But What About Medical Care?

THE most frequent question I get on board ship about living in Panama is, “But what about medical care?”

Amongst USA folks there is an assumption that everything, EVERYTHING in the US is better than anywhere else in the world. The infrastructure. [Obviously these folks have never driven in Europe or Singapore, or flown into Bangkok on Delhi!] The freedom. [Probably they haven’t looked at “The Patriot Act”.] Security. [I grant you no country in the world performs this grand illusion, worthy of David Copperfield, better than the US!] And of course health care. If it is the most expensive, then it must be the best, the US government’s own figures of life expectancy and health care in other countries notwithstanding.

Talk to different folks who have experienced the health care here and you will get different stories. You will NEVER get the total story reading the Internet or any public forum. To get the real story you need to talk and talk and talk to a LOT of people and listen carefully to the Coconut Grapevine. Why? Simply put, Panama is not the US. Panama does not have free speech.

“If you can’t say something nice, don’t say anything at all.”

That’s what my mother used to say and, believe me, it applies in Panama. If you say something that isn’t nice, even if it is true, you can have all of your assets sequestered while you are sued in a law suit that drags on for years. “But I thought it was hard to sue people in Panama?” Yes, but . . . say the wrong thing about the wrong people and you can be ruined. So no one is going to give you the complete story about health care in Panama.

I can, and will, tell you our story, and it’s a good story. We have used the health care here, are satisfied, and have found it far superior to what we were getting in the States. Others have some far different, and frankly very disturbing stories. I get emails and comments from folks who have what I would consider horror stories . . . and I can’t risk publishing them. Of course pick ANY hospital or medical institution in the US and you will hear the SAME stories. Medicine, despite all the fancy machinery and “science”, is still an art. People are still people. Shit happens. People make mistakes and sometimes people die because of those mistakes. And sometimes people just die because it is their time, medical science or no medical science.

Are costs of medical care rising in Panama. Yes, like everything else because, remember, we use the US dollar. Also Panama is on an economic roll . . . some might say an economic boom . . . and that means costs and prices rise. But I have seen what I would consider some outrageous, even for the US, charges for hospital rooms, surgeons and anesthesiologists. Again, I don’t know all the background, but one certainly would not expect hospital stays in Panama to be more than in the US. Is their gouging of gringos? I don’t know. I DO know that, although technically it is not legal, there have always been “gringo prices” and “Panamanian prices” in Panama for everything. As an expat you are perceived to be fabulously wealthy and expected to be anxious to spread that wealth around.

So, provided you have the luxury, before you “jump” I would do a lot of asking around, put my ear to the ground, and find out the experiences of as many people as possible. I can only give you OUR experience.

For example: it’s time for me to get a checkup. I’m off on the ship for months at a time so it just makes sense to occasionally get a physical, have baseline EKG to take along with me and results of the usual battery of lab tests and have an MD tell me I’m still kicking. We have insurance with MS Chiriqui at Chriqui Hospital and we have had this since we came to Panama. Under the insurance plan they paid for half the costs of my tests, and I will pay $20 for my doctor visit. [It used to be $10, so that’s a 100% increase.] My EKG at the Emergency Room at Chiriqui Hospital cost $20. My lab tests here in Boquete costs $80, of which MS Chiriqui insurance paid $40. The doctor I use runs his office as a “clinic” so it is first-come-first-served which is OK by me since medical “appointments” in Panama don’t mean anything.

My wife saw her cardiologist a few weeks ago. It took two trips to David (40 minutes away) since the first time the doctor had an emergency and wasn’t available for her “appointment.” She had to wait a few hours for her “appointment’ but the doctor saw her, spent an hour (60 minutes!) with her and her cost, with the insurance picking up half, was $20.

We like the fact that the doctor is free to practice medicine. He/she doesn’t have to see 10 or 15 patients an hour. He can spend whatever time is necessary with you (unfortunately for you or the others who end up waiting). He doesn’t have to answer to a 20-something kid sitting at a HMO office with no medical training for his diagnosis or treatment. The doctor isn’t being hounded by malpractice attorneys nor does he/she have to carry enormous amounts of malpractice insurance, so he/she doesn’t have to order a battery of unnecessary tests just to cover his/her own butt. Your are not a number, or a “file”, but a person, which we find refreshing.

The hospitals have most of the bells and whistles. They may not look expensive and “clean” by US standards, and they may not even have hot water, but although my wife didn’t like the cold baths, she found the care adequate. This is Panama, and some things that are important in the US are not important in Panama. [Many Panamanians still think that taking hot baths will make you sick, and besides this is the tropics so tap water is rarely ice-cold.]

When my wife needed an angioplasty and stints she went to Panama City because our local hospital wasn’t performing those procedures. Our good friend Feliciano Ballesteros gave support and help in Panama City. Nikki went to Hospital Paitilla in Panama City which is affiliated with Her cardiologist in David had recommended the “best guy in Panama” for this procedure. Hospital Paitilla has relationships with a number of hospitals in the US and Spain including the Cleveland Clinic. With the exception of the cold sponge baths, Nikki found the care good and in a few days flew back to David. The total cost of the angioplasty and two stints was $15,000, of which MS Chiriqui paid 50%, so our out-of-pocket cost was $7,500.

So we have no complaints.

However, there are others who have different stories.

Life is all about risk. Are there risks, sure. More or less than in the US, or Canada, or Europe . . . depends.

Nikki worked 18 years for Ventura County Public Health. Every year the county shifted health care providers for its employees always looking for the cheapest option. Before we left Ventura, Nikki visited the HMO who provided the county employees with healthcare, to get a final check up, stock up with medicine, and pick up her records. Well, some of her records, since in all the switching of health care providers a lot of the records had just been dumped in dumpsters and carted off to landfills. The doctor breezed in and looking at her chart asked, “How are you doing with your diabetes medication?”

To which Nikki answered, “Diabetes. I don’t have diabetes. You must have the wrong chart.”

The doctor replied, “Oh yes you do! We diagnosed it a year ago. Didn’t anyone tell you?”

