Episode Summary
In this episode of The Expat Files, Johnny Mueller explores the world of pharmacies, medications, and healthcare in Latin America. He begins by introducing the show and discussing the variety of pharmacies in the region, including both traditional mom and pop stores and modern chain pharmacies that resemble those in the United States. He highlights the differences between these types of pharmacies, such as pricing, variety, and the availability of traditional herbal remedies. Johnny also touches on the cultural significance of these remedies, especially in countries with indigenous heritage, and shares a personal anecdote about trying a local remedy called Cascaval, which is made from powdered rattlesnake rattle. He concludes by mentioning the availability of first-world proprietary drugs in Latin American pharmacies, though he expresses skepticism about their effectiveness.
Johnny then discusses the affordability and availability of generic drugs in Latin American pharmacies, particularly highlighting the contrast with the United States. He notes that expats rarely complain about the cost of medicine due to the availability of cheap generic drugs and the lack of prescription insurance coverage in the region. He also compares the health habits of expats and locals, suggesting that expats tend to be more health-conscious and less reliant on prescription medications. Johnny provides examples of drug prices, such as propranolol and Tylenol, to illustrate the significant cost differences between the U.S. and Latin America.
In the next segment, Johnny delves into the reasons behind the lower cost of generic drugs in Latin America compared to the United States. He explains that these drugs are manufactured locally, avoiding tariffs, taxes, import fees, and shipping costs. He also addresses the common perception that generic drugs are inferior to brand-name drugs, suggesting that the placebo effect and packaging differences may contribute to this belief. Johnny reassures expats that the manufacturing process for generic drugs in Latin America is rigorous and meets first-world standards, with additional inspections by first-world companies. He also highlights the ease of accessing generic drugs in Latin America, noting that expats often don't need a prescription for most medications.
In this segment, Johnny discusses the accessibility of prescription drugs, including narcotics and painkillers, in Latin America. He highlights that these drugs are available without a prescription and at a much lower cost compared to the United States. He questions why there isn't widespread addiction among locals and expats, despite the easy access. He attributes this to economic factors, such as the relatively low income of locals compared to expats, and the differing priorities and lifestyles of expats, who often have specific goals like learning Spanish or starting a business. He also touches on the availability of substances like marijuana and cocaine, noting that while they are cheap and accessible, they are not commonly used by expats or locals beyond certain age groups or contexts.
Johnny then discusses the role of pharmacy workers in Latin American countries, highlighting the lack of trained pharmacists and the significant role these workers play in the medical system. He explains that while most behind-the-counter staff are not pharmacists, they often have extensive knowledge of common ailments and can provide effective solutions. He also touches on the similarities in drug names across languages and the benefits of paying cash for discounts.
Finally, Johnny explores the cost differences between paying with a credit card and cash when purchasing medications in Latin America. He highlights that pharmacies often offer significant discounts when customers pay cash, ranging from 15% to 40%. He also mentions that some pharmacies have specific days or times when they offer even bigger discounts. Johnny notes that while Viagra and related medications are available without a prescription, he learned this from a friend of a friend. He then shifts focus to expats, explaining that many pharmacies in Latin America offer free medical consultations with certified doctors, a practice uncommon in the first world. Johnny contrasts the healthcare systems in Latin America and the first world, noting that in Latin America, people are less likely to seek medical attention for minor issues due to limited private medical coverage. He recommends expats consider private medical coverage, which he finds affordable, and mentions that doctors in Latin America often work on Wednesdays and make house calls, unlike their first-world counterparts.
