Best Posts in Thread: As we age medical issues

Speaking from experience, my husband and I came to the Philippines in 2009 (he was originally from Dumaguete, anyway, but became a US citizen in his early 30's), when his health had deteriorated and needed my care 24 hours a day. We could much more afford for me to quit work and live in the Philippines than in the US. The medical care he received in the Philippines was, for the most part, okay. Of course, it was not up to par to what he could get in the US, but we knew that before we moved. He dropped his Medicare since he could not travel to the US for care; Dumaguete was his "final destination" and it is exactly where he wanted to be laid to rest. We had PhilHealth, which is very affordable, and is pretty good for helping out for hospitalizations, you just have to be sure to read the fine print or you could get screwed, (I did on his 2 week ICU stay while he was on life support, I ended up having to pay 100% of the bill because of a policy they have of not paying twice within a 30 day period for hospitalization for the same diagnosis). Doctor visits, medical tests, and medications, for the most part, are much more affordable and we never felt the need for any further health insurance to cover these items. So, to answer the original question: Financially, it is cheaper for most medical care in the Philippines. If it is top-notch, state of the art medical care you desire or require, then you best head home, although there are some good facilities in Manila and Cebu, but you won't find that kind of medical care available in the smaller provincial islands. We could never travel outside of Dumaguete for his care, so I cannot give specifics.

 

Cabb raised a very interesting and concerning point. I moved full time to the Philippines at 66 and reluctantly left a couple of months ago at 74. Until a few months before leaving I would have told you I was never leaving. I was renting a beautiful apartment on the ocean in Dauin, I had my long term gf (now fiancé), my motor and truck, my beloved dog… I was in very good shape and enjoyed kayaking in the surf several times a week in addition to beach walking and reading in my front porch rocking chair. And then the health problems began. I won’t go into detail here, but I had been watching my PSA carefully for the past couple of decades, with scores swinging wildly into the teens. I’d had several biopsies in the States and several times visited my urologist in CA during my annual visit there. A local urologist had me on a finisteride drug which lowered my PSA numbers, and, he said, lowered my risk of prostate cancer. In March or April of this year, I came down with a bad cold and cough which wouldn’t go away and began experiencing problems with having to get up every several hours at night, and not being able to complete urination. I had my PSA checked and it had soared to 45. I immediately went to my urologist who ordered a transrectal ultrasound – I’d had one of those several years ago at Siliman. The process wasn’t too bad, but waiting in the freezing cold (yes, cold) waiting area, drinking water until I was about to burst, having to wait about a half hour at 7:30 a.m. to pay for the test… In all it was a most unpleasant experience. The results were inconclusive. I was put on medication to relieve some bone pain I was having and to ease the urination problems. In another month, I tested my PSA again – it had doubled to 90! My urologist offered to do a biopsy, but I’d already decided I needed to go Stateside to have this looked at. During that time, I had also begun to find I had less tolerance for waiting in crowded, often stifling hot waiting areas (not cold like the ultrasound room), sometimes not being able to see my doctor at all, having to drive back to Dumaguete the next day. Now the driving was bothering me more. Around that time, I decided it might be time for me to bail, and with the sky high PSA, sooner rather than later. I somehow managed to liquidate my major possessions, find a new tenant for my apartment, start the process for obtaining a fiancé visa, say farewell to a few close friends, hug my beloved dog one more time, and board the plane back to the US. Immediately upon arrival here, I checked in with Prostate Oncology Specialists in Marina del Rey, CA, and had their ultrasound which showed that I indeed had prostate cancer and that it had metastasized, the worst possible outcome. A bone scan and several MRI’s confirmed the diagnosis. I was placed on a strong anti-testosterone drug and given various injections in my arm, stomach and butt. The encouraging thing is that this cancer can be treated. The doctor here told me that prostate cancer cells can survive and replicate only in a testosterone environment. He warned that my meds may induce female menopausal symptoms such as hot flashes, which they have, but not to a great extent. In short, I have relocated to the retirement community of Green Valley, AZ, am in contact with a cancer center in Phoenix, and generally am feeling fairly fine, though the heat this time of year is oppressive. All the paperwork is in for the fiancé visa, and we’re hoping she may be able to join me here in the not too distant future. Sorry for the lengthy post, but I felt that my situation is relevant to the discussion. There is a lot that I miss about my beachside Philippines lifestyle, but the desert has its own attraction, and I am more comfortable with the conveniences of Stateside living and the availability of first rate medical attention. I would urge anyone with prostate issues to watch it carefully. Prostate cancer when caught early is quite treatable. Once it has spread, there are many new issues to deal with. To those I didn’t have time to say good-bye to, sorry mates, I had to rush away. I wish you all the best. I have no advice to offer for the question at hand, only to relate to my personal experiences.

 

There is a list of all the worldwide hospitals that are JCI accredited - only about 200 places around the world meet this JCI criteria.

Some hospital locations are well known for cardiology, others for cancer treatment, etc. You can search out which location has the best specialty on this web site below:

Philippines Hospitals: find a hospital in Philippines

I suspect much of these decisions to live and die in another place not of your birth depends on many factors, some of which are: ties to the ex-pats current location, health care costs, use and availability of medical insurance, family ties to/within the ex-pats adopted country, and monetary considerations. Other factors can be family and financial considerations back in the home country.

So I put the above website on here so if there is someone reading this who may need specialty care, then these JCI rated hospitals may come in handy.

Not sure what type of insurance plans can be used at these locations - haven't dug down that far. But knowing where these places are, what they specialize in, and how to pay for the treatment and care they can provide (what insurances do they accept?) might be a good thing to know - just in case.

V/R,
nwlivewire

 

Knowing from past and present medical debacles throughout the Philippines, my own and many other friends' experiences, if I had a choice, definitely not here. (Including St Lukes' in Manila, supposedly the best available in the country.) I pay a high, annual medical insurance premium, for both myself, my wife and kids, for exactly those reasons. Singapore, Hongkong & Bangkok offer way better facilities and much more affordable private healthcare from my own experience, having been hospitalized in all three of them.

 

Good luck! and thanks for sharing.

 

Hope you have a full and speedy recovery John, and your fiancee back with you soon. Great post btw.

 

I'm curious how expats deal with the effects of aging. Unless we are lucky enough to die in our sleep after having nice cold beer the night before, many of us will have medical issues that may require hospitalization or conditions (cancer, type 2 diabetes, heart disease, dialysis). Many expats appear to be ex-milatary so they have options like tricare. For US civilians, Medicare is only available in the USA as I understand it, so I'm curious if there is a certain point where it makes more sense to be in the USA for medical and financial reasons or do they just take their chances in the Phils? Do expats tend to move back to the their home countries once the reach that age or just stay in the Philippines in the end? Thanks.