How’s that for quality medical care?

My Day in The Panama Canal

In what may be a classic case of over-reaction, Carnival Corp following the Costa tragedy has now decided that nobody is allowed on the bridge of its ships except the bridge team and the pilots. You will recall that the captain of the COSTA CONCORDIA was entertaining his dancer-girlfriend on the bridge when the ship veered to close to the island and slashed open the hull.

Always in the past I gave my “Bridge Commentary” while passing through the Panama Canal, well, from the bridge! Not anymore. So I was somewhat pissed yesterday to have to give the “Bridge Commentary” from the Horizon Court surrounded by passengers chomping away on breakfast and with, for me, a very limited visibility plus the need to describe the play-by-play without being there.

I was to start at 5 am. I was there, but as so often happens on ships, the right hand didn’t have a clue what the left hand was doing. It was almost 7 am before I managed to get the right people awakened, and get a mic in hand and begin my commentary.

While our normal “Pilot on Board” is scheduled for 5 am, yesterday was not a normal day in the Canal. The pilot was scheduled to come on board at 5:45 am, something nobody thought to tell me about. Normally I check everything out with the Bridge the day before to confirm the schedule … Of course every ship is different and operates differently.

For me it’s a long day … 5 am until about 3 pm when we get through the final locks, with me talking much of the day. So, with both me and Princess looking disorganized, we managed to get things going at 7 am.

I learned that sometimes changing things, even in ways you don’t want, actually works out for the better. I loved doing the commentary from the Horizon Lounge with all the guests right there asking questions. If one person asks a question, or really didn’t “get” how something works or why, the likelihood is a score of other folks have the same question or misunderstanding. And I had stewards filling my coffee and all the food was right there. So eventually it worked out great!

So why wasn’t it a normal day on the Canal? First they were doing a lot of dredging in Culebra Cut. [Culebra Cut was renamed Gaillard Cut by the Americans to honor David Gaillard who was the American engineer who was largely responsible for the success the US had in digging through the Continental Divide. Since the Turnover, Panama has been returning to using the original Panamanian names, so it’s now usually called Culebra.] the dredging forced one-way traffic through the cut. And, the big news, in more ways than one, they were moving one of the giant new gates for the Pacific Locks through the Canal.

The rolling-type gates that will be used in the new locks are made in Italy, then brought across on specially designed barges. The gates for the new Atlantic locks have all been delivered and are sitting beside the Canal near the present Gatun Locks, awaiting installation. The gates for the new Pacific locks have to be brought through the Canal over to the Pacific side. So we got to see the process when we passed one of these gigantic gates, not the largest by the way, in the Canal making the transit. The largest of the new Pacific gates is 11 stories high!! On the picture you can see the centipede-like method of specially constructed vehicles that moves the lock gates.

While we were going through the Canal, with me accessible in the Horizon Court, people were coming up not only just asking questions, but wanting pictures (pity their friends who need to watch them, but I guess it’s easier to watch friends’ vacation pictures on iPad than a full-scale “come over for drinks and see my vacation ‘slides’” presentation), express appreciation for my lectures (Princess take note!), or get me to sign copies of my PANAMA CANAL DAY books. Incidentally, we sold out the books I brought on board and I’m hoping to have more to pick up when we get to Ft. Lauderdale.

Panama Canal Day Gates 1Panama Canal Day New Lock GAteNew Pacific Lock Gate in the Canal

 

Along The Pacific

Between the time we left San Pedro [Los Angeles] and begin our transit of the Panama Canal, ISLAND PRINCESS called at three ports, leaving a lot of sea days in between which are great for me because I get to talk about Panama and the Canal and give people the information they need to get the most our of their experience in Panama. If you can’t join me personally on a ship, you can get the same great information in my book PANAMA CANAL DAY: AN ILLUSTRATED GUIDE TO CRUISING THE PANAMA CANAL.

I thought you’d be interested in the places we’ve stopped en route to Panama.

Cabo San Lucas

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Years and years ago the first time I went to Cabo it was still a sleepy, fishing village. Not any more! It is one of the “Top 5 Tourist Destinations” in Mexico, crowded with tourists, time-share sales people, surrounded by mega resorts with world-class golf courses, and in general, pardon me … a touristy zoo.

One of the best views of the rocks at the tip of the Baja is actually from the deck of the ship, which along with the rest of the cruise ship fleet, is anchored off shore. Local tenders assist in a rapid off loading of guests eager to explore the wonders of Cabo. This is where the Pacific Ocean meets the Sea of Cortez and it is a popular area not just for tourists but for sea lions. There is a natural arch in the rocks formed by the massive erosion of the sea that is three stories tall. Cabo is great for fishing, snorkeling, diving and beaching. If you work at it you can even still find beaches that aren’t jammed with tourists and tequila-fueled party people. One popular beach is nestled between the rocks and known as “Lover’s Beach.” Supposedly it was a private and secret place to carry on a tryst in the sand, which by the way is highly overrated. Nikki and I tried it once and it can get very uncomfortable as in the throes of passion sand gets where it was never intended to be. Today, like most things in Cabo, “Lover’s Beach” although still spectacularly beautiful, is crowded with tourists.

San Juan del Sur

Every time I do a contract I’m hoping for at least one port that I’ve never been to before, and this time it is San Juan del Sur in Nicaragua.  This is a very interesting port, as is Nicaragua, partly because it has so many volcanoes.  If it wasn’t for the volcanoes of Nicaragua the canal might never have been built in Panama.  Now, aside from the colonial charm of places like Granada, and the beautiful vistas of Lake Nicaragua, the area is of particular interest to me because this is where the proposed Nicaragua Canal being built by China is supposed to begin on the Pacific side.

Las Isletas in Lake Nicaragua, one of the areas environmentalists feel may be threatened by the proposed Nicaragua canal and the rush to begin without adequate environmental impact studies.

Puntarenas

Although pretty much a nothing town, except for a fairly nice town beach just a short walk from the pier, Puntarenas is mainly a jumping off point for some fantastic shore excursions that explore the Pacific coast of Costa Rica.

