An Example of the Cost of Healthcare in Panama


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An Example of the Cost of Healthcare in Panama

The cost of healthcare in the United States is insane. In fact, I’ll go out on a limb and say that the whole U.S. system is essentially broken.

As a country, we pride ourselves on trying to be the best in the world. But healthcare is one of those areas where the U.S. has not only fallen short but it’s gone off a giant cliff that seems impossible to climb back up from.

If you look at the rest of the world though, there are plenty of countries that are doing a heckuva lot better in terms of both cost and even quality.

It’s funny to me that there’s still some denial from many folks on this. Because so many people have never left the U.S., they have preconceived notions that if you’re paying ridiculously less for healthcare then it must not be good… or as good as what you could in the U.S.

I’ll pin most of the blame for this on the big hospitals and insurance companies. They’re making such crazy amounts of money that they have no incentive to make changes. And so the lobbyists push to fight change and the marketing shoved down our throats as consumers is that it’s much worse in other countries.

I think we all know that the cost of healthcare in the U.S. is just stupid… I’d love for someone to try to justify otherwise. But on the quality side of things, a little digging will tell you that we’re not necessarily doing as well as many other comparable countries. Aside from that link, another fun analysis states:

The U.S. spends more on health care as a share of the economy — nearly twice as much as the average OECD country — yet has the lowest life expectancy and highest suicide rates among the 11 nations.

— The Commonwealth Fund – Issue Brief January 30, 2020

I’m not going to profess to be some expert in the world of healthcare. I couldn’t even tell you about the quality you’d receive in most of the world. I haven’t spent enough time evaluating the data and really, I haven’t spent much time around the globe.

What I can tell you though is that we’ve been living in Panama for almost two years now. And I gotta say, it’s an incredible eye-opener to see how things really work in another country. I’m not saying everything’s perfect, but considering that many people think of this as a third-world country, I’d still pick my medical to be handled here over the U.S. any day.

I’m thinking most of us would be in agreement that something needs to change in the U.S. in one way or another. Obamacare was certainly an attempt at change but it didn’t do enough. As scary as it may sound, an overhaul is needed. Unfortunately, I don’t think our political system will allow that.

So the change will most likely evolve from capitalistic ventures around pain points, such as changes that powerhouses like Walmart are rolling out or that Amazon is implementing. Don’t get me wrong – they’re not angels. These are changes these companies are working on to help save themselves millions of dollars per year due to the cost of healthcare for their own employees. However, they’ll likely be open to most of us, which will help revolutionize healthcare over time.

Ok, I’m done with my rant but here’s hoping for a brighter tomorrow… especially since we’ll be moving back to the U.S. next year!

Today, I’m going to tell you about a recent visit we made to a hospital here in Panama for a routine mammogram for my wife. I’ll give you the good, the bad, and the ugly.

Making the appointment

My wife, Lisa, let me know that she needed to get a routine mammogram and wanted to try it here in Panama versus waiting until we got back to the U.S. Although we do have ex-pat insurance in place through IMG Global that covers us throughout the world (including the U.S.), we have a bigger deductible in place to keep our premiums down.

In other words, we would still have to pay a pretty good penny to get it done in the U.S. so why not give it a shot here in Panama and see how it goes, right?

Mammograms aren’t my realm so Lisa did the legwork on this one. She’s part of one of the Facebook ex-pat groups in Panama that I’m not called Boquete Friends, which is an invite-only women’s group. She saw a post someone had asked about getting a mammogram here and a couple of suggestions were to go to Mae Lewis Hospital or Chiriqui Hospital. Because I had already been to Chiriqui Hospital for a dermatologist appointment last year and had a little familiarity with it, she went with that one.

Here’s the fun part – Lisa couldn’t get a hold of anyone at the hospital via phone, email, or WhatsApp. Maybe they were just too busy, but those are the fun things about Panama… you just never know.

So as crazy as that sounds, she was never able to make an appointment. But she had also read in that Facebook group that they accept walk-ins for mammograms Monday through Friday from 3pm-9pm and Saturday all day. Good enough for us!

We don’t have a car and Chiriqui Hospital is in the city of David which is about a 45-minute drive from Boquete. We used to take the bus to David before the pandemic and we will again once we get out vaccines in a couple of weeks but we weren’t ready to yet. So we decided to make a day of it, rent a car, and do some shopping while there as well.

For those curious, we reserved an SUV at Boquete Cowboy Cars. We’ve used them before and they’re just good people. Of course, it didn’t hurt that the cost of the SUV was $35 out-the-door (including insurance)!

