20 replies to this topic

[JAC3]

Calderone and Obama are in talks this week in Washington and there is hope that Medicare in Mexico is on the table. In my mind Medicare being available in Mexico is a non-starter.

The lower cost of Mexican health care argument does not take into consideration the net costs to the US Government. Every health care job creates 2.5 additional jobs and each of those jobs pays taxes... and lots of them. Income tax, sales tax, property tax, gasoline taxes, liquor and cigarette taxes and a myriad of additional fees back to various levels of government. And let's not forget the corporate taxes paid by companies supplying to the industry.

Each Medicare dollar spent in the US goes through a series of hands and each time a chunk of that same dollar gets returned not to just the Federal Government but all levels of government. After the return of the taxes on those Medicare dollars the delta between Mexican costs and US health care costs is not as significant as originally thought. Certainly not significant enough to undermine the well-being of Americans with jobs.

But to me the big nail in the coffin of Medicare in Mexico is this thought. Can you imagine any US political leader, at any time now or in the future, placing themselves in the position of being criticized for advocating the "exporting" of jobs... let alone FUNDING the exporting of those jobs!

It is possible I have missed something and welcome comment - please be civil:-)

[mpb]

Calderone and Obama are in talks this week in Washington and there is hope that Medicare in Mexico is on the table. In my mind Medicare being available in Mexico is a non-starter.

The lower cost of Mexican health care argument does not take into consideration the net costs to the US Government. Every health care job creates 2.5 additional jobs and each of those jobs pays taxes... and lots of them. Income tax, sales tax, property tax, gasoline taxes, liquor and cigarette taxes and a myriad of additional fees back to various levels of government. And let's not forget the corporate taxes paid by companies supplying to the industry.

Each Medicare dollar spent in the US goes through a series of hands and each time a chunk of that same dollar gets returned not to just the Federal Government but all levels of government. After the return of the taxes on those Medicare dollars the delta between Mexican costs and US health care costs is not as significant as originally thought. Certainly not significant enough to undermine the well-being of Americans with jobs.

But to me the big nail in the coffin of Medicare in Mexico is this thought. Can you imagine any US political leader, at any time now or in the future, placing themselves in the position of being criticized for advocating the "exporting" of jobs... let alone FUNDING the exporting of those jobs!

It is possible I have missed something and welcome comment - please be civil:-)

I think your estimation of the end results are correct. On the other hand, the average retiree costs Medicare $250,000. Without using Medicare, the US still saves a substanial amount of money, even with the loss of the taxes collected if medicare was in the loop. If Medicare were to be allowed SOB, their costs might be 1/2 of the cost NOB and taking into consideration of loss of taxes, jobs etc. their savings might still be a considerable amount. But as you pointed out, which politician would consider outsourcing jobs outside of the states during an election year.

[JAC3]

I think your estimation of the end results are correct. On the other hand, the average retiree costs Medicare $250,000. Without using Medicare, the US still saves a substanial amount of money, even with the loss of the taxes collected if medicare was in the loop. If Medicare were to be allowed SOB, their costs might be 1/2 of the cost NOB and taking into consideration of loss of taxes, jobs etc. their savings might still be a considerable amount. But as you pointed out, which politician would consider outsourcing jobs outside of the states during an election year.

Thank you mpb. Even without the election year effect the optics of using US taxpayers money to fund the off-shoring of US jobs would seem to me to be very difficult for any politician to defend.

In addition there is the argument that extending Medicare to Mexico would only encourage more retirees to move to Mexico and that would transfer precious wealth from the US, reduce the velocity of money in the US and reduce the US residency and consumption tax base

The average full tax burden in the US is reported to be around 28% so the various levels of government are returned about $70,000 of that $250,000. Assuming the cost of delivering the service in Mexico is as you say 50% of the cost NOB then the net additional cost or delta is $80K per retiree. Please note that I am not a trained economist so the following comment is more of a question that an assertion. It seems to me that there would be an additional tax recovery of 28% albeit on a lesser gross amount each time the residual of that dollar passes through another hand or entity thus reducing the delta further.

Any economists out there that would like to weigh in on that thought?

[hkrause]

You can get lots of information about this topic on the "Americans for Medicare in Mexico" website: http://www.medicareinmexico.org/

If they're not going to extend Medicare into other countries for US Citizens living abroad, it would seem only fair to provide alternate compensation to those who paid taxes into the system for many years, but who can't afford to return to the US every time they need treatment.

Of course, I can understand that most Americans would feel little sympathy, and expect Americans to stay in America if they wish to use US resources and services.

Heather

[willieboy]

Calderone and Obama are in talks this week in Washington and there is hope that Medicare in Mexico is on the table. In my mind Medicare being available in Mexico is a non-starter.

