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Health Care Costs and Availability

August 27, 2010 By Philly 16 Comments

We’ve mentioned this subject before, especially within the living in the Philippines or retiring in the Philippines context.  Medical care seems to be one of the top areas of concern to everyone planning a move here to the Philippines.  And of course, medical care and the costs you have to pay for it should certainly be an area of concern … but I often wonder just how much of an area of concern this should be … and further, if many of my fellow Americans are spending too much time obsessing over this issue rather than making it just a part of the overall decision plan.

As Americans we somehow have become attached to the idea that US health care is the “best in the world”.  Well, it’s just find to believe that the USA id “number one” in everything … but it isn’t always the fact of the matter.

What the US spends

First in the World --- in costs

Actually under current, independent assessments … like the rankings of the Word Health Organization .. the USA comes out a distant 37th or so in overall citizen health rankings.  I’ve written about this before … one article worth reading comparing the US health care costs and Philippine health care costs is here.  I attached an appropriate graphic, and further down a music video … it’s informative, funny and sad, all in one.

But regardless of what Americans are spending right now, an operative question which often comes up is, what can I do about health care insurance if I decide to move to the Philippines.

So here are some answers, presented to the best of my abilities … you always need to check the facts for yourself because, as they say, YMMV (Your Mileage May Vary).

PhilHealth:

First of all, let me remind you about PhilHealth.  I’ve covered it extensively and I don’t want to make this article too long, so you might want to read up on PhilHealth benefits or visit their site themselves.  One way or another it is available to all, not just Filipinos and the cost, for the groups who have to pay, is very small … P 100 a month. $27 USD per year at today’s rate.  If that is the sort of amount you need to budget carefully for, I don’t think you are a good candidate to read the rest of this article, sorry.

Recommendation:  Whatever other choices you make, get PhilHealth for yourself, your spouse, minor children and for elderly Filipino relatives (it’s free for the aged, like US Medicare).  I can’t believe how many people ignore this insurance, especially when they have elderly relatives back in the Philippines and then are staggered by Lolo or Lola having to go into hospital.  It’s a no-brainer to me, get it.

Your Existing Insurance:

The first big bugaboo regarding moving to and living in the Philippines that concerns foreigners the most seems to be the fact that they immediately assume their current medical insurance will not cover them here.

That may be true, but in many cases it is not … and each of you making this decision needs to carefully check, independently, the facts on this regarding your very own policy.

I often get questions like “Will my Blue Cross” cover me there?  The answer is, definitely, I don’t know.  “Blue Cross” is not a single company, it’s a consortium of more than 50 companies in every US state as well as multi-state components such as the “Anthem” product line which provides the insurance most Federal employees call “Blue Cross”.

All plans may differ and you can not afford to make a decision based on what “Joe” says, or on “Mary’s experience”, etc.

Many US policies do cover pan members living overseas.  For example, my own Federal GEHA plan does… in fact it pays claims at the preferred provider rate … a good deal for me.  You MUST check for yourself.

Other Commercial Insurance Options:

OK, let’s suppose you can’t use existing coverage.  Would you be able to buy insurance to cover yourself and your family here.  And what kind of prices are we looking at?  here are just three possibilities I have found.  I don’t recommend any of these outfits, but I chose them carefully because I know they have, overall a very good rating with their policy holders, and they all have the modern outlook of giving you access to rates and coverage online, so people can make good comparisons for themselves.  They are presented in alphabetical order.

Blue Cross Philippines:

Yep, not only is that name used all over the USA, but all over the Philippines as well.  Here’s the main website for Blue Cross Philippines. They have a lot of offerings.  They also make it plain what their offerings and restrictions are on the really elderly … something that many Filipino companies are a little ‘shy’ about owning up to.

There are many different options here, mainly having to do with three things … policy holder’s age, how much coverage the policyholder wants to buy, and where the policy can be used.

It’s very important to notice with this and any other company ho offers the option … if you ask for full coverage within the US,a s well as the country you are thinking about moving to?  be forewarned .. the cost for US coverage is shockingly high.  But for Philippine-only coverage,the costs are very reasonable … often a few hundred USD per year … that’s right, per year.  For us Medicare-eligible persons, it seems very reasonable to just rely upon Medicare when we are back in the US, and buy Philippine-only coverage.  Certainly worth checking out.

Bupa International:

This is an old-line international health care provider, based in the UK, who provides coverage to expats virtually world-wide.  In looking up their various plans, I find they can fit very easily into many budgets … if, again, you exclude US coverage.  Example, for a person my age, 64, coverage outside the US and also including the pre-paid option of repatriation to the US or another country for medical attention, is only about $3600 USD per year, or three hundred US per month.  Many commercial plans that people already pay are in this price range, so while they are not cheap, they certainly fall within reason.  As an interesting illustration … when I changed the requested quote to include US coverage. the cost jumped to almost $12,000 USD per year … yep, that’s how much extra you folks are paying extra back there in the USA for 37th place health care.  Sad.

MEDEX Global Group, Inc.:

This is a US-based company.  i sometimes run ads for them on the site, but I notice that they don’t attract much attention.  They do not even provide coverage for US residents, but their coverage for US citizens residing in other countries seems pretty reasonable.

As with all these companies you need to look closely at all the plans, but as an example, their basic full coverage, including emergency repatriation, comes in at a slow as $1.16 per day .. about $36USD per month or roughly $436 a year.  Certainly well within reason.

Conclusion:

It’s certainly well within reason to get your own health insurance in the Philippines.  I’m afraid the US medical insurance, doctor’s promotional agencies, outrageous drug profits protection lobbyists and other such scum have perverted the thinking of many of my fellow Americans.  remember, you all hail from a country who used to be brave and used to be self-reliant.  Believe it or not, you still can be today … you don’t need “permission” to use the brains and courage God gave you.

I’ve also written on this subject before, listing other possible “freedom of choice” for health care candidates.

By the way, it’s also OK to laugh at ourselves.  Many of the expats I know who are my age … even some younger … are letting themselves become so consumed by worry and “fear of the future” that they are already on blood pressure medicine, tranquilizers and who know what all else to make the drug companies rich.  Relax and stop taking everything so seriously for a while … you’ll still live just as long, maybe even longer.  This will help.

Popularity: 100% [?]

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Live to be 100 in the Philippines — Can It Be Done?

April 8, 2010 By Philly 4 Comments

Who the heck is TED, and who the heck is Dan Buettner?

TED (Technology, Entertainment, Design) is a U.S. private nonprofit foundation best known for its conferences, now held in Europe and Asia as well as the U.S., devoted to what it calls “ideas worth spreading”.[2] Its lectures or TED Talks, widely disseminated on the internet, …… TED Definition on Wikipedia.

Dan Buettner is a National Geographic writer and explorer studies the world’s longest-lived peoples, distilling their secrets into a single plan for health and long life.  Full bio and more links

Well, you are in for a rare treat today, because if you want to watch a bout 9 minutes of video, you can literally change your life … add years to it.

And no, this is not any kind of sales pitch,  no ‘earn money online’ propaganda, no ‘Jobs for Americans in the Philippines’ pitch, and it is definitely not a religious pitch or one of those self-indulgent ‘boost your spirits’ sort of ‘get you mind right’ gimmicks.

It is a fast-paced “thinking man’s” story of who the longest-lived people on our earth are, and some obvious reasons they get to live to those ages.  Also, it’s not about the Philippines, although one of the longest-lived groups on Earth is located very close to the Philippines.