The visit to the hospital

On a Tuesday last month, we picked up the car around 10am and headed to David. We talked about the order in which we’d go shopping and go to the hospital. Even though the post on Facebook said walk-ins were welcome from 3pm-9pm, we decided to head straight to Chiriqui Hospital. If they let her in early, great. If not, we’d go shopping and come back later.

An Example of the Cost of Healthcare in Panama - Chiriqui Hospital

So we parked in the parking garage and headed in. Now, I gotta tell you – this hospital can be really confusing… especially if you’re not fluent in Spanish. Finding your way around the place can be like a maze.

The great thing is that locals here in Boquete and David are generally very friendly. So after wandering around aimlessly for a little bit, I stopped someone and asked where to go for a “mamografía” (thank you Google Translate!). The gentleman gave us directions in Spanish that I mostly understood and eventually we found our way.

An Example of the Cost of Healthcare in Panama - Chiriqui Hospital

We walked in and waited in line behind a couple of other people to the receptionist. I told her in my broken Spanish that Lisa wanted to have a mammogram done. She took down some basic information and then let Lisa know she could wait in the waiting room. She also told me that Faith and I weren’t allowed to wait there to avoid crowding (pandemic rules). I asked how long it would be to which she responded about 30 minutes… not too shabby!

So Faith and I headed out and found a nice little spot to wait in another part of the hospital away from everyone…

Probably 20 minutes later, Lisa texted and said she was done so we went back to find her. According to Lisa, the exam was similar to what she’s had in the U.S. However, she also said it wasn’t as calming here either.

In the U.S., she said they bring you into a quiet room and try to make you very comfortable. Lisa said that here, they just tell you to take off your shirt and they get to business. It wasn’t bad, just not what she’s used to as far as the exam goes.

And that was it. We were about to head out when Lisa told me that they asked us to come back tomorrow to get the results. That would be a real pain for us considering how far it is and not having a car so I went back in to talk to the receptionist since I speak a little better Spanish than she does.

I told the receptionist that we didn’t have a car and asked if we could get the results emailed to us. “No problem” was the response. She had me jot down Lisa’s email address and we were out of there.

We spent probably 45 minutes in the hospital from the time we walked in the door until we left… and with no appointment.

The cost of healthcare

Like a lot of countries around the world that don’t rhyme with “invited crates”, the cost of healthcare in Panama can be extremely inexpensive.

Because we know that the cost of healthcare is cheap here and we have a large deductible, we don’t bother using our ex-pat insurance – that would just complicate things anyway.

Why you might ask? Here’s why – Lisa paid with a credit card before they even did the examination. The testing, x-ray images, and the lab results with diagnosis ran a grand total of [drumroll, please!]

$55.

Yeah… $55. That’s out-the-door and the full amount on our credit card. No premiums needed beforehand, no co-pay, and no frustration.

The side of things I really like is that it’s all said and done that day. Since there was no insurance company involved, you just pay right then and there. In some cases, you pay right after your appointment is done as I did for my dermatology visit. In other cases, you pay before the appointment as Lisa did.

But either way, you just pay the small amount and that’s the last you hear about it. No inflated pricing for different people, no waiting months for insurance companies to argue and “negotiate pricing”, no receiving indecipherable EOBs (explanation of benefits) from the insurance company, and no need to argue later that something was coded wrong.

That’s right, the cost of healthcare is inexpensive. You pay the cost of the service and you’re done.

Oh, and you can ask what the price is and actually know beforehand… amazing, right? Try that with a medical facility in the U.S. – I spent wasted hours and days trying to do that prior to a procedure I had done in the U.S. years ago… to no avail, of course.

As a side note, you can get insurance to use here. We have our ex-pat insurance but that’s mostly just in case we’re in the U.S. visiting and something happens. You can also buy “regular” insurance through various third-party companies or even buy insurance directly through individual hospitals here.

In general, though, the cost of healthcare here makes it cheap enough that self-insuring can be a viable option to at least consider for many folks.

Thoughts outside of the cost of healthcare

Ok, yeah, $55 for a mammogram without insurance is simply astounding to me and probably to you as well. Unfortunately, though, that’s because so many of us who live in the U.S. have become accustomed to a system where we’re just too familiar with outrageous prices.

Know that Panama isn’t the cheapest country out there for healthcare either – it just happens to be the country where we live right now and can take advantage of the inexpensive costs while here.

But pricing aside, here are some other thoughts that you might find interesting.

