Although it is true that one of the major perks for living in Ecuador is high quality, low cost health care, finding it requires some due diligence. Where you choose to live can also have a lot to do with the quality of care you receive.

With the right choices, you will receive personal attention from medical practitioners not seen the U.S. since the 1960s. And, you’ll pay some of the lowest prices in the world. An Internet comparison conducted by HealthWatch International of health care costs in Dec. 2008, found Ecuador’s health care costs to be lowest of 75 countries studied—lower than in China, Malaysia, Mexico, and Panama. In general, you can except to pay 10% to 25% of what you would in the U.S. for comparable services. For major surgery, involving longer periods of hospitalization, costs were even less than 10% of those in the U.S.

Although Ecuador is a developing country, you can get first-rate medical care here, particularly in the major cities. Many doctors are educated in the U.S., Europe, Argentina, Chile, and Cuba, and receive continuing ed training around the world.

In many respects, the medical system is reminiscent of that in the U.S. in the 1950s or 1960s. House calls are common; most doctors do not have nurses; and the average office visit is 30 to 45 minutes. Another throw-back is that Ecuadorian doctors don’t expect to become instant millionaires: the average income for doctors, according a Quito medical association, is about $50,000 a year.

A visit to a general practitioner costs $20 to $25 while a visit to a specialist costs $25 to $40. A psychiatrist will charge $30 to $40 for a half-hour session. Simple, ambulatory procedures are equally inexpensive. For example, the removal of a small lump (under local anesthesia), and a biopsy, costs about $100. Brand name medicines usually cost less than in the U.S., although some cost more. Generics, which are widely available, are also cheaper.

Cuenca, Quito and Guayaquil are the top medical centers
Everyone agrees that Ecuador’s best medical services are offered in Quito, Cuenca, and Guayaquil. It is common practice for doctors in other parts of Ecuador to refer seriously ill patients to hospitals in one of these cities. For example, patients in Esmeraldas, Cotacachi, and Ibarra would go to Quito, while patients in Loja and Vilcabamba would be sent to Cuenca. Health care experts also report that Cuenca picks up extra patients from all parts of the country because of its lower costs. A hospital administrator in Quito estimates that costs for care in Cuenca are typically 15% to 20% less than in Quito and Guayaquil.

Although quality health care is available throughout Ecuador, keep in mind that many services may not be available in rural areas and the quality of health care may not be as good as in larger towns or cities.

Health insurance in Ecuador
Health insurance is a bargain in Ecuador. A review of comparable insurance policies for a 60-year-old man in the U.S. and Ecuador, tell the story. In the U.S., the man would pay a monthly premium of $1,100; in Ecuador he pays $86. A woman, age 50 to 60, would pay $77 for the same policy in Ecuador while coverage for a dependent child, between 2 and 17 years-of-age, costs $15.69 a month.

The policy used in the comparison is offered by Salud, S.A., Latin America’s largest health insurance company, and pays 80% of doctor’s visits, 60% of medications costs, and 100% of  hospitalization. It also offers extra coverage for walk-in procedures and accidents.

As in the U.S., the policies of major insurers consider pre-existing conditions and require that you sign-up for coverage before you reach the age of 70 (some companies require sign-up by age 65).

Because of low costs, the majority of expats in Ecuador do not have health insurance. Your financial situation and tolerance for risk will dictate whether you purchase a policy or not.

Keep in mind that U.S. Medicare will not provide coverage out of the country.

The top three health insurers in Ecuador, by the way, are: Salud, S.A., website: www.saludsa.com.ec;  Humana S.A., website: www.humana.med.ec; and PanAmericana del Ecuador, S.A., email: dany-game@hotmail.com.

Cuenca's best hospitals
An informal survey of local doctors and foreign residents named two hospitals the best in Cuenca. They are Monte Sinai, Miguel Cordero 6-111 y Avenida Solano, Cuenca; tel. 288-5595; and Santa Ines, Avenida Daniel Cordova and Frederico Proano; tel. 281-7888.

Alternative health care
You will also find many options for alternative health care in Ecuador. On a per capita basis, Ecuadorians use alternative services much more frequently than North Americans or Europeans. You will find practitioners of homeopathic and naturopathic medicine in most larger towns.

A major draw for some foreign residents is the fact that the Ecuadorian constitution guarantees citizens and residdents the right to use the health care of their choosing. Ecuador’s equivalent of the U.S. Food and Drug Administration is not a police force doing the bidding of the pharmaceutical industry.

Photo caption: The Military Hospital on Rio Tamebamba is one of 15 hospitals and major clinics in Cuenca.