Blowing Smoke or Telling It Like It Is

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Blowing Smoke

Tobaco was first discovered by Europeans when the visited Cuba and tobacco smoke, aside from being enjoyable, was also viewed as a medication used by European physicians for a wide range of ailments, but especially for cold, stomach pain, and even for resucitation of people who drowned.  The technique used was to use a kind of bellows to blow smoke up the rectum like an enema.  and drowsiness.  So called tobacco-enemas were also used to ease symptoms of hernias.  In the early 19th century people realized that nicotine was poisonous and the practice of blowing some for medical reasons ceased.  But some salesmen, promoters, and professional puffers of products and celebrities, continue the practice of “lowing smoke” up folks ass about the benefits of their products.  Even, believe it or not, blowing smoke about relocating to Panama!

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The other day I had a guy on the ship come up to me with a tattered, glossy magazine that he’d obviously devoured all about moving to Panama. He asked me if it was all accurate or just hype.

Unfortunately, there is a lot of hype about moving to Panama.

Yes, Panama is a great country for expats and retirees, depending on where you are coming from and what you are seeking. But it’s not for everyone. How do you know if it is right for you? Well you have to invest the time, effort, and money in studying, reading everything you can get your hands on but taking it all with a grain of salt, and talking to as many people as possible seeking out folks who will tell it like it is and give you the straight scoop.

BookCoverPreviewThat’s what I try to do on this blog and in my book THE NEW ESCAPE TO PARADISE: OUR EXPERIENCE LIVING AND RETIRING IN PANAMA. First, it’s our experience. Talk to a dozen different retirees and/or expats living in Panama and you will likely get a dozen different stories. Some of those who “package” Panama and make a living off selling the expat lifestyle have a tendency to gloss over some of the realities in order to paint a rosy picture. Panama hasn’t been perfect for us, but it has been fantastic. Nikki and I are both mature enough to realize that there is no “perfect” place, but for us Panama, with all of its frustrations, has been wonderful.

When I get comments on Amazon, like this from Keith Dick, I’m delighted!

“No rose-colored glasses here – Panama is not for everyone. If you’ve never lived outside the US before, particularly in a developing country like Panama – don’t even think about making a move without thorough research. Richard’s book is one of the best. Extremely valuable advice – take it to heart!”

Or this from Daniel Bridges …

“An outstanding, insightful book about the author’s experiences in Panama. It is a very sobering look at his and his family’s experiences, both the good and the not so good. The reader can tell they’ve landed in their paradise. My wife and I are considering relocating to Panama and we’re using Richards book as one of our primary sources of information for an anticipated visit to the country next year. Because Richard does not sugar coat life in Panama, rather he tells it like it is, we feel like we have a more realistic expectation of what life is like in Panama. He most definitely has us studying up on the many aspects to be considered.”

Or this from Dorothy …

“No bunnies and rainbows here, both sides of the coin are exposed. Like any country, Panama has it’s issues and beauty and Richard gives insight to the reader/expat on both so we don’t arrive and end up shocked to find bugs in our paradise. Good job.”

I’m even happy when I get a comment like this one from Ida Freer, a writer who actually helped edit the book …

“You provide a lot of useful information. Overall it led me to decide against Panama, except maybe as a tourist for a month or two. Too bad! I had high hopes.”

Just think, I saved Ida several hundred thousand dollars plus a whole lot of hassle! What if she had moved to Panama and THEN discovered it wasn’t for her?

Here’s my advice …

1. Get my book THE NEW ESCAPE TO PARADISE: OUR EXPERIENCE LIVING AND RETIRING IN PANAMA. Read it. I’ll show you how to decide what it is you’re looking for and how to evaluate and compare different countries. I don’t sugar coat it. Panama is not for everyone, but it may be the perfect place for you.

2. Scour the Internet and get all the information you can, but take what you read with a grain of salt. Sort through and try to separate hype from fact. Start following the various Internet boards that gringos in Panama post on. You’ll find almost as many opinions about everything as there are expats in Panama. No one, including me, has a lock on everything!

3. Carefully study the offerings and promises of the companies offering tours and seminars. Study the recommendations. Search out the company names on line and see what folks have to say. Weigh the cost and benefits. Anyone who promises to tell you “everything you need to know” is clearly blowing smoke. You want to meet as many expats along the way as possible and have opportunity to learn from them and listen to their unfiltered comments. Tour organizers tend to feature expats whose stories are in tune with the story the tour company is trying to tell. Take everything with a grain of salt. Some tours are built around selling one thing or another, which is not always made clear up front. There are real estate tours, carefully designed to allow time for you to see only the developments and properties where they’re getting a commission. For those of my readers who’ve taken any of these tours, I’d welcome your comments and recommendations for others.

Avoid ones where you are just going to sit and listen. You need to have your boots on the ground. If you’re unfamiliar with a place, these may be the way to get started and feel comfortable exploring on your own. Whatever seminar or tour you choose, come early to experience and explore Panama City doing some of the tourist things like seeing the Canal or taking the Hop On Hop Off bus. And set up your return flight so you have time, a week if possible, to visit and explore in depth areas that you think might be possibilities for you. In Panama we pretty much have everything in a tiny country. Big city life, small town living, or life in the country. Mountains or beaches Lowland hot or mountain cool.

4. Once you go back home and sort through your experiences and impressions plan to come back to Panama for an extended stay of several weeks to explore further both as a tourist but also as someone considering living here. Again talk to as many expats as possible. You are the visitor so take the initiative: “Pardon me, we’re just visiting here and thinking of maybe moving to Panama. It sounds like you’ve been here a while. Can I buy you another cup of coffee (or drink!) and ask you a few questions?” Most expats are going to be happy to share.

