Hi,
My wife and I just got back from a conference in Panama. I had mentioned this to some and here is the report.
regards,
5412
REPORT ON PANAMA TRIP APRIL 22, 2010
Our goal was to attend the International Living Conference in Panama focusing on three issues.
The primary issue was to learn about health care for seniors. In the event that our US health care goes the way of the UK, where it becomes rationed, long delays or sub standard. What international options are available? How would one access the care and pay for it?
The second issue was to investigate the country itself. Many folks are migrating to Panama and we wanted to look at is as a country for visits, and/or part time residency.
And finally, there has been a lot of money made in real estate in Panama and Central America over the last few years. What investment opportunities exist today?
I think I will deal with the questions in reverse order as the first two can be answered fairly easily.
INVESTMENT OPPORTUNITIES
As to real estate, there are values today in housing and condos but they are overbuilt and do not expect the doubling and tripling of money as they had over the previous five years. We were told in the first ten minutes, do not buy pre-construction, do not buy with the idea of renting out the property for any kind of profit. The trick to buying would be similar to the US, if you find a desperate seller you can likely make a profitable investment.
There were a lot of Americans concerned about getting money out of the country out of fear that wealth in the US is likely to be confiscated and there certainly is potential for that. It would be very difficult for the US government to repatriate foreign real estate, and it could serve as a hedge against the coming high inflation of the US dollar. Personally I saw nothing unique in Panama in this regard. It is indeed the bustling business capital of Central America so there would be more traffic to buy and sell real estate but they have over-built just like much of the world.
RESIDENCY
We spent one full day with a realtor from MN who has set up a thriving business in Panama. They have several ways for Americans to visit. First is a tourist visa which is likely limited to 90 days. Then they have a pensionado program which comes in various flavors which allows Panamanian residency, either full or part time. I thought it was a requirement for health care but learned I was incorrect. More on that in the next section. There are many economic benefits to the pensionado program including many discounts, including air travel etc.
We looked at some beautiful beach property in manned gated communities on the Pacific coast. Views were incredible and one of the condos had a small bedroom window opening to the hall area. The realtor suggested one would do well to install bars on that window...ummm yeah in a manned gated community.
We drove back to Panama City and he showed us some beautiful high rise condos in the middle of the bustling city. He showed us the building he and his wife live in and their unit is 2500 square feet. Now his home was four blocks from our hotel. I asked him if we wanted to go for a walk, what would be the safest way to go. He said we would be better off not taking a walk; particularly after dark.
It was ironic when I asked him about crime and he said Panama is a very safe place, most of the crime is petty theft. He explained it this way. Say you left a silver vase in a window of your first floor unit. It likely would go untouched the first two days but on the third day it would be gone. The attitude of the Panamanians is that if a person is rich and they leave something of value out in plain sight then they do not need it anyway so they will just go ahead and take it.
Got to thinking about that and realized our US system, for the most part is much more efficient. We have a government who chooses to confiscate from the top 52% of the population who pay all the income taxes, they don't need it anyway. Then they redistribute the wealth they confiscate to the poor and use the distribution to encourage the poor to vote for them because they are better thieves than the other political party.
When you think about it everyone wins. The rich get robbed fairly equally, the poor feel it is fair because it is distributed equally and the politicians get rewarded for being modern day Robin Hood's. For the most part, the country and those who have worked hard and accumulated wealth, are living under the illusion of being safe. Now how cool is that? Now I suspect there are some areas in major cities in particular that one would do well to be careful but it did not seem as widespread as it felt in Panama. No neighborhood, no matter how much wealth, was without it's share of poverty nearby.
It does give cause to the thought that many wealthy people have seen the need to flee from oppressive governments over the history of the world. I hope it does not get so bad in the Us that we see fit to have to do such a thing. If we did, likely so far we would head to Costa Rica or Panama.
And finally it does give cause to why many folks have chosen to move some of their assets offshore, much like the vase, they want to keep it out of sight of the thieves, this time being the government.
HEALTH CARE
The good news is the health care in Panama is considered first rate. Many of the doctors are US trained, and board certified. To our doctor friends who may want to move down there to practice, forget it for the time being all the doctors are Panamanian.
One of the presentations came from the managing director of the Johns-Hopkins facility in Panama City. While they do not have a cancer center, they do pretty much have everything else and cancer centers are available. I asked him about health care for seniors; particularly those in the US and Canada where we may find our health care rationed, delayed or unavailable. He commented that is was certainly available and many folks are indeed coming down there for the quality of the care and the much lower cost of the care.
One of the other speakers lives in Boquete which is a rural area, several hours drive from Panama City and is supposed to be beautiful. He went to the local clinic in Boquete, private pay, and the doctor told him he needed a cat scan and did not tell him why. It cost him a few hundred dollars and they diagnosed cancer of the liver. He said he thought he was a goner and the doctor said not at all it was small, contained and sent him to a hospital in nearby David where he had the surgery and all went well and he is just fine. He is from CA and said he would recommend Panamanian health care to anyone.
Now, here is the rub. We asked about buying insurance. I thought you had to be a pensionado to do that and was incorrect. They have a two tiered system, a public program for the citizens then a private pay. Those that go private pay can indeed buy insurance or just pay the bill themselves which is generally 20-40% of the cost in the US. No one in Costa Rica or Panama complained about the treatment, facilities or the cost.
I then learned that most insurance companies will not insure folks over 70 years old. Being nine days away from 70, that could be a problem.
In speaking with the head of the Johns-Hopkins facility, I told him I would want to continue with my health care in the US as long as it was available. I would want a policy, like an umbrella policy that would cover the cost of care that was unavailable to me in the US or where they would be a long, risky, inordinate wait. He looked a me, and paused, then told me under their charter they could not sell insurance. Then he quickly said, likely there would be a significant need for such a thing and they could set up a separate corporation to provide that insurance. He gave me his card, and I gave him mine and he said he would get back to me shortly.
We then had a presentation from an insurance agent who confirmed the 70 year old limit but said there are companies that will offer international coverage for people over 70. We have two, and soon to be three different folks to contact to learn about what kind and type of coverage will be available.
Bottom line is good, quality care is available, it boils down to the fact that one must find a way to pay for it. If the US goes the way of the UK, I suspect that central America will be flooded with seniors and checkbooks who wish to be responsible for their own health care instead of a government employee deciding how much pain they should endure or when they should live or die.
As I learn more about the insurance side of things, I will pass information along to those who may be interested.
It was a great trip, had fun, saw some cool stuff including the Panama Canal for lunch. At the same time, there is still no place like home...
Best personal regards,
Dennis
PS: Don't buy the fact that most of their folks speak English. Not so. Thanks to a guy name George Woodyard well over 50 years ago I knew the words for fish, beef and chicken. It was the 10+ little words that followed on the menu that described how they were cooked that scared us. Last two nights we ate at a Tony Roma's and pointed to the photos in the menu when we ordered. Guess I needed Spanish III to learn those little words regarding herbs and spices...
