I spoke with a real estate agent yesterday to see whether we have any realistic prospect of selling our house in this economy. I mentioned to her that we would be leaving the area, so of course she wanted to know our plans. “We can’t afford to retire here,” I explained, “so we’re looking at moving south of the border. We’re considering Mexico, Panama or Ecuador.”
There was a silence at the other end of the phone line. “Oh,” she said, “you’re about the fourth or fifth person who’s told me that in the last couple of months.”
Then today, I watched various news and comments on the health care debate in Congress. It is a sad fact that the US is the only Western democracy which does not provide health care for all its people. Alan Grayson summarized the Republicans’ health care reform plan – “Don’t get sick, and if you do get sick, die fast.”
Michael Moore, traveling the country speaking and giving interviews as his new documentary launches, refers to our health care system as “cruel.” Statistics indicate the biggest reason for personal bankruptcies and home foreclosures in this country is the cost of health care. All of which made me start wondering … is our broken health care system and its cost driving US citizens to leave the US and move overseas?
Medical Tourism
Google the phrase “medical tourism,” and you’ll get over 28 million hits. According to an article in the Wall Street Journal, September 30, 2009,
“Insured Americans are starting to see some unusual options in their health-provider networks: doctors and hospitals in Singapore, Costa Rica and other foreign destinations.”
M.P. McQueen writes that a “small but growing number” of insurers and employers are offering Americans the option to seek medical treatment abroad. According to the article, open-heart surgery, costing at least $100,000 here, can cost as little as $8,500 in India.
Some 15 or so years ago, billionaire Richard M. DeVos, cofounder of Amway Corp., made headlines in the British press for his personal medical tourism. After being turned down for a heart replacement here because of his age, he traveled to Europe. According to news reports at the time, he “donated” about $50,000 to a hospital in England, where he then received a heart transplant at no charge, thanks to the British National Health system. DeVos is listed at #117 in Forbes list of world billionaires. Known for his extreme right-wing conservatism which would deny universal coverage to average Americans, DeVos apparently has no compunction about taking advantage of taxpayer subsidies for his health care when it suits him, just as he has no compunction about having taxpayers foot the bill for the new arena for his Orlando Magic basketball team.
Americans Abroad
Estimates place about 6.6 million Americans living abroad, with that number growing rapidly. Richard C. Morais, writing for Forbes.com, reports on a “new lobbying effort” by US retirees living in Mexico to expand Medicare to cover Americans in Mexico. According to Morais, Paul Crist, a former aide to Sen. Sarbanes now living in Puerto Vallarta, has formed an organization to lobby to get Medicare accepted there.
According to the AMMAC (Americans for Medicare in Mexico) website, the choice for many to move to Mexico is
“almost an economic necessity. In a survey conducted by a team led by Dr. David Warner, Professor of Public Health Policy at the University of Texas, Lyndon B. Johnson School of Public Policy, it was found that the lower cost of living is the primary reason seniors choose to move to Mexico. The median income for a retired couple living full time in Mexico is $35,000 per year. There are few places in the U.S. where $35,000 is sufficient for a comfortable lifestyle, while in Mexico that sum is quite adequate.”
(As a side note, I would like to point out that to some of us planning to retire abroad, $35,000 annually is a large budget. An average Social Security check for a worker retiring in 2009 is about $1,500, resulting in an annual income of only $18,000.)
The same survey found that 63% of Americans retired in Mexico had paid into the Medicare system for 31 years or more.
A December, 2008 article in International Living, a well-known purveyor of information for those seeking an overseas life, states:
“We can’t afford to live in the States anymore.”
We’d just finished dinner with a couple of International Living readers. They’ve decided to buy a house in Merida, where we live, and move here permanently.
“Health care and insurance costs alone are killing us. Add property tax, and it’s too much…especially when you consider that the value of our house in the States is falling fast.”
Suzan and I have heard this a lot lately, from Americans wondering where they can go to retire in style.”
(Read the entire article at http://www.internationalliving.com/Publications/Featured/where-to-retire.)
In fact, the organization regularly assesses the cost and quality of health care in all of its discussions of any given country. So do major living abroad resources, like Transitions Abroad, Escape Artist, and others.
The AARO (Association of Americans Resident Overseas) has requested its members to submit their perspectives on health care in the countries they live in. You can see a few of them.
Obviously, health care is a concern for Americans who live abroad. Nowhere, however, could I find any information about how many Americans are driven to move overseas primarily because of the cost and quality of of health care.
So – if you have moved overseas, or are planning to, and your major motivator is health care, please join the dialog! Just click the comment link below, or send an email to info at futureexpats.com.
Excellent post! I greatly appreciate the NHS in Britain and with aging parents I hear a lot of the downsides to the US system. Its frustrating at best and really enraging at worst. Pathetic that such a great country has got this wrong for so long–or more accurately, that such a great country has ket Big Business rule their decision making for so long.