Beach in Puntarenas is withing walking distance of pier

Beach in Puntarenas is withing walking distance of pier

Tour of a beautiful coffee farm high in the mountains of Costa Rica

Tour of a beautiful coffee farm high in the mountains of Costa Rica

John is an old gringo like me who lives outside of Puntarenas.  Every week before the ships come in he gets Tarazzu coffee, my favorite Costa Rican coffee grown at 5,000 feet and roasts it.  He sells it as Shade Lady Coffee.  But be careful, there is another business in Puntarenas called “Shady Lady” … and from her you may get a lot more than you bargain for!  Anyway John sells his coffee and even although we grow excellent coffee, my wife always asks me to bring home some Shade Lady coffee.Puntarenas 028

Now we are off, heading for Panama and the Panama Canal.

Volendam Mar 08 043

A Great Opportunity

Bob Adams is a guy I respect and enjoy listening to.  I think Bob gives one of the best analysis of the economic of Panama and does an excellent job objectively evaluating Panama as a place for investment and/or retirement.  He is a frequent guest on the Panama Relocation Tours and has two very interesting Web sites RetirementWave.com, and PanamaWave.com.

Bob has spent his life working in international development and humanitarian assistance for a wide variety of private and public agencies, work that has taken him to more than 40 nations since he first began as a US Peace Corps Volunteer in the Philippines in 1967. He chose to settle and retire in Panama City in 2004. Since then, like a lot of us, he’s been frustrated with the big outfits promoting expats moving to Panama based mostly on hype, often inaccurate hype, and presenting only a rosy picture of life in Panama without dealing realistically with BOTH the joys and challenges of living in another country and culture.

Bob has a great idea and offers you a great opportunity to check out the facts, something many of the big “conference” promoters are light on, and that is an internet teleconference. For folks considering Panama, here’s an opportunity to get some factual information without spending thousands of dollars to sit in a hotel ballroom in Panama City, or actually fly down to Panama. If you sense Panama may be for you, it makes perfect sense to come on a Panama Relocation Tour which, unlike the hotel ballroom conferences, is a boots-on-the-ground opportunity to see and experience the real Panama.

So here’s the information about the Internet teleconference, a great opportunity at a really great price, only $37.  [Unfortunately I will be at sea with slow, poor and horribly expensive Internet and unable to attend.]

Back At Sea

It’s been over a year since I’ve been back on Princess and I’m happy to be back, this time on ISLAND PRINCESS again as Port Lecturer.

I had a little over a month to get ready and no, it’s not just packing.  On this contract I have 22 separate lectures, bridge commentaries, etc., to prepare.  Even although I did this basic run seven years ago when I started doing this kind of “retirement” job, obviously a lot has changed and even although I may have had the basic structure of past lecturers, everything needed updated and coordinated with the itineraries I’ll be doing on ISLAND PRINCESS … so a LOT of work before I even get to the ship.

ISLAND PRINCESS was built especially for the Panama Canal itineraries and is a Panamax ship, the largest vessel that can sail through the existing locks.  It was christened in 2003, holds 1,970 passengers and 900 crew.

PRINCESS PATRICIA the first Princess ship that sailed from Los Angeles to Mexico.

This is a special time to be back on Princess because it is the 50th Anniversary of Princess Cruises.  And it is a special time for me to be doing the Panama Canal run because it is the 100th Anniversary of the Panama Canal!

Yesterday we left San Pedro, the port for Los Angeles, and today are at sea headed for Cabo. We’ll make our way down and through the Panama Canal onward to Ft. Lauderdale.  Then we’ll be doing the round-trip Ft. Lauderdale itinerary that goes through Gatun Locks into Gatun Lake where we disembark guests for Panama Tours.  The ship goes back through the locks where we stop at Colon to pick up the tour guests and then head onward to a variety of Caribbean ports before ending up back in Ft. Lauderdale for another run of … still going … “The Love Boat.”

People tell me, and I guess that they are right, that I have the “ideal” retirement … living in the mountains of Panama part of the year and spending time getting paid to sail on fantastic cruise ships.

Your Comments

Yes, I know, it’s been a while since I got to the mail …

Costs of Living in Panama

Several of you commented on the recent posts on the cost of living in Panama [Market Basket Comparisons and Live Better for Less] and a couple of you made some good observations.

Richard Janis pointed out that, “Panama like the U.S. has different living costs depending upon location and lifestyle.”

On my first trip to Panama, I spoke to a number of expats about the monthly cost of living. The typical response was that the amount mentioned in some of the expat seminars was too low. Your food cost comparison chart was very good. Panama like the U.S. has different living costs depending upon location and lifestyle.

Many expats I met make an occasional trip to PriceSmart. Other ways to lower food costs involve adjusting your diet to eat more locally produced products and to buy direct from the farmer or fisherman.

Many items are imported into Panama which results in higher costs due to transportation and custom duties. Panama’s inflation rate (currently, 4%) also has an impact on overall costs.
The cost of living benefits (insurance, property tax exemptions, services, medical) should tip the scales towards a lower cost of living for a number of expats.” Richard Janis

Squirrelmama points out that “If you embrace local foods you will come out far ahead.”

Richard, I travel a lot and actually find California food prices cheaper than in many stores in other parts of the US. I think the combination of (1) California’s huge buying power, (2) proximity of agricultural production sites, both in the US and Mexico, (3) rampant competition, drives CA food prices down (now housing, gas etc, is a different story). If you compare California discount grocery prices to Panama “upscale” supermarket prices (such as Rey, 99) I think the prices are comparable, sometimes Panama is even more expensive, and the selection is not as good. I jokingly say the most common product on Panamanian store shelves is the ubiquitous “no hay (don’t have it).” But I think Panama beats many other food markets elsewhere in the US . Moreover, if you are willing to do a little homework in Panama and learn to shop where the locals shop (produce from local markets, street and truck vendors, find a chicken or egg supplier, grow your own vegetable – very easy in Boquete), you can come out ahead even living in relatively expensive Boquete. Shopping will not be as convenient as the one-stop supermercado, but you will make friends with local suppliers. Further, if you insist on cooking Gringo meals with imported foods, or out of season foods, that will push your bill up. If however, you embrace local foods you will come out far ahead. Also, sometimes its cheaper eating at the fondas than cooking at home (just stay away from Panamanian beef, which should have been saved for shoe leather). Volcan’s a bit of a trek from Boquete, but if you are planning a trip there to visit anyway, they sell huge mixed bags of all kinds of produce (I’m talking like 25 pounds, enough for a family of 4 for about a month) for about $5.” Squirrelmama

Dg: “Shopping in Panama is an adventure and can test the gringo mindset.”

