{"id":7537,"date":"2016-11-18T15:00:46","date_gmt":"2016-11-18T20:00:46","guid":{"rendered":"http:\/\/www.escapeartist.com\/?p=7537"},"modified":"2020-12-10T13:06:17","modified_gmt":"2020-12-10T18:06:17","slug":"expat-medical-plans","status":"publish","type":"post","link":"https:\/\/www.escapeartist.com\/blog\/expat-medical-plans\/","title":{"rendered":"My Expat Medical Plans"},"content":{"rendered":"

My Expat Medical Plans.<\/strong><\/h2>\n

One of the major challenges of expat life is making sure you have decent medical care and coverage. I\u2019ve noticed that the 20-somethings that travel the world seldom talk about this. But I\u2019m 57 years old and my wife is only a few years behind me, so it\u2019s already important to us and will only be more important as the year’s tick past. <\/span><\/p>\n

I\u2019ve lived under several medical systems. I started out in Canada with its much-hyped \u201cfree\u201d medical care. Of course, it isn\u2019t free, because nothing is. But everyone is covered and the technology is about as good as anywhere else, more or less. <\/span><\/p>\n

I also lived briefly under the UK\u2019s National Health Service. I have to say I received excellent care there when I had an urgent issue that required an ambulance ride and multiple days in the hospital.<\/span><\/p>\n

As you know, both countries have universal healthcare paid for by taxpayers. But there are problems with these systems. There are too many sick people for the budgets of these services. Wait times for care are so long they would be considered medical malpractice in the United States. \u201cThat triple bypass you need to clear those blockages? We\u2019ll get to those in August.\u201d<\/span><\/p>\n

The underfunded medical services problem is occurring all over Europe. Pharmacies in Spain and Greece have not been reimbursed by the government in months. Many have closed or will only take cash for medications that are supposed to be \u201cfree.\u201d Hospital workers, nurses, and even doctors are going on strike. Wait times at emergency rooms can stretch to many hours, sometimes most of an entire day. The wheels are falling off. \u00a0<\/span><\/p>\n

I also lived in the U.S. for twenty years and have experience with that medical system. Medical insurance in the U.S. does not provide much peace of mind. Sky-high deductibles and big premiums are at least obvious and transparent. But the bigger issue is how often you find out the insurance company has a way of wriggling out of covering the really expensive medicines, operations, or long-term care you might need. Submitting a claim can be like buying a lottery ticket. Maybe you win, likely you don\u2019t. <\/span><\/p>\n

And now the Affordable Care Act (ObamaCare) is moving the U.S. toward the European system. Of course, it has a slight fascist tilt where it mandates enriching the insurance companies that help get these folks elected. But that\u2019s for another post. <\/span><\/p>\n

Rest assured that soon the U.S. will have the same budget shortfall issues that the other national insurance systems have all over the world. Pay more, get less.<\/span><\/p>\n

Here’s a podcast from The Expat Money Show<\/a> <\/strong>where Mikkel and I talk about safely leaving the rat race by starting an online business!<\/a><\/strong><\/p>\n

 <\/p>\n

So What\u2019s an Expat to Do?<\/b><\/h2>\n

I want to quickly go on record that I don\u2019t personally endorse any of these approaches to healthcare. Like you, I\u2019m just forced to use them because alternatives have been driven from the marketplace by legal coercion. So I\u2019m left to carve out a solution using what\u2019s available to me. <\/span><\/p>\n

In a way, the U.S. system and the European\/Canadian systems have opposite polarities. In the U.S. I always felt like the physicians were running the meter on me. First of all, there\u2019s always an invisible lawyer sitting in the room with my doctor and me. That lawyer is looking for excuses to sue the doctor, and the doctor knows it. So I end up paying (deductibles, co-payments, higher premiums, etc.) for every conceivable test and procedure that \u2014 if left out of my treatment \u2014 could be grounds for a lawsuit. <\/span><\/p>\n

Add to that the fact that many physicians have to be entrepreneurial to offset the beating they take on Medicare, Medicaid, and other mandated rules. So my GP might have a 50% financial interest in the lab next door, or the radiology clinic across town. So I get sent there a lot. Maybe more than necessary. Ka-ching!<\/span><\/p>\n

In the UK and Canada, it\u2019s the opposite. All the incentives are to spend as little as possible on each patient. There is never enough money to go around. \u201cCAT scan? Let\u2019s wait and see how you\u2019re feeling next month.\u201d You have to gripe, exaggerate, and fight for every scrap of medical care and diagnostics you can get. Yuck. <\/span><\/p>\n

So here\u2019s my strategy. I\u2019m using elements of each system to try to find a workaround. We\u2019re going to set up residence this year in an EU country, likely Ireland. We\u2019ll be legal residents, taxpayers, and part of the national healthcare program in Ireland. By the way, that system has reciprocity with the rest of the EU, as far as urgent medical is concerned. That\u2019s good for frequent travelers like us. We can augment the government plan with private insurance that will give us higher levels of service. <\/span><\/p>\n

But all of that is still subject to the \u201cyou\u2019re fine, go home\u201d mentality inherent to government systems spending the minimum on each patient and private insurance looking to minimize claims. So we are going to visit a hospital in Thailand or Malaysia about every 18 months and pay for one of their comprehensive packages. Here’s where we will go:\u00a0 <\/span>Bangkok Hospital Pattaya<\/span><\/a><\/p>\n

Listed below is what $2,800 gets you in this part of the world. And this is from an internationally certified hospital that meets the same standards that a U.S., Canada, or European hospital would meet. (Some of these are male\/female-specific, so nobody would get all of them – just most of them.)<\/span><\/p>\n

This is a \u201cgrand executive\u201d<\/strong> package, where you get all of these tests for $2,800. Other packages cost less:<\/span><\/p>\n