I wish I never had to write this article, but I cannot put it off any longer. There are life-threatening secrets you need to know today.
In the fall of 2009, my wife Jo and I went to a town hall meeting in Illinois. The guest speaker was a member of the House of Representatives who served on the committee putting together the law now known as Obamacare. The Congressman stood next to a draft of the bill and answered our questions by reading straight from the text. Most of us left terrified, hoping the bill would never pass.
Jo and I were so aghast that we attended several International Living conferences and even traveled to Costa Rica and Panama to investigate international healthcare options. The thought of going to a hospital where we didn't even speak the language was unnerving, but we needed to know our options.
We spent time with the president of the Johns Hopkins Hospital in Panama—a real world-class facility with mostly US-trained and board-certified physicians. He laid out the details of international medicine for us: "We are gearing up for an onslaught of Americans coming here for health care which they will find denied or delayed in the United States." Much like Canada, eventually Americans will have to leave the country to get quality, timely health care.
Like most countries, in Panama you either have insurance from a carrier the hospital does business with, you pay out of pocket in advance, or you don't get treated.
So, we looked into obtaining international insurance and discovered two things. First, the policies are expensive: over $12,000 for the two of us, who are both currently covered by Medicare. Second, if you want a policy, you need to be under 75 years of age; 75-plus trips around the sun renders you uninsurable.
At the time, Jo and I decided to put it off. Health care in that part of the world is currently less expensive than in the United States, so we took our chances and self-insured. If we needed treatment, we would pay for it ourselves.
Obamacare is now the law of the land. We can't put it off dealing with it any longer. Disagree? Here's a frank look at the law's dirty secrets, courtesy of a few friendly experts.
During our webinar last month, David Galland asked FOX Business reporter John Stossel about his recent book:
"You write that, 'Where governments control health care, but want to limit the costs, everyone has to get in line.' … and then you go on to say, 'Once you accept the idea that taxpayers should pay, then individual choice dies. Someone else decides what treatment you get, and when.' …
"It sounds to me like the end result [is] the government basically decides who lives and who dies. Could that really happen?"
"Sure. I imagine it already happens under Medicaid; they won't pay for every experimental treatment. And in some cases that means who gets it lives and somebody who doesn't dies. But when somebody else is going to pay, there is going to be a limit on that. And the question is: who's going to set the limit? If you pay, you get to set the limit. … It should be an individual choice that you weigh based on the cost, but right now with no cost, nobody even thinks about it.
"The people at FOX are fond of saying … there's going to be this unelected committee of bureaucrats that's going to decide what you get, and they'll decide whether you live or die. … Would elected bureaucrats deciding for you be any better? No. It's the idea that others will decide for us, and that's what happens when it's a third-party payment."
That exchange jogged my memory back to an article Dr. Elizabeth Lee Vliet wrote in July: 10 Reasons Why Obamacare Is Going to Ruin Your Medical Care… and Your Life. Dr. Vliet is an acclaimed expert on the enigmatic law, and one of our featured speakers at this week's Casey Summit in Tucson. She wrote (all emphasis in original):
"Higher expenditures to provide medical services lead to rationing of medical care and treatment options to reduce costs. This is the mandated function of the Independent Payment Advisory Board (IPAB): to cut costs by deciding which types of medical services to allow… or disallow.
"If you are denied treatment, you have no appeal of IPAB decisions; you are simply out of luck, and possibly out of life. This is a radical departure from the appeals process required for all private health insurance plans. Further, the IPAB is accountable only to President Obama, and cannot be overridden by Congress or the courts. IPAB is designed to have the final word on your health.
"Under current regulations, if medical care is denied by Medicare, then a patient is not allowed to pay cash to a Medicare-contracted physician or hospital or other health professional. Patients who need medical care that is denied under Medicare or Medicaid will find themselves having to either: 1) look for an independent physician or hospital (quite rare these days); or 2) go outside the USA for treatment."
Huh. So my cash won't be good enough for US doctors or US hospitals. Good thing I was gearing up to interview Nick Giambruno, editor of International Man, for the August issue of Money Forever, when I first read those frightening statements. It's strange how Nick's comments on currency controls wound up speaking to my healthcare worries. Here's what he had to say:
"Currency or capital controls are a favorite option in the tool box of a desperate government and are fairly common in the world today. Though they come in many shapes and sizes, capital controls are government regulations that prevent you from taking your money in and out of a country. The imposition of capital controls usually precedes some form of wealth confiscation (a currency devaluation or deposit confiscation among other measures) and always comes as a surprise to the average person. By their nature, capital controls have to come as a surprise in order to be effective. …
"There were many… [Cypriots] who saw the writing on the wall and had previously moved to diversify a portion of their savings internationally—most commonly with a Swiss or other European bank account. …
"This concept of diversifying your sovereign risk through internationalization is universal and applies to everyone in the world. It is especially urgent for those who live under a government whose fiscal health is in bad and deteriorating shape. Of course it is only an effective strategy if you act before the capital controls and other restrictive measures are imposed."
It's clear how currency controls can cause one to lose a lot of money, but there can be far worse consequences, too.
As seniors, Jo and I will likely find our care denied or delayed under the new law. What happens if one of us needs a knee replacement or a quadruple bypass and care is denied? We won't have the option to pay cash here at home, so that leaves two choices: go offshore, or go without treatment. I know what my choice would be.
Nevertheless, what if I had the means to pay out of pocket offshore, but I couldn't take my money out of the country? How sad would it be to need a quadruple bypass, be denied care, and still be unable to pay for the procedure offshore because of currency controls?
Here's where things get really sinister: Our government would have no incentive to allow a medical loophole in its currency controls. If we die, we are off the Social Security payroll, and maybe it can even snatch some of our wealth through the estate tax.
While I am not qualified to discuss the pros and cons of health care in individual foreign countries, I can say that you will need money to pay for it. That means money you can easily access offshore. Remember, if IPAB denies treatment, there is no appeal process. You are simply up a creek without a paddle, so to speak.
Moving money offshore—now—could be the most important medical decision you make for yourself and your family. International investments make sense for a lot of reasons; protecting your life is sure one of them.
If you want to learn more, Nick and his team have published an inexpensive special report, Going Global 2013. While it does not outline healthcare options, it is the best, most comprehensive report on internationalization I have ever read. First things first: we need a safety net with money offshore. Then we can determine the best countries for health care and hope we never have to go there for treatment. Better safe than waiting penniless in a foreign ER.
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