5. If you then still are excited about an expat lifestyle in Panama, arrange to come down for 3 to 6 months, rent a place, and actually experience day-to-day life in the area you like best.

Then, when you are convinced this is the right move, pack up and move here, either renting or buying the home of your dreams.

Before you sell all and move to Panama, I’d advise you to come down and check it out for yourself.  Of all the Panama Tours, the best one that I know of is Jackie Lange’s Panama Relocation Tour.  That should give you a good idea if Panama is a possible choice for you.  Then, come down again, rent and stay for a few months and check the fit,  Panama has been a great choice for us and scores of other expats, but it’s not for everyone.  Get beyond the smoke and the hype, check it out, and see if it is right for you.

Ten Reasons to Retire in Panama

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Garden 20I’ve had the pleasure to lunch with Bob Adams several times in Panama City along with the Panama Relocation Tour. Bob loves his life in the hustle and bustle of Panama City. He writes a great blog called Retirement Wave. Adams says, Call it the “Baby Boom” or a “demographic explosion”, every day a wave of tens of millions of Americans and Europeans move one day closer to retirement. Retirement should be a stress-free period in our lives, but it has become stress-ridden. We worry that we won’t have enough money to take care of ourselves. We worry that we will be a burden on others in our society if there is not enough money to support our government’s social programs for retirees. We worry that if the social programs fail, we will be a burden to our children. We worry about being old in a world of terrorism, unable to protect ourselves. These are all fears that weigh heavily on us as we plan for retirement. Worse yet, they are fears we know we will continue to face once we are actually retired. This is much too negative for what should be a positive period in our lives. It could be positive if only there was a practical way to protect ourselves, avoid being a burden to others, and perhaps even make a small contribution to reducing global tensions. There is.

Bob, I, and many others have found a way to do that by retiring in Panama. Here’s Bob Adams “10 Reasons to Retire in Panama” . .

Why retire in Panama? Here’s the short version based on my observations and experience following forty-five years of living and working all over the world.

1) It’s a democracy with freedom.

Freedom of the press, assembly, speech, and religion are all found here. Panamanians are not shy about sharing their feelings and their concerns. Elections are free, honest, and competitive.

2) There’s no military.

Following the dramatic end of General Noriega’s regime in 1989, Panamanians decided they would never again fear that a military general would become a dictator. They closed down the military. The national police force is just that, a police force, and the territorial integrity of Panama is guaranteed by the United States. They don’t need a military and they have the good sense to know it.

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3) They have the Panama Canal…and more.

The Panama Canal does far more than provide 10% of Panama’s GDP (Gross Domestic Product – the total economy). Unlike many small nations that depend on tourism or some natural resource whose price varies depending on the market, the Panama Canal provides Panama with a large, steady, dependable income and will continue to for years to come. It also provides thousands of well-paid jobs for Panamanians. A multi-year, $5.2 billion expansion of the Panama Canal currently underway will add thousands more jobs. These are jobs that pay a great deal more than picking coffee beans or waiting on tourists. And the money from Panama Canal fees reaches out to touch people and businesses everywhere in the country. But there is more than the Canal to Panama. Unlike many other Latin American nations, agriculture plays an important, but relatively small role in the economy. International banking, maritime services, manufacturing, and shipping combine to provide more jobs and tax revenue than the Panama Canal. Panama is also home to the second-largest free trade zone in the world (Hong Kong is the largest) which has had a dramatic impact on the economy, employing twice as many people as the Canal. Panama’s economy is far more modern and service-oriented than you might expect. This means stability not only for Panamanians, but for those of us who retire there.

4) Panama has a thriving middle class.

With the Panama Canal and a number of other established sources of income as mentioned above, Panama’s middle class is growing. As Americans and Europeans know from their own experience, a healthy middle class is the foundation for a stable economy and a secure democracy. You don’t have to search for the middle class in Panama, you can find them everywhere.

0145) Americans and Europeans are welcome.

I am struck by the fact that Americans and Europeans are not looked at with awe nor are they disliked. Another contribution of the Panama Canal has been the introduction of hundreds of thousands of people from all over the world to Panama over the years, including tens of thousands of Americans assigned to support the Canal before its turn-over to Panama in 1999. Panamanians are perfectly comfortable with people from other nations. They’ve lived with them for decades and many of their “visitors” remained to become residents. English is widely-understood and also spoken by many of those who deal regularly with expatriates, although many Panamanians are hesitant to speak it at first, for fear of embarrassment, as is so often the case in reverse! In that regard, Spanish language instruction is readily and inexpensively available.

6) The currency is the US dollar.

There are two benefits to this. For Americans and others with dollars, there is no need for currency exchange or to worry about exchange rates. The Panamanian Constitution forbids the government from printing paper currency. Thus a second benefit is that, unlike most nations, the Panamanian government cannot just turn on the printing presses when it wants more money. Panamanians have to earn their currency from the world market through hard work and intelligence. There is none of the wild inflation that has plagued so many Latin American nations.

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7) The climate and surroundings are beautiful.

Panama is basically a mountain range bordered by beautiful Panama beaches. However, these are not cold, barren mountains. They are “soft”, rounded volcanic Panamanian mountains and the volcanic soil provides an excellent base for lush vegetation. If you prefer a tropical climate, you won’t be disappointed on either the Atlantic or Pacific coasts. If, like me, you prefer a more temperate climate with easy access to the Panama beaches (it’s almost impossible to be more than an hour’s drive from a Panama beach; 30 minutes is more common), move up the mountainside and you’ll find it. The flowers, trees, birds and other animal life are varied and many are strikingly beautiful. It’s what you would expect in that part of the world and Panamanians are doing a decent job of protecting their environment, far more so than many nearby nations. Eco-tourism is a growing industry in Panama and for good reason.

