Care in private hospitals is generally adequate for most common illnesses and injuries. Doctors and hospitals often expect immediate cash payment for health services. U.S. medical insurance is not always valid outside the United States. Supplemental medical insurance with specific overseas coverage, including provision for medical evacuation, has proven useful in many emergencies. Education is theoretically free at all levels, but because of the acute shortage of public schools, many private schools are in operation.
Primary education is compulsory.
In the late 1980s the school system of Guatemala included about 8500 primary schools, which were attended annually by some 1,098,000 pupils. Secondary schools had an annual enrollment of about 241,100 students. Guatemala has three other universities, as well as schools of music and plastic arts. Total university and college enrollment in the late 1980s exceeded 67,000. The economy is dominated by the private sector, which the government only takes 10 percent of the GNP, compared to more than 40 percent in the U.S. and much more in Europe.