“I agree with squirrelmama. Depends on how and where you shop in Boquete and how willing you are to shop around because you can’t get everything in one supersized walmart nor in any one place at all. Shopping in Panama is an adventure and can test the gringo mindset. The fruit and veggie markets have much better prices than what you recite. We bought six bananas, eight romas, a pineapple, a papaya, a large bag of green beans, a head of cabbage, strawberries, a cucumber and a papaya yesterday for less than 7.50. I couldn’t buy that in a grocery store in upstate NY for less than 20 dollars. And I pay less than $5 for butter. I could go on… A smart shopper and meal planner can get what she wants for less, just avoid canned things, they are expensive, and shop fresh.” DG

More comments …

Larry Hansen … “Another excellent posting Richard, I enjoyed it very much.  Paid $2.49 gallon for Shell regular in Memphis, TN yesterday.”

Larry, excellent observation of how prices for common things, like gas, differ widely across the US.  Where you are coming from in the US makes a big difference on what saving you enjoy in Panama.

Mark Perren Jones … “Thanks so much Richard…I have been waiting a long time to see a comparison like this.”

My comments on the cost of condoms generated this,

“I was at Arrocha in David today. They had condoms near the register so I noticed the price. $1.99 for 3 Trojans. Even less for the non-name brand. Even if they gave these out for free I wonder if men from a Catholic society would use them.”

I guess my friend who complained about the $4.50 cost for three I guess might have been shopping for the extra-large, ribbed, raspberry jelly flavored ones.

Pros & Cons

Regarding Pros & Cons of Living in An Expat Community, which featured a piece written by Jackie Lange …

From OldSalt1942 …

The worst phrase in guide books is “English is widely spoken…” Outside of tourist businesses, NO, it’s NOT.

One doesn’t need to be “fluent” in Spanish to have a good life here outside of the expat community, but you do need to become “proficient.” There is a big difference. Being proficient means you make mistakes in your verb conjugations, use a wrong word here or there. I never leave home without my small, plastic covered Spanish/English dictionary. NEVER! I am proficient to the point that I will go to a business office like Cable Onda, IDAAN and others, never ask if anyone speaks English (In my opinion the rudest thing you can do. At least learn the phrase, “lo siento, no hablo Espanol) and do my business in my mangled Spanish. And you know what? It hardly ever takes me longer to get things accomplished than it takes a Panamanian. And the way I’m treated by Panamanians is totally different from how monoglots in the expat community are treated. Believe me, I’ve seen it in action.

From Robert & Helen …

“If you speak fluent Spanish it makes almost everything far easier. We were in David 2 weeks ago and stayed at Gran Hotel National. Great location, excellent food, large fine rooms and a friendly service. $77 per night incl. tax and breakfast. We asked local people about second car dealers, where to buy cheap vegetables, fruit and meat. When one speaks fluent Spanish, the locals become even more friendly and interested. Most locals asked if I was Spanish. No I am from Holland. Then the subject went to football (soccer) and the ice was broken.” Robert & Helen

Stuck-ups??

Richard, I love your articles. But,  I beg to differ with you. The expat community in Boquete is not friendly. I have been here five years, close to Boquete, go there often and I can count on my fingers how many times an expat has returned a greeting. They are for the most part stuck-ups. Joelappj

What “lists”?

My husband and I were on Jackie’s Sept 2014 Panama Relocation Tour and loved it and have fallen in love with the country. Unfortunately, we did not get to meet you then, but we had dinner with your lovely wife Nikki. We plan on returning this year for a few weeks to explore by ourselves and if that works out well, retiring full-time in the Boquete/Volcan area in June 2016. Your information here is very helpful, as was the info that Jackie gave us on the tour. I do have one question for you please. When we were in Volcan visiting with Soup Campbell, he told the group that it was a “must” that we need to follow your checklists in your book. I’ve read the New Escape to Paradise and don’t see any checklists that he mentioned. Can you direct me to where I might find these? Any help that you could provide would be greatly appreciated! Liz Richmond

Liz, I think what Soup was referring to are not checklists per se, but the process we used to narrow-down our search for a country and a place to retire. In Chapter 3 “Finding Paradise” of my book THE NEW ESCAPE TO PARADISE: OUR EXPERIENCE LIVING & RETIRING IN PANAMA, I talk about you and your partner making independent lists of what you want in a place to live, and the process we used of researching and assigning values as a way to compare countries and places where we might be interested in living.

One Million & More  

Since I’ll be spending the next few months in and out of the Panama Canal on a regular basis, I’ve been updating my lectures on the Canal.  I’ve been pretty much running around the world and other than Canal transits on two world cruises, not spending time in the Canal.  Now the expansion project is moving toward completion and the one millionth ship has passed through the Canal.  That is an interesting story because it appears that someone was “asleep at the switch” when the one millionth ship, a Chinese ship called FORTUNE PLUM slipped through unnoticed.  A few weeks later the Canal authorities realized what had happened, tracked down the ship, and the next time it passed through the Canal presented the ship with a plaque and took the pictures.