Topics
Living in Latin America, Pharmacies in Latin America, Traditional vs. modern pharmacies, Herbal and indigenous remedies, Expatriate experiences, Cultural heritage and medicine, Affordability of generic drugs in Latin America, Comparison of healthcare systems between the U.S. and Latin America, Health habits of expats and locals, Insurance coverage for prescription medications, Generic drugs in Latin America, Cost differences between generic and brand-name drugs
Chapters
00:00:00 Opening 00:00:44 The Importance of Pharmacies in Latin America 00:02:02 Traditional Remedies and Cultural Heritage 00:03:37 Personal Experiences with Local Remedies 00:04:46 Availability of Drugs in Latin American Pharmacies 00:05:06 Contrast Between U.S. and Latin American Healthcare Systems 00:06:15 Why Expats Don't Complain About Drug Costs 00:09:43 Why Generic Drugs Are Cheaper in Latin America 00:10:53 The Psychological Effects of Generic Drug Packaging 00:12:40 Quality Control and Standards for Generic Drugs 00:14:28 Pharmacist Filled It 00:14:30 Access to Prescription Drugs 00:14:33 Availability of Medications 00:14:39 Confirming Drug Availability 00:14:41 Addictive Substances 00:14:48 Street Drug Availability 00:14:54 Drug Availability Confirmation 00:14:56 Generic and Brand Name Availability 00:19:55 Johnny's Personal Perspective on the Situation 00:20:01 Returning to the Topic of Latin American Pharmacies 00:20:04 The Role of Pharmacy Workers in Latin America 00:24:33 Cash Discounts at Pharmacies in Latin America 00:25:04 Medical Exams and Consultations at Pharmacies 00:26:35 Healthcare System Differences and Private Coverage for Expats
Transcript
Automatically transcribed from the original recording; names and wording may contain errors.
[00:01] South of the border, down Mexico way That's where I fell in love When the stars above came out to play Hi everybody, I'm Johnny Mueller And you're listening to the Exped Files Living in Latin America The one of a kind show that tells you what it's like To live, work, play and or retire in Latin America So let's get started Here was a picture in Old Spanish Lays In keeping with one of our opening themes Of what it really costs to live down here Considering all the day to day items you might have to purchase I think it's about time that we take a trip to the pharmacy
[00:47] Now, first of all, Latin America is just loaded with mom and pop pharmacies Practically every street corner has at least one And in Spanish, they're known as farmacias And just in the last few years Great mega chains of pharmacies have appeared down here Patterning themselves after the big mega chains up in the United States like Walgreens Although, surprisingly, I haven't seen any first world franchise pharmacy chains Appear down here yet like Walgreens Though I bet in a few years they do land Considering all the first world franchises that have come down So anyway, if you do go into one of these big chain store franchise pharmacies You're going to find that if it wasn't for the fact that everything's in Spanish They are pretty much exact clones of Walgreens And how these big mega pharmacies differ from those mom and pop stores
[01:36] Is that the big ones can offer a little better price discount And they advertise and market themselves like crazy In a way those mom and pop stores could never afford to do And of course, the big chain stores have a lot more variety And sell a lot of ancillary stuff Like hardware items, stationery, foodstuffs, and cosmetics Again, just like the big pharmacy chains up in the first world And another big difference is that most of the mom and pop stores Sell herbal and local remedies that you'll never find in those big chain stores In fact, sometimes you'll see whole walls of glass jars Filled with odd looking plants and roots and powders And the type and variety of that strange stuff All depends on where you are in Latin America And the types and tribes of indigenous people that originally lived in the area
[02:23] Because you have to remember that down here Up to 50% of the population might have indigenous blood That means their original cultural heritage could be Inca, Aztec, Mayan, Toltec, or whatever And for example, if you consider a country like Guatemala That has a Mayan heritage Did you know that the tribes of the indigenous people that live there now Speak more than 20 different independent languages With each one of these tribal groups having their own kinds of herbal and medicinal remedies And a lot of those traditional age old medicines and cures Are still being mixed up in mom and pop drug stores And don't ask me if they actually work or not But a lot of people swear by them And they're always in demand So you have to assume that they do work much of the time But who knows just how much of it's due to the placebo effect
