The Guatemalan Tonsil Chop
While reading the New York Times during my lunch break, I came across a photo article about people who have gone into “medical bankruptcy.” Someone in each family featured had fallen ill and needed treatment, but due to the cost of said treatment and the time they were forced to take off work while recovering, they found themselves unable to pay. For six years now I have been living outside of the United States. I have traveled around the world and lived in three separate foreign nations. In each, I have thought about how my life there compares to what my life might have been in the United States. While there are many things I love, appreciate, and miss about the US (Netflix! Spray butter! Central heating!), it is imperative to note that regarding health care, I have never been subjected to such unfavorable odds of physical and economic survival as I have in my own country.
Putting aside the drastic difference in dental and optic care I’ve experienced in Taiwan (about $50 to fill numerous cavities, get X-rays, and get a teeth cleaning, and about $150 for two pairs of beautiful new glasses and an eye exam), and forgetting about the government-financed prescriptions I received in France (Me pay? Mais, non!), let’s move along to my first real surgical procedure abroad: a tonsillectomy in Guatemala. I can hear you thinking: “Gasp! The horror!”
The background: I’ve had troubled tonsils for as long as I can remember. In fact, I’ve probably had an infection or been on antibiotics in over half of the countries I’ve visited. I can smell Amoxicillin from a mile away. After 28 years of literally hanging in there, my tonsils had finally started to give up the fight. In addition to your run-of-the-mill tonsil infection every few months, I started to get tonsil stones, which as you might know, are one of the most putrefying, disgusting, and socially-debilitating ailments from which one might suffer. The crevices in which said stones hid became deeper and more convoluted. I began to believe that my tonsils were less tonsil and more bacteria honeycombed with what used to be tonsil. The final straw came when, while poking at my dying right tonsil in a vain attempt to force out some of the nasty white bits peppered throughout it, I actually poked through and into the tonsil. Yes, there was a Q-tip sticking straight out of my tonsil, much like a flag of surrender, raised all-to-late, tinged with blood and waving vainly in the breeze. That was at the beginning of November. By the end of November all offending material in my throat was safely gone, never to squirt blood or tonsil pus again.
Some might say that I’ve risked my life in some way by forgoing the “civilized” hospitals of the United States for the highland clinics of Guatemala. Did they take my tonsils out with scissors? Did they give me whiskey as an anesthetic? Am I now permanently disfigured and banished to the attic like the Elephant Man? Do I mysteriously lack a tongue? No. The procedure was every bit as clean and safe as what it would have been in the States. I have all the necessary parts of my mouth and throat, save for two chronically infected tonsils that had long ago given up on me, but which I’d before been too scared to part with. Regrets? Only that I hadn’t done it sooner.
Could I have done this in the States? I suppose so, but think of the costs. Although it was difficult to find any sort of quote on the internet for a tonsillectomy in the US, one source from 2004 indicated that the price would be about $5,000. That’s just the surgery and hospital stay. I’m proud to say that I paid just $1,500 for everything related to the curing and extraction of my tonsils in Guatemala. Imagine if I’d gone to the States where, by the way, I haven’t got medical insurance. How much would I have paid for doctors’ consults, for prescription drugs, for hospital stays? Reading this article, it seems many of these bankrupt families actually had health insurance. Of course, the deductible and monthly payment being so high and the company only paying 80% of the procedure, they ended up paying a huge percentage out of pocket. One family had, I believe, a $4,000 deductible and an $850 monthly payment. That means they have to spend over $14,000 on health care each year to make getting health insurance make sense. And by the way, this is exactly why I don’t have insurance.
Medical tourism is a growing industry around the world. I certainly would have never gotten into it if I wasn’t currently living in Guatemala, but now having officially been added to the group of people who choose to go under a foreign knife, I’ve got to say, I feel pretty cool. It’s kind of like being asked to choose the lesser of two evils: you could suffer for several more years until your tonsils decay out of your head of their own accord, or you could take lots of time off work to go to the States and pay immense amounts of cash to have them taken out. But I thought of an even lesser evil that really wasn’t so bad at all: if I do the deed in Guatemala, the cash loss won’t be so great, and I won’t die of some sort of infection of the blood. Like I said, I’m feeling very clever right now.
Of course, it’s important not to exalt the Guatemalan healthcare system here. Guatemala is no better than the States. Having gone to the swankiest, best-recommended doctor I could find, I ended up paying what in Guatemala is no small chunk of change. In fact, what I paid on health care throughout the month of November was more than what I make in three months in Guatemala. I had to dip deep into the reserves to gather the necessary resources to undertake this little adventure. Imagine that you’re a normal Guatemalan who doesn’t have a stock portfolio (most of whom make less than half of what I make each month). Where on earth are you going to come up with $1,500? You’re not. You’ll go to a cheaper doctor, maybe not such a smart one. Maybe you’ll be the experimental subject for this year’s crop of medical students. Maybe you’ll just have to wait until you tonsils mold over and you accidently swallow them in your sleep. Guatemala theoretically has free emergency health care. If your appendix bursts, they’re not going to send you packing to the next world simply because you can’t pay. But they’re not going to take out your tonsils until they’re so big they’re about to cut off your air supply.