Almost the same thing happened as this blog passed the one million visitor mark.  Regarding my post One Million …

“Way to go Richard! I always look forward to sipping an early morning coffee while reading your blog each day. Thanks for your amazing chronicles!”  groverscorner

“Hi Richard. Your blog is pretty unique in that you tell us a little about politics. Not opinion. You kind of lay it out there. Gracias. I’m doing my first visit this Thanksgiving. (Independence day in Panama) Just want to be sure … Panama A to Z is in book form? Went to order but it didn’t work out. Si, I’ll try again.” David Hubble

David … PANAMA A TO Z is in progress. Hope to find some time to finish it up while I am on the ship for the next few months.

“I read every blog and frankly would like one every day. All the best to Nikki, and good luck with harvesting.” Barbara

Thanks all. Barbara, FYI, the post you are reading … took 2 uninterrupted hours! When I am on the ship I really don’t have Internet access. It’s expensive and slow … so other than finding an occasional free wi-fi area … which you do by watching all the crew members sitting on the cement with their lap tops and iPads … it’s pretty tough just to get out one or two a week.

Remembering Mario

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I’m in Ventura, California today, before boarding the ISLAND PRINCESS this coming week in San Pedro.  I’m visiting my friend Renato Dean.  He and Mario were inseparable brothers and during their stormy adolescent years became almost like our sons.  Both grew into exceptional men and we’re grateful they were a part of our lives.  Mario drove a truck for a living and last month was killed in a fiery crash of his big rig. I need some time to grieve with Renato in Ventura.  Several of you commented on my posts Mario Dean and Condoms 3 for $4.50, “I’m Sexy & I Know It” & Jesus & Captain Morgan [aside from the comment on the price of condoms above] …

“Oh Richard…this news really struck my heart…i am so sorry for your loss of Mario. Hold on to your wonderful memories. My condolences to family, friends & mentors.” Dirtybabiescry

Mario Sketch“So sorry for your loss, I love that sketch! It looks just like the pictures. I am glad you have it.” bolts2panama

I am so sorry for your loss of a great friend. I love reading your commentaries and thank you for sharing your thoughts of Mario with us. melindajo612

“I too wondered how you were going to pull it together, but you did an excellent job. I believe this is probably one of your best blogs, if not, ‘The Best.’” Thank you. Sunnymikkel

“Thanks for your wonderful blog Richard. I love the eclectic mix of ideas. My heart is with you in the passing of your friend and in hoping that you remain happy and healthy in your adventures.” Kathy Campbell

“Thank you for your blog, but specially for this one. It touched me deeply. Life and death, but also ‘eternal’ life. Thank you.” Rosario

Live BETTER for LESS in Panama

I sometimes get a little upset when so much of the press about moving to Panama advertises, “Cheap! Cheap! Cheap!” We worked hard all of our lives and whatever “nice” things we have we worked for, so when we retired we had no intention of living on the cheap. Yes, we did have “fixed” incomes, although we’ve found some ways to augment that income which is a good think since the return on CDs and savings has plummeted. But we wanted to live nice, not ostentatous, but nice. And we moved here from the “Gold Coast” of California the Ventura/Santa Barbara strip along the ocean. It wasn’t cheap in Ventura, so for us at least ten years ago, Panama offered a better lifestyle for less money. And I think for many people from many, but not all, parts of the US, Canada and Europe that is still the case.

Because we worked hard, and still work hard even though “retired,” we’re not going to have a lot of time to run all over trying to find the best deal on cabbages or whatever. Some folks enjoy doing that, and they do save money, but we just don’t have the time. And I don’t mind paying a fair price. I’ve never been one who feels compelled to bargain the other guy down so I can feel I made some kind of “killing.” Some things ARE more expensive in Panama and the price of a lot of things has more than doubled over the past ten years, largely, I fear because we use the US dollar which has been systematically devalued although nobody wants to come right out and say it. In many Latin American countries the money is devalued overnight. In the US … think the frog in the pot of water that gets set on the fire … we’re not supposed to notice or admit that all of our wars and bail outs of financial fat cats have made the US dollar worth less, and a few might argue worthless. Although actually the US $ is still viewed by much of the world as a safe and secure currency, even although it’s only backed up by “the good faith and credit” of the US.

As I pointed out the other day, comparing the cost of the same food items … my market basket if you will … in Costco, Santa Rosa, CA and Price Smart and Rey in David, Panama was slightly more expensive! And I didn’t even include Haagen Daaz which when frequently on sale is HALF the price of the same thing in Panama. Of course I also didn’t include ahi grade tuna steaks, $4.50 a pound freshly caught here and $35 or so a pound in California.

So the emphasis needs to be on BETTER, not just cheaper.

So I was pleased with Jackie Lange’s piece entitled How You Can Live BETTER for LESS in Panama. It’s particularly interesting to me since Jackie moved here from Texas, which is a whole lot more affordable than California.

Can you really live for less in Panama? Well, it depends on how you live, where you live in Panama, and where you’re coming from. For most people, it is possible to live for less in Panama.

Some people reassess their priorities when they move to Panama. Instead of the 3000 sq ft house with a big yard they had back home, they downsize to a comfortable 1500 sq ft house in Panama.

Other people go from a 1500 sq ft house back home to a 3000 sq ft house on an estate in Panama. Obviously, a bigger house will always cost more to maintain and take more time to manage.

Sure some things will cost more. But there are many ways you can live better and live for less… much less.. in Panama. No matter what size home you live in, whether you rent or buy, there are many ways you can live for less in Panama. See details below…

UTILITY COSTS

The cost per kilowatt-hour in Panama is the same that I paid in Texas. But the big difference is that in Boquete I don’t need an air conditioner or heater running 24/7 like I did in Texas, my electricity bill went from $250 – $350 a month to less than $50 per month.

In Texas, I paid $70 per month for metered water. In Panama I pay $60 a year for unlimited water use.

Plus I get an additional 25% discount off all utility costs because I am over 55 and have a residency visa.

Just these two items alone save me over $3000 per year.

Soup Campbell lived in Fairbanks Alaska before moving to Panama. His annual heating and electric bill was $8500 and now it is less than $600 per year. That’s an $8000 a year savings.. and living for less in Panama

HOUSE PRICES

If you moved from a New York, California, London or Dubai, you’ll think Panama prices are bargain. But if you move from Texas, Oklahoma, Florida or Arizona, the house prices in Panama could be higher.