[03:09] And I'll tell you another thing As far as expats are concerned Almost all of us stick to the first world remedies that we're used to Because remember that old saying Better the devil you know than the one you don't Because after all is said and done Expats I know, no matter how long they've been down here Are just a little gun shy About mixing up a lot of colored powders and roots Downing them and hoping for the best And I have to admit since I'm adventurous I have tried a few And as a rule they're not for the faint of heart Although whatever the locals take in the way of natural remedies like that They're always cheaper than the pills and the capsules and the liquids In other words the more conventional treatments And by the way talk about being adventurous Once during a bad allergy spell I actually got talked into trying this remedy called Cascaval
[03:56] Which believe it or not is the powdered rattle of a rattlesnake And you know the only reason why I tried it Was to tell people that I tried it Now down here you'll find all your proprietary drugs You know all the expensive ones that you see advertised on TV That you're supposed to ask your doctor about if you have certain symptoms You know for those ever changing states of human nature That they just had to go invent a pill for Well they have all that stuff down here too And it's about the same price as you'd pay at a pharmacy in the United States So don't worry If you've seen your favorite drug of the month advertised on TV up north You can get it down here too Even though, paraphrasing Gary Nell As a rule that stuff's all crap So if you're not on a budget down here
[04:41] And you want to buy first world proprietary name brand medicines Go ahead and do it Latin American pharmacies, especially the big chains, have them all But the thing that long time expats really like about the pharmacies down here Is that they've got so many generic drugs That are so ridiculously cheap That I've never heard a single complaint From any foreigner living down here about the cost of medicine And that's exactly the opposite of what you hear from people in the United States Who are forever whining about their own medicines and medical payment plans And in fact most of the whining I hear from people up north Are from people who are on a drug plan Who actually get a pretty substantial discount on the cost of their medicine But I don't have to tell you that now, do I? And speaking of insurance policies
[05:27] I've yet to meet a person down here Who actually has a plan that does cover prescription medicines And though I've heard plans like that do exist There's so few and far between That I have to guess that less than 1% of the Latin population Has ever even heard of a plan like that Much less is enrolled in one And as far as expats, like gringos and Europeans I understand if you work for one of the embassies Or if you're in middle or upper management In one of the first world multinationals down here Like Walmart or Sears or Office Depot, Nestle's or Microsoft Then you do automatically get a kind of a first world prescription plan Along with nice first world style HMO coverage Which includes a vision plan and dental and all that But we'll leave that for a later show When I talk about medicine, surgery and hospitals down here
[06:15] So why don't I ever hear expats complaining about the cost of drugs down here? I think one big reason is that expats mostly being worldly, educated and adventurous types Well I can attest to the fact that most of them I know Are in better than average shape And a lot of them even exercise once in a while And so far anyway, no expat that I know Has a bathroom cabinet full of pills That is to say, not anything like you'd find in the average house in the United States Cause you see, I'm a kind of a secret snoop If you invite me into your house, eventually I'll end up in your bathroom And the first thing I'll do is I'll look in your medicine cabinet To see how your colon's doing And to see how neurotic you are So if you invite me to one of your parties, watch out But seriously, you can learn an awful lot about a person and his family
[07:03] By just taking one quick look in the bathroom medicine cabinet I wonder why they don't put locks on those things And I just read a sad thing about first world people That the average 50 year old is on five different prescription medications Which sounds pretty pathetic compared to the average 50 year old Latin And I've asked around and done some unofficial polls on this myself And of course, I've peeked into a lot of medicine cabinets down here too And you know what, it's hard to find a 50 year old Latin guy or gal Who's on a single prescription medicine at all And I've done a good deal of quizzing on this And I've asked that same question to a couple of dozen 50ish expats down here too I'm talking about first world guys and gals that have been down here a long time Because it wouldn't be fair to ask that question to a new expat that just landed
