One expat’s nightmare experience with the IESS; ‘They will be the cause of my death’

By Michael Littmann

If you have been reading CHL and other gringo publications over the past few months you will have read about the corruption and mismanagement within the Cuenca Social Security (IESS) hospital, Jose Carrasco Arteaga, and the members of the expat community less than satisfied with IESS. Cancer radiation machine broken. Knee problems and a failed IESS treatment program. IESS surgeons operating on the wrong leg of a patient. Less than impressive experience with an IESS gastroenterologist.

To that end, I would like to share with the Cuenca expat community my experience with IESS. No writer’s embellishment. Every word is true.

I am 73 years old. I relocated from NYC to Cuenca 11 years ago in July of 2013. I have had diabetes since 2005 / 2006. My only income is my monthly social security retirement payment. Therefore, 10 years ago I enrolled in IESS.

‘Jose Carrasco Arteaga Hospital has written me off,’ says Michael Littmann.

December to mid-January. This past December I began getting severe numbness in my groin, buttocks, and the upper part of the back of my legs. Very difficult to walk. Much pain and discomfort. With the help of my medical facilitator, I tried to get an appointment with an IESS general practitioner. Phone calls and IESS website. No appointments available. By mid-January I gave up, and due to the severity of the problem(s) I thought it best to try go outside of the IESS system and pay “out of pocket” for medical services (but with only a monthly social security payment, very, very difficult).

Mid-January to mid-February. Found an endocrinologist at Hospital Mt. Sinai (2 office visits – $80). Blood tests at CoreLab ($156.00). X-Rays at MediMagen ($50.00). The results of the comprehensive blood test revealed my PSA level was 9. Should be 4. Prostrate surgery is 10. Because of this, the endocrinologist at Hospital Mt. Sinai referred me to a urologist (office visit – $50). MRI at MediMagen ($255.00). This led to 2 more visits with the urologist ($100.00). Results of the MRI revealed a polyp on my prostrate. I was told it may be cancerous. I needed to have a biopsy asap. At this point I have paid my medical facilitator $280 for his time / service, translations, and transportation. Also $100.00 for related medication in Farmasol. From mid-January to mid-February I had paid “out of pocket” for medical services, $1,071.00. This, with only my monthly social security retirement payment.

So, after pricing out the biopsy at MediMagen ($450.00, plus the cost of medicine before and after the procedure, and payment to my medical facilitator – $550.00), at this point I realized paying “out of pocket” for medical services was futile. And if after the biopsy, hospitalization was required for surgery, what then? I could no longer go down this road. Money is not available to do this on my own by going into a private hospital. So, back to the IESS system again.

Mid-February to mid-March, with the help of my medical facilitator, all attempts to secure an appointment with an IESS general practitioner (which then would hopefully lead to an appointment with an IESS specialist / urologist) failed. No appointments available once again.

On March 18, in frustration, despair, and in pain from the numbness in my groin, buttocks, and the back of my upper legs, I went to the Emergency Room of the Hospital Jose Carrasco Arteaga for help. They turned me away. I was told that my condition was not an emergency and to call the IESS appointment number to schedule an appointment with a general practitioner.

Finally, on March 23, my landlord and friend of 8 years, a man of considerable importance here in Cuenca interceded on my behalf and through his business contacts he secured an appointment for me with an IESS general practitioner for April 25 (but, over 1 month later).

April 25. The appointment with an IESS general practitioner was at El Dispensario Medico Del Centro (Borrero y Bolivar in El Centro). At this appointment a complete blood and urine test was ordered by the doctor, as well as an ultrasound exam, and I was told to go downstairs to the scheduling window and schedule the tests. My follow up appointment with the IESS general practitioner to discuss the results of the blood, urine, and ultrasound tests would not be until June 3 (5 weeks later). June 3 from April 25.

The first available appointment for the blood and urine tests were scheduled for 2 weeks later on May 6 (from April 25). The ultrasound was scheduled for June 27 (2 months later). June 27 from April 25.

May 6 – blood and urine tests at El Dispensario Medico Del Centro (laboratorio).

June 3 appointment to discuss the results from the blood and urine tests. I was advised that my PSA was now 12. In February it was a 9 (after blood tests with the urologist at Hospital Mt. Sinai). Normal 4, surgery 10. I am now 12. Due to the severity and urgency of my situation, the IESS general practitioner tried to make an appointment with an IESS urologist for as soon as possible. No appointments available with any IESS urologists. To that end, a form was filled out online by the IESS doctor and sent out to private clinics, doctors, etc. to try to get me an appointment with an urologist out of the IESS system. I was told I would receive an e-mail within 2 weeks with an appointment. If no e-mail as received, I was instructed to return to the El Dispensario Medico Del Centro (Gestion de Red, 2nd floor) in 2 weeks to find out my “status”.

June 17 – 2 weeks later. No e-mail received with an appointment date. Returned to El Dispensario (Gestion de Red) as instructed. No appointments within, or out of, the IESS system with urologists. Told to wait another 3 weeks and if no e-mail received, return to El Dispensario (again) to find out my “status” (that would be July 8).

June 19. Received an e-mail from IESS Unidad de Gestion Red (Network Management), Hospital Jose Carrasco Arteaga. “At the moment the agenda of the IESS is oversaturated. No appointment with IESS specialists. Suggest you look elsewhere for treatment”.

10 years paying into the IESS system, and I am now being told to look elsewhere for treatment???

June 27. Appointment at El Dispensario (laboratorio) for my ultrasound exam. Results as per the ultrasound doctor… “Prostrate and kidney functions look good. No problems”. For the problems with the severe numbness and pain in my groin, buttocks, and the back of my upper legs the doctor is referring me to a traumatologist (possibly pinched nerve, sciatica, herniated disc).

END GAME – So where does that leave me now? I have no idea. I am back to square one. I have been getting the run around with IESS since I started this process in mid-January. It is now mid-July. 6 months with numbness and pain. So much time wasted trying to get appointments with doctors, to get the necessary tests, to get follow up appointments. Looks like I have come to end of the line with IESS.

According to the endocrinologist and urologist at Hospital Mt. Sinai my PSA is 9. Surgery is 10. Prostrate has a polyp and could be cancerous. Need biopsy as soon as possible, and maybe surgery. According to the general practitioner at IESS my PSA is 12 and I need to see a urologist as soon as possible (but, there are no appointments available). According to the doctor who gave me the ultrasound exam, my prostrate is good (that is not problems). I need to see a traumatologist as soon as possible for the numbness and pain in my groin, buttocks, and upper back of my legs. My opinion, the right hand has no idea what the left hand is doing. I am screwed.

And it makes no difference now whether I need to see a urologist for my prostrate problem (if it is the prostrate), or not. And it makes no difference now if the problem is a pinched nerve, sciatica, or herniated disc and I need to see a traumatologist. The Network Management of Hospital Jose Carrasco Arteaga has written me off saying that the doctors are oversaturated, and there are no appointments with any specialists. Look elsewhere for treatment.

Due to the inability of IESS to provide the necessary medical services to me that I have been paying into for the past 10 years (by my best guess that would be about $9,600) I am not hopeful for a positive outcome. The IESS system is designed for failure. Failure meaning death.

The cause of my death? IESS.
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Michael Littmann can be contacted at littmannmichael2013@yahoo.com