In Puerto Vallarta and other places in Mexico, there are some of the top hospitals in the world and especially in the Western Hemisphere or in the Americas. This is especially true for Guadalajara, which is a four hours drive from Puerto Vallarta, but even in Puerto Vallarta, there are hospitals. One is called Amerimed, which is one of the bigger hospitals in Puerto Vallarta. And yes, there are American-trained doctors.
Because I work in insurance and we do health insurance, I have a pretty good knowledge of the hospitals and the Americans who use the hospital, and they all rave about how good they're treated, how good the doctors are, and especially the cost. It's such a high quality of care for a fraction of the cost in the States.
Luckily, I have not had any personal experience of needing to go to the doctors at the hospitals in Puerto Vallarta. That's a good thing, too, because I don't have my own insurance yet. I'm sure it will happen at some point, but I'm not concerned about the medical care I would receive without having insurance.
There are private hospitals that take private insurance, and then there are government-run hospitals that people get through their work. A lot of expats who come down to Mexico who don't want to spend the money on the private hospitals go to the government hospitals, which are in a system called IMSS. They're all throughout Mexico.
The doctors are still good in the IMSS system, but they're a little understaffed. You get put in a room with five or six other people. If you have someone who wants to come stay with you overnight, they have to sleep under your bed. A lot of times you have to bring your own toilet paper and bathroom products. IMSS hospitals don't take people according to the severity of whatever they're at the hospital for. They take patients on a first-come-first-served basis. You could have a gunshot wound and be waiting for days because you got there and there are so many people ahead of you.
There is a big difference between the quality of care, the experience, and capabilities of the doctors between the private hospitals and the government-run hospitals. A lot of people will start off with the government-run hospitals, will go there once, have an extremely bad experience, and then decide it is worth to pay the money to go to the private hospitals.
Private hospitals here in Puerto Vallarta look and smell exactly like a hospital in the United States. The costs of the private hospitals down here at Puerto Vallarta are obviously not as much as the US, but depending on what you're there for, the prices can get up in the US $20,000 to US $40,000 range. That's why it's good to have health insurance if you can't pay these amounts out of pocket and you don't want to go to the government. Something that might cost $75,000 in the US would cost $20,000 or $30,000 in Puerto Vallarta, with the exact same quality of care. Some of our clients for our health insurance have even said that the quality they received here in Mexico is better than what they've experienced when they lived in the States.
The doctors here are extremely good. A lot of them are bilingual. They speak English, especially here because Puerto Vallarta is a tourist town. You can get your own room. They have chemotherapy. They're very advanced down here at Puerto Vallarta.
My experience as an American woman in Portugal 30 years ago was not good; at that time I found it a frustratingly "macho" country. However, this has definitely changed, perhaps as Luis da Silva mentions in an earlier post, this is due to most women now working, better education, and greater exposure to global influences. 
There are different types of churches here in Nicaragua. There are those that are very decorated and those that are more humbly decorated. It just depends on where you go, what neighborhood the church is in, and if it is located in a city. 
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Originally from Northern Ireland, and after a 10 year stint of working in the cruise industry and traveling extensively, I decided it was time to settle somewhere and find a "grown-up job"! 