The lower cost of Mexican health care argument does not take into consideration the net costs to the US Government. Every health care job creates 2.5 additional jobs and each of those jobs pays taxes... and lots of them. Income tax, sales tax, property tax, gasoline taxes, liquor and cigarette taxes and a myriad of additional fees back to various levels of government. And let's not forget the corporate taxes paid by companies supplying to the industry.

Each Medicare dollar spent in the US goes through a series of hands and each time a chunk of that same dollar gets returned not to just the Federal Government but all levels of government. After the return of the taxes on those Medicare dollars the delta between Mexican costs and US health care costs is not as significant as originally thought. Certainly not significant enough to undermine the well-being of Americans with jobs.

But to me the big nail in the coffin of Medicare in Mexico is this thought. Can you imagine any US political leader, at any time now or in the future, placing themselves in the position of being criticized for advocating the "exporting" of jobs... let alone FUNDING the exporting of those jobs!

It is possible I have missed something and welcome comment - please be civil:-)

Calderón

[jaykay]

JAC3,
You make many statements as if they were indisputable facts. When you do that, please state where your "facts"
came from. Every reason you stated as to why Medicare shouldn't be paid to folks in Mexico could apply to Social Security too.
Medicare is not a freebie. We all paid into the pot. I paid in every since Medicare came in to being. Now your logic (in my opinion) is flawed. I am assuming you are sincere. If I can't access that money that I paid in, no one in the US is going to get a nickel. As for your statement that the delta is small, that is a strange statement. My wife, a lifelong medical professional (RN) had her gall bladder removed here. There was no time to go north. Her costs were around $10,000 dollars. In one of those weird timing things, her boss in California had to have her gall bladder removed also. Her costs ran close to $100,00 dollars.
My wife thought that the care here was superior to California. Considering the state of our country, anything that could save money should be investigated, and every impartial study I have seen thought that the US would save a ton by paying here instead of making people go home. Why isn't it being done now? The AMA is against it. They don't care about us, only their pocket book. Common sense tells me that a lot more Americans would retire down here if they could use the Medicare they have already paid for. I really could care less about somebody in the US who I'm sure doesn't care about us down South. What you are really saying is, we should all go north for medical treatment so people up there will get more of the money that we paid in. Interesting viewpoint.

[JAC3]

JAC3,
You make many statements as if they were indisputable facts. When you do that, please state where your "facts"
came from. Every reason you stated as to why Medicare shouldn't be paid to folks in Mexico could apply to Social Security too.
Medicare is not a freebie. We all paid into the pot. I paid in every since Medicare came in to being. Now your logic (in my opinion) is flawed. I am assuming you are sincere. If I can't access that money that I paid in, no one in the US is going to get a nickel. As for your statement that the delta is small, that is a strange statement. My wife, a lifelong medical professional (RN) had her gall bladder removed here. There was no time to go north. Her costs were around $10,000 dollars. In one of those weird timing things, her boss in California had to have her gall bladder removed also. Her costs ran close to $100,00 dollars.
My wife thought that the care here was superior to California. Considering the state of our country, anything that could save money should be investigated, and every impartial study I have seen thought that the US would save a ton by paying here instead of making people go home. Why isn't it being done now? The AMA is against it. They don't care about us, only their pocket book. Common sense tells me that a lot more Americans would retire down here if they could use the Medicare they have already paid for. I really could care less about somebody in the US who I'm sure doesn't care about us down South. What you are really saying is, we should all go north for medical treatment so people up there will get more of the money that we paid in. Interesting viewpoint.

jaykay

I agree with your viewpoint entirely. Please be clear I am not advocating that Medicare should not be paid to folks in Mexico. There is a great case for Medicare to be available here. Some of those points were well stated by yourself. Please reread my comments in that light and you will probably agree we are not at odds.

I am just saying that I cannot imagine a US administration prepared risk the political capital to make it happen -- ever. And again that is not a fact it is just my opinion. If you agree with that then the end result is the same... it will not be available here.

The question is how do you live here and make it work for you?

[Mainecoons]

I'd be concerned that Medicare would push medical inflation in Mexico as it has in the U.S. Agree that it would probably be political suicide for anyone up there to push this through.

[AlanMexicali]

I'd be concerned that Medicare would push medical inflation in Mexico as it has in the U.S. Agree that it would probably be political suicide for anyone up there to push this through.

How can a very insignificant population of over 65 Americans affect the cost of medical care, private or public, in Mexico in all areas of the country or were you specifically talking about in your expat community?

[PV Kids]

Medicare is going broke. It will never be expanded, only contracted. There aren't enough new workers to pay for us old geezers, SSA or Medicare. It's a demographics issue not a political issue. Our generation was so clever and successful in limiting our birth rate we are now going to get the unintended consequences. Any questions, see Japan.