8) The cost of living in Panama can be much less than in the US or Europe.

How much you will save by living in Panama will be determined both by the amount you spend in your home nation and the lifestyle you choose in Panama. There’s such a great variety among expatriates that it’s impossible to tell you how much you’ll save, but if you have any desire to spend less, you will find it far easier in Panama than in North America or Europe. Folks from low-cost rural areas express astonishment at how much cheaper it is to live comfortably in Panama. Those from higher-cost urban areas will save less, but they seem to have one thing in common: they live comfortably, cut their expenses, and save money. It’s always been a reason to relocate to Panama and it remains a big one today, but the final result for you will depend on your lifestyle. Panama has room for a very wide range of tastes and lifestyles.

9) The people of Panama are just plain friendly and a pleasure to know.

The factors above and others unmentioned in this “short” description leave Panamanians among the most pleasant, relaxed people I’ve ever met. They are more cosmopolitan and sophisticated than many who live in wealthier nations as a result of their long-term exposure to a wide variety of international visitors and Canal users. There are poor people in Panama, but there is none of the grinding, desperate poverty that is so common in much of the world. I have worked in poorer nations all over the globe for more than four decades. There are poor people here, but nothing to compare to the grinding poverty found elsewhere. International financial institutions rank Panama in the “upper-middle income” category and that sums it up well.

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10) If you want to retire, Panama wants you.

All of the above makes retiring in Panama an excellent choice for retirement, but here are some very direct incentives. As a pensionado [retiree] in Panama, you receive:

  • 50% discount at most recreational, movie, and sporting events
  • 30% discount off public transportation (including buses and ships)
  • 25% discount off Copa airline flights
  • 50% discount off hotel stays on weekdays (30% on weekends)
  • 25% discount at selected restaurants
  • 15% discount at fast food restaurants
  • 10% discount off prescription drugs
  • 20% discount on doctor’s visits
  • 15% discount on dental work
  • 25% discount on your electric bill (if less than $50)
  • 25% discount on your telephone and water bills.
  • In addition, you can bring in all your household goods free of taxes and import a new car every two years for private use.

All that is required to qualify as a pensionado is that you must be in good health, AIDS-free, have an up-to-date passport from your country of citizenship and a verifiable monthly pension income of at least $1000 per month for an individual, $1250 for a couple, plus $250 for each additional dependent, if any. Foreigners who become pensionados can buy and own Panama property and enjoy exactly the same rights and protections as Panamanians, not always the case in many nations and an important point people often forget to consider. As for income taxes, you will be pleased to know that in Panama you pay no taxes on income earned outside of Panama.

Panama is not paradise, no nation is. Panama is still a relatively young nation and has its growing pains, but it’s made a great deal of progress already and it’s headed in the right direction. For the rest of us who are not Panamanians, it is a nation where we can live comfortably for much less money and far less stress than we have come to expect in our own societies. Best of all, we are “good” immigrants. We save money living in Panama, but we also bring with us the money that creates jobs and opens possibilities for Panamanians they would not have otherwise. They know that and so we are genuinely welcome.

Many would say “beautiful”, but if I had to choose one word to describe Panama, it would be “comfortable”. In this crazy world full of fear of terrorism and fear of not having enough money to pay the bills, that’s a description of a good place to retire.

All The Glitters . . .

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On the Road Scholar program, Panama Canal Adventure: Exploring Mexico, Nicaragua, Guatemala & Costa Rica, I’ll be talking about something that  all Americans together.  For all Americans that one thing is gold.  It was the insatiable appetite for gold that brought the Spanish explorers and conquistadors, spawned the California Gold Rush, helped create the Panama Railroad, heightened settlement in the Western US territories, and indirectly led to the creation of the Panama Canal.

When Columbus first arrived on what is today the Isthmus of Panama, he went ashore and traded cheap tin bells to the local Indigenous in return for their ornaments of solid gold.  It was the search for MORE gold that led Balboa across the Isthmus to, along with Pizarro, beomce the first Europeans to lay eyes on what they called the “South Sea,” later to be renamed “the Pacific” by Magellan.  Pizarro would go on to conquer and settle Peru, seizing not just more gold, but incredible amounts of silver, gems, and hardwoods as well.

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In 1518 Diego Velázquez, Governor of New Spain, sent Hernan Cortes on an expedition to Mexico.  Cortes sailed from Havana and put into the tiny fishing village of Casilda where he recruited troops the conquest of Mexico.  Through brute force, along with a healthy   dose of deceit, Cortes he managed to defeat the Aztec Emperor Moctezuma and in just three year Cortes and his 500 men had conquered Mexico.

1665_German_edition_of_Las_Casas_02The Spanish of course came with three purposes in mind: first, to spread Christianity, even at the point of the sword; and second, to loot as much treasure as possible; and third, to claim everything and anything, seen and unseen for the Spanish Crown.  To achieve their goals they were prepared to destroy anything and anyone who stood in their way.  The Indigenous people they supposedly came to “save” were not just treated cruelly, but often sadistically.  Bartolome de las Casas, was a chaplain to the conquistadors who repented of his actions and became a Dominican friar.  He was so appalled by the Spanish cruelty that he wrote A Short Account of the Destruction of the Indies  and Sent to Phillip II of Spain 1552.  The  Apologetica Historia was published in part 40 years after his death and the full text not until 1909.