Why do I think it belongs here on my site about retiring in the Philippines?  Pretty simple.  There are a couple-hundred thousand total foreigner retirees living here in the Philippines and in my 10 plus years of dealing with literally thousands of them, and with living here almost 4 years meeting literally several hundred of them, I could sum up the mental attitude of many of them in one word.  Pissed Off.  OOps, sorry I guess that is two words.

Back on the old days in the Air Force we had a little saying about certain folks who got mad at the drop of a hat, or who lived their lives in the anger mode … we said they were “Spring-loaded to the Pissed Off position”, just as there are a lot of switches on the instrument panel of a fighter aircraft that are spring-loaded to the safest position and if the pilot starts to move one and then changes his mind, the switch snaps back to safety rather than, say, blasting the fuel drop tanks off the wing unintentionally.

Well the fellows (and a few gals our there) are ‘spring loaded’ the other (unsafe) way.  All someone has to do is think about saying something controversial to them, mention the “wrong” political party, or look at them them wrong was as they pass, or call them “Joe” and BANG … pass me an ordnance expended report please, I think I have to fill one out.

If you are living your life this way back in the US, or even of more concern here in the Philippines where living is alleged to be slower paced and more enjoyable, you just might want to do some thinking about how many years you have left … if you aren’t sure where to start you might like my article on how to take government health care and all the other irritations you are currently seething about and think of each day and each week a little differently.  You have, on average, about 3900 hundred weeks to your life and undoubtedly you have already burned up a large number of them.

I found the video of great value.  If you are hesitant to invest the time in watching it, or worried that it will try to sell you something or else make you feel bad about not exercising or eating the wrong things, I can assure you that is not the case at all.  In fact you might be surprised to know that the special groups of folks with long life expectancy illustrated show, they don’t exercise in any formal matter, they pretty much eat what they want (in moderation, of course), and they have no problem with moderate drinking.  live_2_two

Trust me, it isn’t scary.

Also, many people I have known tell me, “Oh I won’t live long, my father died young, it’s in my genes”.

Well, you may think that, but guess what?  The best scientific research to date shows that indeed, your genes are a factor in how you long you live … but only about 10% of all the factors that affect how long you’ll live a healthy, productive life.

So if 9 to 1 odds tempt you, even at all, might want to watch this and find out you are not doomed to die at 50 or 60 or whenever you dad or mom did.
On the graphics slide here, in a nutshell are the 9 major components of long life the study found in the major world areas where people routinely live much longer than the rest of us do.

When the study says “live longer” they are talking about people who routinely live to be 100 or even quite a few years longer … actively living, not kept alive as a vegetable.

That’s why I slugged this article as Live to be 100, but, like most headlines, it isn’t telling the whole truth.  Most of us reading this likely won’t live to be older than the 80s or so, but the “Take Home” from the video is many of us can add twelve years or more to our active and enjoyable lives, just by making some conscious lifestyle changes … including toning down the rage and frothing at the mouth over whomever your personal bogey men might be and letting some of the anger in our lives go on a regular basis.

Again, nothing to sell, no preaching, no gym membership … 9 minutes for a potential of 12 years?  Sounds like a worthy expenditure of time to me … watch it and tell me what you thought.

Popularity: 6% [?]

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Just What Is Good Health Care in the Philippines?

March 14, 2010 By Philly 10 Comments

An American retiree in the Philippines recently asked me a very interesting question about emergency services and medical care in general for retirees in the Philippines.  One thing you have to keep in mind, when planning on retiring here, is that in many cases there are no good answers.  You have to think this through carefully.

Those considering moving to the Philippines mostly ask questions about how much groceries or electricity costs or other minor money issues.  I live in the Philippines and I’m happy with my decision. However I would be the first to state that I am taking some big risks by doing so … risks that make the number of pesos in my electric bill pretty
inconsequential.

The is no effective emergency service in almost all of the Philippines (Davao City and Makati two notable exceptions).  You don’t call 911 and get a cardiac care team at your door, when there’s a pileup on the NLEX and people are lying broken and bleeding in the road no “flight for life” helicopter swoops done and transports the victims.  It just doesn’t exist almost anywhere and it’s not likely to in the lifetime of anyone reading this.  One of the important indicators that the leadership and “movers and shakers” in the Philippines are not even thinking of this sort of service in the future is that in many major cities, the “911″ phone number isn’t even reserved for future emergency services … in much of Metro Manila, for example, dialing 911 will get you a pizza delivery service.  To not even reserve the number for future us means nothing much along the emergency services line is likely to happen any time soon.
One of the reasons I chose to live on the outskirts of Manila is medical care. I can get into major medical facilities in Manila in an hour or so … nice for seeing specialists or for having elective procedures done at good hospitals.

But I’m under no false illusions here … if I have something like a major heart attack … I’m dead … simple as that. Those who depend upon or expect world-class emergency medical services are not going to find them here.  Air evacuation services might offer some help )I even promote a very good one, here), but air evacuation/MedEvac back to your home country is not always medically feasible. (for those of you who are retired US military, the network of medevac flights the USAF used to fly ’round the world’, is essentially gone.  The C-9 Nightingales are gone, the medevac squadrons are gone and likewise many of the scheduled flights those with less serious conditions one could “hitch hike” to military hospitals on are gone too … they will never return.

I don’t want this to sound strictly gloom and doom, but I have talked to many who just haven’t thought through what would happen to them if there is no 911 to call.

Mass Casualty Simulation
Creative Commons License photo credit: Werner Vermaak

As a side note, one of the bigger news stories the week I first wrote this article was the death of a fellow named Max Soliven, perhaps the most illustrious Filipino journalist ever.  He was in Japan and suffered a heat attack in the departure lounge at Narita airport, Tokyo.  Japan has excellent medical care and has emergency services operated in a manner that makes most US services look like amateurs … and helicopter evac is readily available and frequently used … especially for VIPs which
Max certain was.  However, he was dead in seconds … when it’s your time, it’s your time and no amount of insurance or technology can ‘fix’ things.

The real problem seems to be to me that those still living in the US seem to think they have the best medical care in the world, when, in fact the US can’t come up to better than a dismal 37th in WHO’s latest rankings. France (number 1) would be a much better choice, but I don’t see many moving there.

This recent article shows me US medical care seems to be slipping rapidly:

This past Wednesday, ABC News reported on the the “spike” in maternal deaths in the United States over the past several years with due shock.

The news report stresses how shocking it is to hear that so many women die of complications in childbirth when we live in the United States of America. How could this be? They wonder. How could be be ranked so far below Greece, The Czech Republic, and Japan? How could this be happening in our country?

The U.S., in fact, ranks 33rd out of 33 industrialized countries in maternal deaths per year. Our infant outcomes aren’t much better, either…

But reports, real or imagines, detailing how the most expensive health care system in the world is slipping badly, doesn’t do anything to change the fact that health care, especially emergency services here in the Philippines is not nearly up to the standards of the US.

When you make the decision to move to the Philippines or not, or when you decide where in the Philippines you want to live … better give health carer a little more thought than the local price of a Sam Miguel.

Popularity: 11% [?]

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Health Insurance Quotes — Philippines

December 10, 2009 By Philly 9 Comments

This article was originally written a few months ago.  It has been significantly corrected, updated and expanded with new, hands-on information.  In addition I have added a note about one of my advertisers at the end, a provider who not only offers health insurance in the Philippines, but provides what appears to be very good insurance (and emergency repatriation) at what looks like pretty reasonable rates to me.

I just posted about having my eyes fixed while living here in the Philippines and it provoked a surprising amount of interest.  Not so much about the eye operation itself. but about what has turned out to be one of the most contentious items in recent US memory .. health care insurance.

