Peru is yet another of the Americas which has undergone a major change over the last 20 or 30 years which has resulted in an improvement in the economy, increased wealth in the country and now thankfully an improvement in health care. The Peruvian government has for some time been looking towards the poorer area of the population who have for many years been forgotten and effectively disowned. However, over the last 20 years so there has been a significant improvement in the number of services, both medical and non-medical, available to those in more rural areas of Peru and those who are struggling financially to survive.
So what exactly can you expect if you visit Peru and what kind of health care is available to nationals, non-nationals and expats?
General health care in Peru
Peru is a country which has only recently developed an export sector which has thankfully led to an increase in support for the Peruvian currency thereby allowing the authorities to pay down significant debt built up over the years and also invest into the country’s infrastructure. It is easy to forget that Peru is a country where 20% of the population effectively control 54% of the national income and 50% of the population live in poverty while 20% are below the official poverty line. This is a country where general medical healthcare has been difficult to provide and in many areas of the country has been non-existent in the past.
When you consider that the average life expectancy in Peru is around 68 years this may not seem too bad for a country which had a life expectancy of under 50 only 20 years ago, however the situation is very different across Peru. The difference between life expectancy in any two areas of Peru can be as much as 20 years which perfectly illustrates how the rich in the country have access to better health care in Peru than those on lower income and in poverty. So what exactly is available for those with income and those in poverty?
Public health care in Peru
Since the beginning of the 1990s there has been a significant improvement in general health care in Peru and many areas of the country often ignored in the past are now well and truly on the radar of the Peruvian authorities. It is now the intention of the Peru government to introduce a better standard of health care in Peru which covers the length and breadth of the country and takes in those at the higher end and the lower end of the income scale. However, this public health care system in Peru has not always gone to plan and a number of third parties have become involved to try and assist and speed up the introduction of better quality services – especially to the poorer groups of the population.
The Peru healthcare system has seen a massive reorganisation of local healthcare services and the US humanitarian agency has been involved in the roll-out of this system for many years. This is an agency which covers a great number of developed and underdeveloped nations around the world which are crying out for better healthcare and better systems. Thankfully the Peru government has had the foresight to bring in the US humanitarian agency both for financial and practical assistance.
The government operates a system for those in poverty although treatment is dependent upon certification by a social worker otherwise the person involved will need to obtain their own healthcare via some form of insurance.
Private health care in Peru
When the Peruvian Social Security system effectively collapsed in the 1990s this brought about a major change in the way in which healthcare was delivered in Peru with the government forcing those in the private sector to take out their own health insurance. Indeed there is also a health insurance system for the public sector for those who can afford it and the authorities continue to focus their own specific funds on the low-income and poverty stricken areas of the country. So what can you expect from private healthcare insurance in Peru?
Firstly it is worth remembering that Peru is still a developing nation and as such even the private health insurance sector is relatively undeveloped and you will not always obtain the correct medicine at the correct time. However, it is also worth remembering that there has been massive progress over the last 20 years and more and more overseas healthcare companies are now targeting Peru as a potential source of significant income and significant profit in the future. As the economy continues to expand, thereby attracting more and more overseas businesses and expats to the country, the need for quality private healthcare insurance services will grow and the standard of service delivered will continue to improve.
If you’re looking to move to Peru, either with work or as a new homeland, it is highly advisable to look towards private healthcare insurance because even if you were to strictly speaking qualify for free healthcare in Peru, the government and the local authorities will always put the Peruvian population first.
National health policies and plans
There has been a definitive split in the healthcare service of Peru with those unable to pay offered free medical treatment and those in the public and private sector, who have significant income, effectively forced to take out their own private healthcare insurance. Indeed companies operating in Peru also have an obligation to contribute to the costs of healthcare with some of these funds used to finance the free public healthcare service.
Until the disparity between wealth and poverty in Peru is addressed, something which could take many years, it is likely that those who can afford to pay for private healthcare insurance will be ushered down this particular route by the Peruvian authorities. However, despite the fact that the private healthcare sector in Peru is “not as good as it could be” at the moment, there is no doubt there is scope for improvement as more and more overseas companies enter the market.