Antigua, Guatemala was one of the most important cities in the Spanish Empire in the New World in charge of everything from Chiapas, Mexico to Colombia, which of course then included what is today’s Panama.  Guatemala had an additional treasure, some of the finest green jade in the world.

pre-columbian-gold-museum-costa-rica-el-guerreroThe Spanish looked on Costa Rica as a worthless, backwater colony, with no large Indigenous group to enslave, so they focused elsewhere.  From Mexico all the way through Central and South America these were highly skilled goldsmiths who created incredible work of art.  All the Spanish were interested in was the gold, so all of the Indigenous masterful gold works were melted down to be shipped in ingots to Spain.  Some of those that remain are wonderfully preserved and displayed in the Costa Rica National Museum in San Jose. The other great gold display is at the Gold Museum just off Bolivar Square in Cartagena, Colombia.

Coclé_Penn_04The greatest cache of Pre-Columbian gold in Panama was discovered when a river changed course and in doing so  disturbed a previously unknown Pre-Columbian burial site.  Suddenly incredible works of gold art began poking through the river banks.  Archeologists from the Peabody Museum of the University of Pennsylvania were called in to excavate what has been dubbed “The River of God.”  The incredible gold work has been carbon dated to AD 450–900.

As the Conquest progressed, Spain faced the challenge of taking all that loot back home.  Gold, silver and gems from Central America. Peru, and Colombia, made Panama City “the richest city in the world.”  From Panama City the loot was taken across the Isthmus by mule trains, sometimes 100-150 animals long, to be stored in Portobelo to await the arrival of the Spanish treasure fleet. It was the inconvenience of this transit that led to Charles V, the Holy Roman Emperor, a/k/a Charles I, King of Spain, in 1534 to send a survey party to design the route for a canal across the Isthmus in order to to provide a more efficient and seamless operation.

Eventually Veracruz, Mexico; Cartagena, Colombia and  Isla Margarita, Venezuela (for pearls) would become stops on the route of the Spanish treasure fleet.  Naturally the other major world powers of the day, France, Holland, Britain, looked enviously at Spain’s position in the New World, nicknamed “The Spanish Main,” because they wanted a piece of the pie as well.  At times there were outright attacks, but much of the time pirates, thieves, and privateers, sanctioned thieves, we used to nip at the Spanish heels.  The Spanish Treasure Fleet was a lucrative target for the pirates and privateers.   So Havana, Cuba and San Juan, Puerto Rico became vital stopping points for the treasure ships to reprovision before hopping on the Gulf Stream, a kind of 101 freeway back to Spain.  So in both Havana and San Juan you have these magnificent El Morro forts designed to provide safe harbor for the Spanish shipping.  And Havana, by virtue of its position in the Caribbean, was the “key” to the entire region.  One of the symbols on the coat of arms of Havana is an old-fashioned gold key.

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I’ll be discussing all this with my small group of Road Scholars on the VEENDAM as we make our way from San Diego to Fort Lauderdale, visiting Mexico, Nicaragua, Guatemala, Costa Rica, Panama and Colombia.  One of the things I love about this kind of itinerary is the way the histories intertwine with one another and we can talk about how all of this connects together.   Here we have an underlying golden thread that binds the history of this entire region together.

Medical Emergencies on Panama Relocation Tour

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Jackie Lange and I go way back.  She knew me, from reading my ESCAPE TO PARADISE  book before she came to Panama, and I’ve known her since she arrived.  A well-know and very successful real estate investor trainer in the States, when she relocated to Panama and an ex-pat lifestyle of course her friends and associates had questions!  “Why Panama?”  And they wanted to come down, visit and take a look for themselves. So she put together a mini-tour for a few friends.  More people got wind of “the tour” and wanted to visit.  One thing led to another and the result has been Jackie’s highly rated Panama Relocation Tour.  She’s been conducting these tours now for nine years, and I’d guess that half of the ex-pats who’ve moved to Boquete in the past nine years have come as a result of Jackie’s tours.  I don’t always have the same take on everything as Jackie does, but I’ve been on her tours several times and I don’t know of a better way to investigate Panama initially and decide if Panama is for you.  Panama isn’t “cheap” but you can live far better for less in Panama.

low-cost-medical-care-760x360Medical care of course is a prime concern when considering such a move. Panama uses, and has always used, the US dollar.  We call it the “Balboa” but it is in fact the same US dollar you use in the US.  As the US dollar has been devalued things cost more in the US, and, since Panama uses the US dollar, things cost more here as well.  Unfortunately greed, the medical term is “gringo bingo,” has set in, particularly with some of the local hospitals, Just like in the US, Europe, and elsewhere in the world, you can experience great medical care, or have a miserable, even deadly experience.

It’s in that context that I want to repeat Jackie’s report of the accounts of two recent participants in her Panama Relocation Tours who experienced medical emergencies while on tour.

Medical Emergencies During a Panama Relocation Tour

santiago panama public hospitalThis is our 9th year of offering Panama Relocation Tours.  In all that time, we’ve only had very few minor medical situations until the February 2019 tour when we had two major medical emergencies which required visits to a hospital emergency room.  I’m sharing details about these two emergencies so you can see the costs and quality of the care received at a public hospital and with doctors in Panama.

In Panama, there are public hospital and private hospitals.  The private hospitals cost more.  At the private hospitals, you’ll pay $15 – $20 for a routine doctor visit or $40 to $50 for a specialists.

