care of very quickly. Of course, having someone else paying the bill helps since DR insurance does not care. The cost of a leg and possibly a life. DR 70K = US 1,500.

I have NO idea what the last case I talked about would cost in the US. I don't want to think about that. What I do think about is that for a cheap US $10K this young man with a family is working and doing wonderful things. I know that 10K is a lot. Not for those around this young man and his. He is working and back to school with big dreams that I know he will attain.

I think of Chuck and Candy, RIP, of Money Jungle. They did amazing work helping those that needed help. I hear that Monkey Jungle is still open and hopefully continues with their mission.


Remember Les? Canadian that took 9 - 9mm shots while protecting a bunch a visiting Canadian teens. People showed up at the clinic offering what they could to help cover the hospital costs and get him back to Canada. Some helped care for his property in the DR. Les just received the highest award for heroism that Canada has.

The system is what it is. That does not mean that YOU have to bow to it. Sometimes ya got to step up and take a swing at doing....
 

DR Solar

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OK.. one more case and I'll stop.

A friend has a worker. 24 years old that keeps putting eye drops in and has dark glasses. He asks and the young man says that he has Glaucoma diagnosed by a local glasses guy. My friend wonders about it for such a young man and since he needed to go the S.D. to do things including seeing his ophthalmologist takes the kid with him.

A complete exam is done. He does NOT have glaucoma nor is anything wrong with his eyes at all other then the drops that WILL make him blind after several years. 2K pesos. He said that he never saw a person so relieved, happy and the kid broke down in tears. So did he and not ashamed to say so.
 

cobraboy

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Your post DR Solar just points out the same problem as the other thread.
No money, no medical treatment, die or lose a limb, they don?t care.

Why are there so many amputees in the D.R?
Because the doctors know they will not be paid to take the time to save the limb?
So they just cut it off?
In another thread, I think there was some confusion.

While it's true that any American hospital must admit an emergency patient under the Emergency Medical Treatment and Labor Act (EMTALA), there are a few caveats:

1) The requirement is ONLY until the patient is stable enough for transfer to another facility.

2) The patient still must pay. The treatment is not free. The hospital can choose, after inability to collect from the patient, to write off the debt as uncollectable (and damaging the patient's credit, etc.) or use as a credit against their indigent funds account many have.

The EMTALA is an unfunded mandate, and is a primary reason many hospitals have permanently closed their Emergency Department.

In the DR clinics can just say "no" instead of shutting down their OR.
 

southern

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Dec 13, 2016
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I am fortunate in that I am fully insured and can travel for medical needs.Further, I understand modern medicine is business. However I have a problem with a Doctor and health care system that refuses to treat seriously injured or sick elderly based solely on their cash flow. Whats next, paying more for sterile equipment? Paying extra for accurate lab work, qualified Doctor etc.I have seen the facilities here. With a few exceptions like HOMs most medical facilities are seriously sub standard. The U.S Army can set up a full trama unit at the end of a dirt road in 8 hours. The island reportedly can't get someones blood work correct. I'll take my chances in a U.S hospital anytime.*
 

cobraboy

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However I have a problem with a Doctor and health care system that refuses to treat seriously injured or sick elderly based solely on their cash flow.
Wouldn't that be involuntary servitude to require, by gubmint force, one to labor against their wishes?

BTW: we don't know the blood word performed in the DR was wrong.
 

jd_mine

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if you have a dominican health insurance (a good one) and have friends/family in medical field, DR does a neat job in terms of health services. i appreciate that i can see any specialist, any time, without referral from a GP. and private hospitals are pretty nice.

This is what my wife hates most about healthcare here in Europe. She cannot get over the fact that she needs to go through our GP to get a referral for a specialist and then needs an appointment. I tried to explain that a GP might have an better idea what kind of specialist would be needed, but she doesn't buy it.
 

southern

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This is what my wife hates most about healthcare here in Europe. She cannot get over the fact that she needs to go through our GP to get a referral for a specialist and then needs an appointment. I tried to explain that a GP might have an better idea what kind of specialist would be needed, but she doesn't buy it.

Most excellent point.
 

DR Solar

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Some interesting points have been brought up but first I'd like to know HOW the Dominican medical system works? I read all the time that the Doc's and staff are on strike over pay. Who pays them? The Gov., the hospital owners or they are free agents to charge as they wish that "rent space"?

