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Puerto Rico Health Care

Is Puerto Rico Health Care On Life Support?

No matter which news station you tune into, you will likely hear something scary about Puerto Rico. The fiscal and debt situation on the island have been front and center, followed closely by the Zika crisis reports. However, problems with Puerto Rico health care are not far behind.

Some might even say Puerto Rico Health Care is already on life support.

So, this begs the following questions: Why? Is it true? And, what has our experience been like?

Let me take these one at a time..

Puerto Rico Health Care: Crux Of The Problem

At first glance, Puerto Rico offers some generous health care benefits to its residents, see my post Healthcare in Puerto Rico. Unfortunately, for decades, these benefits have not been adequately funded. So, it is true that health care on the island is in trouble. The reason is simple, federal government doesn’t offer the same amount of funding to Puerto Rico as it does to mainland states.

Nearly 60% of all people on the island depend on Medicare and Medicaid for their health insurance. Yet the federal government offers a smaller percentage of funding to Puerto Rico. AND, it enforces a cap on that funding (something it doesn’t do with the mainland states). This results with Puerto Rico receiving only 15-20% federal matching funds for these programs, compared to an average of 57% for the mainland states. Consequently, Puerto Rico needs to borrow money just to provide health care to nearly 2.3 million of the 3.5 million people currently living on the island.

Need I remind you these are AMERICAN CITIZENS?

Doctors Puerto Rico

It is now estimated that nearly a full third of the $72+ billion-dollar economic debt in Puerto Rico can be attributed to health care expenditures.

Scary, right?

Adding to the problem, nearly 3,000 doctors have left the island over the last 5 years in search of better paying jobs in the states. An estimated 400 doctors leave every year resulting in serious shortages of medical specialists. Think about it, that’s more than a doctor per day!

Another problem is the lack of good nursing care in Puerto Rico.

Ask just about any resident here and they will tell you “our doctors are good but nurses, not so much.” It is partly due to the vast shortages of medical workers. In fact, it’s not uncommon, to have just one nurse working an entire hospital floor. It is normal and expected that you (as a patient) bring your own “support staff” to your hospital stay – i.e. family, friends. They are expected to help take care of you and provide your basic nursing needs. No, I’m not kidding. Your loved ones are expected to spend the night with you at the hospital and help you clean yourself, go to the bathroom, and even feed you.

In addition, it’s also pretty common for you to be required to bring your own blankets, water pitcher, towels, etc. No, I’m still not kidding.

Puerto Rico Health Care: Local Horror Stories

If you spend any time in Puerto Rico, you will hear horror stories from other Americans (and sometimes native Puerto Ricans) that tell the tale of the health care woes on the island. Complaints range from atrocious nursing care and unacceptable conditions, to hours spent in reception rooms and months spent waiting for appointments.  These problems are often fueled by the lack of nurses and medical specialists. Less doctors, means longer waits for available appointments.

We have a friend that went to see a doctor for a 1 pm appointment and waited until midnight to be finally seen. MIDNIGHT!? I swear I’m not making this up, folks.

Another friend, a trained nurse, tells some crazy stories from her stays in the local hospitals. I won’t recount the gory details but, suffice it to say that, we have been told time and time again, “Puerto Rico is great but don’t get sick here”, and I am starting to see a theme..

Puerto Rico Health Care: Our Experience

So, now let me address this from our own experience. Since we have been here, both Tim and I have had some relatively minor health problems. We learned that the best way to find a doctor is to ask someone local for a recommendation. This way, we have found some great physicians that do not require us to wait for ours in their waiting rooms.

In fact, when I go to see my doctor, I learned of this trick: I show up at 6 AM, she starts seeing patients at 6:15 AM, so I don’t have to wait. I know this sounds drastic but I’d rather get up early, then wait for who-knows-how-many hours.

Doctor health care

We have had experiences, like the one at a dentist office, An Appointment? HA!. In this case, we didn’t wait but no one told us that the dentist wasn’t there to see us. So, we had to come back multiple times. This is the way of life here, folks.

What’s Good About It?

On the plus side, we have found the doctors to be good and provide very personalized care. Our doctors literally, take our vitals, weight, and do the entire visit – there are no nurses doing that for them. Maybe this is why it takes longer but you get a very attentive doctor in exchange.

The other thing that is good here is the cost of health care. It is MUCH cheaper than in the states. Tests, appointments, and prescriptions are all cheaper. In fact, many Americans prefer to get their dental work done here because it’s cheap and good.