First of all, no social security number needed. The fact that we’re still giving out this number to every facility we visit in the U.S. is mind-boggling. With the number of regular hackings in the healthcare industry, this is just asking for trouble. It should be illegal for facilities to require this info. If you’re not aware, the only reason they really want this information is so they can use it for debt collection if needed.

On this visit for Lisa’s mammogram, they asked for her name, birth date, email address, and checked her passport for her ID number. Do you have insurance you want to use? No? Ok, no problem.

That’s it. No other info needed… a little bit of privacy still exists!

Another facet I found interesting was how quickly things were handled. From start to finish, we were in that hospital for no more than 45 minutes – without an appointment!

And then, Lisa received the test results the next day. A secure link was emailed to her that took her to a site to view the results and diagnosis. It also contained the x-ray images that could be downloaded. That’s a big deal if you’d want to bring them to another doctor at another facility without it being a pain in the @#$.

Then there’s the facility itself. This is not some state-of-the-art building design. It’s a good facility but the weight is on practicality over presentation. That can be good or bad depending on how much you value that sort of thing.

My understanding though is that generally, the equipment they use throughout the facility is as good as (and in some cases better than) what we have in the U.S. I can’t vouch for that so take it with a grain of salt, but there’s been nothing so far that’s made me think otherwise. In Lisa’s case, she said the equipment seemed pretty standard and the digital x-ray results are a good sign.

I’ve also be informed that the doctors here are trained in the U.S., Mexico, and France. So they’re receiving the same education as the doctors in the bigger nations. Interesting, right?

Finally, a note on the quality of the care. I mentioned in my dermatology post that I’ve never had such a high quality of care at a dermatologist appointment before. In Lisa’s case, she said they were very forthright in doing their job. As she put it, their bedside manner didn’t impress her. She also said that may be because of the language barrier (my dermatologist spoke fluent English). So we had two different experiences on that level.

We’ve only been to this particular hospital twice – once for my dermatologist appointment and once for Lisa’s mammogram. I don’t want it to come off as if we’re experts on this subject. But I do like to share our experiences, both good and bad, as we have them to help give a better understanding of what things are like in other parts of the world.

And knowing that there are places where the quality and cost of healthcare can be extremely good is important. Whether you’re considering moving to another country or even just investigating the idea of medical tourism, knowing the facts can be something very useful.

If you’re interested in possibly moving to Panama or living here part-time, I’d highly recommend the Panama Relocation Guide. This awesome online guide was put together by Jackie from Panama Relocation Tours and can be a great help in planning. Jackie knows her stuff and this can provide you with the answers, contacts, and resources you’re looking for to help in making your decision to move here.

And if you’re looking for a more hands-on experience, the Panama Relocation Tours offered through her company are always highly rated. A tour can easily help you see the pros and cons of the country to determine if it’s right for you. It’ll also help you figure out where in the country you should consider moving to.


Plan well, take action, and live your best life!

Thanks for reading!!

— Jim

27 thoughts on “An Example of the Cost of Healthcare in Panama”

  1. Excellent post! Thank you! Curious to if you know of any travel agents in Panama that can help my husband and I plan a vacation to the Boca Chica/ Boquete area? We are not ready for the full relocation tour just yet! Thank you!

    1. Thanks, Jessica! I don’t personally know any of the travel agents around. However, I do hear the name Andrea Cook from Viaje Vacations mentioned very highly by quite a number of folks in Boquete. Maybe start with contacting her and seeing where that takes you. Good luck!

  2. Reading this is just so mind boggling to me. My wife and I are still working through the bills and insurance negotiation crap from a surgery of hers back in September. I’m hoping that the letter we received last week was the final one, but it was written in such legalese that it was hard to translate.

  3. Thank you for sharing this, it’s very eye opening. The cost of healthcare is truly insane here in the U.S., and I believe it’s going to be only for the wealthy soon. My husband and I would be retired by now (I think) if it was not for the overwhelming cost of paying for decent health insurance on our own – and we are healthy. I am hoping you’ll be writing a post soon on what are your plans for health insurance when you move back to the U.S.

    1. You’re in the same boat as so many Americans who would like to be retired but can’t yet because of healthcare costs. It’s really a mess. I hope you’re able to get there soon!

      I made a note to discuss our health insurance plans when we move back – that’s a topic on a lot of folks’ minds.

