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A tale of two hospitalizations

Mary Boland
Post Independent
Glenwood Springs, CO Colorado
What Do We Really Want?
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“Ask not for whom the bell tolls. It tolls for thee.” John Donne, 1624

This winter, the bell tolled twice, once for my husband and once for myself.

Fortunately, the calls were answered by two excellent Catholic teaching hospitals. One, St. Mary’s, is in Grand Junction. The other is Hospital Dr. Rafael Angel Guardia in San Jose, Costa Rica.



While the outcome was successful in both cases, the two hospitals could hardly be more different, and I think the differences are very instructive.

My husband was in St. Mary’s for three days in order to have a gastroenterological procedure and multiple blood transfusions. For those three days, the hospital bill was almost $20,000, not including the bills for the anesthesiologist or gastroenterologist.



Some weeks later, I came down with pneumonia three days after our arrival in Costa Rica and ended up spending 10 days in San Jose’s main hospital. That included two episodes in intensive care plus multiple x-rays, ultrasounds, etc. The hospital bill for those 10 days was $7,000 and included all the doctor bills.

At St. Mary’s, my husband had a large private room with his own TV and private bathroom. The room was equipped with several nice armchairs for the comfort of his visitors. And downstairs I was able to avail myself of a lovely cafeteria where one found a considerable variety of healthy foods at reasonable prices, and it was open around the clock.

But what if we didn’t have the insurance to pay for all this? How could we possibly feel comfortable with this knowing that at least 50 million of our fellow citizens are uninsured? And that includes almost 48 percent of those too young for Medicare. What happens to these poor souls?

In Costa Rica, except for my intensive care episodes, I was always on a ward. At first a relatively small ward and then a much larger one. There was nothing so frivolous as private rooms and bathrooms, let alone TVs. If you were well enough, you could read or walk to a lounge and watch whatever was on that TV.

Every ward had a central nursing station, and both interns and residents were constantly present, as were many nursing assistants. If or when anyone took a turn for the worse, doctors and nurses were immediately at the bedside and, as I experienced, removal to intensive care was also immediate. Senior teaching physicians circulated frequently, examining patients, adjusting their care, and putting the younger doctors through intense examination.

Every ward was scrupulously clean, patients were showered and changed every day, as was their bed linen. I found the food terrible, but my fellow patients didn’t seem to mind it too much.

No one in Costa Rica ever has to worry about their fellow citizens not being able to afford care. Everyone is covered by the country’s well developed, publicly funded, comprehensive health care system. For this coverage, workers pay between 10 and 15 percent of their income; the unemployed receive free coverage.

Costa Ricans have a GDP of about $9,000 per capita, and they are spending about 9 percent of that for this health care. Outcomes are as good as those of affluent Organization for Economic Cooperation and Development (OECD) countries. In fact, Costa Ricans’ life expectancy of 78.7 years is higher than ours in the U.S.

We are spending almost 18 percent of our GDP on health care, and we are the only major advanced society without a system for providing universal coverage. The World Health Organization ranks the overall performance of our health care system 37th, not first. This obviously contradicts the oft-repeated claim of the right that we have the best health care in the world.

Sure, if you are very rich or very well insured, and need high-tech treatment of a rare condition, the U.S. is probably your best chance. But for a huge number of us, the U.S. is the worst chance.

A final irony. The National Federation of Independent Businesses (NFIB) filed the lawsuit to overthrow Obamacare on behalf of one Mary Brown, who was outraged that the government should force her to buy health insurance. But before the case got to the Supreme Court, the NFIB removed Mary Brown’s name as a plaintiff.

That was because Mary Brown became very sick. Without insurance, her medical bills bankrupted her and caused her to lose her business. But did NFIB drop its suit? No, it just dropped Mary Brown’s name from the suit. Furthermore, her unpaid medical bills will in practice be charged to the ever smaller number of us who can afford insurance.

– “What Do We Really Want?” appears on the second and fourth Thursdays of the month. Mary Boland is a retired teacher and journalist, a proud grandmother and a longtime resident of Carbondale. Follow her on twitter @granny boland.


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