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Sunday, May 21, 2006

COLUMN: HOW TO HELP U.S. RETIREES - AND MEXICO, TOO

Here's a proposal that would allow the United States to solve its immigration crisis, control sky-high healthcare costs and rebuild ties with Latin America in one stroke: Make it easier for millions of Americans to retire in style and pay lower medical bills south of the border. Read more about the proposal in The Oppenheimer Report.

38 Comments:

Anonymous mini-me said...

I got an even better idea. All the Latin American illegal alien Cuban Chicanos, and their friends get on those big Carnival cruise ships, and go back to "your" country of origin. Hell, i will proudly drive those ships to and from.

10:43 AM  
Anonymous mini-me said...

This comment has been removed by a blog administrator.

3:54 PM  
Anonymous Mousqueton said...

Your proposal has only one flaw. What if Americans decide that instead of Mexico they would rather retire to the South lakes of Chile, or the sleepy slopes of Cordova, Argentina, or the primitive charm of the sacred valley of the Incas in Cuzco, Peru. If they do, Argentineans, Chileans and maybe Peruvians would stay home, but, all the rest would continue to come looking for a better life.
Remember John Kennedy's "Alliance for Progress"?
If we would have spent in Latin America what we are spending in Iraq, we would be self sufficient on everything, including oil; plus, we would not be killing anyone.

4:06 PM  
Anonymous mini-me said...

No, the critical flaw is that retirees would be unable to do anything but be retired in Mexico. An "immigrant" retired in America can realize a second career if they choose to do so.

5:35 PM  
Blogger Lili said...

As far as Mexican immigration laws, they are strict for a reason. Mexico isn't a country of immigrants and experienced decades of foreign invasion from Europe and the United States, who not too long ago owned a large portion of Mexico's land and property, especially in the north (The person who wrote that article of course excluded history...hello, the Mexican revolution???). Let's keep these realities in context when trying to write "smart" comparative articles...

If you can barely provide jobs for your own, why would you allow thousands of immigrants in to take the jobs that are needed by your own people?(Isn't this one of the main concerns of the U.S., Mexicans not leaving and coming here?). Access to professional jobs is a problem for recently graduated Mexican college students...Not that Mexico shouldn't allow foreigners to come in and move up in society, but you can't compare the situation with the United States, that is ludicrous.

By the way, Mexico is experiencing pretty large waves of migration from Central and South America...Argentines and Brazilians, Salvadorans and Guatemalans are all over the country now. Many are attempting to enter the US, and staying when they can't.

Also, in Baja California where I own a home, there are thousands of American retirees, and more are coming each year. They want beach front property and can't afford life anymore in the United States.

I also read an article about how more Americans are moving to Argentina now...

10:36 PM  
Anonymous Eduardo said...

Ok. and then I think you mini-me need your own weblog.
Blogger and Wordpress are the best, but if you do not like their themes, do not give up.
Try Bloglines or LiveJournal before.
Thank you for giving me the chance to practice my English here.
I do not even start learning at the (LASFCELS) Legal Alien Super Fast Cool English Learning System yet.
After all, English is so easy for me, but please do not try to make me speak like a cowboy; I aint got no time to waste.
Bye, from Spanish to English Converting Name System:
Eduardo or Edward or Eddie or Ed

10:43 PM  
Anonymous Angeles said...

Andrés, I had the opportunity to hear your comments on immigration when you were in Chihuahua and I heard your report about this article with Pedro Ferriz this morning, so I took a look at your report and the comments as soon as I arrived to the office.

As you know, in México we are used to look at the political side of every situation, since here is common to use every statement with a hidden political approach. I have talked to many people I know in the US who is about to retire and they think México is a great option. I agree with you about the political tint this situation has but also go together with Lili's blog commentary, it makes sense.

Changing subjects, it's a pity that the US being a wonderful country has people like mini-me, who doesn't even know ortography (spelling) nor grammar! He definetly must be only cappable to pilot cruises and nothing else. I personally think he souldn't even be allowed to have a dog, I doubt he even knows what to feed the animal.

No pude evitar mencionar esto, también voy con Eduardo ;)
¡Saludos!

11:27 AM  
Anonymous mini-me said...

angeles wrote: Changing subjects, it's a pity that the US being a wonderful country has people like mini-me, who doesn't even know ortography (spelling) nor grammar! He definetly must be only cappable to pilot cruises and nothing else.