  4. Yeas a shocking state the USA has for healthcare. I had a baby and was told it was fully covered with my very expensive insurance – and yet still had $6,000 charges outside of the health coverage!!! You can’t plan or ask, and you can’t really negotiate unless you want to spend hours and become an expert in the medical code system…not the thing you have the right mental state to do with a newborn! Thanks for sharing another reason to think of moving outside the USa

    1. Wow, sorry to hear about those unexpected costs – that’s no joke! Yeah, the cost of healthcare can be much cheaper in a lot of places around the world. It’s not for everyone though – folks who don’t like change or want things exactly the same as they’re used to can be in for a real shock when moving abroad. So, you do have to make some concessions. That said, I absolutely love it in Boquete – such a beautiful place with friendly people… and the lower cost of living doesn’t hurt either! 🙂

  5. I did a google search, and the average cost of a mammogram in Texas is $70.00 to $180.00. I’m not sure if a doctor’s referral is required… or if the mammogram includes the cost of reading the imaging results. For those that qualify, free mammograms are also available at many locations throughout Texas.

    The average annual salary of a doctor in the US is: $313,000; and in Panama the average annual salary for a doctor is $60,000. I’m just saying cheaper is not always better, especially when it comes to your health.

    Your post was thought provoking and it’s interesting to hear about the cost of medical procedures in Panama.

    1. Great comment, David and that’s fair. I’m not saying that the cost was so much cheaper than the U.S. in this type of care. But the stories I’ve heard from friends who have needed operations or procedures done here have easily saved thousands of dollars. That said, I do like a $55 cost better than a $70-180 cost! 😉

      With your point about the salaries, that’s a part of the reason why the costs are less expensive. Because there’s really no such thing as malpractice suits here, the doctors don’t need to pay ungodly amounts for that insurance. They also don’t live or work lavishly here so they don’t have higher costs.

      And then, the pricing is really just a reflection of the cost-of-living here. Just like the costs of goods/services and salaries can be much more expensive in a state, like California, it can be much less expensive in a Midwest state. The same goes for Panama – the costs are low because the salaries are low. This doesn’t necessarily translate into quality. That would be like inferring that the quality would be worse in a cheaper state in the U.S. than a higher-cost one. It’s absolutely possible, but can’t really be derived by the costs or salaries.

      Anyway, that’s just my two cents. I can’t personally talk too much about the quality since we thankfully haven’t needed to get much done. However, with a couple of experiences under our belts and everything we know of from friends here, I can see why medical tourism, in general, is becoming more and more popular.

  6. I recently found a medical admin person at my US dermatology office who DID answer my inquiries about costs (especially if you’re uninsured) for routine screening exams by asking in a different way: what are the min & max charges they’ve seen for such services? I cannot think of any other private sector service that is so shrouded in secrecy as healthcare costs. The dermatology office had a price list/ranges for the vast cosmetic procedures they offer – another first, there are NO price lists in any US healthcare provider’s office. I bet ENTERING a US hospital is likely $500-$1,000 MINIMUM just to get started, regardless of whether you have cut from a kitchen mishap or a massive trauma burns, injuries, gunshot wound(s), etc. Don’t even get me started on dental, hearing and vision – all treated as afterthoughts/add-ons in the US. I’d gladly pay a tiny increased tax so ALL Americans could enjoy low- or no-cost annual screening/wellness exams like mammograms, prostate, dental, hearing, vision, neonatal, skin checks, etc. Instead, our system relies on employers negotiating prices that cause routine services like mammograms to have widely differing costs for EVERY woman, and place an additional burden on women to make ANOTHER appointment to get an order/prescription for the radiology aspect. There are only 2 kinds of mammograms – why isn’t one the default and the other deployed as needed instead of mandating another medical appointment? I’ve been rejected at radiology facilities whose web sites say no order is required, and then they insisted on having an order when I got there. I can make my own appointments for ALL other screening/wellness exams, but not mammograms – ridiculous and one more way to marginalize women. Kudos on the car rental – they’re in short supply with outrageous costs in most developed countries right now.

    1. Haha, I found a topic to really push your buttons, Mary! 😉 But there’s no doubt about it – things need to change in how the U.S. handles healthcare. That’s both sad and maddening that you can’t make your own appointment for a mammogram. I didn’t know that was the case, but that just seems silly to me.

  7. Were your and Lisa’s results easier to understand/laymen’s terms instead of the foreign language EOB that communicates so little in the US? Was it in English, Spanish, both?