Sound familiar? In our lovely America, if you’ve got something that’s not an emergency (such as a pair of dysfunctional tonsils) you’ve got nowhere to go for help. If you’re in chronic pain and you can’t afford the medicine to make it go away, too bad. If you want to find out if you’re dying but have no money for a doctor’s visit and tests, better start hoping for the best. And yet the US has so much wealth. I mean, really, SO MUCH. I am amazed every time I go back by the things the government does for us: the quality of the roads, the myriad traffic signs and signals, the relative lack of corruption, the straightness of the sidewalks, the mere existence of sidewalks. We demand all these things, from institutional integrity to sidewalks, but we don’t demand the right to live healthy lives? Why is this not a priority?
In Guatemala they’d like to have universal health care. It’s not a matter of “should we,” but a matter of “how could we.” The sad reality of the developing world is not so much a lack of money, but the abundance of ignorance, impunity, and therefore corruption. Money comes in, but only 9 out of 10 former dictators can reliably tell you where it goes. Guatemala is a country with huge problems. But in the US we’ve got so much going for us. Although it might at first seem otherwise, nearly 100% of the population is literate (compared to about 70% of Guatemala). We have the best universities in the world and though they’re really expensive, programs do exist to help you pay for them. Instead of being worried that the US’s children are malnourished, as a whopping 50% of Guatemalan kids are, we actually worry that American kids are too fat. Come on, really? If we’ve got all these fabulous advantages, if we’re the biggest economy in the world and so damn awesome, if we’re smart enough to send people to the moon and make Paris Hilton seem interesting, can’t we find a way to make a simple operation affordable to those who need it? Can’t we even muster the mental strength to understand why universal health care is so necessary? Even if we approach this from a purely utilitarian perspective, we’re better off when everyone can afford decent health care; preventative care leads to catching problems early, ergo less time off work and fewer expensive emergency procedures. Being entirely selfish, just think how nice it would be if the guy next to you on the subway had his tonsils taken out instead of breathing his gross, tonsil-stone-laced, bad breath all over you and giving YOU strep. Do we agree?
Honestly, I’m hardly the person to advocate going to the doctor. I admit – I hate it. But I hate a lot of things and still manage to recognize their necessity. My tonsils (and a few stomach parasites) have forced me to go to the doctor throughout my various journeys around the world, and all along I have been consistently surprised by the quality of the medical care I have received. The United States is the only developed country in the world without some type of universal health care program. It wasn’t until I got to Guatemala that I found a country whose health care system was comparable to ours: you can get great care, but only if you sell your stock portfolio and/or first born child to pay for it.
To see the referenced article, go to http://www.nytimes.com/slideshow/2009/11/25/us/1124BANKRUPTCY_index.html.
Putting aside the drastic difference in dental and optic care I’ve experienced in Taiwan (about $50 to fill numerous cavities, get X-rays, and get a teeth cleaning, and about $150 for two pairs of beautiful new glasses and an eye exam), and forgetting about the government-financed prescriptions I received in France (Me pay? Mais, non!), let’s move along to my first real surgical procedure abroad: a tonsillectomy in Guatemala. I can hear you thinking: “Gasp! The horror!”
The background: I’ve had troubled tonsils for as long as I can remember. In fact, I’ve probably had an infection or been on antibiotics in over half of the countries I’ve visited. I can smell Amoxicillin from a mile away. After 28 years of literally hanging in there, my tonsils had finally started to give up the fight. In addition to your run-of-the-mill tonsil infection every few months, I started to get tonsil stones, which as you might know, are one of the most putrefying, disgusting, and socially-debilitating ailments from which one might suffer. The crevices in which said stones hid became deeper and more convoluted. I began to believe that my tonsils were less tonsil and more bacteria honeycombed with what used to be tonsil. The final straw came when, while poking at my dying right tonsil in a vain attempt to force out some of the nasty white bits peppered throughout it, I actually poked through and into the tonsil. Yes, there was a Q-tip sticking straight out of my tonsil, much like a flag of surrender, raised all-to-late, tinged with blood and waving vainly in the breeze. That was at the beginning of November. By the end of November all offending material in my throat was safely gone, never to squirt blood or tonsil pus again.
Some might say that I’ve risked my life in some way by forgoing the “civilized” hospitals of the United States for the highland clinics of Guatemala. Did they take my tonsils out with scissors? Did they give me whiskey as an anesthetic? Am I now permanently disfigured and banished to the attic like the Elephant Man? Do I mysteriously lack a tongue? No. The procedure was every bit as clean and safe as what it would have been in the States. I have all the necessary parts of my mouth and throat, save for two chronically infected tonsils that had long ago given up on me, but which I’d before been too scared to part with. Regrets? Only that I hadn’t done it sooner.