[07:51] Anyway, most of them are on no more than one prescription medicine Which is a far cry from their couch potato counterparts up in the first world, that's for sure And believe it or not, most of the expats I've found that were taking prescription medicines Were either embassy workers or worked for transnationals down here Which means these guys did have a drug plan, surprise surprise So what about the actual price of the drugs down here? Well, let's take for example the drug propranolol Which was one of the very first beta blockers used for high blood pressure Now it's been a generic drug in the first world for a long time And it's also of course a generic down here In other words, it's no longer protected by patent So you're not paying those outrageous proprietary drug costs Like you do in the first five to seven years when a drug first comes out
[08:39] So up in the first world, you can get 40 milligram tablets of propranolol That is, if you're good at shopping around You'll find that the best price you can get is between 10 and 15 cents each But down here you can get that generic 40 milligram propranolol tablet For about 5 cents, which is a third to a half of what you could buy it for in the States And that's pretty much true of all the drugs down here If you buy the brand name drug, you're going to pay about what you pay in the United States And if you buy the generic equivalent, you're going to pay half or less than half Of what you'd pay for that equivalent up in the first world And I'm talking about the generic equivalent Which is already marked down as much as 75% below the proprietary brand name Take for example the brand name Tylenol, which is acetaminophen
[09:25] Now if you buy the generic equivalent, acetaminophen It's going to be about 75% cheaper in the United States But of course, you knew that So why do you think that is? Why do you think even the generic drugs down here Are so much cheaper than the generics up in the United States? Well, I'll tell you That's because the generic brands that you buy down here Are all made down here in Latin America So there's no tariffs or taxes or import fees or shipping costs Or currency fluctuations involved And that fact can be a sticky problem for expats when they first find that out Now up in the first world, you often hear the charge That generic drugs are second rate And they're just not as good as the brand name drug Well, I'm not going to spend a lot of time arguing that point
[10:10] And I only suggest that you try the generic drug and see if it works for you What could be simpler than that? And honestly, I've read some reports too That state that the advantage the brand name drug might have over a generic Is simply due to the placebo effect itself In other words, you believe the brand name drug is better Because they came up with it first And they did the research and got all the patents on it And we shouldn't forget that there's another psychological effect in play here too It's that the generics usually come so simply and basically packaged That they look a bit crude But when you think about it, that's just another way to keep the price down Especially when you find out that with the name brand drugs Often the packaging costs more than the medicine itself In other words, the name brand has a multi-million dollar advertising and marketing campaign
[10:59] And the generics don't, of course So bottom line is, most expats down here are pretty healthy and don't take many drugs And when they do get sick, they go right for the generics And for you expats out there who are taking a medicine for a fairly rare condition Not to worry, because they have practically everything you might need down here And by the off chance that you're taking something extremely special and they just don't stock it Remember, like I told you in so many past shows You can order everything and anything off the internet down here But just one last thing about generics Now, I've been harping in a lot of past shows about the way Latins do things in general I mean, how they cut corners and use inferior materials And how they take bribes and don't deliver things on time
[11:45] All the little details that they miss that allow even the most average first world expat To excel in business down here Because it really doesn't take a first world brainiac to improve on the status quo So, what about generic drugs? If they're made down here, and they are, won't the local manufacturers be cutting the same corners And missing the same details when they make that product And that's what goes through most expats' minds the first time they buy a generic drug And they read on the package that it's made in Peru or Mexico or Brazil And that's when those doubts creep in Well, believe it or not, I've actually been in some of these manufacturing places myself So, let me ease your mind a little bit Let me reassure you that everybody's wearing hair nets, masks, gloves, and little booties