Shared Memories
Creative Commons License photo credit: BobPetUK

I’ve only been an American for 63 years now, so at times my own country still puzzles me ,,, but here’s country where the president can declare, unilaterally, nonsense like a ‘Global War on Terrorism’ (whatever the hell that is supposed to mean), pursue it virtually unsuccessfully for 8 years and people just nod and switch the TV channel to the Oscar Awards, but mention trying to take care of women and children dying because they can’t afford the most expensive medical care on earth and even old farts like me are ready to rise up and have a revolution.  Strange.

Anyway, one of the reasons I live here in the Philippines is, medical care is good and neither Republicans or Democrats have a freaking word to say about how I avail of it.  You know, Americans used to be known for and proud of standing on their own two feet, and it is still possible today to live without being told how to by some bureaucrat.  And I don’t need protests, I don’t have to worry about rallies and Second Amendment rights and I don’t even know if I am supposed to be a conservative or a liberal .. actually, I guess I am both at different times as the spirit moves me.

Now just because I enjoy making my own health care decisions and even paying my own health care bill (yes, I said that .. if I still had my US government insurance in force here I would be paying more than $169 each and every month for it.  So 34 months here at $160 a month would be nearly $6000 gone forever in the greed of providers who don’t really provide.  Instead, since I have lived here,  I’ve paid about $1860 plus a few more dollars over the past few years paid out of pocket.  I feel I am way, way ahead of the game.

Of course some people are going to say they can’t conceive of life without health insurance.  So fear not, there are alternatives to going barefoot.  Here are a few candidates, all are likely somewhat expensive but are very useful for US or UK or Aussie folks who want a security blanket as well as health care insurance.

AXA PPP healthcare
Resident expatriate or local national…working, traveling or retired, when you’re living abroad you deserve quality healthcare insurance from a company that knows their way around the world of private health!
>> Details & Contact Info

Clements International
Moving Abroad? Clements International, the leading provider of expatriate insurance, offers individuals and businesses coverage for property, automobiles, health, and liability.
>> Details & Contact Info

Expatriate Life Insurance
Expatriate Life insurance
>> Details & Contact Info

Global Rescue
Global Rescue will bring you home from anywhere if you are sick or injured. It will protect your health and it could save your life.
>> Details & Contact Info

HealthcareAnywhere
U.S. Style Global Insurance / A-rated Insurance Company
>> Details & Contact Info

HTH Worldwide
HTH provides Expat health insurance (Global Citizen plan) to U.S. citizens living abroad or foreign nationals residing in the U.S. The Global Citizen plan is underwritten and administered in the U.S. It meets all state requirements and is HIPAA compliant.
>> Details & Contact Info

Integra Global Personal Health
International Health and Medical Insurance for expatriates of all nationalities. Comprehensive health plan for the best care worldwide including access to US health care.
>> Details & Contact Info

World Nomads Travel Insurance
Recommended by Lonely Planet, World Nomads travel insurance is available to people from over 150 countries and is designed for adventurous travelers.
>> Details & Contact Info

More like these are available here at Expat Exchange

I am not advocating any of these plans, nor do I earn from any of them .. opinions rendered are thoes of Expat Exchange and I provide this strictly as a service to my readers.  Caveat emptor.

If you want a ‘more homegrown solution, these guys have a familiar name and have been in business here in the Philippines for nearly a century now, they will be happy to provide health insurance quotes to anyone who asks, Filipino or foreigner. Blue Cross Philippines.  You want to take note of something as you review their site and price and compare the domestic health care plans and their international health care plans.

The international world-wide dollar denominated health care plans may seem at first what you need, but do you really need a plan that expensive if you are coming here to live in the Philippines?

In many cases I think their Philippine-only Peso denominated comprehensive health care plans are mote than enough … last time I got a quote on one of these plans it was less than $200 a year for a single person under 65.  In fact that was the last time I got into any kind of health are plan provisioning and pricing, because the fellow I got the quote for arbitrarily decided that I was stupid because the plan was so cheap … go figure.  He asked me to find him a price, I did so, and he went off on me becuase the quoted prices was too low to suit him.  Needless to say I haven’t provided any more quotes for folks, I have addresses and contact data, you can get you’re own … I’m obviously not smart enough, myself. ;-)

Americans are so brainwashed by the health care insurance industry that they get mad when you offer them a bargain.

Anyway, that’s a little more regarding medical health care insurance here in the Philippines, personal health care and how you can likely afford to take care of tour own health care insurance plan needs here in the Philippines.

Now as I mentioned at the top of this article … if you let your eyes drift down to the bottom of this page you’ll see a big fancy banner for Medex International.  This is an outfit that sells both temporary travel and long-term health care insurance to expats, including those living in the Philippines, long and short term.  Although their ads often use “teaser” figures (as ads will), I have checked their rates for a number of different scenarios and find that a great majority of you reading this can get coverage for rates under $4 a day, sometimes way under $4 a day … for what appears to me is pretty comprehensive coverage.  I am not an expert, I do not buy from this company personally, and I do get a commission if you buy from them, but mandatory disclaimers aside, I don’t see how you can use health insurance coverage is a reason not to move to the Philippines.  What else is holding you back?

MEDEX - Travel Medical Insurance from $1.22 per day.

Popularity: 17% [?]

Filed Under: Medical

I Don't Sell This, But You Might Want To Buy

October 21, 2009 By Philly Leave a Comment

It’s very nearly Open Season for the US Federal Employee (and Retiree) Health Benefits Plan.  This is “Fed Speak” for the special time per year when you can opt-in to the program or change plans, coverage modes, etc.  It will run from 9 November through 14 December 2009.  This has a lot to do with living in the Philippines for some folks … because if you carry the right plan … I’m featuring one here, the one I have used for years and am very happy with .. you are covered in the Philippines and insurance woes for you and your qualified family members are gone for life.

I know that in the US there is tremendous smoke and thunder reverberating across the land every day, but let me tell you something … after 40 tears experience with the Fed Employees program:

It’s cheap (so far as any health insurance is cheap), it’s well managed, it’s one of the most efficient plans in the world … often been copied by other countries who are able to provide for their citizens … and here’s the fact most politicians and irresponsible journalists (who all have their coverage, by the way) who hurl ridiculous charges around won’t tell you … it’s essentially the plan that every Congressman and Senator gets into for life, and they never leave it, because they know well that in this case the government is doing far, far better than for profit opportunists can do … they just don’t want most of you to have it .. haves telling the have not’s they don’t need what the haves have.

Anyway, no more politics, if you are eligible, don’t miss out on Open Season and it’s hard to beat GEHA’s plans and services. (Again I have no relationship with these guys except as a highly satisfied customer)

Introducing the new benefitsw of better health.

You know it’s important to take care of your health. Now you can
choose a plan that makes it easy to do all the right things. Take a look
at GEHA Standard Option and you’ll discover one of the lowest premiums in the FEHB program.

We’re also one of the best values, because GEHA benefits are designed to prevent disease and help you lead a healthy lifestyle:

  • Low premiums for Standard Option;
  • In-network preventive care coverage on colonoscopies, mammograms and immunizations, with no deductible;
  • $10 copay for in-network office visits;
  • $5 copay for in-network eye exams;
  • Discounts on gym memberships, workout equipment and NutriSystem® meal plans.

See a complete menu of benefits here and download your Open Season materials. Then make a wise choice for your health. Choose GEHA.

