Calls to create a government-run health system here make me nervous. I paid into such a system for nearly two decades, so I can provide a first-person report.

The Costa Rican state medical system frequently is praised as top-notch and free. The better adjectives would be usually adequate and paid by someone else. The country is a mecca for North American retirees.

I gave the system about 30% over what I paid my employees each month. They and dependents then had access to major hospitals and a vast web of local clinics.

This month the Costa Rican Social Security agency reported on hospital wait time averages in 2019: 335 days for surgeries and 189 days for routine medical treatment. Clearly the system is flooded.

Staffing is a problem. The law forces new physicians to work at government hospitals. Patients must stand in line at 4 a.m. to get a slip so they can stand in another line to make an appointment. The doctor may or may not show up.

The many U.S.- and European-trained specialists make far more money in private practice and at private hospitals. That is unless one happens to be in higher administration. The director of one hospital drives an Aston-Martin.

As a resident expat I was required to pay into the system, but I never used it. Others did, and some had high praise for low-priced medication and good treatment. I lost a younger friend because the regional hospital she went to, while pregnant and with a heart problem, had no cardiologist available. She died awaiting transport to the capital.

The public children’s hospital saved the life of my employee’s child, who had childhood leukemia. But that only was after a private doctor correctly diagnosed the condition. A public clinic physician said the child had arthritis.

A public doctor sent an acquaintance home after an exam. Instead, he flew to Atlanta where a cardiologist had him in emergency surgery in 24 hours.

It seems to me U.S. residents are much more in control if they remain the source of medical payments.

James Brodell

Cumming