[12:34] Just like in the first world And these places really are clean But I can ease your mind even more by telling you that Almost all of the generic drugs consumed in the first world are manufactured down here That's one way they can produce such an inexpensive product Because labor and materials are so cheap here So, to ease your mind, just remember All those generic drugs that are made down here Have to go through a strict process of verification of dosage, sanitation, and purity Before they can be sold on the first world market And not only do all these plants have their own in-house Latin American inspectors Which, I admit, isn't saying much But here's the key thing The first world company that imports the products also has an inspector on staff, too And he's the guy, not the Latins, that makes sure the products meet first world standards
[13:23] And that little oversight makes all the difference in the world Thank God for that, huh? And if that's not convincing enough, well, you can always buy the brand name Now, here's a point that absolutely shocks expats when they first come down here I know it did me It happens the first time you go into a pharmacy and you realize you don't need a prescription Not for anything Not in the mom and pop drug stores anyway Though I know that some of the big chain pharmacies, they'll ask you for a prescription On some of the more dangerous substances But they're not in any way strict about that either Because if you bring in an empty bottle Or you give them the phone number Or even just the email of your doctor back in the States or Europe Well, I've never seen it fail yet
[14:09] And think of this for a minute What good does your first world doctor's name, address or email even do When the staff at the pharmacy doesn't even speak English In fact, one expat told me he saw an indigenous lady Walk into a pharmacy and hand the guy a prescription written on a greasy brown lunch bag And of course, the pharmacist filled it So am I saying you can get just about anything without a prescription down here Including antibiotics, antipsychotics and heart medication and heavy duty painkillers I'm telling you, yes you can Okay, then what about the addictive stuff like morphine and codeine, oxycodone and Vicodin You know, all those painkiller drugs people paid big money for on street corners up in the States Oh yeah, I'm telling you, you can get that stuff too
[14:56] In brand name or generic So if that's true, the next question you have to ask is Why aren't all the locals, and for that matter, expats Why aren't they all zoned out and addicted to that stuff I mean, that's the logic politicians always use with marijuana up in the United States They say if you legalize it, the streets would be filled with drugged out people with zero ambition, right? Well, I'm here to tell you that that legalization experiment has been going on for more than a century down here I mean, Latin America has a half a billion people And any time they want, they can walk into a drugstore and buy a scheduled drug For example, let's take Tylenol-3, which is acetaminophen and codeine Strictly a pain pill, addictive of course, that physicians and dentists prescribe in the States and Europe
[15:44] When somebody has moderate to severe pain Well, up there it's tightly controlled because it's become a pretty popular street drug Well, up in the United States, if you buy the generic Tylenol-3 You're going to pay about $1.50 to $2 for each tablet And of course, that's by prescription only Now down here, you're going to pay for the same thing, about $0.25 for a tablet So even when you compare the generic prices down here It appears like you could become a raving codeine addict at a huge discount But you know what? I've been looking and asking around And the truth of it is, I can't find anybody who's hooked on anything like that And I'm talking about both the locals and the expats You just don't find that kind of controlled substance abuse down here
[16:29] And don't forget, when I say controlled substances These products are only controlled substances up in the first world, not down here Now for me and other expats, it's easy to see why the locals don't go overboard and get addicted to this stuff Though for us, it might be dirt cheap to buy codeine for 25 cents a tablet For the locals, that's big money Think of it this way, if you bought a bottle of 100, it would cost you $25, right? No big deal for an expat Even an expat who's getting by on a crummy social security check is making at least $1,000 a month, right? Well, like I've said so many times before, the average latin makes about $200 to $400 a month Which means an expat making $1,000 a month while he's living large While the average latin guy, he's always cutting corners and shaving pennies
[17:16] In fact, the average latin guy is living from paycheck to paycheck and has nothing in the bank Hmm, I should talk, that's about how half the people in the first world are living right now, aren't they? Anyway, so if that's the explanation why latins don't get hooked on controlled substances, which aren't controlled at all down here What about expats then? I mean, the average expat has 4 to 10 times the disposable income of the average latin guy So why aren't expats hooked on these drugs? Why aren't all of us walking around like zombies? I don't know, you tell me, maybe it's because the expats I know don't sit on the sofa all day eating junk food watching ESPN and Jersey Shore Maybe it's because all the expats I know are down here on their own specific kind of a mission