Don’t miss our next live online chat with GEHA President Richard Miles. Submit your chat questions today, then log on Tuesday, October 27, at noon Eastern Time on www.geha.com.

(800) 262-GEHA

Official information and prices at: http://www.opm.gov/insure/health/planinfo/index.asp

Popularity: unranked [?]

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So How Much Did It Hurt?

October 5, 2009 By Philly Leave a Comment

As regular readers will recall I have been writing quite a bit about my recent cataract removal/lens insertion operation here in metro Manila, Philippines.

I promise this will be the last for a while, it’s going to be a bit before I decide if I am going to buy a pair of cheap magnifying half-lens glasses for reading, or get a real reading prescription, get RK-LASIK surgery for near vision only, or, as both me and my surgeon,  Alexander C. Santa Maria, M.D still hope, that my left eye (which was always nearsighted in the past will continue sliding back to slight nearsightedness so I can read books and paperwork comfortably.

Right now my distance vision is great and my “arm’s length’ vision (like looking at a computer screen comfortable is also accurate and comfortable.  We just have to wait to see if my eyes will get \nearsighted’ enough to read at near distances.  Right now my vision is so great, overall, that I am not worried about this minor impediment.  All “old men” like me eventually suffer from “short arm” disease, so a little bit of close up help will be a tiny price to pay if it has to happen.

One of the reasons I wanted to write about this today was that a lot of people have the wrong concept of what’s involved in the surgery.

In older methods of cataract repair the eye was cut open extensively and people have grown used to seeing folks what dressings over the eye, being laid up for quite a while for the cuts to heal and sutures to be removes … and based on several I have known personally, quite a bit of pain and discomfort until the eye healed,

image

Rather than write about it, I’ve linked to this excellent site which even has a video of the procedure.

There has been no discomfort what so ever with either eye.  The biggest pain involved was a needle prick in my hand where the anesthesiologist administered a mild sedative.  She fixed that with a little local anesthetic.

I was not ’knocked out’ at all, in fact the team needs the patient conscious to aid them during initial lens alignment.  The eye is deadened with a local anesthetic, dripped in and there is not the tiniest bit of pain (although there is a fantastic light show …kind of like when you press on your eye when it is closed … as the doctor works with the laser.

It takes about 15 or 20 minutes total time and you are ready to leave in less than an hour.

There’s no dressing or eye patch, just a simple set of workshop safety glasses to protect the eye from being touched or having any foreign objects fly in.

Although it is recommended (and I concur) you have someone drive you home.  Seriously, though, I could have driven an hour after the op, my vision was that good.  I really enjoyed my first night home after the first op … World Poker Tour was ion TV and for the first time in years I could see if cards were spades or clubs without waiting for the commentator to tell me.

Read the rest of the great cataract operation  information here, and trust me … if your vision is affected, even a little, see your doc (or mine, I’ll hook you up).  Being affected a ‘little’ is a lot worse than you will have guessed, if you have the operation.

This could be a wonderful present for a loved one here in the Philippines too … don’t let them live the rest of their life in the dark.  Literally.

 

Popularity: 2% [?]

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How Much Is A Cataract Operation In The Philippines

October 3, 2009 By Philly 24 Comments

As regular readers know I usually try to keep close track of things people are searching for when the find PhilFAQS, the place on line where you learn the FAQS (Frequently Asked Questions) about living in the Philippines.  That’s where the title of this post came from.  That specific query has been typed and landed here at least 20 times in the past 20 days.

Well I already mentioned it in some detail here, where I talked about medical tourism at the grass roots as a business, but I’ll post in here again to make it easier to find.

Owen's Intense Eye

Creative Commons License photo credit: ClickFlashPhotos

I went to a doctor who practices here in Marilao at our local hospital, Nazarenus.  The doctor was highly recommended in two ways … first by several other doctors whom I know and second by the fact that he just completed a similar procedure on my mother-in-law’s eye … and mother was ecstatic over the results.  (any time you’re contemplating something you might be a little nervous about, always send in the 80 yo lady to test the waters first, ;-) .

His name is Alexander C. Santa Maria, M.D and he’s a board certified ophthalmologist (eye M.D.) and has operating privileges in several Metro Manila hospitals, and you can reach one of his offices at area code 44-711-5429. (to call from the US you would use 011-63 (the code for an international call and the country code for the Philippines) in front of this number.)

I first went in for a regular eye exam (about P400) and we talked about the options with the cataracts.  The doc wanted me to try a special medication that was supposed to arrest further cataract growth for a month … I tried it, got no satisfaction and went back to the doctor and said, let’s do both eyes.

I had one session in his office that took a while where we measured both eyeballs to see what the biometrics of the cataract lenses should be,  That ran a total of P1,000.

I also had to see my regular family doctor, Edgardo P. Guce, FPCP, FPCCP. (44-840-7948), an Internist and Pulmonologist, for routine blood work, chest x-ray and EKG to ‘certify” me as safe for “Dr. Santy” to operate on.  These tests and Dr. Guce’s clearance ran about P1400 total.

Then my operation, consisting of Phacoemulsification, or phaco. A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called “small incision cataract surgery.”  (this is the one you want!  Recommended) for each eye (we did them two weeks apart) cost under P40,000 (each) (all in).  The operations included 4 to 6 weeks of follow-up in office care … I’m scheduled for what might be my last appointment with Dr. Santy this coming Thursday.

So if you have been adding this up, we’re talking about six weeks total time so far and a grand total of a bit over P8,2000.  At today’s Pesos/US Dollar rate that works out to under $1,750.00 USD, grand total including incidental eye drops, puto for the office staff (Google is your friend), tricycle rides, etc., but does not include Dr. Santiago’s Christmas gift for this year … the way my eyes feel, I owe him a very nice one.

I have some US estimates that indicate about $8,000 USD is close to a bottom-line price for this work in the US … so I think cost wise I did pretty well.  Medical care-wise it would be hard to think of anything that could gave gone better.  I wish I had had this work done years ago … it’s literally life changing … and talk about feeling younger ;-)

Popularity: 42% [?]

Filed Under: Medical Tagged With: , ,

Blatant Ad Or Life Saving Info

September 30, 2009 By Philly Leave a Comment

Every so often I have a tendency to mention my advertisers/sponsors here at PhilFAQS.  I try not to make a habit of this, just as I try never to feature anything which is not potentilaly useful.

No matter how seldom I do this, some won’t like it … they want averything free.  Sorry.  I point out things I think may be of use, even if the service costs something.  We’ll have to agree to disagree on this subject, then.

One thing people ask me about all the time when thinking about trips to the Philippines is health insurance.  In particular they are thinking about health insurance that makes them feel confident because the company is US-based asnd in particular that they have insurance that will pay to have them MedVacwd (medically air eveacuated) back to the US … they want to get back to that 37th best health care system I guess.

Well, here’s a very nice potential solution to those issues:  If you’ll notive I have been running side bar banner ads for these folks and their plans are particularly interesting.

In addition to the ‘fky back to the US benefit, these plans can be bought for a year at a time and the annual costs for an under 70yo in the Philippines is substantially less than some commercial hospitalization insurance, so it might be well worth looking into:

Why MEDEX for Your Travel Insurance Needs?

  • More than 30 years of helping people in 200+ countries and 500+ international cities
  • The largest, independent, American-owned assistance company
  • 59,000+ credentialed international providers dedicated to your health and safety
  • Multilingual coordinators to help you overcome language and culture barriers
  • 98% customer satisfaction
  • The company of choice for major corporations, non-profits, universities, and insurance companies

It’s more than insurance…It’s MEDEX.