Wow, i will be honorable and refrain from responding in kind. Depending on how my day turns out!!

1:43 PM  
Anonymous Anonymous said...

Please mini-me, leave a foot note telling us how is your day today at the end of each comment.
It is not easy to understand that bipolar disorder.
I think we can help you with your Cuban-Latin American hate fixation.
And also remeber that I am Argentinian and that is not "poca cosa". Have you ever try our steack (a juice slice of meat cut from a fleshy part of a beef carcass) or our red and white wines? America (wide sense) is wonderful.

3:02 PM  
Anonymous Eduardo said...

I am sorry the comment above is mine.

3:03 PM  
Anonymous Anonymous said...

This comment has been removed by a blog administrator.

3:26 PM  
Anonymous Anonymous said...

dear mr oppenheimer,

as an amerikan expatriate living in acapulco, the proposals you put forth have been kicking around out "ex"-community for several years. you surely make far more sense than all the other geniuses in foggy bottom and beyond. you are obviously one smart lontsman and it is always a pleasure reading you via the internet.

g-d bless,

lee wm sachs
011-52-744-4838616

3:26 PM

6:33 PM  
Blogger bogjudge said...

Your report in the Herald on May 21 was intriguing. I am retired and live in Panamá. I have canceled my Medicare coverage and the $80 savings has allowed me to buy a comprehensive medical insuance policy here for about $40 per month. There are no delays, no beauracracy. Claims get paid (and denied). Medical care and facilities are excellent.

Given the corruption extant in both public and private sectors, top to bottom, in Mexico (and Panamá), I doubt the United States Government would be willing to export medicare coverage to Latin America. Besides, that would be too innovative. I surmised that you anticipated this by including the qualifier "with the proper legal framework" - however, how does one prosecute medicare fraud, so endemic in the United States, in Mexico?

The use of the National Guard, 15,000 (or 30,000 or 45,000) Border Patrol Agents or the entire US Army to guard the US - Mexico border is laughable. I lived in Las Cruces, New Mexico for years. That country down there is BIG. Throw in Texas, Arizona and California and you have a VERY BIG place.

7:08 PM  
Blogger Lili said...

Sorry, I know this is off topic, but I would move to Argentina for the meat! I think it is the best in the world...

My boyfriend is from Argentina and I am thinking of marrying him JUST because of how he prepares steaks! jajaja

2:58 AM  
Blogger VenePana.com said...

Medical coverage in Mexico or other Latin American countries is a viable idea, if and only if, rampant corruption is tamed in those countries. The costs of protecting the U.S.' nearly bankrupt Medicare system from fraud in a foreign country outweighs any benefit from cheaper costs of medical service.

11:54 AM  
Blogger You Know Me said...

As someone from the USA who recently retired to Merida, MX I can report that moving here and gaining retiree residency status if not the least bit difficult. In fact, the folks at the Mexican immigration office were, without exception, pleasant and efficient.

Foreigners here may enroll in the Mexican national health insurance program or buy private insurance at much more affordable rates than in the USA, with its profit driven health care system.

The other nice thing about Merida is that folks here are very tolerant of others, no matter the lifestyle. So being here I don't have to put up with meatheads like mini-me, whose bigoted type is all to common in the USA.

6:15 PM  
Blogger philiplundquist said...

I think your proposal has some merit, but as a 56-year-old baby
Boomer, I'd like a fuller addressing of the present challenges than just to
urge us, upon retirement, to leave our country. Geez, that reminds me of
what we heard during LBJ's own 'unnecessary war based upon a pack of
lies' - "If you don't like it here, leave." Reminds me of the anology of
an undesirable person moving into your neighbourhood. Why should
everybody else move from home because a jerk has moved into the
neighbourhood? He is the one who should leave, and it is all those millions of
criminal invaders who need to leave our country. Not to wax anachronistic
here, but it really was LBJ who screwed our generation - even
post-mortem, in that he blew our Social security Trust Fund, in considerable part,
on the Vietnam war. Remember the Confederates' wistful ballad - "Look
away, look away, look away, Dixieland"? We mustn't look away. It's
bloody unpleasant and damnably attributable to others, some of whom have
conveniently up and died on us, but we must face things. It's hard, and
it's necessary. And we must do it right now. But - and pardon me for the
shrill language - our Government leaders haven't the spine of a worm,
nor the morals of Rasputin. From the "Bridges To Nowhere " (87 - 13 vote
in the Senate) to the present sordid sellout of our heritage and
financial underpinnings through the amnesty legislation, we have been left
with a debased discourse in which your proposal that we get out of town
and let the kids and the criminal invaders support us more cheaply in
Guatemala or wherever passes for credibility. Thanks for reading. Short
of a Lewis Carroll or an Emile Zola - whom we desperately need at this
critical time - I offer you my humble comments....Philip
Lundquist...telephone 702-2566979 (My mother and her family came here from England,
and I worked for years with Air New Zealand and use Yahoo/New Zealand
for e-mail, but I'm a U.S. citizen and currently reside in Las Vegas,
Nevada)