Expats in Peru
Expats in Peru need to be fully aware of the healthcare situation in the country and the very fact that government funding is highly focused upon those in poverty and the more rural areas of Peru. As a consequence, if you have wealth and you have income in Peru then you are unlikely to qualify for free medical healthcare and will need to take out private healthcare insurance as soon as possible. However, you must also be aware that some specific treatments and illnesses may not be covered by private healthcare insurance therefore you should look at the fine print before signing any documentation.
In simple terms you should in theory forget about public healthcare in Peru and instead look towards private healthcare insurance for accidents, medical treatment and medicines. The cost of private healthcare insurance in Peru will also vary widely depending upon which companies you look towards and the level of cover you require. If you are employed by a company in Peru then you should also look towards the corporate end of the healthcare market and see whether any workforce insurance is available.
Health care benefits available to expats
As we touched on above, it is highly unlikely that expats living and working in Peru will qualify for free public healthcare with the authorities forcing those in the public and the private sector, with income, to look towards private health care insurance. Companies operating in Peru are also obliged to contribute to the cost of healthcare with the vast majority of government funding focused upon those in real need of medical assistance.
Do not make the mistake that many have made in the past, assuming that there is a comparable NHS system in Peru because ultimately you could be left high and dry requiring treatment which you are not covered for and may not be able to afford.
Medical conditions prevalent in Peru
One of the main issues in Peru is still the rate of mortality between the various areas of the country and the various groups of the population. There are some areas of Peru where the risk of dying is three times that of the national average with a 20 years difference in life expectancy across some regions. There are also a number of medical conditions prevalent in Peru which include a variety of preventable diseases such as measles, jungle yellow fever and hepatitis B although there are also a variety of intestinal infectious diseases such as diarrhoea and cholera not to mention HIV/AIDS, tuberculosis, malaria and a variety of sexually transmitted infections.
As a consequence you should study carefully the immunisations required before living and working in Peru and ensure you have health care provisions in place. Even though improvements have been made with regards to a number of the above medical conditions you need to go into this situation with your eyes wide open and fully aware of the potential risks.
The future of healthcare in Peru
The 1990s saw a major shift in the focus of health care in Peru which has ultimately led to a three tier system with free healthcare for those in poverty, health insurance for public/private sector workers and a requirement for employers to contribute to the system. Until such times as health provisions available to those in the more rural areas of Peru are equivalent to those available to major city residents we are likely to see any government funding focused upon those in poverty. As a consequence, if you’re looking to move to Peru, either for work or to live, you will more than likely need to arrange your own private healthcare insurance before landing.
As the economy in Peru continues to grow, fuelled disproportionally by exports, it is likely that the standard of living will improve across-the-board although this could take many years to reach those at the lower end of the spectrum. A successful economy will lead to more funding for the government which will lead to more funding for the health care services in Peru and the private healthcare sector should continue to grow. Major changes have occurred over the last 20 years but there is still much to do and the very fact that the Peru depends to any extent upon third-party assistance to deliver health care in Peru should not be ignored.
While some people looking at potentially moving to Peru for employment or to start a new life may well be surprised to learn that free health care in Peru is not always available to everybody, there is certainly a need to focus government spending upon those at the lower end of the spectrum. This is likely to continue for some time to come and those who can afford to take out health insurance will continue to be ushered down this particular route by the authorities.
For those who are moving to Peru in the near future there may well be a number of short-term difficulties when you bear in mind the fact that the private health care insurance sector in Peru is still relatively underdeveloped. Even though the sector is improving on an ongoing basis there continues to be concern regarding the availability of specific treatments and specific medicines even to those people who can afford to pay for the “best” health cover in Peru.
If you are moving from a country where there is some form of NHS available to each and every one of the population you may well find yourself moving to a very different environment in Peru. Do not expect a like for like change in healthcare systems, be prepared to take out your own healthcare insurance upon landing and ultimately make yourself very aware of the potential risks and dangers to your health in Peru. In simple terms, there have been major improvements in health care in Peru over the last 20 years or so but there is still some way to go and the integration of the public health care sector and the private healthcare sector is not quite there yet.