Why TravMed Choice for Your International Medical Insurance Plan?

  • Provides travel medical insurance and emergency evacuation protection
  • Guaranteed payment to foreign providers
  • International medical insurance options of $50,000, $100,000, $250,000, and $500,000
  • Deductible options of $100 or $250
  • Sports Rider option for the adventurous traveler (not available to residents of Washington state)
  • Includes MEDEX as your assistance company

Make TravMed Choice Your Choice When Traveling.

Want trip cancellation? Need a scholastic program? Want evacuation only?

MEDEX has a plan that will fit your needs!

Think it through.  You wouldn’t want to spend your whole bankroll on something as prosaic as a busted leg or a motorcycle wreck, would you?

Popularity: unranked [?]

Filed Under: Medical Tagged With: ,

Accredited Hospitals Philippines

September 23, 2009 By Philly 7 Comments

I’ve been seeing a lot of searches here on PhilFAQS lately for hospitals in the Philippines who are accredited or approved for TRICARE payment.  (TRICARE is the US Military-provided program for medical care for US military retirees and their dependents.)

tricare_providers There are quite a few hospitals TRICARE accredited, as with so many other questions on the ‘Net, Google is you friend, just go to the list of Philippine TRICARE accredited providers and you can search by hospital or individual provider all across the Philippines.

Please note:  I post these links as a service.  I tested this link right now, 10:13 Philippine standard time, 22 September 2009.  If it doesn’t work please don’t write to tell me I posted a bad link … I can’t make government sites perform and I do not post links that don’t work at the time I posted them.  I am always loathe to post any government links because, especially with TRICARE they always, always, always cause me problems.  Please address complaints to the appropriate government web master and not to your devoted scribe who can only post what works at this moment … thanks.

Now.  A number of accreditation inquires come this way that do mot involve TRICARE.  These folks are looking for hospitals with US “accreditation”.  For my purposes, this means hospitals who are accredited by the Joint Commission International (JCI).  This the global arm of the US-based Joint Commission on the Accreditation of Healthcare Organizations (JCAHO); the same body that certifies over 18,000 hospitals in the United States.

Presently there are only two hospitals in the Philippines who are JCI accredited:

image The Medical City, Manila or TMC.  I have only attempted to use their facilities once ,,, very unsatisfactory in terms of parking and physical access to care facilities for patients.  (in fairness this was at a branch office, not at their main location.  However, I was really disappointed that a JCI accredited hospital would even put their name on the branch office I visited with my elderly and infirm mother-in-law.  The receptionists in the main floor foyer did not think it unusual at all that a frail 80yo lady would be asked to climb 16 larger steps to reach the examination room.  “Oh no sir, we have no elevator, sobra mahal (too costly)”.  Accessibility in the Philippines is only a crap shoot, even from organizations who act as if they know what proper health care delivery should consist of.

image Saint Luke’s is one of the oldest and perhaps the best known hospital in the Philippines.  I’ve had two experiences with St. Luke’s, both satisfactory.  Years ago they processed my wife to be’s medical clearance so that she could travel to the US.  Even some folks in the US INS did not know that unlike a majority of countries, St Luke’s is fully accredited and new arrivals to the US who were examined and passed by St, Luke’s don’t need any further exams/immunizations.  St. Luke’s is the hospital where US Embassy civilian personnel are routinely sent as well.

A couple Christmases ago we had a very long and scary night with my mother-in-law, traveling from hospital to hospital cleared the city until we finally went where we should have in the first place.  The problem was cleared up and we were home in time for breakfast.  http://philfaqs.com/live-there/a-christmas-medical-odyssey/

I also had a neighbor develop a very serious brain condition which posed an immediate, life threatening problem.  She had immediate brain surgery at St, Luke’s and fortunately made a full recovery … impressive medical staff there.  Recommended.  http://philfaqs.com/live-there/blinded-by-the-white/

Popularity: 19% [?]

Filed Under: Medical Tagged With: , ,

Health Care Here and There

September 13, 2009 By Philly 2 Comments

I’ve written more than a few articles about heath care and medical issues in the Philippines.  Occasionally I compare things with the US and other “Western” or “Industrialized” or “First World” nations as well.  In general, health care here in the Philippines could stand a lot of improvement.

But if you read about my learning experiences with my mother-in-law, my neighbor across the street with the sudden onset cerebral aneurysm and my own recent delicate eye operations, overall I certainly don’t have any significant complaints … the Philippine medical system has been more than good to me.

Of course as soon as I mention any other developed country (and even the Philippines) and the US in the same article, I am mixing apples and oranges.  How’s that?

Simple … the US stands alone among all the top nations of the world … the US has no accessible health care system that serves all citizens (and legal immigrants) at a basic or better level.  What are we, people, chopped liver?  A bunch of unproductive, dirt-poor, short-sighted “can’t dos” drifting helplessly on the uncharted sea of life?

It is difficult for me to watch the current, distinctly “uncivil”  health care debate in the US without owndering:

  1. What has happened to my own country, can’t you tell the difference between fact and insurance lobbyist rhetoric?  Follow the money … who wins and loses in this argument?
  2. What the Hell are you fighting so hard to protect?  Do you think the current insurance company engineered ‘greed machine’ is really a decent system, compared with other countries’ health care?

My blogging friend Don Brown is a fellow Federal retiree.  He writes a lot of articles regarding his former career in Air Traffic Control and safety, so he might not resonate with many of you out there reading this … but I tip my hat to Don for finding and publishing this video.

Take the time to view it and think … just what is it that the Town Hall “aginners” there in the USA are trying so desperately to “protect”?  The right of children and the poor to suffer?  The right of the insurance industry to drive American health care costs 40% higher than any other nation on earth?  The right ofdrug companies to charge doubel for the excat same drug in the US as they, themselves, charge in Canada?

Watch and wonder:

Popularity: 3% [?]

Filed Under: Medical Tagged With: ,

3900 Marbles and Government Health Care

September 9, 2009 By Philly 5 Comments

Let me ask you folks a question.  I just had a conversation with a lady who wanted to bounce some ideas off me about business.  It was a pleasant conversation, but there was on “take away” from it that still kind of rings in my ear and rattles around in my brain, even an hour or more after our conversation ended.

The main thrust we were talking about involved health care and health services and she made a statement right along in the regular flow of the conversation that I have probably heard a thousand times before … but it just jumped right out at me this time, and I have been thinking about it ever since.

The statement went something like this …”after all, if we are talking to retirees, their absolute number one concern is health insurance.”

No some of you are already retirees, as I am, and many of you, I will guess, want to live long enough to become retirees, so let me ask you … is “health insurance” your number one concern?

I mean seriously, when she said that to me I had to physically hold myself back from laughing or making some sort of wise ass comment.  That would have been rude, and I am sure it would have mystified the lady I was talking to, because the way she said it left no doubt that it was very high up in her mind (she’s not yet at retirement age by the way’) and she clearly feels that is a number one concern of most, if not all retirees.

So why did I have to hold back a laugh and take pains to try not to say something insulting?  Because, quite honestly, health insurance is way, way, way far down the list of my most pressing concerns.

Now I am fortunate … I have health insurance.  So I realize that the subject is going to be higher on the “worry list” of those who don’t have health insurance than on mine … that’s only natural … but if anyone else cares to chime in … do you really feel it is top of your list?

Especially with the current pitched political battle going on in the US … distorted way away from the issues of health care, by the way … and funded behind the curtain by the huge, rich, powerful (and in my opinion) crooked US health insurance mega-industry … I realize it may be hard to get a clear and unbiased view on this, but health insurance is hardly the number one thing on my mind.