12:20 PM  
Anonymous Anonymous said...

Dear Mr Oppenheimer,

I received your excellent penetration on that special interface between the present politicized turmoil which has - at this pointed - degenerated into what amounts to a level of absurdity and where all facts are almost lost. As your article (published in the San Diego Union Tribune several days ago) has succeeded ingiving a realistic and much needed focus where the general nature of Mexican labor (and this within a wide "arc") can be transformed into to be trained to perform the much needed medical services typifying the needs of our senior citizens. We are presently faced with a horrendous future in recognition that not only is the cost of services - as witnessed with the present - are strangling all budgetary solutions but allso affect the availability of skilled nursing personnell by virtually "stealing" them primarily from the Phillipines and India; and of course affecting their own medical attention deficits!

I am taking the liberty of transmitting to both you and my daughter Angela Kocherga who was anchor in Mexico City for many years for a number of well established TV channels, but just recently has transferred her office to work out of El Paso a rather lenthy effort which I made over a year ago. This matter has been so frustrating in that I do not have the required connectives to find a welcome understanding at some HIGHER political level to bring this project to a fruition.

If both you and my daughter feel that the following study has a logic and application then I would ask both of you to help coordinate this proposal for acceptance.
I am most certain that if any of you would have some means of having this proposal brought to the attention of Mexico's president FOX it would arouse further investigation
I have been accumulating in my dossier a sizeable portfolio of facts which would service to give thyis proposal ADDED strength in providing the numbers involved.

I would appreciate your comments either by email or on my cell 619 840 6221.

Sincerely,

Eugene Kocherga


--------------------------------------------------------------------------------

Background to the following presentation covering the subject of health care, credit should be given to Leslie Berenstein of the San Diego Tribune who provided a well documented study on this important and highly controversial subject (three issues dated August 22nd, 23rd & 25th '05 ). It left the reader impressed with the egregious and ineffective level of the existing health care system! As this continues to remain in limbo, any continuation providing partial and mostly ineffective & "patched up" solutions progressively escalates the huge social impact to what has to be unmanegable level to those 60 million "over 65 age level! It takes little forward vision to recognize the heritage of the imponderable consequences being passed toour future generations!



The subject of health care and its attendant negative effect on the factor of "cost worthiness" within the context of effectiveness, targets the middle class majority of our population with reduced financial capability affecting those receiving painfully reduced Social Security benefits and in particular those at the poverty levels.



It's spillover effect, relating to San Diego, when compounded with the fifth highest cost of housing nationwide, affects all of us in that we are trapped into an endless and an ever-limiting future! Needless to mention that these same circumstances correspond to all levels of senior citizens wherever they may be.



Surprisingly there is an effective, viable solution, which becomes apparent when placed in perspective to our closeness to the Mexican border. And what is proposed herewith as an ostensibly viable and effective solution for San Diego also serves as an effective solution, on a much larger scale nationwide. In it's application all aspects of health care needs would be brought together. All health care facilities - Medical, Medicare and private health care - would be beneficiaries and would further provide ample allowance for that fast growing, ageing and poverty level sectors. The objective: overwhelming cost benefits while maintaining optimal medical care within the framework providing maximal nursing facilities. It should be noted that California state expenditures for Medicaid alone is on a level next to the budgetary provision for the educational sector! In general estimation at a total cost of less than half of actual budgetary provisions!