But, the public hospitals are much more affordable.   Anyone can use the public hospitals.  There is no monthly fee to use the public hospitals, instead, you just pay when you go.  It is typically about $2 for a routine doctor visit or $5 for a specialists at a public hospital.  Interestingly, the doctors who work at the private hospitals are required to work a certain number of hours each week at the public hospitals so you could see the same doctor, but for a fraction of the costs, if you go to public hospital. However, unless it is an emergency situation, you might wait longer to see a doctor at a public hospital than a private hospital.

I have been to the small public hospital in Boquete for physical therapy a few times after messing up my shoulder with a weird yoga move called the Five Rites.  Even though I had an appointment at a specific time, I had to wait about 20-30 minutes for my treatment.  The doctor spoke perfect English and my treatment was $5.   The results were great!

Some expats who live in Panama decide to “self insure” (meaning they do not buy health insurance) because the costs of health care is so affordable at the public hospitals.   Instead of paying a health insurance premium, some expats set that money aside for any medical expenses.    You’ll understand why when you see the costs below.

Honestly, I think it is better to get health insurance if you can afford it because you will have more choices about which hospital and doctor you can go to.  You never know when a serious illness or accident could require a longer stay at a hospital or even surgery.   Don’t worry, there are affordable health insurance options in Panama too.  I’ll write about health insurance in a different article.

When considering a move to Panama, it is comforting to know that very affordable and quality health care are available for you in Panama. There are hospitals throughout Panama and more being built, or expanded, every year. Some hospitals are larger than others.  Only some of the larger hospitals are open 24/7.

EMERGENCY #1 – Vivian’s legs and feet were swelling.  She knew something was not right.  This is her write up about her experience with Panama medical care two times in Panama:

medical care in panamaUpon my arrival in Panama I noticed that my right ankle was swollen. Thinking that I must have banged it at some point during my trip preparations I spent the afternoon before the tour elevating and icing it. Unfortunately, my efforts did not decrease the swelling, which was advancing up my leg.

I had never experienced this so needless to say I was concerned and as we rolled into the second day of the tour I informed Jackie of my situation. We agreed that I would go to the hospital when we arrived at our stop that afternoon – which I think was Santiago.

My visit to urgent care was challenging in that the staff was not proficient in English. However, a combination of limited English, Spanish and Google Translate helped to weather the language barrier!

The process at this hospital was to first consult and then pay for the prescribed treatment. In my case it was meds via IV. Upon payment, the IV was set up. During the procedure there was a shift change and my follow up was with a doctor who spoke English well. She ordered a lab and an additional med. I paid no additional cost for the follow-up consult or meds. I was there several hours as is typical of urgent care/emergency. The total cost – $4.50!! See the receipt below

There was a slight improvement but unfortunately the treatment did not fully resolve my problem. At this point I was thinking of cutting my trip short in order to return home and get to the source of the problem. However, Jackie cautioned against traveling before the situation was under control and as we were now in Boquete, Jackie took me to her personal doctor. He not only spoke English but patiently explained to me initial concerns about the possibility of a DVT. Once he felt a DVT could be ruled out he focused on the blood pressure which was at 190/100. To bring it under control he prescribed a sublingual med and oxygen for 60 minutes. This resulted in significantly lowering my BP. He gave me a 10 day’s sample of medication to keep my blood pressure low and ordered a battery of labs. The cost for the visit and treatment: $65.00.

The next day Jackie took me to her preferred lab and returned with me the day after that to pick up the lab report. The cost for the labs was $57.00. A follow-up appointment with Jackie’s doctor to review the labs was $12.00. At this visit the doctor signed off on my travel and gave me a prescription which I didn’t fill because I still had samples.

Upon my arrival home my primary doctor continued the meds prescribed by Jackie’s doctor, and ordered a repeat of the same labs! An additional test she ordered was an ultrasound.

I share this experience for two reasons: 1) to provide a picture of the very reasonable out of pocket costs for emergency health care of this nature, provided by both a public hospital and a private doctor and 2) to express my gratitude to Jackie for her generous, PRICELESS care and support, including an invitation to stay at her house if my trip had to be extended!). THANK YOU, JACKIE.

I also want to thank my “angel ladies from Houston”, and the group in general for their well wishes. I hope all are well and thriving. 😊

Note that Vivian has been fine ever since but decided to ditch the meds and treat her high blood pressure with natural remedies!

emergency room bill in panama

EMERGENCY #2 – This one was very scary!  A tour client had a major seizure just before boarding the bus on the second day of the tour.  Luckily, her Uncle was with her.  This is his write up about their experience with the emergency room at a public hospital in Panama:

chitre panama pubic hospitalI’ve been back home for ten days, have caught up with things (if that ever actually happens), and now turn my attention to the Panama Relocation Tours (PRT).  I can only say that it was a great experience, that Jackie and her crew managed to provide a relaxed and comfortable environment while conducting a unique educational and experiential tour.  I believe the Panama Relocation Tours is the best possible way to experience Panama.  Jackie clearly knows Panama and is exuberant about it – it is beyond enjoyable to listen to her describe a country and a people she obviously loves and, after my experience, I can see why I would come to love them too.  Panama is a beautiful country, with much to offer (so much that my wife and I hope to be living there in a few months) and a people who love life.  You can tout the less expensive lifestyle, readily available fresh food, exceptional medical care or great weather.  These are all considerations but in the final analysis it has to be an environment you can live in, thrive in. Panama is the perfect confluence of good living and the Panama Relocation Tours will prepare you for living there.