[18:04] Like to learn Spanish, start a business, retire, find the love of their life, whatever I might be wrong, but I'm guessing the average expat's life plan doesn't include getting addicted to cheap and available narcotic substances And you know, you can carry that idea further to substances like marijuana and cocaine I mean, down here is where they produce the best and most powerful stuff Here's where you can get both marijuana and cocaine for a tenth of the price you could buy it in the States And it's pure and it's powerful That said, you rarely find expats indulging in this stuff Though you might see it pop up at the occasional party or at a beachfront vacation bash It's not like it's on anyone's top ten list of things to do Not like it was when we were back in college anyway
[18:51] And as far as the locals, you do see some marijuana use here and there But that's mostly with teenagers, high school and the college crowd You know, the age when you're curious and you want to experiment Of course, I'm not talking about the street gang members and the narcos Their lives revolve around drugs and everybody knows that And those kind of dirt bags exist everywhere, down here and in the first world So, I'm asking you again, why isn't a huge percentage of the population hooked on marijuana and cocaine Including the expats I mean, not only is it much cheaper than booze, but there's practically no law enforcement Now, I think this would be a great subject for a master's thesis Because up north, with all those arguments about legalization Everybody seems to forget the experiment has been going on since the conquistadors came down here
[19:39] 500 years ago and saw how the indigenous people got high on pot, mushrooms, ayahuasca And made a certain kind of tea out of coca leaves And the results are in folks When it's legalized, society does not go out of control and dive off the deep end And if it did, I'd be looking at it square in the face every day and it's just not happening Let's get back to what happens when we visit a Latin American pharmacy Now, the people that wait on you behind the counter in Latin American pharmacies Might look all bright and polished and professional in their uniforms But the vast majority of them are not trained pharmacists And I've done some checking myself Seems that for about every 20 people that stand behind that counter and sell you things Only about one is a registered pharmacist
[20:25] Whereas in the first world, you have to have a registered pharmacist on the premises To even open your doors for business It's not like that at all in the third world Though I know they have that same law down here too But of course, nobody enforces it Now, that said, the strange thing is the people behind the counter here have a lot of power Because remember, everything's for sale here and you don't need a prescription So if a mother comes in with her young child And let's say the child is complaining of headaches, vomiting, and cramping Well, that mother's looking for answers right away And that person standing there working in the Latin pharmacy Is the first contact and first line of defense Because just like in the first world, nobody likes to go to the doctor They'd rather ask the pharmacist for his or her so-called expert advice
[21:14] Before ever making an appointment to see a doctor Which in both cases is going to cost some real money Even though down here in Latin America, you'll be shocked to find That even if you go to a medical specialist Most of them charge about $20 or less for that visit Which is chicken feed for an expat But for a local, it could be two days work And that's why the average Latin down here Will always hit on the pharmacy workers first For a diagnosis and a cure So that's why down here, those people working behind the counter at a pharmacy Play a huge role in the medical system And surprisingly enough, most of them know what they're talking about I mean, for basic infections and aches and pains Insect bites and allergies, you name it These guys will have a pretty good idea of how to solve your problem
[22:00] And they'll even give you quite a few options Now, I know at this moment your first world mind is having a lot of doubts You're thinking, how could these guys who are not even pharmacists Diagnose and treat these people without doing at least some damage along the way Well, the thing is, you see, about 90% of all the medical problems That walk into a given pharmacy They fall into about 5 or 10 easily diagnosed categories I mean, suppose you have a urinary infection And you shout out your problem to the pharmacy clerk Well, it's kind of like looking it up on the internet That guy has seen so much of the same thing He's going to have 5 or 6 solutions for you right on hand And suppose somebody walks in with conjunctivitis Your common red eye Now, that's so very common down here in the tropics Because people don't wash their hands much