I would have to say yes. Many US expats I have talked with share the same view on the US health care system. And this is not coming from people who just relocated to Mexico, but from people who have years living here. I think we could expect a larger affluence of US Citizens overseas as the US cost of living increases.
Michelle, you’re absolutely right. Big Business has taken over EVERYTHING here, including our government.
You have got it right on. This country is no longer by the people and for the people. It’s by the big corps and for the big corps! We are planning our move within the next year and it’s out of here. We lived in Africa for 13 years where our health insurance cost about $100 per month and covered everything with no co-pay! And they made money too.
We are just sick of the corporate greed in this country as we have seen all too clearly in the past few years. Most of our representation in Washington actually represents the corporate interest first and then their constituency only second, if it’s okay with their corporate friends.
Tom
WOW!! I just found your fantastic blog through our discussion on this topic on Linkedin. I have just linked it to my own expat blog.
Just a few days ago I wrote a post on the same subject, comparing the costs of medical treatment in the U.S., France, and Spain, which might interest you:
http://expat21.wordpress.com/2009/09/15/comparing-costs-of-health-care-treatments-in-france-america-britain-and-france/
A procedure for treating a broken arm in France cost 2230 Euros (to someone vacationing there)while the same treatment in America would cost $30,000 in Denver, according to a physician friend I have there.
Expat 21
Thanks, Expat 21. I just looked at your blog, and this article particularly. Very nice!
A few years back — 10 or so — my son broke his hand. It required surgery and several pins, screws, etc., as well as multiple doctor visits before and after. My recollection is that even back then it cost over $25,000. Fortunately, at that time we had insurance that paid all but reasonable deductibles.
US and Canadian citizens aren’t moving to Mexico specifically for cheaper health care but for an overall lower cost of living and improved way of life, in which lower medical costs are a big part.
I don’t think anyone is flocking to Mexico just to get treated at Mexican general hospitals and sign up for the Mexican social security health insurance, IMSS.
Too many other factors are at work, not the least of which is the huge culture shock for those who move to Mexico unwilling to embrace a new culture. You shouldn’t move to Mexico just to save money, or else you’ll always be a miserable fish out of water, even with more money.
It should be noted that it is possible to live in the poorest areas of the US such as Brownsville/McAllen,Texas, for less than the overall costs of desirable areas of Mexico, with excellent health care, Medicare, and all the other safety nets of the US.
But it is very hard to live a desirable standard of living in the US on many people’s incomes, Social Security or not, and lower health care costs are part of the more affordable standard of living in Mexico even when you have to pay cash.
I have a book coming out in a week or two called The Best How-To Book on Moving to Mexico which has in-depth chapters on health care costs and quality in Mexico, including a lengthy personal report on my own experiences having two knee replacement surgeries in Queretaro.
The total cost in Mexico was about $6,800 per knee, compared to at least $40,000 in the US. Even though Medicare would have covered much of the hospital costs, all the related costs of having the surgery and rehab done in the US were far higher than the $6,800 in Mexico.
I’ve been treated for irregular rapid heart beat in a general hospital in San Miguel de Allende for about $50 USD per four-hour visit including x-rays, EKGs, IV meds and cardiology specialists. Private doctors charge as low as $20 for a full hour, and about $50 an hour visit for a specialist who usually has had some training in the US.
My first book, Falling…in Love with San Miguel: Retiring to Mexico on Social Security, also has a lot of information giving specific prices for our retirement to Mexico seven years ago.
If anyone wants in-depth information on all aspects of moving to Mexico on a budget, including health care costs, please check out my website at http://www.fallinginlovewithsanmiguel.com, and my two books, the first of which is already on Amazon.com and the second one will be out within two weeks.
Carol Schmidt
My husband and I are researching moving to Mexico when we retire (hopefully in less than 22 months) because, in large part, we do not believe we can maintain a decent standard of life in the US on Social Security. While health care is certainly a large part of that, it is not the only reason.
I, for one, want the experience of living in and learning about a different culture. Not to mention the fact I don’t like the direction in which the US is headed.
Hi Sandra, thanks for your comment. Do you have a specific location in Mexico picked out yet?
You sound a lot like me — while the realities of trying to live on Soc Sec are scary and have to be faced, I’ve always wanted to live in another country and immerse myself in the culture and the language.
Michael Moore has more brains and common sense than all of the Republicans combined. It’s good to see the GOP getting nailed on their luddite and obstructionist tactics, since they do nothing to move America forward. It seems like the Republicans would prefer to live in the Stone Age instead of the 21st century.
My Husband and I are both retired and have come to realize that we can’t enjoy retirement in the US. It is too expensive for us. We are gathering information about moving to Mexico. i am so excited about my research that I want to be there today. We will gladly take any advice anyone has for us.