An analysis of the elements involved in the existing health care scenario if applied to a nationwide solution reveal:

1)An endemic legal litigious factor as an contributory cause of the spiraling costs which affect in some degree every and all aspects of our health care system! That constant threat where the slightest, and even the lightly perceived questionable patient attention can give cause to ignite costly mal practice action. This represents a scary deterrent to the evolvement and use of the established normal medical care practices and procedures. This factor alone obligates the medical community to undertake a costly defensive insurance which further contributes in escalating costs and to an extent providing a destabilizing moral effect in the workplace..



2) The acute shortage of trained nurses is also another overwhelming hindrance in providing optimal care in all cases of hospital procedures where both normal and specialized attention are required. Compounding the shortfall and limitations on the trained nursing staff (a shortfall of over 100,000 nurses in 2003..) is the recognized high salary levels dictated by scarcity in this category requiring the costly use of contract nursing arrangements. It should be noted that nationwide this single expensive cost of contract personnel, in 2003 amounted to $16billion and by itself alone representing an 8% value of a total operating revenue of $389billion! This aspect further escalating the problem even to the extent where nurse instructors - an indispensable educational requirement toward generating a cadre of trained nurses - are difficult to retain within the bounds of traditional salary levels.



The situation further magnifies the inadequacies affecting optimal nursing effectiveness by the shortage of non specialized staff assistance to assist with the performance of the multiple menial tasks. There is a disinclination to accept minimal salary for work which is traditionally considered both demanding (requiring 24 hour presence) and socially "undesireable". When factored in both of these cost components become a sizeable portion representing 51.9% of the $389billion total operating revenue in 2003..





3) Given the limitations straining the availability of specialized surgeons and doctors in the face of increasing health care requirements and cognizant of the ever present intimidative effect of mal practice implications, the innumerable lab tests and investigative interventions become essentially defensively measures! These, further adding another significant cost element!



Another spin-off is the stimulus of incentives providing the medical equipment industry to actively develop constant additions of innovative and costly medical equipment . And within the perception and recognition that the intimidative legal aspects require such acquisition as a possible additional protective measure; arguably some of marginal value.



4) The medicinal aspects should also be recognized as another distorting factor affecting the cost of medical care. Here we are faced with a national wide recognition of the costly breadth and scope of the structured pharmaceutical industry. It is difficult to appreciate that a substantial segment of our population - facing up against the a powerful lobbying efforts of the pharmaceutical industry with the ironic support of FDA regulations - are now obliged to order their medication from Canadian suppliers. This has in effect caused a "revolt" and disavowal in certain states. There must be an ultimate solution to this controversy but being so politicized cannot be expected to be resolved in the short term - if at all! In the meantime the impact of cost worthy availability remains particularly severe affecting our aged and pensioned segment of the medically needed.



It is when we start dealing with the crunching numbers of our population that the enormity of any solution becomes awesome! There are of course two main aspects of health care affecting a distinction in that with advancing age, at some point in their lives, some form of care will be needed! It is that group, representative of those whose monthly allowance - whether from Social Security or other pensions plans - are limitative in providing the care necessary for survival! And if measured in terms of any reduction on a nationwide health care cost - could never provide an equitable fit!

!

The second group being the working majority, representing those covered by health insurance, are at least sheltered by their relative health and energy permitting them with the means to carry them well into the early stages of retirement. This general group is far more capable of defending themselves by their productive capacity and which allows some form of provisions for an assured future. But there always comes that day where the debilitations of advancing age will inevitably come into play!



In rough numbers, if one considers that of the 65 age +, there would be a population of approximately 40 million who, if judged by normal economic conditions are capable of withstanding the costly aspects of survival with adequate medical care. However a rough assumption would indicate that a remaining group of about 20 million are handicapped by inadequate pension provisions and whose medical condition is a source of extreme concern.



Having provided general definition of the existing elements affecting the availability of health care for the two main groups of population it is necessary to undertake formulating a solution, which offers some level of relief. And this within the factors of the population to be attended to and just how can all of the individual and varied elements of the medical profession be brought together to provide that indispensable long term viable solution.





Our Mexican and US border holds a unique opportunity of providing such a solution!. And it is within the viability of combining the resources of both the Mexican and US medical capabilities where significant relief can be realized!. It is the very attainable proposed program establishing sizeable hospital housing facilities equipped with the necessary equipment. The location would require it to be on the Mexican side of the border. With commencement of this program and upon the attainment of the targeted effectiveness with realizable cost worthy results would then propel the next step in the extension creating similar facilities. Location would have a desirable closeness to the larger population areas on the US side; such as Tijuana, Calexico, Nogales, Cd. Juarez, Laredo, Matamoros etc. Sites would be selected based on accessibility and closeness having determined demographic considerations applicable to the distinct levels of beneficiaries requiring multiple and varied aspects of medical attention.