Now, I have to apologize to Jackie and her crew and to everyone on the Panama Relocation Tours.  On the second day of the tour my niece, Brandy, had one of the most significant seizures I had seen up to that point.  She’d had a VNS (vagus nerve stimulator) implanted which was supposed to prevent her seizures a year prior to the tour, and there hadn’t been a seizure incident in that year, so I was very surprised.  But though I missed two days of the tour I had the benefit of being immersed in Panamanian culture and got a mini-tour of Panamanian medicine.

When she went down she was caught by some members of the tour. We were at the Sheraton Bijao and there were two staff members there immediately helping with her as we tried to keep her on her side so she wouldn’t aspirate.  Within two minutes there was a doctor also helping and we eventually got her cognizant enough that we could put her in a wheel chair and take her to the small aid room in the hotel.  Jackie was very calm and spoke to me suggesting that the best course of action would be to get her to a hospital.  All of the people on the tour were very supportive and promised to make sure all of our bags were loaded on the tour bus.

david panama public hospitalIn the aid room the doctor monitored Brandy’s oxygen levels and ran a short ekg strip, neither of which impressed him.  He decided we needed to go to a clinic and we jumped into a cab and headed to San Carlos (a town that warrants further investigation).  The hotel doctor rode with us and briefed the doctor in the clinic before leaving.  They immediately took Brandy back into the examination area and left me to figure out how things worked.  As it turned out, the Panamanians have great patience and took very good care of me.  Any of them could look at the paperwork I had and point me in the right direction.

The first stop was the check-in receptionist.  After a few minutes of gestures and sound alike words she suddenly picked up her cell phone and used it to translate.  It was smooth sailing after that.  She gave me the completed form and I walked down the hall to pay $1. I was then stopped by another clerk and she had another bill for lab work so I took that to another window to pay $42 dollars for a UA and complete blood workup.  We were in the clinic for three and a half hours and toward the end I was given a bill for IVs, three of which were used so I went to a different window to pay $6.82.  The labwork indicated that Brandy had a beginning UTI and I was sent to the pharmacy to pick up ten days worth of two medicines, $1.85.  The doctor examined or interacted with Brandy every step of the way and frequently called me in to explain (in perfect English) Brandy’s status.  When it was time to leave one of the clerks called a cab for us and waited with us on the curb and explained to the driver where we needed to go.  So it was three and a half hours of exemplary medical care (I was a medic in VietNam and an EMT all of my adult life), with very fine people (both the medical people and the patients) for a TOTAL of $49.67.

san carlos panamaSince we had left all contact information behind, we headed back to the Sheraton Bijao.  The manager immediately recognized us and offered any assistance he could render.  He put me on the phone with Jackie – still cool as always and we decided we could catch up with the tour by catching a bus on the highway near the hotel.  The hotel manager immediately had us in a taxi who got us to the highway just in time for him to jump out and flag down the bus to Santiago.  I had thought a car would have been more comfortable, especially for Brandy, but after we were on the bus we found it quite comfortable and again, everybody friendly and helpful.  It was a two and a half hour ride to Santiago which cost $15.00 for both of us.

The next day Brandy was not completely recovered and Jackie and I decided that it would be better to skip that day of the tour and take Brandy straight to Boquete where she could rest in the same hotel for several days.  Jackie, in her graciousness, paid for a car to take us to the Oasis Hotel and she had already called to inform them of our early arrival.  After a couple of days of rest Brandy was able to participate in a  couple of tours which she found delightful.

If I wasn’t convinced that Panama was the place to retire before this experience but am certainly convinced now. I can’t imagine retiring anywhere else.

I cannot thank Jackie and her crew enough.  This is a tour that was conducted very professionally and yet you were made to feel as though you were a personal friend and were there to have a great time. Thank you Jackie, and if ever I can do anything for you, you need only ask.

I met many wonderful people on the tour, all of whom I wished to talk with and all of whom I hope I see again.  Again, I apologize for any distress or inconvenience this incident may have caused.  I thank you all for your help and for your graciousness and concern. It was easy to get right back into the tour mode thanks to all of your support.

Terrance Davidson
Colorado

CAN YOU IMAGINE WHAT THESE EMERGENCIES WOULD COST WHERE YOU LIVE?

punta pacifica hospital panamaSo, why are the costs so low in Panama and so high where you live?  That’s a question I get asked often. The answer is that the costs, especially at a public hospital or clinic, are based on what a simple Panamanian worker can pay.  Someone like a gardener might only make $25 – $30 a day.

The other reason the costs are so low in Panama, compared to other countries, is because lawsuits are rare so doctors do not have to spend a fortune on malpractice insurance.   You’ll find that most doctors offices are simple but clean.

I’ve had two eye surgeries in Panama which my health insurance paid for.  My surgeon told me that when he filed the insurance claim for $2,200 in Panama, he gets paid $2,200.  But when his daughter, who is a doctor in Miami, files an insurance claim for $7,000 she will be lucky to get paid $3,500.

These are some of the reasons health care costs are more affordable in Panama.

CONCLUSION

As you can see from the two medical emergencies above, quality and affordable health care are available in Panama.   I don’t take any medications but I’ve been told that some medications are much more affordable in Panama too.

By Jackie Lange – Panama Relocation Tour

At Sea with Road Scholar

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panama-canal-bridge-amsterdam-061218-c037.jpg.image_.750.563.low_I’m excited to be going back on Holland America’s damn ship VOLENDAM for a cruise from San Diego to Ft. Lauderdale.  I’ve done this same trip years back lecturing and doing the bridge commentary through the Canal working with Holland America.  This time I’ll be doing it as lecturer for a small group of Road Scholars.

