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David C. Murray

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Posts posted by David C. Murray


    What I wrote was that health care in the private sector is cheap, not that CAJA premiums are cheap.


    Even if CAJA enrollment does cost $400, and not everyone pays that, by the time you factor out deductibles, copays, etc it's still pretty reasonable.


    Crime reports in Nicaragua, Costa Rica, Panama, the U.S. and everywhere else in the world are notoriously inaccurate. Differences in definition and the incompleteness of reporting by both victims and police agencies render them almost meaningless. And if different agencies are reporting on different jurisdictions, that's another layer of inaccuracy.


    Health care in Costa Rica's private sector costs the same whether you're a tourist, a temporary resident, a permanent resident or a citizen. As a legal resident (temporary or permanent), you are required to be enrolled in the national health system, the CAJA, whether you elect to use it or not. As compared to the cost of medical care in the U.S., care here is dirt cheap. Can't speak to Nicaragua or Panama.


    There is no evidence that the crime rate in Costa Rica is materially higher than the rate in other Central American countries. In fact, the murder rate is significantly lower.


    Panama, too, is subject to governmental instability. Can you say, "Manuel Noriega"? Costa Rica has an unbroken of democracy that dates back to 1948. No other Central American country has a record that approaches that in any way.


    For whatever it's worth . . . We recently renewed our U.S. passports at the U.S. Embassy here in Costa Rica. It took about ten days or two weeks for the new ones to be available. When we went to pick them up, the Embassy clerk "stamped" the old ones ("punched" is more like it) so that they're obviously no longer valid but she then returned them to us with the new ones.


    We had to make an appointment to make the application for the new passports but not to pick them up. We felt like the service was pretty good.

  4. Without disputing anything you wrote above, Paul, I think there's another dimension to this matter. Excluding the population who are wholly dependent upon the CAJA for their medical care, the market for some products here in Costa Rica is very small and the number of those who can afford them is smaller still. In the past, participants in this Forum have asked about the availability of some little-known, rarely prescribed medications which they can obtain in the States. What they've learned is that those meds are not provided by the CAJA and that they're not available from the commercial pharmacies.


    In order for any product, whether it's a pharmaceutical, organic cheese, or engine oil, to be made available, there has to be a potential demand large enough to persuade the supplier to bring it to the market. While I'm skeptical that many medications are approved for distribution here or anywhere else on the basis of bribes to the approving bodies, still the costs associated with distributing anything in any market have to warrant the potential for profit. For better or worse, the companies aren't doing any of this out of the goodness of their hearts (if such exists).


    konotahe, you wrote, "The US government closed down online buying of drugs from Canada and used the same excuse, that the drugs were not approved by the FDA. It was a lie."


    Well, yes and no. You are absolutely correct that the U.S. government has restricted or prohibited the importation of drugs from Canadian pharmacies but it wasn't only because they were not approved by the FDA. In fact, most of the drugs offered by the Canadian pharmacies bear the same names and packaging as what's dispensed in the U.S.


    The underlying story is that the problem of overtly counterfeit drugs is very significant. You (and certainly I) are in no position to know, or to be able to find out, what's in that little pill under the plastic bubble unless by some chance you (but certainly not I) are a qualified chemist and have a fully equipped analytical laboratory. That stuff could be anything or nothing at all. By restricting distribution in the U.S. to U.S.-sourced products, there is a better (but not absolute) chance that the product is what the label says it is and that it'll do what it's supposed to do.


    None of that, however, is to dispute the obvious fact that drugs in the U.S. are more expensive than they should be or need to be and that the pharmaceutical companies are profiteering.

  6. Shea, I think that, if you look a little deeper, you'll find that the Breathe Right nasal strips are not "forbidden". Rather, they are simply not on the list of items which are allowed. There's a difference between what is prohibited and what is just not yet approved. If the strips are not on the approved list, they simply may not have been acted upon by the Ministry of Health. Absent some request to approve them, they'll probably continue to be not importable.


    None of that means that the Breathe Right nasal strips are not a legitimate product.





    The purpose of limiting the importation of medicines and other products is, in fact, a public health one. Like the U.S. Food and Drug Administration, the Ministry of Health here controls what is legally available in an attempt to prevent dangerous or ineffective products from entering the country. And, again like the FDA, the Ministry of Health has limited resources with which to investigate what is safe and effective and what is not. Importing approved medications through official channels makes most, but not all, things available in one form or another.


    There are, of course, some products that are not approved for importation. In the main, those are things that have very limited applicability. That is, few of Costa Rica's 4.25 million or so inhabitants need them. It's not so different in the U.S. where access to experimental drugs is limited. Of interest, however, is that I use a medication which is not available in the U.S. So the door does swing both ways.

  8. Years ago, I worked in a rural Michigan county where there was a huge lumber yard. Almost everyone who worked there was originally from Dothan, Alabama. Why, you ask? It was because as the business expanded and more employees were needed, the first of those Alabamans recruited his family members to fill the vacancies. I'm confident the same is true of businesses in New Jersey.


    The other thing I can say is that once when talking with a Michigan apple grower, I learned that they had to recruit seasonal employees from only one or another Latino ethnic group. If they mixed (say) Mexicans with Haitians, they'd have a bloodbath on their hands. So, again, maybe Costa Ricans work best with their family members and countrymen and by coincidence some of them started out in New Jersey.


    Actually, it's not so unusual. If you investigated many American cities, you'd find entire neighborhoods that are or were dominated by one european ethnic group or another. The Germans tend toward German neighborhoods and the Irish with the Irish.




    Gayle, I think a lot of Costa Ricans presume that we don't speak Spanish. This happens to me fairly frequently. A neighbor and I went into an air conditioning repair shop just this morning. The only one in the place looked up, smiled, and immediately started hollering for another guy who does, in fact, speak some English. We could have done our business in Spanish, but he presumed otherwise.


    Even when I initiate a conversation in Spanish, it sometimes doesn't "take". If I go into our local fereteria, where I'm known, and ask for "pintura blanca de aciete" (oil-based white paint), as often as not I get a blank stare.


    Ya gotta laugh . . .

  10. Arlington must have changed a lot since I grew up there. Coming up from the Potomac, there were three sets of named streets. The first, all in alphabetical order, had a single syllable. The next had two syllables. We lived farther out first on N. Powhatan St., then on N. Jefferson, and finally on N. Ohio. Cross streets were mostly numbered. It was pretty east to find your way around.


    Glebe Road may have signs with differing names, but at least it's continuous coming uphill from Chain Bridge (right) that crosses the Potomac. There were/are some diagonal streets but what the heck! Nuthin's perfect.

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