At some point a nationwide balance of the much heavier impacted healthcare facilities would be achieved by the border site capacities able to absorb ever larger number of health dependant beneficiaries. It would be noteworthy to consider the convenience of the much lower service costs of medical attention with particular interface with that sector of the heavy dependant sector of the elderly beneficiaries.



To attain a level of effective success, it would necessarily require the committed and combined effort of both countries to undertake an effort, at a higher governmental levels to resolve the issues to be addressed in what would eventually develop, over time to be appropriately termed a: medical cross border"industry".



In its initial stages providing health care benefits, the beneficiaries would be subject to an adjusted payment structure of US health care system significantly less costly than comparable care and treatment as dictated by the higher costs nationwide.. . A bi-national medical supervisory authority would serve to set the goals of the quality levels required with the corresponding cost levels. Above all the choice of the facility for hospitalized attention would be entirely at the volition of the beneficiary for the treatment and attention required. It would however be notably quick to common knowledge that the service factor would be unquestionably more satisfying in the Mexican facilities than those available in the non-border nationwide equivalent facilties.



Optimal success would require a dedicated bilingual effort to underwrite both medical education and nurse training facilities over an extended period to take place in Mexico which offers an abundance of knowledgeable, youthful manpower responsive to the prospects of a desirable future . It would require programming to a future where the combined medical effort of both the US and Mexican medical groups would translate into providing an effective, reduced cost solution covering the complete gamma of the varied forms of health care.



This approach would necessitate ease of access, from both border points to provide the effective solution - in all the unique and distinct forms - for all persons (health givers and patients) directly related to the medical facilities situated on the Mexican side of the US border. Which given the comparably larger health care scale would necesitate direct access to the site by the opening specific access of an immigration "gate". Locations for health care sites would be interfaced to the close proximity of whichever US border city with access by air, road way and any other forms of transportation. These same considerations would be applicable in addressing the family, housing and educational facilities for the key US medical personnel serving that area hospital site.



There can be no question that this innovative program to provide the hospital/care giving facilities would result in dramatic lowering of cost of specialized medical and nursing care together with the other attending servicing requirements. As a point of comparative appreciation: the present nationwide 51.9% personnel/labor factor cost would we reduced by at least one half! If related to an initial hypothetical commencement to cover only 10% of the reported (2003 figures) of $390billion to represent the total operating revenue the applicable figure of $39billion would show - using the aforementioned defined personnel cost of 51.9% - to yield a figure of $20.2billion thus providing a saving of $19billion.! As a point of comparative reference, the total of US registered hospitals in 2003 was 5,794 showing an indicated 975,962 beds which generated total admissions revenue of $461billion.



Mexico has already established itself as a provider for effective medical training (the University of Guadalajara has had a lengthy experience in training US medical students for admittance within the approved AMA medical requirements). There is an abundance of trained nursing resources and medical doctors both mandated by Mexican law to serve a one year internship. This actually provides valuable "hands-on" experience under extremely difficult conditions which ends up delivering an excellent background and one applicable to the betterment of medical skills.



Not to be overlooked is the factor and the availability of almost every one of the recognized, established world wide pharmaceutical companies who - almost all - have their own manufacturing facilities in Mexico. The level of technology and lower pricing levels can be considered comparable to those located in Canada and with instances where the manufacturing output, because of the much larger population being served, combined with exported sales to other Latin American countries, are significantly greater in scale..



At this point it would be illustrative to provide a point of contrast to quantify the difference by selecting the traditional costs associated with childbirth (covering medical and immediate post natal care):

Whereas the typical US hospital facilities charge approximately $20,000 to cover all expenses for normal childbirth delivery the comparable medical intervention with services in a top quality hospital in Guadalajara, Mexico would be between a low $2,000 to higher level $3,000! Comparable contrasts would have a validity in almost any and all forms of medical and surgical interventions and particularly so as to hospitalization services and attention.

.

It can be concluded that the designation of physical location of medical facilities on Mexican territory is intended to suppress the costly and intimidative role of litigation. When combined with the reduced cost of medicaments, adding factors providing location of less costly construction of medical facilities jointly create a significant reduction on the overall health care costs.