Dominican insurance? I thought the EVERY Dominican had at least some health coverage in the, what I thought was the Gov. hospitals. So EVERY Dominican could have health care. I'm guessing it does not work that way. Health insurance can be purchased and is very... very cheap compared to most other places. But "I'm not sick today to I don't buy it" seems to be the attitude on the average Dominican. (I bought starter plans for my employees for a year and none renewed.)

My wife and I have our Med. insurance from a US company with a US $5K deductible. Even the emergency med. plane if needed we keep paying those rates that really are not that bad. We both have had some procedures here that in the US would have cost several 10's of thousands. One we calculated at over 150K with the procedure plus the air/hotel/rentals/... Here in the D.R. we never have reached the 5K deductible but we do write off medical on our taxes. So works fine from that point of view.

But lets get back to... How does the system work for the average Dominican person?

Ty.
 

dv8

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Some interesting points have been brought up but first I'd like to know HOW the Dominican medical system works? I read all the time that the Doc's and staff are on strike over pay. Who pays them? The Gov., the hospital owners or they are free agents to charge as they wish that "rent space"?

Dominican insurance? I thought the EVERY Dominican had at least some health coverage in the, what I thought was the Gov. hospitals. So EVERY Dominican could have health care. I'm guessing it does not work that way.

But lets get back to... How does the system work for the average Dominican person?

ok, so.

the doctors on strike are those working in public hospitals. their salaries are a part of regular government budget, along with stuff like paying the cops and public school teachers. nurses and other public hospital staff are also paid from the budget which covers all costs of running public hospitals.

the very same doctors often have private practices and work in private hospitals where they are being paid partially directly by the patients and partially by health insurance companies (if they have a contract with them). but this is a separate matter.

all dominicans and foreigners alike are entitled to free healthcare in public hospitals. the problem is that often there are no beds available, no medicine and not even basic amenities like bed sheets, running water and so on. some public hospitals are in better situation than others, some are tragically bad. all depends on how the funding is... hmm... used.

large number of dominicans have private health insurance. it can be very cheap and it can be more pricey. those who are legally employed have the most basic insurance plans with low limits. good medical plan will have wider coverage. thus the issues mentioned by you earlier, with insurance companies refusing to cover certain procedures. if one has a good plan - and a good doctor - this should not be much of a problem.

average dominican is pretty much screwed in terms of health care. if they have no insurance the option is either public clinic or getting into debt in order to pay for private health care. some people die because public hospital has no capacity/personnel/medicine/equipment to help them. some people die because the private hospital will not accept them without upfront payment.
 

Milo Mitt

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In my case, over $100,000 US to save my leg when I developed gangrene after a Dominican taxi driver hit me and ran over it with a minivan.

Wow, and this was in the US I assume? I did not even know what gangrene meant when I read your post so I had to google it. I hope you recovered.
 

DR Solar

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Thank you dv8 for your informative and well done post. It confirms most of what I had thought.

The young man with the shattered arms and head was taken to a public hospital and had some treatment but the hospital did not have the equipment needed so they took him to another semi-private (as they called it) hospital. Some of the same doctors at the public hospital showed up at the semi-private. So your assessment is pretty right on.
 

cobraboy

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While understanding the angst many have over a clinic's policy of "no money, no treat", I suspect these same folks forget one embedded aspect of the Dominican culture: "If it's free, it's for me!"

If these private hospitals did not implement their "pay first" policy, they would be innundated by folks 24/7 demanding free medical services creating an operational and financial nightmare.

Based on the causal result of not implementing such a policy, I don't blame private clinics one bit for that policy.

However, if the gubmint had a mechanism, some kind of fund, that would guarantee clinic's reasonable reimbursement for admitting critical patients without paying first until stable, policies may change.

In the US, private ER's refuse non-critical indigent patients all the time. This is nothing new.

Keep in mind in the DR pretty much anyone can open a clinic. However, in the US, a clinic (hospital) must have a CON (Certificate of Need) issued by the state gubmint to establish the hospital. Gubmint controls supply, and generally speaking---and I know this from personal experience---requires a certain % if indigent care guaranteed as a condition of CON award.