[jaykay]

I read an article at least 8 years ago about Social Security but I think it would apply to Medicare also. The reason social security is in trouble is because all those years the money was being collected, it got dumped into the general fund so the deficit wouldn't look so large. The same thing happens to taxes from airports and taxes on gas that is supposed to go to highways and bridges. Both parties are guilty. If that money had been kept separate, the amount would be hugh. Ditto roads bridges and the airport system. If you hit the internet you can find many books and studies on the subject. It was actually debated in the 2000 election for president. Remember the "lockbox" discussion? It was made fun of on SNL.

[Cessna195guy]

Quit dreaming, it's not going to happen. We chose to move to a foreign country, and must accept the fact that we give up certain benefits, regardless of what we paid into. Their maybe some other solutions in the future, such as a medigap plan for expats, but it's in the early stages and can not comment any further on it at this time.

For those who are living abroad that have Medicare, their is alternate choice that will cover you for accidents & emergencies, not urgent matters. You can purchase a travel insurance policy for up to two years at a time, it doesn't cover pre-existing conditions. To learn more about how this works, feel free to send me an email with your contact information, Name, Phone Number(s) and age as well as the best time to call. My email is roger@protexplan.com

[JAC3]

Alternately, if you qualify for Medicare there is a way that you can live here and use Medicare for critical illness or injuries. It involves a combination of self-insurance and the ability to get to your home Medicare hospital in the US in emergencies. Self-insurance for day to day medical care in the Lakeside area has proven to be very cost effective and the service is first rate. Getting Medicare to cover the heavy lifting utilizes the contributions that you have already made over the years. (This strategy requires a credit card with a $12,000 limit and SkyMed. The membership is only $522 per year for an individual or $860 for a family). Contact me for the details.

[JayBearII]

1) How is travel insurance going to cover someone who has lived in Mexico for years? Would having a US address be enough? Would one renew every 2 years for "travel" in Mexico even tho we live here full-time? Not criticizing, just asking.

2) I thought Sky Med only covered trips "home" to the US or Canada if that (not Mexico) is your primary residence and you can prove it. If it were an emergency, wouldn't they take you to the nearest hospital where adequate care can be provided (i.e. from the beach to GDL)?

[JAC3]

2) I thought Sky Med only covered trips "home" to the US or Canada if that (not Mexico) is your primary residence and you can prove it. If it were an emergency, wouldn't they take you to the nearest hospital where adequate care can be provided (i.e. from the beach to GDL)?

Hi JayBearll

Thank you for asking. SkyMed has a plan for full time residents of Mexico which I alluded to in a post above. In the event of a critical illness or injury SkyMed will take you to the designated location of your choice. Closest adequate facility does not enter into the discussion. If you are in Ajijic or at the "beach" or in the US or Canada or the Caribbean and you have your "home" stated as NYC then that's where we take you . You do have to be able to legally enter the country of choice but no proof of residency is required by SkyMed. And you can change that choice at any time upon 30 days notice. I hope that answers your question.

[jaykay]

JAC3,
I think you have a dog in this fight. It's always a good idea in these threads to state in front if you have a commercial interest in the subject. People then can judge if your points are strong on their own merits.

[ChrisB]

I am a full time, permanent resident of Mexico. At 65 I have to apply for and pay into Medicare Part B. Can I then return to the states for surgeries?

[JRPJR]

JAC3,
I think you have a dog in this fight. It's always a good idea in these threads to state in front if you have a commercial interest in the subject. People then can judge if your points are strong on their own merits.

I think if you reread his post you will notice he says "If you are in Ajijic or at the "beach" or in the US or Canada or the Caribbean and you have your "home" stated as NYC then that's where we take you" The 'WE" could be a tip off but info may still be of value..

[JAC3]

JAC3,
I think you have a dog in this fight. It's always a good idea in these threads to state in front if you have a commercial interest in the subject. People then can judge if your points are strong on their own merits.

I agree.

My automatic signature indicated my position with SkyMed and outlined clearly that SkyMed is prepaid emergency medical evacuations so it was my belief my financial interest was obvious. Unfortunately, the mod asked me to remove my signature and I complied. As a result, now the signature does not show on my current or historical posts and thus I appear to have been sneaky. Sneaky was not what I was going for

The mod seems to be reasonable so it is my belief that he/she will allow me to set the record straight here. The message is if you live in Mexico and want to access Medicare, SkyMed has a cost effective plan that will work. Anybody that would like to know more, please PM me and I will be happy to walk you through the strategy.

[JAC3]

I am a full time, permanent resident of Mexico. At 65 I have to apply for and pay into Medicare Part B. Can I then return to the states for surgeries?

Yes.

Please PM me if you would like further details.