Road Scholar is an exciting, non-profit organization providing ongoing educational travel opportunities for adults 55 years of age and older.  My mother-in-law used to enjoy these trips back when it was called Elderhostel.  The official name of the organization is still Elderhostel, but the programs are branded as Road Scholar, a name with much more appeal to the over 55 group than Elderhostel.  Baby boomers would prefer any name but “elder”!  And most of us gave up staying in hostels years and years ago.  It didn’t take me very long to forgo hostels for Holiday Inns, which were pretty much the same “luxury” as hostels, but with swimming pools.  When we were in the travel agency business and my kids were little, they wondered why their friends went camping and we didn’t, and my response was, “Well, honey, occasionally, when I can’t get comped elsewhere, we do sometimes stay at Holiday Inns.”  Lest you forget what Holiday Inns were like, if you go with us on the PEARL MIST Great Lakes cruise and visit The Henry Ford museum in Dearborn, Michigan, they have one of the very first Holiday Inn rooms on display, along with all the Model Ts and the like. The room is appropriately dreary complete with shag carpeting and a tiny bar of motel soap.

road scholar JPEGSo rebranding from Elderhostel to Road Scholar made a lot of sense, although if you’ve wandered through academia and haven’t yet had sufficient memory lapses, it’s hard to hear Road Scholar without thinking Rhodes Scholar … big difference.

Road Scholar has a well-designed and well-executed program of literally thousands of educational travel opportunities and forget about hostels.   Hostels are for kids and we have a ton of them in Boquete, since in addition to all the expat tourists dreaming about moving to Panama, the wealthy Panamanians from Panama City who are escaping the traffic, heat, and pollution of the big city, we have loads of back packers from all over the world.  Road Scholar offers comfortable, secure, upscale accommodations carefully selected to fulfill their mission “provide enriching educational adventures at extraordinary value.”

Road Scholar likes to think of “the world as a learning opportunity” and offers over 5,500 programs.  They make it easy for single travelers and even have exiting and thoughtful programs celebrating holidays like Christmas and New Years with a small group of 25 or so like-minded folks in places like New York, Strasburg, Savannah, Quebec City, Santa Fe and others.  What a concept: the most exciting holiday destinations, with a group of friends, with no fuss, no muss, no drama!  Some of their programs are operated as small groups on both large and small ships, like this trip I’m part of on the VOLENDAM.  And Road Scholar is even chartering it’s own ship starting next year offering exclusive voyages.

OLYMPUS DIGITAL CAMERASo the program I’m heading on, Panama Canal Adventure: Exploring Mexico, Nicaragua, Guatemala & Costa Rica, leaves from San Diego visiting Cabo and Chiapas, Mexico; Antigua, Guatemala; Corinto, Nicaragua; Puntarenas, Costa Rica; transiting through the Panama Canal; Cartagena, Colombia, and Holland America’s private out-island in the Bahamas, Half Moon Cay.  I’m excited to be working with Road Scholar, and excited to be working with a small group.  I’ve spent much of my time lecturing to big groups in giant theaters on board ships, but never actually getting to meet and know the guests.   Since I’ve been working on small ships, I’ve had the opportunity to actually meet and get to know the guests.  The over 55 demographic of folks who travel on ships like PEARL MIST, and go on Road Scholar programs are typically well-educated, well-read, well-traveled people who have had fascinating life experiences.  So for me it’s exciting to be able to share with that kind of group.  With Road Scholar I have time to dig into some of the topics without having to worry about dumbing-down,  The reason why I’ve enjoyed longer cruises, two world cruises, and the exotic itineraries is having the opportunity to tie together the histories of countries and regions.  This is an ideal itinerary to be able to pull together a fascinating and intertwined history!

cropped-april-ll-volendam-183.jpgAnd to be able to take folks through the Panama Canal is, for me, one of the most fun experiences in the world.

Autosave-File vom d-lab2/3 der AgfaPhoto GmbHSince we’re traveling through one of the best coffee growing regions of the world, I’m going to do my talk about coffee and, since it’s a small group, we are actually going to do a coffee tasting of the coffees from Mexico, Guatemala, Nicaragua, Costa Rica, Panama, and Colombia.

 

Magical!

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Because of the orientation of our mountain home in Boquete, every morning we can sit on the front porch, or terrace as it is called in Panama, and facing due east enjoy our coffee while watching a spectacular sun rise. Beautiful!  But because the back terrace, and the openness of the house onto the back terrace, when the sun starts going down behind Volcan Baru it is just magical!

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And as I mentioned in my Retirement 2.0 post, unfortunately it is time for us to move on and to downsize, making this spectacular property available to the next adventurers.

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Retirement 2.0

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Those of you who’ve followed my blog know that we are in the process of “retiring from retiring” … well, actually moving from Retirement.1.9 to Retirement.2.0 … a little more relaxed and with less responsibility. So, we’re selling our home just outside of Boquete, described by many as “the most beautiful home in Boquete.”

So here’s a little backstory and a little behind the scenes of what it costs.

When we moved to Boquete 15 years ago if you wanted a North American style home you pretty much had to build it. We initially lived in Valle Escondido, Boquete’s first gated, guarded, “planned” community. We purchased the third house built in Valle Escondido. At the time Valle Escondido was still mostly undeveloped and pretty much Panama. So we lived through all the building, waking up to workmen yelling to each other across the Valley and peeing outside our kitchen window. But when it was nearing being built-out, although beautiful, it really was no longer the Panama we came to enjoy. It became like any gated, guarded community in California with well-heeled expats and weekend mansions for wealthy Panamanians.