The acquisition cost of the house is not the only thing you need to take in to consideration. Buying a house is a one-time expense. You also have to take in to consideration the monthly or annual expenses of Panama vs. where you live now.

Saving $3000 to $8000 a year on utility costs alone makes it possible to live for less in Panama. But there are many other savings.

I paid about $3500 a year for property taxes for my house in Texas. I pay ZERO property taxes for the next 13 years in Panama. That’s because houses built before 2011 got a 20-year tax exemption. My Panama house was built-in 2007 so I still have 13 more years with no property taxes. (This is the same 2/2 furnished house I originally rented for $600 a month)

Over the next 13 years, that’s a $45,500 savings compared to what I paid in Texas.

House insurance in Texas cost me $1500 a year. In Panama I pay $125 per year.

According to http://www.valuepenguin.com homeowners insurance rates continue to rise at a steady rate throughout the United States, up over 50% in the last 10 years. The Florida average for a median priced house insurance is $1933 per year which does not include Flood Insurance which is required in much of Florida.

It’s not just what you pay…. you have to take in to consideration QUALITY of life too.

Read how Debbie Fishell of http://www.escapeartist.com/panama/ explains how she lives better for less in Panama.

The home I purchased in Panama is probably at least half of what a similar home in an oceanfront community in the USA would have cost me. Not to mention, my utility bill last month was under $40 for everything – electric, water, trash included. I don’t need AC here, but in Arizona we were rarely under $200, even in the winter, and near $400/month in the summer – just for electric! Another plus to my monthly budget are the local Farmer’s Markets. Again, I pay about 1/2 the price I paid at Farmer’s Markets in the states for wonderful, fresh, and organic produce in Panama.

Veggies – Panama $2/large bag organic greens vs US $4-6/ bag of mixed organic greens

I also have about 30 Amazon Parrots, a couple of large iguanas, and a cute turtle that visit my yard regularly. I call them my free “wild pets” because they take care of themselves!

HEALTH CARE

Doctor Visit in Panama – This is a big savings, especially if you don’t qualify for Medicare yet. If I stayed in the United States, my husband and I would pay about $15,000 a year for insurance, with a very high deductible, which would not be as good as I have in Panama.

In Panama I pay less than $2500 a year for health insurance that covers me in Panama, in the United States or anywhere else in the world. My deductible is $1000 but I only have to pay that if I have a procedure done outside of Panama.

My husband currently pays $900 a year for a medical reimbursement plan but he is switching to worldwide medical insurance like I have so he is covered anywhere in the world too.

Once he is registered for worldwide health insurance, our total health care costs will be $5000 a year for worldwide coverage for both of us compared to $15,000 a year for US insurance only. That’s a $10,000 a year savings!

$5000 a year is still a big expense even though it is much less than the USA. We could reduce our costs if we were only covered in Panama. But I like to travel and want to option to have any procedure done in the USA and covered by my insurance.

My 32-year-old daughter in Texas looked in to getting Obamacare. At $285 a month ($3420 per year) with a $6000 deductible she decided to pass. See other prices at http://www.valuepenguin.com/ppaca/exchanges/tx

I asked my insurance agent in Panama what it would cost for my 32-year old daughter to get worldwide health insurance in Panama. I got a quote of $1200 a year with a $1000 deductible. Much better than Obamacare! And she will be covered worldwide.

Because it is so affordable to go to a doctor, many people decide to put that insurance money in savings then self-insure (pay out-of-pocket).

In Texas you pay $125 – $185 for a general doctor visit.

In Panama it is $10 to $20 for a doctor visit. A specialist will cost $40 to $50. These prices are without insurance!

And the doctors in Panama put the CARE back in to Health Care. They will spend as much time as they need to evaluate your situation, carefully explain your options, and even give you their cell phone number so you can call them if you are not better quickly.

A few years ago I had to go to the emergency room at Hospital Chiriqui in Panama. I was in so much pain I forgot to give them my insurance card. After two IVs, pain medications, blood tests and other lab work, and a great doctor who spoke perfect English, my emergency room visit was less than $50 without insurance.

Try getting that price at an emergency room in the USA!

Soup and Sue Campbell came on my tour a few years ago then moved to Volcan. Soup had a stroke a few month ago. With no insurance, he paid $75 a day for a hospital stay. His total costs for the stroke with 3 doctors, CAT Scams, MRI’s, medications, and several days in the hospital was less than $4000.

A friend in Florida recently had a stent put in his heart for $125,000 out-of-pocket. Richard Detrich’s’ wife Nikki had the same procedure done in Panama City a few years ago for less than $20,000. Plus her medical reimbursement plan paid for half.

[Richard: True, but unfortunately this would not be the case today.  Some might say the medical establishment in Panama has gotten greedy: prices have soared.  And that insurance, has almost completely changed the terms on us.  Thankfully in the States we have Medicare and a Medicare Advantage Plan which, now that we are both over 65 works better for us in all but emergency situations.  In an emergency we take our chances in Panama.]

A few months ago Lee Zeltzer recently paid $20 for an EKG at the local hospital in Boquete. In the United States, the average cost for an EKG, without insurance, is $1500.
MISCELLENOUS SAVINGS

In Texas I paid $225 a month for my ATT cell phone use including data. In Panama I pay $9.99 a month. But I could just buy minutes as I need them and have no monthly charge. That’s a $215 a month savings!

My internet cost MORE in Panama and I get less speed. I currently pay $135 a month for 2 mbps. HOWEVER.. the internet service provider Cable Onda is installing cable on my street so soon I will be able to get 15mbps for only $25 per month. (I can’t wait!). If you want high speeds at affordable prices in Panama, you need to live in an area which is serviced by Cable Onda.

In Texas I paid $75 per month for Cable TV. In Panama I pay $30 a month for cable TV with 200+ channels and many are in English.

In Texas I paid $35 to get someone to mow my lawn. They were finished in less than an hour. In Panama I pay $15 for a gardener who is here from 8-4.

