The numbers are hard to ignore.
According to the 2016 report from the Boards of Trustees, Medicare Part A will run out of money in less than 11 years. As a country, the United States is experiencing “deer caught in the headlights syndrome”; We’ve been alerted to a grave impending danger, but we’re frozen into inaction.
Whether we choose to accept it or not, something has to give. The truck is barreling down the road, and if we don’t do something soon, we’ll all be roadkill. Why don’t our leaders act? Because they can’t come up with a solution that doesn’t either cut Medicare benefits or raise taxes, or both, and what politician wants to run on a platform of cutting benefits and / or raising taxes?
I am proposing a third solution, one that will not only eliminate the Medicare funding deficit without raising taxes, but will do so without cutting benefits: Provide Medicare recipients with a voucher for 75% of what Medicare would pay for their procedure in the U.S. and then let them receive their healthcare services anywhere in the world they choose.
What patients don’t spend, they keep.
After studying for years what it’s like to live abroad and now doing it myself at the age of 59, I’ve read what others report and now experienced personally how the quality of healthcare services in many countries abroad is as good or better than the United States, and how the cost is a mere fraction of what it would be in the U.S.— sometimes as much as 80% less.
As an example, I can visit my general practitioner here in Mexico for less than $20 out of pocket, without insurance. A visit to a specialist such as my neurosurgeon will set me back $40, also out of pocket with no insurance. Apart from my personal experiences, on the Best Places in the World to Retire website we have more than 400 expats who have answered close to 1,000 questions about the cost of healthcare in Mexico, Panama and even Nicaragua, with the overwhelming majority reporting that the costs were significantly less than half of what they paid in the U.S.
In a recent study we asked expats living in Panama the cost of healthcare. 44.6% said it was from half to a quarter of the cost in their home country and 29.7% said it was less than a quarter of the cost of their home country. In a soon to be published study covering Mexico, 40.7% said healthcare costs from half to a quarter of their home country, while 31.6% reported costs that was less than a quarter.
Using my voucher solution, Medicare beneficiaries could pay for their healthcare abroad and have money left over for a nice vacation in Puerto Vallarta or perhaps to even fund their a grandchild’s freshman year of college, all while Medicare saves billions.
But low costs are close to meaningless if we don’t receive quality healthcare outcomes. I’ll start again with my personal experience and that of my wife and our friends, which has been that the quality of care is excellent for expats in Mexico.
Consistent with what I read from the expat contributors on our site, I have found that the physicians they use here in Mexico take much more time with each patient, listen much more attentively (all in English, by the way), and are good doctors.
The above referenced surveys also backed this up, with expats reporting that the quality of care abroad was about equal to what they received in the U.S.
In Panama, Hospital Punta Pacifica is a high-end facility managed by Johns Hopkins Medicine International, where we are told the care is less than half the cost of the US.
Even in Nicaragua, Hospital Metropolitano Vivian Pellas received accreditation by the Joint Commission International, a prestigious and difficult to attain indicator of high quality.
In the U.S., we have so mangled our own healthcare system and burdened it with so much gunk and costs, that unless there are major changes, we will soon be experiencing some very significant and very nasty problems. And who expects those changes to take place any time soon?
There may be all sorts of issues and interest groups that would thwart any effort to implement my voucher solution, and of course, there would be details to be worked out.
However, to those who reject it, I have a question: What is your better solution?
Chuck Bolotin is the founder of Best Places in the World to Retire (click on: https://bestplacesintheworldtoretire.com/), a website that provides credible information to those researching moving, visiting, or doing business abroad. Prior to that, Chuck founded, funded, ran and sold two companies. He is a frequent guest lecturer at the Eller College of Management MBA Program, mentored at the Arizona Center for Innovation, and frequently sat on the Desert Angels Screening Panel in Tucson, Arizona. After selling his home in Arizona and completing a one year road trip through Mexico, Chuck now lives in Ajijic, Mexico, with his wife, Jet, and their two dogs.
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