Losing my marbles IMG_0263
Creative Commons License photo credit: clrcmck

Each of us is born with a finite allowance of days.  We get what we get.  We can’t buy more.  We can’t change those days by going to Harvard and getting a PhD.  We can’t get more by going to church, or by partying,  giving money to the poor or opening a girly bar and selling beer at half price.  We have what we have.  That’s the number one issue on my mind … what do I do to maximize the time I have left.

Long time reader Tom Glenn sent me an email the other day with a story attached that really got me thinking.  I was really busy with a couple items I had mapped out as “must dos” on that day, but after I read the story Tom shared I just packed up my wife, drove past my in-laws house and picked up our two precious nephews, bundled everyone in the car and drove to Mr. Henry Cy’s closest branch office of nirvana … otherwise known as SM … using my new eyes along the way … my “first solo” since surgery … and spent a long time riding carousel’s, driving electronic game race cars and trying to drop little balls through hoops to win absolutely useless prizes for Sami, the three year old who loved every minute of it.

I didn’t windup getting anything done on my to do list that day, but you know something?  I think I spend my time one heck of a lot more wisely, I know the bys and I both had more fun … and I didn’t think about “health insurance” or “government health care” for one minute.

The older I get, the more I enjoy Saturday morning. Perhaps it’s the quiet solitude that comes with being the first to rise, or maybe it’s the unbounded joy of not having to be at work. Either way, the first few hours of a Saturday morning are most enjoyable.

A few weeks ago, I was shuffling toward the garage with a steaming cup of coffee in one hand and the morning paper in the other. What began as a typical Saturday morning turned into one of those lessons that life seems to hand you from time to time. Let me tell you about it:

I turned the dial up into the phone portion of the band on my ham radio in order to listen to a Saturday morning swap net. Along the way, I came across an older sounding chap, with a tremendous signal and a golden voice. You know the kind; he sounded like he should be in the broadcasting business. He was telling whomever he was talking with something about “a thousand marbles.” I was intrigued and stopped to listen to what he had to say.

“Well, Tom, it sure sounds like you’re busy with your job. I’m sure they pay you well but it’s a shame you have to be away from home and your family so much. Hard to believe a young fellow should have to work sixty or seventy hours a week to make ends meet. It’s too bad you missed your daughter’s dance recital,” he continued; “Let me tell you something that has helped me keep my own priorities.” And that’s when he began to explain his theory of a “thousand marbles.”

“You see, I sat down one day and did a little arithmetic. The average person lives about seventy-five years. I know, some live more and some live less, but on average, folks live about seventy-five years.

Now then, I multiplied 75 times 52 and I came up with 3,900, which is the number of Saturdays that the average person has in their entire lifetime. Now, stick with me, Tom, I’m getting to the important part.

It took me until I was fifty-five years old to think about all this in any detail,” he went on, “and by that time I had lived through over twenty-eight hundred Saturdays. I got to thinking that if I lived to be seventy-five, I only had about a thousand of them left to enjoy. So I went to a toy store and bought every single marble they had. I ended up having to visit three toy stores to round up 1,000 marbles. I took them home and put them inside a large, clear plastic container right here in the shack next to my gear.

Every Saturday since then, I have taken one marble out and thrown it away. I found that by watching the marbles diminish, I focused more on the really important things in life.

There’s nothing like watching your time here on this earth run out to help get your priorities straight.

Now let me tell you one last thing before I sign off with you and take my lovely wife out for breakfast. This morning, I took the very last marble out of the container. I figure that if I make it until next Saturday then I have been given a little extra time. And the one thing we can all use is a little more time.

It was nice to meet you Tom. I hope you spend more time with your family, and I hope to meet you again here on the band. This is a 75 year old man, K9NZQ, clear and going QRT, good morning!”

You could have heard a pin drop on the band when this fellow signed off. I guess he gave us all a lot to think about. I had planned to work on the antenna that morning, and then I was going to meet up with a few hams to work on the next club newsletter.

Instead, I went upstairs and woke my wife up with a kiss. “C’mon honey, I’m taking you and the kids to breakfast.”
“What brought this on?” she asked with a smile.

“Oh, nothing special, it’s just been a long time since we spent a Saturday together with the kids. And hey, can we stop at a toy store while we’re out? I need to buy some marbles.”

So what about it?  Anyone think that buying marbles is a good idea?  Is the best things in life actually losing your marbles?  And is ‘health insurance’ really, really, really as important as the TV bobble heads want you to think it is?

Popularity: 6% [?]

Filed Under: Medical

Philippine Living — Eye Surgery and Hidden Assets

September 5, 2009 By Philly 2 Comments

As many of you have been reading, I’m recovering nicely from having both my eye lenses replaced in cataract surgery here in the Philippines.  Suring the past few weeks when I wrote about various aspects of the surgery I looked a number of times for inline information about the hospital where my eye doctor practices and where I had the )out patient) surgery performed.  Couldn’t find it.  Figured there wasn’t a web site.  Asked my doctor and he made some vague reference to his FaceBook account and (scourge of the Internet in the Philippines) his |”Multiply” page )don’t get me going on Multiply, *sigh*

But low an behold there is a web site for my hospital’s eye clinic and a good one too.  Methinks they need to pay a bit more attention to how people find them via Internet searches, but they can’t be faulted in their eye care efforts.


Fatima Eye Laser Center

Eye Surgery Philippines 

Keratorefractive Surgery

It is a branch in Ophthalmology which makes use of technology to correct errors of refraction by applying laser, or knife surgery, as well as other devices to the cornea to correct errors of refraction.

Cornea and External Eye

It is a subspecialty in Ophthalmology which addresses diseases in the cornea as well as the external part of the eyeball such as the conjunctiva, the eyelashes, the eyelids and the sclera. Common conditions this discipline manages are corneal scars, infections of the conjunctiva, dry eyes and ulcers.

Glaucoma

This subspecialty deals with the effect of different conditions and risk factors which affect the optic nerve, usually through a mechanism of increased intraocular pressure. This discipline seeks to identify people with glaucoma and applies various diagnostic and treatment modalities to control its worsening.

Retina

This subspecialty deals with diseases of the retina, a neurovascular tissue lining the inside of the eyeball. Common diseases addressed by this discipline are retinal detachment, diabetic retinopathy, and age-related macular degeneration.

Pediatric Ophthalmology

This subspecialty deals with ocular diseases common in children. This discipline addresses amblyopia, retinopathy of prematurity, congenital cataracts and congenital glaucoma, among others.

Uveitis

This subspecialty deals with ocular inflammation in the middle coat of the eye, known as the uvea. Various immunological and inflammatory diseases are addressed by this specialization, usually clinically presenting as red eyes. Conditions by the uveitis specialists addresses common and not so common diseases such as TB uveitis, SLE, chorioretinitis, among others.

Low Vision Rehabilitation

This is a discipline wherein patients with low vision are trained skills to improve their quality of life. Patients who have a limited prognosis of visual improvement could still benefit from activities designed by consultants from this field.

Cataract

This specialty of Ophthalmology deals with addressing one of the most common causes of blurring of vision in the adult population—- lens opacity or cataracts. The center routinely does cataract surgeries usually on an out-patient basis using state of the art phacoemulsification machines.

Orbit, Plastic, Lacrimal

This specialty deals with diseases of the orbit, or the bony cavity which houses the eyeball, the lacrimal gland or the organ for producing tears and addresses aesthetic and reconstructive operations on the eyelids for certain indications

Great folks there at Fatima, highly recommended.