[22:46] They tend to sweat a lot and they like to touch their eyes Well, the guy or girl at the pharmacy knows 3 or 4 good treatments for that too So, you get the idea that at any given pharmacy Where they have 4 or 5 people behind the counter When those 3 or 4 guys put their heads together They can come up with a couple of pretty good options for whatever ails you Oh, and while I'm at it, if you have a particular drug That you have to get at a pharmacy down here Most of the drug names sound very much the same Whether they're in English or in Spanish Because they come from a common scientific Latin root For example, acetaminophen, which is Tylenol Is called acetaminophen in Spanish And just plain Tylenol is called Tylenol And as for aspirin, it's called aspirina
[23:32] Not so tough, huh? You get the idea So, whether you know Spanish well or not You really won't have too much trouble figuring out your medicines down here But sometimes they'll have their own brand name in Spanish Which might not have anything to do with the chemical ingredients So, you'll have to look at the box or the package To see what the chemical name is And then you should be able to figure it out Switching from English back to Spanish And for example, if you pick up a list of the drugs in a Latin pharmacy Let's say, for example, the specials of the month that are on discount You can just plug into Google the pharmaceutical names you don't know And the English equivalent will generally come right up for you After not more than 1 or 2 tries Oh, and another thing, down here They'll always give you a huge discount if you pay cash Because, like I said in the past show
[24:18] Processing checks down here can be a nightmare for the seller Since such a high percentage of them bounce And if you pay with a credit card You can be sure they'll slap at least a 5% surcharge on the purchase price But if you pay cash, every pharmacy down here Will give you anywhere from 15% to 40% off And believe me, that's such a terrific deal You should always walk in with cash And, like in the States A lot of the pharmacies will have a specific day Or time of day where they offer even bigger discounts And while I'm at it, before you start sending me emails about this Yes, they do have Viagra and all its related cousins And don't worry, you don't need a prescription And how do I know that? A friend of a friend, of course Enough said about that
[25:04] Now, here's something that could be of special interest to expats And I don't know why they don't do this in the first world Because it's a really great idea On second thought, I do know why they don't do it up there And I think you'll figure it out too Anyway, at least two times a month Nearly every pharmacy will have a little medical examination station set up And there'll be a real board certified doctor there At least for some posted hours And he's there to give free exams and consultations to anybody who comes by Now, isn't that a great promotion? I've never personally used that service myself But imagine how that would go over in the first world And I know up north, in pharmacies like Walgreens Once in a while, they'll advertise that a nurse will be there
[25:50] To take your blood pressure and check your blood sugar and things like that Now, somehow I can't see it working up north for doctors Nurses maybe, but not doctors I can't imagine my old first world doctor giving up his golf game to do free exams on people That would be heresy But it happens all the time down here And I don't know what kind of deal these doctors have with these pharmacies From what I've learned, they're not getting paid It's part public service and part to build their practices, I suppose Because down here, it's pretty easy to get into a doctor You don't have to wait days and days And when you get to the office, wait hours and hours Because the fact is, people down here do not run to the doctor for every little ache and pain It's not at all like what you see in the first world And a lot of that has to do with the fact that at least 80-90% of the people do not have private medical coverage
[26:41] And though insurance companies and private hospitals do offer those plans It's just way too expensive for the average guy But for expats, private coverage is ridiculously cheap And I always recommend that you buy it, right away But I'll go into that in depth in a future show But let me just tantalize you with this little bit Personally, I pay $1,000 a year in a first world style hospital plan That pays 80% of all my costs And if I ever have an emergency room visit, it's free And you heard me right, I pay $1,000 a year for that Not $1,000 a month And there's another very interesting thing about doctors down here Guess what? They don't golf And that means they actually work on Wednesdays
[27:27] Hallelujah And even more amazing They make house calls You've been listening to The Expat Files, living in Latin America And don't forget you can email me on anything at all about Latin America The Expat Files at gmail.com That's theexpatfiles at gmail.com See you next time Nos vemos