A bus to Panama City $10.60 with pensionado discount. I don’t know what it would cost for 8 hour bus ride to anywhere in North America but I bet it would be more than $10.60

Soup and Sue Campbell paid $199 for an inflatable 4 person hot tub at Novey in Panama. They are advertised online for $400 in the United States.

Electronics and appliances cost about the same in Panama as they did in Texas.

Furniture prices are the same if you buy them in a store. But you can have high quality furniture custom made for a fraction of what you’d pay in the store… and be giving work to a Panamanian too.

If you have a residency visa and you are a woman 55+ or a man 60+, you will get these pensionado discounts:

50% off entertainment (movies, theaters, concerts, sporting events)
30% off bus, boat, and train fares
25% off airline tickets
25% off monthly energy bills
30% to 50% off hotel stays
15% off hospital bills
10% off prescription medicines
20% off medical consultations
15% off dental and eye exams
20% off professional and technical services
50% off closing costs for home loans, and more…

Last month I flew to Las Vegas. I looked up the non-stop flight I wanted on Copa Airlines web site. It was $710. Then I sent the flight information to my travel agent in Boquete. She got the pensionado discount for me so I only paid $521. More savings!

[Richard: This air deal is a great benefit when you haven’t reached 65 and qualified for the over 65 rate, or when an airline doesn’t offer a senior rate.  Unfortunately you con’t get to combine the senior fare and the pensionado discount, which are the same fare.]

GROCERIES

Farmer’s Market in Panama
Fresh Produce
If you buy a lot of imported items at the grocery store in Panama, you will pay more for your groceries. But if you buy local produce and local brands, you will save money. There is a huge variety of fruits and vegetables readily available at farmer’s markets and at the grocery store.

Even produce which is not grown in Panama, like apples and pears, are readily available.

An example, imported Del Monte can tomatoes are $1.69 a can at Romero. But a Panama brand of can tomatoes is only 59 cents. Or, buy fresh tomatoes at the farmer’s market to get much better quality for even less.

If you avoid anything that comes in a can, bag, or box you will save money.. and be much healthier too.

In Texas I paid $150 – $200 per week for groceries. In Panama I pay right around $80 – $100 per week.

orangesJust like North America, you will save by buying produce when it is in season. In Panama you can buy 100 Panama oranges in season for $4 a bag. Get 50 pounds of carrots for $6. In Panama if you buy imported oranges, they are $1.45 a pound. I don’t know what they cost in the USA now.

The sweetest pineapple you have ever tasted is 75 cents to $1.50 each depending on the size.
Pineapple is available year round in Panama. I paid $5 for a pineapple in Texas and they did not even have any flavor.

Soup Campbell reported these prices in Volcan: beer in the grocery store $0.35 -> $0.50 / can, Soda in the grocery store $0.50 -> $0.75 / can, Milk in the grocery store $2.50 / gal

Richard Detrich recently did a comparison of food prices in the most expensive area of northern California compared to Panama. SEE THE COMPARISON HERE

EATING OUT

When you eat at Panamanian restaurants for $3-$4 you get a full plate of 1 meat, rice with beans and a salad.

Or, you can eat at an upscale restaurant like Panamonte for $25 a head. There are plenty of restaurants with prices everything in the middle too. One of my favorite restaurants in Panama City is El Greco, a greek restaurant where it is about $10 a meal including beverage.

Panama Relocation Tours Coronado
Lunch in Coronado
In Coronado, the tour group sometimes eats at Coronado Cafe. We have delicious chicken kabobs and grilled vegetables for $9.95 (see photo on the left)

Last night my husband and I went to Big Daddy’s restaurant we each had a huge organic salad with fresh blackened tuna steak on top and margaritas. Total Bill with tip was $22

When I was recently in Vegas, I paid $20 for 2 eggs, 1 piece of bacon, and a piece of cold toast, orange juice and nasty tasting coffee. In Boquete I can get that same breakfast, with great coffee, for less than $5.

My favorite restaurant in Volcan is MANA. If I lived in Volcan I’d just go there to eat every day because the food is so good and affordable. LOOK AT THEIR MENU AND PRICES HERE

Last weekend, Soup and Sue Campbell reported that they went to Deep Forest Tavern near Volcan to listen to 3 hours of “Gringo Music” They had 2 hamburgers, 2 fries, 2 cokes for $7

PERSONAL CARE

Hair cut in PanamaA men’s haircut is $2-$3 in Boquete. My husband paid $20 in Texas

I get high lights, low lights and a haircut for $40-$50 in Panama. This cost me $200 plus a tip in Texas.

A manicure and pedicure is $12 in Boquete. It was $65 in Texas

In Panama, I get a massage every week because it is only $25 for a really good 1 hour deep tissue massage. In Texas I paid $65-75 per hour for a massage.

LIVE BETTER

hummingbirdIn Boquete, and many other areas in Panama, you can leave your windows wide open to get fresh air every day. I’m surrounded by spectacular views or lush green mountains and flowers everywhere. It’s good for your soul.

Nature is all around you in Panama. It’s up close and personal.

Panama is like having 3 countries in one… and you can drive to all of them in a day. There’s the Pacific Ocean to the south, the Caribbean Sea to the north, and a huge mountain range in the middle. There are 1500 islands surrounding Panama. Plus I have ready access to Panama City. And I’m less than a 2 hour drive to Costa Rica (country #4).

There are often specials at all-inclusive resort next to the Pacific Odean for $69 a might – which includes food and adult beverages.

You can visit primitive indian tribes or monkey sanctuaries, see sloths and beautiful blue butterflies.

Or go to Bocas del Toro on the Caribbean Sea for a weekend of swimming in turquoise blue water, lively music and dancing. I love their rock-n-roll concerts.

Just about every day I have a flock of green parrots fly by my bedroom window on the way to the jungle area next to my house where my organic coffee grows. My yard is filled with hummingbirds.

When you don’t have to work so hard to keep up with all the expenses in North America, it removes the stress. So you can live better!

The list goes on and on about ways that I live a better life in Panama. You could too!

