Wednesday, September 25, 2013

Healthcare Emergency in Cabarete, Dominican Republic

Today is a historic day for sailboat racing with Team Oracle USA winning America's cup using a boat with a hydrofoil while the discussion in national news is all about Obama Care and the opening of the healthcare exchange and the American Healthcare system in general. Well, my story touches on both topics!

At a recent MaiTai event in Cabarete, Dominican Republic, I bought a super cool hydrofoil board from Nick at Riding a foil board with a kite is a little bit tricky to learn - basically you have to get used to a lot of power coming from the bottom of your board, about a meter below your feet! At sea level  water is about 750 times as dense as air. The "wing" on the bottom of the foil is about 1 square foot of total area. "Air adjusted", that's equivalent to about 750 square feet of kite. A 10m kite is about 100 square feet, so the power from the board is seven times as strong as that of the kite. In reality, the power doesn't feel that disparate, probably because either I have a math error, logic error, or because the way the foil rides is very different than the way the kite flies. But in any case, the power coming off the foil is strong.

The conditions in Cabarete bay are nearly perfect for learning to foil board - small waves on the inside, sandy beaches, and in the mornings, light wind. On this particular morning, I was the only kiter on the water as a foil lets you ride in extremely light wind. I was somewhere between my first and second hour using the foil, and was just getting the hang of it. Just enough to get that initial "cocky confidence" that frequently results in trouble. I starting riding a bit faster than normal, and then fell downwind of the board. I thought I was clear of it, but about a second later, something hit my head.

I put my hand on my head and it was quickly covered with blood. The white pad on my foil started turning red as did my vision. Not really that big a deal: heads bleed a lot, way out of proportion to the pain or the severity of the injury. I was a few hundred meters out and started to body drag back to shore - foil under one arm, flying the kite with the other hand. 

I went to to Laural's kite school / shop and one of the instructors there said I should go to the hospital as I'll need stitches. Here I was in 3rd World country (at least according to this mapneeding healthcare. I was a bit worried! Laural showed up and took me to the local clinic - a small place right in downtown Cabarete called Playa Dorada Medical Center. 

I've had a number of cuts and other injuries - 6 stitches in Breckenridge, Colorado a couple of years ago, a rib dislocation issue in San Mateo, and a while back, tore an ACL playing soccer. In each of those cases, I sat in a waiting room at least an hour and the bill was over $2K. In the case of the ACL, I visited four emergency rooms and finally ended up at Stanford. After sitting around for over an hour, I walked - limped, actually - out after I called a doctor friend who said he would see me in the morning and there was probably nothing they could do anyway, other than give me pain killers.

My worries about healthcare in the DR were unfounded. The doctor showed up almost immediately and put a few stitches in my head. He cleaned up some coral I had in my foot and advised me on an asthma issue. He prescribed some antibiotics which they gave me on the spot - I didn't have to go to a pharmacy and wait in another line as you do in the US.  

The doctor asked if I had health insurance. I said I did, and he said I am better off not using it! I didn't fully understand his explanation, but he said something about the hassle and cost of dealing with the insurers in the US, and in the end, my out of pocket would be MORE if I used my insurance than if I just paid the bill. I was a bit skeptical, until I saw the bill: $100 for the doctors time, the hospital time, the stitches, and whatever else. $91 for the medicine.

Total time spent: about 1 hour. 

I was back on the water by 2.

Without a doubt, this was the best healthcare "emergency" experience I have ever had. And it's not even close: the service was excellent, there was no wait, the price was incredible, and there were far fewer hassles and forms to fill out. I was pretty concerned when I was initially hurt - seeing red trying to get to shore - but in the end, the whole thing was a great experience given the situation.

In trying to find a link to the clinic I went to, I found another post with a similar story: That story talks about a different hospital - I was an a small medical clinic, but the overall experience and conclusion are similar.

In the end, it's not that the healthcare in the DR is particularly good. It's that ours is particularly bad. I know we can do better - I hope we figure this one out before I'm too old and need some serious care!