Could I have done this in the States? I suppose so, but think of the costs. Although it was difficult to find any sort of quote on the internet for a tonsillectomy in the US, one source from 2004 indicated that the price would be about $5,000. That’s just the surgery and hospital stay. I’m proud to say that I paid just $1,500 for everything related to the curing and extraction of my tonsils in Guatemala. Imagine if I’d gone to the States where, by the way, I haven’t got medical insurance. How much would I have paid for doctors’ consults, for prescription drugs, for hospital stays? Reading this article, it seems many of these bankrupt families actually had health insurance. Of course, the deductible and monthly payment being so high and the company only paying 80% of the procedure, they ended up paying a huge percentage out of pocket. One family had, I believe, a $4,000 deductible and an $850 monthly payment. That means they have to spend over $14,000 on health care each year to make getting health insurance make sense. And by the way, this is exactly why I don’t have insurance.
Medical tourism is a growing industry around the world. I certainly would have never gotten into it if I wasn’t currently living in Guatemala, but now having officially been added to the group of people who choose to go under a foreign knife, I’ve got to say, I feel pretty cool. It’s kind of like being asked to choose the lesser of two evils: you could suffer for several more years until your tonsils decay out of your head of their own accord, or you could take lots of time off work to go to the States and pay immense amounts of cash to have them taken out. But I thought of an even lesser evil that really wasn’t so bad at all: if I do the deed in Guatemala, the cash loss won’t be so great, and I won’t die of some sort of infection of the blood. Like I said, I’m feeling very clever right now.
Of course, it’s important not to exalt the Guatemalan healthcare system here. Guatemala is no better than the States. Having gone to the swankiest, best-recommended doctor I could find, I ended up paying what in Guatemala is no small chunk of change. In fact, what I paid on health care throughout the month of November was more than what I make in three months in Guatemala. I had to dip deep into the reserves to gather the necessary resources to undertake this little adventure. Imagine that you’re a normal Guatemalan who doesn’t have a stock portfolio (most of whom make less than half of what I make each month). Where on earth are you going to come up with $1,500? You’re not. You’ll go to a cheaper doctor, maybe not such a smart one. Maybe you’ll be the experimental subject for this year’s crop of medical students. Maybe you’ll just have to wait until you tonsils mold over and you accidently swallow them in your sleep. Guatemala theoretically has free emergency health care. If your appendix bursts, they’re not going to send you packing to the next world simply because you can’t pay. But they’re not going to take out your tonsils until they’re so big they’re about to cut off your air supply.
Sound familiar? In our lovely America, if you’ve got something that’s not an emergency (such as a pair of dysfunctional tonsils) you’ve got nowhere to go for help. If you’re in chronic pain and you can’t afford the medicine to make it go away, too bad. If you want to find out if you’re dying but have no money for a doctor’s visit and tests, better start hoping for the best. And yet the US has so much wealth. I mean, really, SO MUCH. I am amazed every time I go back by the things the government does for us: the quality of the roads, the myriad traffic signs and signals, the relative lack of corruption, the straightness of the sidewalks, the mere existence of sidewalks. We demand all these things, from institutional integrity to sidewalks, but we don’t demand the right to live healthy lives? Why is this not a priority?
In Guatemala they’d like to have universal health care. It’s not a matter of “should we,” but a matter of “how could we.” The sad reality of the developing world is not so much a lack of money, but the abundance of ignorance, impunity, and therefore corruption. Money comes in, but only 9 out of 10 former dictators can reliably tell you where it goes. Guatemala is a country with huge problems. But in the US we’ve got so much going for us. Although it might at first seem otherwise, nearly 100% of the population is literate (compared to about 70% of Guatemala). We have the best universities in the world and though they’re really expensive, programs do exist to help you pay for them. Instead of being worried that the US’s children are malnourished, as a whopping 50% of Guatemalan kids are, we actually worry that American kids are too fat. Come on, really? If we’ve got all these fabulous advantages, if we’re the biggest economy in the world and so damn awesome, if we’re smart enough to send people to the moon and make Paris Hilton seem interesting, can’t we find a way to make a simple operation affordable to those who need it? Can’t we even muster the mental strength to understand why universal health care is so necessary? Even if we approach this from a purely utilitarian perspective, we’re better off when everyone can afford decent health care; preventative care leads to catching problems early, ergo less time off work and fewer expensive emergency procedures. Being entirely selfish, just think how nice it would be if the guy next to you on the subway had his tonsils taken out instead of breathing his gross, tonsil-stone-laced, bad breath all over you and giving YOU strep. Do we agree?
Honestly, I’m hardly the person to advocate going to the doctor. I admit – I hate it. But I hate a lot of things and still manage to recognize their necessity. My tonsils (and a few stomach parasites) have forced me to go to the doctor throughout my various journeys around the world, and all along I have been consistently surprised by the quality of the medical care I have received. The United States is the only developed country in the world without some type of universal health care program. It wasn’t until I got to Guatemala that I found a country whose health care system was comparable to ours: you can get great care, but only if you sell your stock portfolio and/or first born child to pay for it.
To see the referenced article, go to http://www.nytimes.com/slideshow/2009/11/25/us/1124BANKRUPTCY_index.html.
Labels: guatemala, health care, tonsils
posted by bethany at 18:15
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