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Panamanian health system evidences excess of untrained personnel


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Panamanian health system evidences excess of untrained personnel

Tue, 08/28/2018 - 11:08

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An analysis of the current situation of the Social Security Fund (CSS) in Panama revealed that there is an excess of unskilled labor and political appointments that lack the required profile, according to speakers presented at a meeting held in the Central American country.

In the Forum "For a Preventive, Universal and Quality Health System," the former president of the Chamber of Commerce, Industries and Agriculture of Panama (CCIAP), César Tribaldos, said the current situation in that entity maintains certain shortcomings that thwart its functioning and diminishes the care of its insured.

He said that, in addition, due to the lack of training programs, the system does not have preventive health plans; instead, bad attention predominates, there is a large number of non-friendly staff that causes dissatisfaction in users, and the long lines continue as they wait to obtain medicines that are not available, among others.

Tribaldos pointed out that only in personnel expenses of its payroll, the CSS increased 22 percent, that is, about 95 million dollars between 2015 and 2016.

"The health system provided in the CSS is not efficient, it does not provide a solution, the crisis was aggravated due to the shortages of supplies, equipment and medicines, (...) in the case of shortages there is the possibility of declaring a national emergency to solve this as soon as possible, because it is unsustainable," he said.

He stated health is a state issue that each government must contribute to maintain the objective: "a quality health system", and these should be refocused on the individual for the prevention of the disease, given that the CSS has resources, staff and enough money, and the current service it provides is not justified.

He also said separating the health model from the economic benefits model is feasible, since it has proven positive in other countries, as long as cronyism is eliminated and autonomy is strengthened.

Meanwhile, the president of CCIAP, Gabriel Barletta, said that health, as well as education, is one of the major concerns of our society, both for its impact on the life of the population and on the model of the country's future development.

"Both fundamental rights require structural reengineering, and in the case of health, it shows a situation aggravated by the crisis of a sustained nature in the Social Security Fund," added the union leader.

The activity that was focused on the project "Agenda País 2019-2024" was carried out in partnership with the United Nations Development Program (UNDP) and other business associations.

The meeting was attended by representatives of the Pan American Health Organization (PAHO), the World Health Organization (WHO), civil society, politicians, businesspeople, among other sectors.

 

https://www.panamatoday.com/panama/panamanian-health-system-evidences-excess-untrained-personnel-7689

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Bonnie, I think your doom and gloom comment is a bit of a stretch.  I know of an older person who has spent a considerable time in Regional hospital and reports that the care she received there was excellent.  That included operations and chemo treatment.  The previous warden for David was extremely negative towards the public system and he decamped, in part, for the U.S. after his insurance premiums went to over $1000 a month.  Not too many people can afford that, especially those on a fixed income.  Maybe people should look at a mid range alternative - private care for routine matters but with the option for a referral to the public system in case of an emergency.

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39 minutes ago, JohnF13 said:

Bonnie, I think your doom and gloom comment is a bit of a stretch.  I know of an older person who has spent a considerable time in Regional hospital and reports that the care she received there was excellent.  That included operations and chemo treatment.  The previous warden for David was extremely negative towards the public system and he decamped, in part, for the U.S. after his insurance premiums went to over $1000 a month.  Not too many people can afford that, especially those on a fixed income.  Maybe people should look at a mid range alternative - private care for routine matters but with the option for a referral to the public system in case of an emergency.

What mid-range alternatives are you talking about, John. I'm not familiar with them. Most comprehensive plans, those good for major illnesses and accidents, are essentially mid-range plans because of their high deductibles.

 

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I believe I explained it in my post.  Private for regular stuff like annuals, colds, coughs etc and only use the public system if you have a serious problem.  Even though I have a private plan, the huge annual premium increases mean that in a couple of years I may have to choose between health insurance and eating.  With my particular deductible, I would need to incur about $17,000 in costs before I can make a claim.  That's every year.  Makes me wonder if I had saved the annual premiums, how much ahead financially I would be.  

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So you're talking about no health insurance at all. Even those of us with expensive coverage pay for regular stuff up to a deductible, which is usually at least $5000. The choice is what happens beyond that: how to pay for catastrophic illness or injury. Virtually anyone can afford the day-to-day stuff, but medical catastrophes can be financially ruinous without insurance.

The idea of saving what you would pay in premiums for future costly treatment is a good one IF, and only if, you have the financial wherewithal to pay for costly care initially, i.e., should you encounter a costly health crisis before you've saved enough to pay for it. I've never used my health insurance, have paid hefty premiums which grow heftier by the year, and now wish I had chosen that option. Unfortunately, I was in no position to know when an unanticipated crisis might arise. That's the nature of unanticipated crises. And I've had enough experience with the public system via helping others that I know I don't want to be there if I should suffer a debilitating accident or illness. (A friend who spent time in a public hospital described the experience as a cross between "One Flew Over the Cuckoo's Nest" and "Midnight Express.") But, then, when it comes to matters of health, I am very risk averse. Others are braver (or more foolhardy).

Edited by Bonnie
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4 hours ago, Bonnie said:

So you're talking about no health insurance at all. Even those of us with expensive coverage pay for regular stuff up to a deductible, which is usually at least $5000. The choice is what happens beyond that: how to pay for catastrophic illness or injury. Virtually anyone can afford the day-to-day stuff, but medical catastrophes can be financially ruinous without insurance.

