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World Association of International Studies

Post Medicare and Treatment Abroad
Created by John Eipper on 12/06/17 3:27 AM

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Medicare and Treatment Abroad (Timothy Brown, USA, 12/06/17 3:27 am)

On our skyrocketing medical costs:

One thing that can be done to reduce at least its marginal costs would be to authorize Medicare to pay overseas just like other Federal health providers like the VA, and other insurance programs do, including Federally supported ones. Medicare would save a great deal by doing so because the bill is much lower. My most recent brush with this was some time ago in Costa Rica. Needing a checkup, we chose to use a local hospital. When they checked with our secondary insurance AFSPA they were told to do anything they needed to do and AFSPA would cover 100% of it regardless. Why? Because the cost in US dollars in Costa Rica was about 70% lower than in the US.

Our moderator's friend got his dental work done in Mexico because it costs less that half what it would cost in the US. There are lonely parking lots on the US side of the Mexico-US border with strips of dental offices on the Mexican side where people in the know have their dental work done to reduce the costs of dental work by 50%, and sometimes more.

On national debts: A reasonably large debt (usually the product of paying out over a period of years more than the Treasury brings in) is necessary for maintaining the value of a currency, but it can become destructive if it gets out of hand.

Some decade ago when Venezuela didn't have enough national debt to keep its currency's exchange value, we helped them create one debt so they could minimize exchange problems. (Talk about historical debt ups and downs!)

One thing that seems to be missing from this discussion of a national debt is inflation. If inflation continues at, say 2%, in 20 years the national debt will actually have lost about half of its real (not nominal) value.

JE comments:  It was a student--not friend, although I like him very much--who had his wisdom teeth done in Colombia (not Mexico).  He just returned to Michigan.  I'll ask him to write up his experience for the Forum.  

At what time did Venezuela not have "enough" debt?  Was it during the oil-frenzied 1970s?  Remember that Weimar Germany inflated its way out of WWI reparations.  Did Venezuela basically do the same under Chávez and Maduro?  No debt would be issued in Bolívares (fuertes) to be sure, but Venezuela has a Byzantine system of competing exchange rates.

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  • Medical Treatment Abroad; "Medivalue" (Timothy Ashby, South Africa 12/06/17 9:08 AM)
    Timothy Brown December 6th) is absolutely right to advocate allowing Medicare to follow other US Federal health care providers in authorizing patients to pay for medical care overseas. The cost savings are indeed staggering, and the quality of the care is as good (and some cases better) than that in the USA. US patients generally average savings of 60-80% (including travel and accommodation) over domestic costs.

    As a personal example, in South Africa (where Rosemary and I are going tomorrow) we pay the Rand equivalent of around $25 each for a full dental exam including X-rays, and our local dentist uses state-the-art technology. Earlier this year I had a root canal, a crown replacement and a series of fillings (plus treatment for a gum infection) for a total cost of the Rand equivalent of $800. Although we both use the NHS in the UK (and think the service is good), we prefer to have medical and dental work done in South Africa because there is usually a long waiting period to see a specialist in the UK after referral from one's GP.

    In 2014 I co-founded a company called Medivalue that was to be the "Expedia of Global Medical Care." The project was shelved for several reasons (including a lawsuit against my co-founder for deviously trying to take over the company--I won) and because I became extremely busy after Obama's December 2014 liberalization of relations with Cuba.  I am considering reviving the company as I have had quite a bit of investor interest over the years.

    At the moment, I am very busy working on a Cuban Retirement Villages project, which we believe will have a growing "Baby Boomer" market in North America and Northern Europe due to the excellent quality of medical care in Cuba and the fact that Boomers from "Yuma" will able to enjoy a comfortable, secure retirement in Cuba for about 25% of what similar facilities would cost in the US Sunbelt.

    I'll report from South Africa where we'll be until the end of January.

    JE comments:  Tim Ashby also sent a PowerPoint deck on Medivalue, which I can forward to interested WAISers.  Tim, an online global health clearinghouse is truly a "disruptive" idea whose time has come.  Best of luck with it! (Sorry; I just broke my own rule to avoid the annoying buzzword "disruptive" in the sense of industry-changing or innovative.  I'm still of the old-school belief that being "disruptive" gets you sent to the Principal's office.)

    Cuba is trending in WAISworld.  Aldona and I are heading to Havana next week for some educational fact-finding.  It will be my first visit in almost 20 years.

    Safe travels, Tim!

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    • Medical Treatment Abroad (Tor Guimaraes, USA 12/07/17 6:04 AM)
      I agree with both Tims Brown and Ashby about allowing Medicare to pay for medical treatment in other countries.

      What I find very disturbing is how can a situation like that exist, where our nation has selected their leaders who apparently have prostituted themselves and commonly turn on their own people to the point where nothing seems to work.

      How is it possible that a little besieged and starved Communist nation run by dictators can provide better/cheaper health care for its people? What has happened while the American people standard of living deteriorated so much? And now we seem unable to control our own destiny.

      JE comments:  Some optimism, Tor...?

      Allowing Medicare payments to other countries might drive down costs, but it would also open a can of worms for potential fraud (not that there's no Medicare fraud already).  A question for Tim Brown:  what process does the VA have to ensure its payments abroad are legit?

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