Any analysis of benefits would clearly reveal that, upon the location and establishment of multiple number of medical facilities, within the scope of the program suggested here, would without doubt serve, to reduce and alleviate the burden and inadequacies of our existing nationwide health service facilities,. An added and measurable advantage would be to create and stimulate a climate to facilitate a dampening effect nationwide to the unrelenting trend of escalation of costs of services.



The initiation of a program attending to timely development of this program would require sizeable financial involvement. This would required institutional intervention to underwrite the investment funding which will no doubt provide an attractive return on investment. An involvement between the Mexican and US health authorities at the highest levels would be indispensable to resolving the various cross-border factors. The coordinated interest of both would provide a fertile opportunity for NGO investment offering financial viability in the obtainment of investment funding.



Upon commencement of operation of the physical establishment and the overall total health care structures on the Mexican side of the border, the sizeable personnel requirements of the less skilled service personnel would be readily achievable given the traditional abundance of labor resources in Mexico. This in itself, given the awesome requirements of service personnel to support the inflow of health receivers to be anticipated. As an index of the figures involved, nationwide in 2003 there was a total of 820,653 hospital beds covering total admissions of 36,300,000 health receivers!



In summary to attain effectiveness addressing the sizeable number of elderly Americans 65 years+ (presently established at 35Million; with that figure increasing to 70Million in 2030..) almost all on varied levels of restricted pension benefits (or those classified as being on a poverty level) mandates an urgency to provide a less costly and adequately effective medical attention. This would require a program multiple positioning of physical hospital sites, housing and corresponding infrastructure along the full length of the US, Mexican border!



It should be clearly apparent that all of the basic elements of viability indicates that combining both Mexican and US medical facilities (located on the Mexican side of the border) can prosper only with the joint intervention of both US and Mexican governmental cooperation and facilities! The legal aspects of extra territoriality, institutional and legal requirements would require considerable effort to find an acceptable solution to the satisfaction of numerous medical, governmental groups. And there cannot be any doubt that there would be a most eager interest on the part of both countries to realize a concrete understanding to this most desirable solution of our already neglected problem (and one with each year become more burdensome….)



I wish to state that copies of this written report combined with copies of your three issue journalistic presentation have been forwarded to a Dr. B. Blancarte who has an established political base in Guadalajara and to Sra. Martha Diaz de Romo, ex CEO of three leading Hispanic radio stations in San Diego. Both have expressed a positive response which they will carry on to higher levels if a comparably favorable reception could be expressed from the San Diego/US side.



Please contact me with your comments and/or inquiries,

Sincerely, Eugene Kocherga Cell#: 619 840 6221

1:27 PM  
Blogger Charles said...

Charles Wilkes
to aoppenheimer

A lot of us have settled in San Miguel de Ayende in Guanajuato state in the middle of Mexico high up in the mountains where it is cool.

I agree with eveything you have said. Now it needs to go to Presidente Fox, President Bush, and all members of Congress.

3:02 PM  
Blogger Charles said...

The country most welcoming new retirees South of our border is Panama. I wish Mexico would learn from them. The country which has most withdrawn their former welcome mat is Costa Rica. They decided to only welcome business, not retirees now. Since retirees do not have school age children and are never a police problem, all countries should welcome us, as we also bring and spend hard currency in their countries.

But while not a perfect US retiree host country yet, Mexico is so much better than the US is they seem wonderful by comparison. The people (at least in the provinces, not the large cities like the D.F.) are honest, and welcome us. And those who have only Social Security as their income can easily live in Mexico, but not in the US.

Incidentally most of us on Social Security retirement truly resent the fact that although we pay for it, we cannot claim Medicare outside the borders of the US. I do not believe that there would be the same rampart fraud as there is inside the US, provided that the claims were required to be reported by retirees personally, and not by the service providers as in the US, which is where the reported fraud originates. We are all over 65 (I am 80) to even be eligible, and I do not think we would be dishonest in reporting our Medicare-eligible health expenses.

The alternative is for us to drop out of Medicare and save the $80.00/month, since equivalent medical insurance in Mexico is roughly $40.00/month. But as many of us travel back to the US to visit family at least once annually, we still need coverage in the US, and few drop out of Medicare as a result. But there are many without US families who have vowed to never return to the US again, and do drop out to save money.

