Best Place to Get Sick
A recent change in Cuba just made me think of this. I originally thought about this when I found out that access to health care in Canada was based on just being there, not on having residency. The differences and considerations seemed worth a post.
First, in Nicaragua, everyone who is here is entitled to what you might call a minimalist level of health care. This is actually what a majority of the people here have. They can walk into a state-run health clinic or hospital and get free care, no questions asked. In parallel with this, there is private practice where people can pay for care. This goes from local doctors all the way up to major hospitals. There are also some private but free services available. My experience with this is that private doctors volunteer to see a limited number of free patients.
Employed people in Nicaragua are supposed to be inscribed into INSS which is a combination social security and health care system. This entitles you to a step up on the level of service. For example, the state-run hospital in Estelí has a separate facility for those covered by INSS.
Costa Rica is pretty similar to Nicaragua. Free care is available. Anyone who is there can also enroll in a health insurance plan. The insurance provider is the government but the plan is a lot like HMO plans in the US. It pays 80% of in-plan care, 70% of others with the usual list of limits and such. When I first moved to Costa Rica I enrolled in this plan. It cost about $40/mo. The equivalent plan in the US cost about $300/mo.
While I have never verified this, it seems the Costa Rica plan would cover you in, for example, Nicaragua. The 70% limit would apply as well as the typical costs consideration but typical should not be an issue as health care costs the same or less in Nicaragua than Costa Rica.
This finally gets me to the change in Cuba. Health care there has been like Canada in that if you are there, you get service. The big difference is that in Canada, doctors are private but, in Cuba, everyone works for the government. But, Cuba just added a new requirement to travel there, travel health insurance.
Requiring it makes sense and is probably something Canada should do as well. But, I was initially put off as it is just one more hoop to jump through. The good news, however, is in the fine print. If you travel to Cuba without it, you will have to buy their insurance at a cost of $3/day. All in all, that seems like a pretty reasonable price.