Here’s something that mat throw you; for many drugs, you don’t need a prescription. Now, of course, this doesn’t apply to narcotics or other more dangerous drugs. You’re not going to give yourself chemotherapy without a prescription. However, for things like cholesterol or blood pressure medicine, “no prescription? No problem.”

We simply go to our local pharmacy and ask for what we need and they provide it. The same medications are often one-tenth cheaper here than in Michigan. WOW!

OK, so…?

So, is Puerto Rico health care on life support? Yep, no doubt it is.

Things will need to change drastically and soon. It all boils down to money. But, there is definitely potential for greatness.

Is it horrible? In our experience, it has been fine but we have never needed hospitalization. So, we can’t comment on that.

If you’re considering other Latin American countries, don’t be fooled. Puerto Rico’s health care is often compared to the mainland USA; other countries do not do the same. So, if you hear about this great heath care in Costa Rica, you may want to do your research. It’s all about what you compare it to. “Great” is truly a relative measure. A health care system may be great if you compare it to 2nd world countries but if you compare to USA or EU, not so much..



About Joanna

is a Polish American living in Arizona with her husband Tim. She is a founding partner of JTR Tech and she is proud to be a professional geek. She had dreamt of living abroad for many years. So, she and Tim created AbroadDreams.com to document the process of making their dream of moving abroad come true. They spent 2 years in Puerto Rico and several months in Spain and Poland. Now they are exploring the American Southwest.

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  1. Great Information!

    My wife and I are planning to move to the Island next year (not new to living abroad, spent 2 years in Belize). Quick question about the Healthcare infrastructure in PR, do you know if there are private Hospitals, and Private Insurance or is everything part of the Underfunded, State run Medical system? I’m sure if they exist they are more expensive, just wondering if there is even a more expensive option.

    Thanks for all the information you guys provide been following you for a while now.

  2. Joanna, after all your research, you chose to move to Puerto Rico. Did you miss this (healthcare) and would you do it again? I am an expat living in San Miguel, Mexico.

    • Hi Michael,
      Thanks for your comment. I don’t think we “missed” this healthcare issue. It’s more a matter of learning more, as we became familiar with the system. On paper, PR’s health care sounds awesome. In reality, there are some problems. I think that no matter which place one chooses, there are things that get discovered after a time of living there. This is why we choose to rent. We have friends that jump right into buying real estate but for us, we need to try it before we buy it. And this even goes as far as neighborhoods, not just country/state/city.
      So, anyway, would we do it again? If you mean, would we choose to move here again? Absolutely! Puerto Rico has an amazing amount of advantages, not the least of which is that fact that it is part of USA. But we do have some concerns as to the longevity of our stay here. The last 2 years have been great but I think now that we know the inside scoop on some of the problems, the luster has warn off a bit. Would you not say the same of Mexico? I have certainly talked to other expats from Costa Rica and Panama that felt the same as us. Some even moved back to the States.
      Healthcare is not a deal breaker for us. However, other things may be. We will have to wait and see.

      • I certainly agree that it is better to rent first, unlike some who come here and buy a house in one or two days. Here, it takes living here to know which colonia is best. We initially very happy with our rental on Umaran just five blocks from the Jardin. However, the noise particularly from motorcycles coming up the hill could shatter our sleep. Now we live on Huertas, still close to the Jardin in Centro, but is so quiet. Of course living in Centro may not be for you if you dislike fireworks and weddings.
        I have no desire to go back to the United States. It is too expensive for us anymore. I’d also have to give up on the sunshine and warmth of the people.
        Is there anything I don’t like? Just the paperwork that needs to be in quadruplicate and each page officially stamped. Some complain that appointments don’t get followed up on time/. Well, you just have to say, “Well, that’s Mexico.”
        Over all, we have made more friends here than we had in Portland, and love our decision to sell our house and move.

  3. I love your honesty! Thank you.

  4. Great information as always Joanna. I’ve been in San Juan for a month now.

    Was a bit concerned about a medication to control my glucose levels, which was over the counter in Thailand, as well as CHEAPER than water… Lol

    I asked a Walgreens pharmacist about a few simple back pain meds that a few years back, could be purchased over the counter, which she said needed a prescription at her store…

    So what’s the best route to by pass a prescription in your experiences? Maybe a pvt pharmacy?

    I’ll be headed to Luquillo soon to check out your area.

    Also what’s best way to travel there from San Juan, I don’t see any buses going there?
    Jer { ;~>)

    • Hi Jerry,
      The best thing to do for medications is to go to a local pharmacy, not a national chain. Walgreen’s and CVS have the same rules as they do in the states but the local neighborhood pharmacies are the ones you want. As for travel, you pretty much need a car on the island. Otherwise, it’s tough.