Dental Care in Columbia?

2005-03-08 07:56:49 PM
Gettin' outa hand ........
Thailand, Columbia, Mexico, what's the
matter with the good old U.S. of A.?
Joel
Need good, inexpensive health care? Try Colombia
By Ruth Morris
Staff Writer
Posted March 7 2005
BOGOTA ?While Orlando Gonzalez visits his native Colombia, he will
bask in the warmth of friends, and get his eyes checked. He will stop
by the sauna at his favorite country club, breathe the stinging scent
of eucalyptus branches, and get his teeth cleaned. He will watch his
daughter, a skilled golfer, tee off on their old green, and then take
her to have her tonsils removed.
"The health system in Colombia is very good, very human," said
Gonzalez, a real-estate developer based in Pembroke Pines, explaining
his decision to sprinkle medical appointments into a vacation
otherwise characterized by leisure. "In the States ... it's in
shambles. The only concern is the almighty dollar."
The doctor's office often is to a Colombian vacation as Graceland is
to a holiday in Memphis, Tenn. Like Gonzalez, many Colombians who live
in South Florida travel back to their dangerous and war-weary country
for medical treatment, citing bargain prices and a more relaxed
bedside manner. Patients flock to other Latin American countries too,
especially for plastic surgery, but Colombia is regarded as having a
particularly sound health sector for those who are not gravely ill and
can afford private treatment.
The trend runs counter to the perception of undocumented and uninsured
immigrants running up costs at U.S. clinics and public hospitals. But
it also underscores surging health insurance premiums in the United
States that have pushed millions of citizens and immigrants off
insurance company rosters.
The result is an army of Colombians stacking up their holiday
calendars with fertility treatments, dental work or refractive eye
surgery -- procedures excluded from or only partially covered by
health plans in the United States. Others sign up for something akin
to an extreme medical makeover, dipping out of one doctor's office and
into another, seeking out everything from obesity-busting gastric
bypass surgery to perkier breasts to herbal remedies. And as word
spreads, even non-Colombians are finding their way to Bogota's upscale
clinics.
Gonzalez and his wife pay privately for basic health insurance in the
United States, which assures them of emergency care. For smaller
complaints, they find the money they save in Colombia easily covers
the cost of their plane tickets. Gonzalez adopted this system five
years ago, he said, after going to a Miami hospital emergency room for
a few tests and an injection and receiving a bill for more than
$2,000. Other Colombian immigrants said U.S. coverage and treatment
were simply out of their reach.
One popular destination is the aquarium-adorned office of the family
dentist, like the sunny quarters in an elegant northern sector of
Bogota where Dr. Jorge Gomez fills cavities. U.S. insurance policies
generally cover about 50 percent of dentistry costs. But with
Colombia's competitive prices and an attractive dollar-to-peso
exchange rate, full prices on Colombian dentistry often fall below the
deductible that U.S. patients are expected to pay.
"They come for a weekend. They see their mom, they have a good time,
and they visit me," said Gomez, who has 50 regular patients from
overseas, as he peered into an open mouth. "It's not because they love
me," he said with a chuckle. "It's about the pocketbook."
Some patients, however, say they prefer their Colombian physicians for
reasons beyond economy. Robert Baron, an American choreographer based
in Los Angeles, first visited Gomez while he was working on a musical
in Bogota and needed some enamel work done. But it was the dentist's
warmth that brought him back for orthodontic work.
"He invited me out to his family farm to have dinner and told me to
try such-and-such restaurant around the corner." Baron said. "There's
a little more humanity, as opposed to our system, where it's, `Come
in, ciao, you're done.'"
Dr. David Himmelstein, co-founder of the Center for National Health
Program Studies at Harvard Medical School, said the medical migration
must be taken against a backdrop of narrowing coverage in the United
States and steady rises in premiums, and of huge profits flowing into
the pockets of drug and insurance company executives.
"Our health care prices are way out of line with the rest of the
world's. We have a system that costs an extraordinary amount, and
delivers incredibly bad value for money," said Himmelstein, who
supports a government-financed health plan in line with the Canadian
model.
According to industry figures, about 85.2 million U.S. residents have
spent at least some time without health insurance over the past two
years, a figure equivalent to one in three Americans under the age of
65, when Medicare kicks in.
Reacting to Colombians' assertion that their nation's physicians are
more personable, Himmelstein said: "Poking and prodding, sticking a
needle in someone ... almost anything you do to a patient [in the
United States] is paid at a per-minute rate that is hugely out of
scale with what you're paid to sit and talk to them."
Colombia's health system also cuts deeply along economic lines. While
high-end doctors like the ones favored by overseas patients line their
walls with diplomas from U.S. and European universities, public
hospitals are crowded and undersupplied. Some struggle just to keep
sutures in stock.
An exception is the renowned Barraquer Clinic for eye care, which
charges its wealthier patients extra to subsidize services for the
poor. The imposing white building is named for its founder, Dr. Jose
Barraquer, who pioneered the techniques that later evolved into the
popular LASIK eye surgery. The procedure is not covered by insurance
and can cost more than $2,000 an eye in Boca Raton, or $550 in Bogota.
Not surprisingly, it has helped to draw thousands of foreign patients
to the clinic.
"Tourism has grown up around this clinic," said Cesar Navarrete, the
clinic's administrator, who keeps a file of hotel brochures stacked
between medical journals on a messy desk.
"Everyday I'm invited to lunch" by hotel managers, Navarrete joked.
Asked whether he might try to capitalize on the overseas visitors to
raise more money, however, he frowned and said: "That's not what we're
about."
One floor down, speaking between consultations, Barraquer's son, Dr.
Jose Ignacio, elaborated.
"My father's idea was to improve the quality of life for the patients,
not the surgeons," he said.
Ruth Morris can be reached at rmorris@sun-sentinel.com or
954-356-4691.
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