Popularity: 3% [?]

Filed Under: Medical Tagged With: , ,

Philippine Living — Medical Tourism Two

September 2, 2009 By Philly 3 Comments

Based on my recent articles regarding my vision woes … actually, now vision hallelujahs, thank you all very much for the well wishers … My eyes are now working GREAT!

I got to the hospital at 0718 this morning, spent about an hour while my eye was dilated, chatting with a lot of doctor and nursing students about the US and why on earth an American would come and live here in the Philippines )the hospital I used, was in the OR being prepped by 0815 and was in the recovery room by 0915, where I was quickly checked out and sent on my way … breakfast in McDonalds at the ‘home SM’ right after 10 am when they opened.  My doc said my eyes excelled at something, on both of them the cataracts were much thicker and took more time to destroy than he had expected .. we Americans excel at having thick cataracts I guess ;-)

I’ll go to the doctor for my first follow-up check tomorrow at 10 am, here in our local hospital.  I probably will be conservative and take a tricycle, but I really don’t think I’d have any trouble driving … I feel I could have drive home from the operation, it went that well.  Believe me, if there are any of you reading this with any cataract issues at all, get the operation, earlier rather than later, your out look on life will surely improve.

On the way home from the mall treated myself to a pair of real, non-prescription sun glasses … I was going to get some Oakley’s … Thermonuclear Protection you know *or thermo-nucloolar if your name is Bush), but they wanted about P8,000 and for all I know they were knockoff Oakley’s anyway, so I settled for an $8 pair of Ray-Ban look alike’s … I smiled all the way home.

The hospital I used is pretty interesting.  It’s a larger teaching hospital and looking over their programs I think I should probably write more.  They seem pretty cost effective, they had a number of students in the top ten of the latest NCLEX board results and they even go out of their way to welcome foreign students.

The Philippines isn’t just a place to get good medical care, cheap, it would be a great place to get say a nursing degree.  Almost all the nursing schools here only offer four year bachelor of science in nursing (BSN) for a lot less money than schools in the States get for a two year RN, and anyone who passes the NCLEX exam is North-American qualified.  I’ll have to learn more about this.  Anyway, the hospital info is:

 

Our Lady if Fatima ValenzuelaOur Lady of Fatima University (OLFU) has three (3) campuses: main campus in Valenzuela, Metro Manila; Quezon City campus and Antipolo campus.

Main Campus in Valenzuela

Highly charged and steaming with activity, the main campus offers 34 undergraduate courses and 5 graduate courses. It schools 12,500 students. The Valenzuela campus has easy access to downtown Manila and metro Quezon City.

Address: 120 McArthur Highway, Valenzuela City, Metro Manila

Telephone No. : +632 291-6644, 293-2703 to 06,291-6538 loc 110

Fax No. : +632 291 6504

Email Address: admissions@fatima.edu.ph Web: www.fatima.edu.ph


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Popularity: 4% [?]

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Living in the Philippines — More Vision Updates

September 1, 2009 By Philly 1 Comment

Don’t worry, I still love ya all (well, I try, anyway), but I will be getting eye number 2 .. the right (dominant) one fixed on the morning of Wednesday, 2 September.  The operation is normally very simple and quick, and I should be ‘seeing’ with that eye immediately, but judging by how the first op went, the eye will have about 20:10 vision for the first few days and then gradually work it’s way down to 20:20, where the left eye is now. 

20:10 you say, isn’t that even better than the norm of 20:20?  Indeed it is, but it is like looking through a telescope, everything is flat and there is no perspective and depth of field cues. 

The real reason posting may be sparse is I need mid and near vision to read the computer screen and type.  The replacement lenses I am getting are single vision … that is optimized for distance (beyond 20 feet) viewing.  If I were 20 or 30, this would be no problem.  Since I am in my 60’s, Presbyopia rears it’s ugly head ..

Presbyopia (Greek word "presbys" (???????), meaning "old man" or "elder", with Latin root "-opia", meaning "eye"[1]) describes the condition where the eye exhibits a progressively diminished ability to focus on near objects with age. Presbyopia’s exact mechanisms are not known with certainty, however, the research evidence most strongly supports a loss of elasticity of the crystalline lens, although changes in the lens’s curvature from continual growth and loss of power of the ciliary muscles (the muscles that bend and straighten the lens) have also been postulated as its cause.

Similar to grey hair and wrinkles, presbyopia is a symptom caused by the natural course of aging; the direct translation of the condition’s name is "elder eye"[1]. The first symptoms (described below) are usually first noticed between the ages of 40-50. The ability to focus on near objects declines throughout life, from an accommodation of about 20 dioptres (ability to focus at 50 mm away) in a child to 10 dioptres at 25 (100 mm) and leveling off at 0.5 to 1 dioptre at age 60 (ability to focus down to 1-2 meters only)…

near sighted eye image About 33% of “accommodation … the ability of the eye to focus in closer than infinity, comes from the lenses.  The rest comes from other eye aspects which are not changed by the cataract surgery/lens replacement. 

So how close I will be able to focus and whether I will be able to read a book or my computer screen without reading glasses is not yet able to be determined.  After weeks, the new lenses will stabilize and then we shall see, literally, what I shall see.  In the meantime. I’ll make do.

To give you a clue, the left lens, formerly 20:525 when last tested, was 20:20 for distance vision last week.  Pretty big improvement, eh?  The doctor selected the lenses parameters so that the left eye should stabilize at slightly nearsighted, giving me reading capability without glasses, but it is to early to tell.

Anyway, I think I mentioned some of this before, just making a note to let everyone know why I likely won’t be posting for a few days … meanwhile my ‘oldies but goodies’ plug-in will crank out some blasts from the past … enjoy. 

Eye surgery in the Philippines?  You bet.  Great medical care, cheap prices, caring nurses and physicians, you just have to count the medical experience here in the Philippines as one of the real plus factors.

Popularity: 2% [?]

Filed Under: Medical

Living in the Philippines with Cataracts

August 26, 2009 By Philly 2 Comments

I’ve gotten a lot of feedback and more than a few well-wishers from my auricle on getting my tired old eye fixed up here in the Philippines, with or without medical insurance.  Thanks to all who have been commenting/mailing.

But I’ve noticed more than a few people haven’t grasped the concept of what was wrong with my eyes and what’s been done to fix them, permanently.

imageI’ve worn glasses for years because my eyes have not had sufficient visual acuity.  That is, at their best focus, things that should have been easy to see were not, lines did not have sharp edges, fine details were indistinct and tiny objects that a person with normal acuity (sharpness or focus) should have been able to see.

But a few years ago I went for a routine eye exam/new glasses prescription and my ophthalmologist told me I was showing signs of cataracts.  Shocked me a little because of my age, but explained a lot about why it was much harder to see at night and why oncoming traffic at night seemed to cause so much extra glare.

Cataract Defined


What is a cataract?

A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.

A cataract can occur in either or both eyes. It cannot spread from one eye to the other.

What is the lens?

The lens is a clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light-sensitive tissue at the back of the eye.

Image of the eyeIn a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals that are sent to the brain.

The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image you see will be blurred.

Are there other types of cataract?

Yes. Although most cataracts are related to aging, there are other types of cataract:

  1. Secondary cataract. Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.
  2. Traumatic cataract. Cataracts can develop after an eye injury, sometimes years later.
  3. Congenital cataract. Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.