Since part D is so new, I don't yet know about that, but I expect that the net cost of prescription drugs even after part D is cheaper in Mexico as it is in Canada. And often you have to make monthly payments to be eligible for part D, which further reduces your net income from Social Security, which is little enough already.

Incidentally I am a veteran of World War II, and mostly get my own medical care at a VA clinic near my house, where my doctor is the most qualified doctor I have ever had. I pay a co-payment on office visits and prescription drugs from the VA, but I consider this to be one of the few bargains I receive in this life. I do not need Medicare coverage to receive this benefit, as a result there is no real reason for me to continue Medicare in Mexico.

Charles Wilkes

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6:03 PM  
Anonymous Anonymous said...

Bogjug,what are you doing in my country,by the way?
Another american expat trashing
Panama?

Do yourself a favor.Go back to
the U.S and stop whinning about
what Mexico,Latin America doesn't have.

I don't like the U.S but I do not
go there to live either.I prefer to stay in Panama and be a First Class citizen here.

Your comments are very contradictory.

9:07 AM  
Anonymous Anonymous said...

I live in Latin America and I m ashamed to see the illegal inmigration to the U.S by the
easy-life seekers.

But,I do not agree with the american expats in Latin America either.They do not have right to
get jobs in here ,where barely
we have enought to eat.
In Panama for example,the americans expats are taking jobs from panamanians.
That is not correct.
Just because the U.S cost of life is so high,the american expats have no right to come to Panama to take advantage of our country.
No way!

The best policy is stay where you were born and do not cause problems to others.

9:17 AM  
Anonymous Anonymous said...

Charles Wilkes,in which world do you live in?
Latin Americans WILL not welcome no american expats to Panama,mexico or anywhere in Latin America.
We do not owe you nothing.

I live in my own country therefore with full rights as citizen...can you say the same?

9:21 AM  
Anonymous Anonymous said...

Costa Rica had closed their doors to american expats for the huge social problems they brought.
American expats do not pay
taxes in Costa Rica nor in Panama.
Therefore,I pay the taxes for
10 more american expats.
Nice,hum?
Besides,american expats in Costa Rica brought child prostitution,
pornography and pedophilia and
other sex related crimes to
Costa Rica.
Was Costa Rica continue to open
the door to those american
expats?
Of course not.

Panama is doing the same.
The government cancelled the
"pensionado-retired person program" .
From now on,if you want to live in
Panama as expat,you will need
at least 100,000 in investments.
Soon,Panama will shut the door
to american expats because of
the abuses to the retiring program.

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What is a condominium?
A condominium is a type ownership where certain parts of the property (the units) are owned by individuals, and certain parts (the common elements) are owned in common by the unit owners, all of whom are members of the condominium corporation (the organization responsible for the operation of the condominium). Ownership of a condominium means you own the specific unit plus individual interest in the common property. You have ownership over all space and improvements within the walls of your unit.
It is very important to know that you are buying the condominium building first and then the unit, so make sure you like the building and its financial position. I will assist you with this.
What are condo fees and are there property taxes for condos as well?
A condo fee is a fee that each owner is charged to cover the expenses of the complex and individual unit. For example, in a high-rise condominium, the condo fee includes all utilities, plus building insurance, management and reserve fund contributions. When the plan is registered at Land Titles for a condominium, a separate title is created for each unit. And shown on each title is the owners share in the common property, which is expressed in "unit factors". This "unit factor" can be based on the units proportionate square footage or the initial market price in comparison to the rest of the complex. A budget is prepared for a condominium complex, and the fees are allocated according to the unit factor of each condominium unit.
There are also property taxes for condominiums, and they are also calculated based on the unit factor.
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PRECONSTRUCTION CONDOS IN COSTA RICA
Purchasing a condominium before the construction begins is a way for developers to get the working capitol they need for their projects and for investors to save money on the finished product. Many times investors are able to resell the condominium for a profit before the work is complete, and in some cases condos have sold multiple times with multiple profits before there anyone actually took delivery of the real estate.

This practice is very common in Costa Rica as it provides economic incentives by means of low priced, preconstruction deals to the client, which is mutually benefitial to the developer. The precaution that we take and recommend to our clients, is to be sure that the developer who is building the project, has a proven track record either abroad, or more importantly, here in Costa Rica. Ask your agent to give you some background on the developer, and the team involved in the project including the architect, builder, and developer
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