    As AI image processing becomes increasingly more sophisticated, radiologists will likely become robot monitors, conducting spot checks and second opinions once the robot/software/AI has completed its initial assessment and reached a conclusion/diagnosis. Maybe we’ll have more mass radiology/scanning as a result – stand or lie on a scanning device, get a full body scan, receive an overall score with detailed breakdown by major body part or system (neurology, circulatory, cardiology, dental, vision, hearing, orthopedic, etc.) Seems like that could easily be scaled so more people can get annual screening exams and be better informed.

    1. It was easy to understand… if you speak Spanish. Since it was online though, Lisa was able to just copy and paste the text into Google Translate to read everything. Nothing complicated in the terms either.

      I do agree that once the catalyst for change starts really hitting the healthcare industry, we’re bound for some massive changes. We’re already seeing a lot of that with the archaic banking industry. I think this is going to be a bigger dragon to slay, but there’s no doubt that its day will come and things can only change for the better.

  8. Good info to know. I had an EKG 6 months ago here in Boquete & paid $40 for it. I can only imagine what that would have cost in the USA. I had 9 blood tests & my husband had 7 blood tests. All 16 tests cost $150. The blood type test for getting a driver’s license was $5. Medical costs were our #1 reason for leaving the USA. Thank you Panama!

  9. The drugs they are using in Panama… The techniques and procedures… The equipment… Who created them? Panamanians?

    I completely agree the costs in the US are out of control. But nearly every significant medical breakthrough… Nearly every breakthrough drug… has originated in the US.

    If we could get health insurance companies out of the equation, things would be significantly better. But it won’t happen.

    Many years ago in the UK, the PM went to the Freakonomics guys to create a better solution. Dubner and Levitt figured it out. And the PM immediately dismissed them. It’s worth reading about.

    1. Thanks Lake – hopefully, this didn’t come across that I think Panama medical is further ahead than what they offer in the US. Instead, what I’m trying to profess is that the healthcare system is broken in the States. Until that gets fixed, it’s important to know that there are other options in the world.

      I’ll definitely look up the proposal from Dubner and Levitt. Sounds like it could be really interesting! Thanks!

      1. The lower costs in foreign countries come at the expense of the US taxpayers. The US pays a fortune for health care, then other countries can copy the drugs and techniques at little cost to them.

        Don’t misunderstand, US health care is a mess and there is no good solution. Too many hands in the cookie jar. An Executive Order by Trump has led to up front pricing, which is a start. I was at the dermatologist yesterday and was surprised as they handed me a price sheet before I saw the doctor.

        Personally I think health insurance should be limited to catastrophic care. Everyone needs to be responsible for their own basics. The Christian health sharing services that have sprung up are significantly lower in cost for this reason. Plus they do not cover anything caused by your own stupidity (drunk driving for example.)

        Dubner and Levitt are brilliant. Here’s a synopsis into that article. The book version goes more in depth. https://freakonomics.com/2014/05/19/a-freakonomics-proposal-to-help-the-british-national-health-service/

        As a side note, very pertinent to the vaccine fallacy of present day, is this wonderful 3 part series from them several years ago. https://freakonomics.com/podcast/bad-medicine-part-2-drug-trials-and-tribulations/

        Thanks for the blog. I love reading about your adventures and hope to join you in early retirement very soon!

  10. I truly wish that the cost of healthcare improves… but we know 3 things that are certain, death, taxes, and that healthcare in the U.S. won’t improve.

    I got my wisdom tooth removed in Asia and it costed $50. The ONLY reason it costed $50 was because I didn’t have insurance. It would have costed $500 in the U.S. WITH insurance (I got the quote), ha ha! I’m not sad at all..

      1. Oh, the quality was so much better too. The technology that they used to extract the tooth plus the plethora of medicine to take good care couldn’t be beat. The medicine was cheap too, I think it was something like $10.

        10/10 would do again!

        So when you said the out the door cost was $55, I could relate to that very much.

  11. You’ll get no argument from me Jim. Healthcare in the states is expensive! If I visit the doctor and only see him for 10 minutes, it costs me $150. And that’s *with* insurance!

  12. I think it’s pretty similar in Thailand.
    People can go to the private hospital and pay. The price usually is affordable for expats but would be expensive for locals. Local people go to public hospitals. It’s a lot cheaper there, but you have to wait around quite a while. The public hospitals are usually very busy every day.

    1. That’s interesting, Joe – same type of system in Panama with private or public hospitals and clinics. I’ve seen the waits at the public clinics and would rather stick with the private ones just because of that (though I’m told the same doctors are required to float between the public and private hospitals). Everything that I’ve noted has to do with the private hospitals just because those are the only ones we’ve experienced thus far.

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