TAXES

The United States taxes citizens and residents on their worldwide income. Citizens and residents living and working outside the U.S. may be entitled to a foreign earned income exclusion that reduces taxable income. The exclusion is available only for wages or self-employment income earned for services performed outside the U.S.

If you are a US citizen living overseas at least 330 days a year, you could qualify for the Foreign Earned Income Exemption. The income must be active income. Passive income does not qualify.

In 2014, you can deduct $99,200 in income from your taxes. If you and your spouse both live and work that is almost $200,000 on tax free income.

If you are in the 33% income bracket, that is a savings of $66,000 per year for a couple.

IN CONCLUSION

With all these savings, you can see why so many people are moving to Panama!

A little savings here and a little savings there … all add up to BIG savings when you live in Panama.

In Panama, just like everywhere else in the world, prices have gone up in the last 5-10 years. But for the most part, prices have gone up much less in Panama than they have in North America.

Sure you might pay more for a few things but overall you will save money in Panama

You really can live for less in Panama!

Join us on a Panama Relocation Tour in 2015 to see how you can live for less too!

US – PANAMA FOOD COSTS COMPARED Item Per Item

Just how much cheaper is life in Panama?

Good question, and much of the information you will find on-line is OUTDATED or very generalized.  The folks who make a living offering seminars about offshore living and living internationally often hype how cheap it is in Panama compared to the US, without giving details.

I noticed something interesting talking with people on the Panama Relocation Tours. Jackie avoids the hype and encourages folks to browse prices in the stores, check out availability of drugs they need and prices, even take a look at what furniture, electronics are available, and they usually a stop at our little “big box” store, Price Smart. When folks check out  the local grocery stores they’d frequently say, “I don’t think food is that much cheaper here than in the US.”  Hmmm.  Well, that got me to wondering.  So when I was in the US last week I went to Costco in Santa Rosa, California.

Now Santa Rosa is in Sonoma County, the North Bay area, one of the most expensive areas in the US.  In some parts of the US store prices are obviously going to be cheaper.  I walked around with my clipboard and wrote down food prices.  Then I came home to Panama and did the same thing at Price Smart and Rey supermarkets.  Rey actually sent a security guard over to tell me I couldn’t check prices.  I laughingly explained that I just wanted to see if prices were better at Rey than the new Super 99 across the road.  He assured me that prices were cheaper at Rey … then when I pressed him a little, just smiled and winked. Panamanians are great at non-verbal communication!  But I was almost finished and we parted friends. Rey is one of the better grocery stores. Then I went home and did the best I could, adjusting for the fact that Panama uses the metric system and the US does not.

So here’s a list of things I might buy in the store and a price comparison …

Price Comparison 102014 aPrice Comparison 102014 b

So, for me and for this list, food prices generally would be slightly MORE, not less, in Panama, and this was a comparison of prices in Sonoma County, one of the more expensive places to live in the US.

And this doesn’t take into account that most store chains in the US have weekly sales with loss-leader items, so if you shop carefully you can save big time. Panama stores NEVER have a genuine, US-style sale.

HOWEVER, understand that food costs are just one item.

If I lived in Sonoma County I wouldn’t be able to get my monthly buzz haircut for $3!! Figure $25 at Super Cuts. My car insurance would be more like $500 a month than $500 a year!  For a house like ours we’d be paying at least $7,000 a year in property taxes, and in Panama I have a 20-year property tax exemption.  My water bill is $60 A YEAR: try that in California!  Trash is $30 A YEAR.  An hour massage is $35 to $45 when the tourists are here, and off-season $25 to $30.  My wife’s hair cut is $5 plus tip … my daughter had her hair cut in Somoma for $90!  And she didn’t like it!

So looked at as a whole, Panama is less expensive than many places in the US.  

Food and eating out have almost doubled in the ten years we’ve been here.  Yes, you can still get a basic Panamanian-style lunch [chicken, pork or tough beef, rice and beans, and a tiny salad and drink] for $5 or less.  But it you want to go out … Panamonte is Boquete’s oldest and most consistent restaurant offering good food, good service, and a wonderful ambiance.  It seems to be the only place in town that doesn’t change owners, names or go out of business in 3 months.  Dinner for two, no cocktails, but a glass of wine, tax is going to run your $50-60 for two.  25% off your entre if you are a Pensionado. In Seattle, overlooking the Sound and Pike Market, very high rent area, the local celebrated chef’ is Tom Douglas, and the restaurant is Etta’s.  Same basic dinner restaurant is going to run $60-70 for two.

Now here’s what I don’t understand.  Panamonte has been in the same family since 1946 whereas Etta’s is in one of the highest rent districts in Seattle.  The minimum wage in Panama is $1.53 an hour plus tips (10% standard, but 15% in better restaurants) and the minimum wage in Seattle is $9.32 an hour plus tips (15% standard, but 20% expected).  Given low, or no rent, huge difference in wages, and, OK, maybe food costs are similar, but why these prices in Panama??  Yes, gringos … mea culpa! … like a good restaurant and are used to paying, and tourists from Panama City are used to paying a lot to eat out, but in Boquete?

The single-dip ice cream cone which used to be 25 cents is now 65 cents.  Hojaldre, the fried breakfast bread, used to be 10 or 15 cents, now its 25 cents.  A great breakfast at Central Park (omelette with everything, 2 hojaldre, orange drink and coffee) used to be $2.50 and now is $5.25.

I see three reasons for the run up in prices: Panama is on an economic roll, the high cost of oil and we import most things, and the devaluation of the US dollar which is the currency of Panama.

It was interesting for me to notice that bananas cost about the same!  Actually we don’t buy bananas since we have so many banana trees on our farm.  We grow potatoes so why are we paying 20 cents more per pound.  Meat is a lot more expensive in the US: must be all those hormones they add. I grant you my list is a pretty gringo list, but, hey, I are one … and I like eating what I like to eat.  Sometimes I like the Panamanian staples of rice, beans, chicken and for variety chicken, rice, beans, but not all the time.