Radiation cataract. Cataracts can develop after exposure to some types of radiation. It’s likely (at least to me) that radiation certainly related at least in part in my cataract problem.  I worked for years with high power microwave transmitters, extreme long range radar and my favorite … dozens of very bright radar display consoles we had in Cheyenne Mountain.  These fellows were ‘oldies but goodies’, they worked really well if you could keep them working, but they were old and not easy to fix.  They had come to the Air Force as a ;gift; from the FAA.  After I worked there several years I found out why the FAA got rid of the screens … the air traffic controller’s union had proved the radiation they emitted was above national health standards, and this illegal to expose FAA civil service employees to.  The Air Force, however, didn’t care so much for their active duty and civilian employees ,,, they scarfed these babies up in a heart beat and used them for years.  Thanks General xxxx. “Nothing is too good for my people, see that that is what they get.>

Anyway, moving on, what treatment is available?

Treatment


How is a cataract treated?

The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.

A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and your eye care professional can make this decision together. Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you. In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult. You do not have to rush into surgery.

Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy. If your eye care professional finds a cataract, you may not need cataract surgery for several years. In fact, you might never need cataract surgery. By having your vision tested regularly, you and your eye care professional can discuss if and when you might need treatment.

If you choose surgery, your eye care professional may refer you to a specialist to remove the cataract.

If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually four to eight weeks apart.

Many people who need cataract surgery also have other eye conditions, such as age-related macular degeneration or glaucoma. If you have other eye conditions in addition to cataract, talk with your doctor. Learn about the risks, benefits, alternatives, and expected results of cataract surgery.

What are the different types of cataract surgery?

There are two types of cataract surgery. Your doctor can explain the differences and help determine which is better for you:

  1. Phacoemulsification, or phaco. A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called "small incision cataract surgery."  (this is the one you want!  Recommended)
  2. Extracapsular surgery. Your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The rest of the lens is removed by suction.  (My father-in-law had this procedure last year.  NOT recommended.  Significant pain and a long recovery/adaptation time.)

After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.


Phaco is the procedure I had.  Highly recommended.  The entire procedure on my worst (left) eye was don
e in 30 minutes from the time I laid down on the sort of operating couch until I was in a wheel chair being taken to the changing room to get back in my street clothes.  Most painful part of the entire procedure was getting the ;stick; of the IV needle for the mild sedative the anesthesiologist gave me.  Actual pain in the eye is covered with a local anesthetic that is dripped into the eye. 

This is nor ‘laser’, ‘Lasik’, ‘RK’ or ‘Radial keratotomy’ which are procedures that shape the outside of the lenses to correct acuity problems.  In my case, the net result should be that I don’t need glasses (the left eye was exactly at 20/20 yesterday when I had my checkup and scheduled the second eye (a week from today).  But if the new lenses are not 20/20 after the several weeks it will take the eyes to fully adapt, ‘touch up’ RK could be performed or I might need a pair of ‘reading only’ glasses.  Only about one third of the far/close distance adaptation the eyes need to make come from the lenses, so it’s still possible for a guy my age to suffers from ‘short arms;,  Time will tell, but my point is, Lasik or RK only deals with the outside of the eye’s lenses, my Phaco cataract surgery completely replaces the lenses from the inside … and boy am I loving it.

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Medical Tourism Philippines?

August 23, 2009 By Philly 3 Comments

I’ve been meaning to write more about my recent and still to come eye surgery here in the Philippines, when I came across this article.  I guess, in many ways, I’m just another medical tourist myself.


Insurers aim to save from overseas medical tourism – USATODAY.com

By Tom Murphy, The Associated Press

Elizabeth Kunz left her dentist’s office this spring with a mouth full of problems and no way to pay for them.

The South Carolina resident went out of her way, literally, to find a solution, which turned out to be in Central America. Her trip to the tropics is part of a health insurance experiment for trimming medical costs: overseas care.

As Washington searches for ways to tame the country’s escalating health care costs, more insurers are offering networks of surgeons and dentists in places like India and Costa Rica, where costs can be as much as 80% less than in America.

Until recently, most Americans traveling abroad for cheaper non-emergency medical care were either uninsured or wealthy. But the profile of medical tourists is changing. Now, they are more likely to be people covered by private insurers, which are looking to keep costs from spiraling out of control.

The four largest commercial U.S. health insurers — with enrollments totaling nearly 100 million people — have either launched pilot programs offering overseas travel or explored it. Several smaller insurers and brokers also have introduced travel options for hundreds of employers around the country.

… the article, of course, isn’t specific regarding the Philippines, but still pretty interesting in this time of medical insurance turmoil.

The Philippines has several formal programs in place that attempt to boost medical tourism here in the Philippines.  I think many things are still along way from ready for prime time, but you can easily justify, even make a nice profit on a trip to the Philippines today … and be healthier if you get some treatment along the way.

In my recent article about my eye surgery in the Philippines I noted some of the huge differences in expenses.  One forth, or less what my lens, the hospital bill, my surgical, anesthesiologist, nursing care and follow-up visits would have cost in the US.

If I had been in the US, this operation likely would have been covered or mostly covered by health insurance (since I am one of the lucky ones who has it).  But then again, some of my Philippine expense likely will as well … my TRICARE insurance has a $300 USD annual deductible to meet, this is my first US fiscal year in the Philippines that I have spent that much, so I intend to get the other eye done as well before September 30th and submit the whole package.  If TRICARE pays their maximum reimbursement I’ll only be out  a few hundred dollars total .. either way I am happy.

Imagine someone reading this post (dimly, through cataracts as I have been) who does not have health insurance.  If s/he wants to see clearly again from a US source, it will run at least $8,000 USD, completely out of pocket.  Let’s do the Philippine math.

typical 3 star Philippine hotel Discount roundtrip ticket, about $1300 USD.  Three star boutique hotel very near hospital/doctor’s office, 21 nights, $875 USD.  Initial medical work up, eye biometrics. blood work, x-rays, clearance for surgery … about $50 USD.  Two lens replacements and after care, all in: $1700 USD.  By my calculations that comes up to less that $4000 USD, or about half what it would cost in the US.  Now I didn’t include figures for food, drink, entertainment in there, because if you stayed in the US you still have to eat every day, and you can certainly eat three good meals a day in Quezon City (where I based these figures on) for less than you spend every day in the US, so let’s not descent too far into penny pinching … you could save a lot.

I have a hole in my moth in the rear of my left lower jaw.  I had one molar extracted many years ago and then more recently another molar root canalled, posted and capped.  This was a 100% top quality US dentistry job for about $1200USD out of pocket.  It turns out it was crap work. (US Medical and dental care is number one in only one area, price).  The crown came lose.  The root canal went bad (sepsis .. in spite of all the rental plants and aquariums in the dentists office and the ‘beauty queen’ receptionists who get the appointments wrong, someone didn’t wash their hands.  Just before I moved the crown came lose again.  What a sage.  A year after we moved here to the Philippines the crown came lose yet again and I got mad and went to a local dentist and had the whole mess extracted … P900 Pesos.

But if I wanted to (should have) saved that tooth … or needed another root canal/crown job, here’s just one place I could try (I know this dentist does good work, and note that she published her prices online, no hidden tricks or scams)  for something like PhP 9000  about $186 at today’s rate.  That’s about $1000 USD saved on one tooth, get two or more root canals and caps and your whole trip to the Philippines is paid for )not to mention how much nicer your mouth will be)

As I said at the beginning of this article, some of the major, big-dollar plans for promoting medical tourism here in the Philippines are not yet at the level I would like to see them … but medical tourism to get yourself better care at big savings is readily available to anyone.

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