 The idea of saving what you would pay in premiums for future costly treatment is a good one IF, and only if, you have the financial wherewithal to pay for costly care initially, i.e., should you encounter a costly health crisis before you've saved enough to pay for it. I've never used my health insurance, have paid hefty premiums which grow heftier by the year, and now wish I had chosen that option. Unfortunately, I was in no position to know when an unanticipated crisis might arise. That's the nature of unanticipated crises. And I've had enough experience with the public system via helping others that I know I don't want to be there if I should suffer a debilitating accident or illness. (A friend who spent time in a public hospital described the experience as a cross between "One Flew Over the Cuckoo's Nest" and "Midnight Express.") But, then, when it comes to matters of health, I am very risk averse. Others are braver (or more foolhardy).

  I would disagree with your statement that a medical catastrophe would be financially ruinous.  The public system is there and available for every qualified resident.  Costs are reasonable and you do pay for some things yourself.  I have spent some time at Regional helping out a friend.  While it is not the most modern hospital, the staff there treated my friend with compassion and sympathy.  I guess it depends on your expectations, some folks can never be pleased.

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6 hours ago, JohnF13 said:

  I would disagree with your statement that a medical catastrophe would be financially ruinous.  The public system is there and available for every qualified resident.  Costs are reasonable and you do pay for some things yourself.  I have spent some time at Regional helping out a friend.  While it is not the most modern hospital, the staff there treated my friend with compassion and sympathy.  I guess it depends on your expectations, some folks can never be pleased.

I'm never pleased to be in a hospital at all, but if I were recovering from a heart attack or stroke, major injuries associated with a vehicular accident, or anything similar that involved severe pain and required long-term medical care, I would not want to be in a hospital with crowded, noisy wards; bathrooms down the hall; and frequent lack of needed medications (including pain medication) and linens. I have observed all of this and more in the public hospital. There is a reason that Panamanians of means choose private hospitals. But to each his own.

I also question whether expats should be taking advantage of the already overly taxed Panamanian health system. An important element of planning a move is to plan to take care of one's own health needs rather than expect Panama to foot the bill-- or, as I have observed numerous times in my 12 years here, to expect other expats to chip in for unexpected, expensive health crises.

 

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I agree with your sentiments, Bonnie.  But, medical care is the same as pensionado benefits - there to be used if you choose.  That, I think, is the crux of the matter - choice.  As for medications, if they are not available in Regional, you can always source them elsewhere, but I suspect that a shortage is a shortage is a shortage.  Mae Lewis pharmacy has never impressed me, they don’t have even basic meds in at times.  As a non- CSS person at Regional, you will pay for all drugs and prescriptions - but at a cheaper price than at a private hospital.  Private insurance is another matter to be discussed in a different forum, but my one comment on it is that it seems to be structured to drive older folks off the plan using economic means.  My old insurace company increased my premiums 51% in a three year period, the last time claiming 12% inflation costs along with 11% annual increases.  Anyway, I’m done here, merely pointing out some options that are either missed or unfairly dismissed by authority figures.

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Bottom line is...this is not the place to be seriously ill.  If you can transport yourself back to your home country do it.  In the mean time there are local insurance programs here that are affordable for minor stuff ( ie : gallbladder or hernia surgery) .  That said, saving every month for a rainy day is a very good idea. For a person with health issues, I'd think twice about choosing Panama to retire unless of course you do have a fantastic insurance program and a good hearty bucket of money.  

With regard to catastrophic illness:  what usually happens is others bail the individual out, whether it be friends or family. 

Edited by Brundageba
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2 hours ago, Bonnie said:

An important element of planning a move is to plan to take care of one's own health needs rather than expect Panama to foot the bill-- or, as I have observed numerous times in my 12 years here, to expect other expats to chip in for unexpected, expensive health crises.

Totally agree! If anyone is planning a move to Panama or any other country their number one concern should be health coverage.

 

13 hours ago, Bonnie said:

A friend who spent time in a public hospital described the experience as a cross between "One Flew Over the Cuckoo's Nest" and "Midnight Express.") But, then, when it comes to matters of health, I am very risk averse. Others are braver (or more foolhardy).

We have a 3rd generation Panamanian friend here in Boquete who had her father in the public hospital. After a few days, they took him out and brought him to Mae Lewis. They described deplorable conditions at the public hospital.

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23 hours ago, Moderator_02 said:

He said that, in addition, due to the lack of training programs, the system does not have preventive health plans; instead, bad attention predominates, there is a large number of non-friendly staff that causes dissatisfaction in users, and the long lines continue as they wait to obtain medicines that are not available, among others.

This quote from the Panama government that is in the lead post of this thread.

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Yes.  AND don't expect nursing care in the private hospital to be as you remember it in the USA .   Plan on having a friend or family member at your bedside for your needs.  This seems to be the way of things in Latin countries.  That said, long hospitalizations are costly moneywise but as well it's wear and tear on those who are in your attendance at your bedside...friends and family, community hospice volunteers, wardens.  I never hear much of that mentioned when it comes to inquiries on healthcare from those interested in settling here.

Edited by Brundageba
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