All of this conversation causes me to wonder about a lot of things; like,,,,
Are the old folks, among the locals, being treated for broken bones resulting from a fall? Are any forced to live alone and take care of themselves?
Is cataract surgery available to those going blind?
Are they able to bath themselves?
Is heart and blood pressure medication available to them?
The list goes on and on. Ask yourself if there is someone who will change your diaper.
Again, I will venture to guess that the vast majority of xpats will chose to leave the island and give up their residency for health reasons. The ironic part is that it doesn't have to happen, but will if the status quo is maintained. The problem seems to have several parts, each of which could be resolved. First, there is at least, a perception that the local medical community is unprepared to provide quality services. If this perception is incorrect I would hope that they would just tell us and let us know that the skills are in place to provide quality medical services on the island, but lack infrastructure to practice in. It so, they might consider doing what the inept US government is doing. That is to permit and support private enterprise funding of "community projects" where the investors become stockholders and directors in the project.
Even if the medical community were to concede that there simply not enough qualified doctors to support such a project and were willing to import foreign physicians to fill the gap the problem would soon be resolved.

I'll be happy to discuss my avatar with anyone who knows what it is.