We had purchased some properties for investment including a tiny abandoned coffee property. We liked escaping to that property and my wife got the idea to restore the coffee, and she did … and today we enjoy our own home-grown coffee, along with bananas, oranges, lemons, and a bunch of other stuff. So we liked going up there, loved the spectacular view, and were getting tired of what was being called the “gringo ghetto” so we decided to design and build our dream home. We designed it with the help of our friend Brad Abijian,, and took our design to a local architect to prepare the drawings.

Building wasn’t easy. We sourced materials from all over … tiles from Spain, cherry cabinets built for us in China, slate from India … and it all came wonderfully together, but not without a lot of hassle: subcontractors and workmen who didn’t show up, a general contractor who spent all our money finishing up his last project. Amazingly I didn’t end up in the loony bin. I’d begin every day praying that none of the workers would die (no OSHA!) and that I wouldn’t kill the builder.

We ended up with a beautiful home and property: a private driveway lined with beautiful royal palms, flowers and tropical plants everywhere, banana, citrus, coffee trees and other tropical fruits. No neighbors. Very private with spectacular mountain views. And, right off a paved road, just 12 minutes from “downtown” Boquete, and 30 minutes from David and the new 400 store shopping mall under construction.

012-4-copyPeople thinking about escaping to Panama always wonder about the cost … so here’s what things cost …

• Town water $60 A YEAR!
• Trash pick up $30 A YEAR!
• Propane gas … for hot water, clothes dryer, cooking … $70 for a huge tank which lasts about 3 months.
• Electricity … for our house with 4 dehumidifiers, electric spa, our won well and water systems, out buildings, and rental casita on the property … $110 a month.
• The beautiful landscaping around our home, the rental casita and our driveway is maintained by one neighbor … a university student … who works one day a week, usually just 8 hours, at $1.75 per hour.

We have chosen to maintain the coffee as a hobby farm. We enjoy being a part of the coffee culture tradition in Boquete which goes back 100 years. We love our fantastic Arabica coffee … and so do our kids and friends. We hold out, and process coffee for our own use, but most is sold “in the cherry” to large, local coffee producers. Boquete coffee is some of the best in the world and snapped up by folks, like Starbucks, who blend our coffee with other coffees to boost the flavor. So if you drink Starbucks … every billionth bean may be mine!

We break even on the coffee. Yes, there are opportunities to sell it on line, or to sell it all to a restaurant in North America that wants to offer an exceptional single-source coffee which is exclusively theirs. But we are retired and have a lot of things going on, so we haven’t pursued these opportunities. Others have done so, very successfully.

A future buyer of the property might continue to grow coffee, or expand the operation, or switch over to nut trees, build greenhouses, or turn it into a pasture for horses. There are lots of options and opportunities for a B&B or rental cottages. If you want to go off the grid and grow much of your own food, this is the place to do so.

What does coffee cost us? We fertilize, trim, and spray a couple times a year. For much of the time we had a full-time worker who managed things. Our total cost for that full-time guy was under $6,000 a year. Eventually we decided that we could hire local kids, mostly university students, to work for us on a short-time, occasional basis. That costs us less, has proven to be more efficient with less required paperwork with the labor board, and is a way to support the dreams and education of our local kids, many of whom we’ve watched grow up. The “labor intensive” time comes in October to December when we pick. Unlike the big farms that bring in Indigenous folk who come in from the comarca (kinda like an Indian reservation, although with more self-control and independence than Indian reservations in the States) to do the picking. Because we’re just so small, we just use our Gnabe Bugle Indigenous neighbors, mostly members of the little church up the road. For us this is much, much better. We support and look after our neighbors, and they look after us. We’ve had many of the same people pick for us now for eight years. We’ve watched their kids grow and start their own families. So we break even with coffee, although, the truth is I think we would gladly have paid for this experience.

Right now you can’t make that much picking and selling bananas, citrus, and other tropical fruits, so we just use these for ourselves, or share them with our neighbors.

More information on our home for sale

What’s here?

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DSC_0481LIVING IN PANAMA

Fifteen years ago when we moved to Boquete, Panama, there really wasn’t a whole lot of information available online, and blogging was somewhat new, so I began blogging about the joys and challenges of living in Panama. Then lots of folks started blogs, so now I only write occasional pieces about living in Panama. But not to fear … there is a whole repository of interesting blogs about life in Panama right here.

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WORKING THE HIGH SEAS

It is a tough job, but someone has got to do it. My first cruise ship gig was back in the 60s on the cruise staff of a student ship to Europe. Eventually I started working my vacations as a chaplain on cruise ships, that led to us owning travel agencies in Southern California, and then after retiring early and moving to Panama, and then 12 years ago I began lecturing on cruise ships. Now, after countless cruises, two trips around the world, and lecturing on over 294 different ports, I’m still enjoying being at sea on luxury cruise ships. It is a better retirement job than being a greeter at Walmart, not that there is anything wrong with being a greeter at Walmart. So, come along and share the adventure!

Dr Richard Detrich

BOQUETE PANAMA PROPERTY FOR SALE

We have a beautiful Tuscan-style estate home just outside of Boquete with 4 acres of tropical landscape with coffee, banana, avocado, and citrus trees. We also have a spot right on and overlooking the water in Boca Chica. And, I’m still working on ships 4 to 6 months a year … so eventually we are going to want to downsize. So, if someone comes along who wants a beautiful tropical estate …

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