Whether inside the USA or abroad, older Americans become incapable of defending themselves against impending death.
There is nothing more cruel and insensitive than romanticizing living abroad and traveling the world without a care in the world. Travel writers, financial advisors, and the whole travel industry put forth incredibly dangerous advice, veritable black holes that warp and destroy the light of realistic and sensible advice.
Please, use a little common sense. It is difficult enough to grow old inside the USA, where we speak English, understand the system, and have family support. Dying abroad, alone, brings only overwhelming fear and trembling.
Today is July 9, 2013, and I have spent approximately two months observing my 79-year-old mother and 80-year-old father. We, the Graham family, are lucky: We are strong, capable and cohesive enough to provide support to elder members of our clan. And more importantly, we are large enough. There are more than 20 players, adults who can pitch in and assist.
In concert, Medicaid, Medicare, home health care, nursing homes, doctors and hospitals have woven together a system that forces American taxpayers to help Americans, whether they are rich, middling or poor. We just do not throw people out into the cold; nobody dies in the streets, except for those who demand to do so. Generally, as best I can understand, Medicaid will pay and welfare will pay; there is money available to pay for medical treatment for indigent and impoverished Americans.
There is nothing noble about this. The medical industry and pharmaceutical companies are milking the system for every penny possible. And the insurance industry somehow takes money from tax-paying U.S. citizens to cover the easy stuff.
Can we provide these services for ourselves while alone in a foreign country?
Yes, we can handle the easy stuff. Regular medical bills are affordable, and assisted living is especially simple outside the USA. We can hire a live-in person to take care of us for U.S. $10-20 per day,
One time, I offered to buy some of my mother’s medicine abroad, a prescription she regularly fills inside the USA. Her insurance copay was the same as the total price for the same quantity and dosage in Guatemala or Thailand, for example. Inside or outside the USA, the out-of-pocket cost is about the same. In essence, self-insuring outside the USA is possible.
Can or will the doctors and hospitals pay millions of dollars to keep you alive abroad? I believe the answer is no; only the USA elongates life by keeping almost hopelessly handicapped elders alive for years after they cannot go to the toilet alone.
Buying a home abroad after age 65 is lunacy, a scam; it is romantic and unrealistic, and we never seem to get that this fantasy is hogwash. Humans have a never-ending capacity to hide from reality and deny what really happens.
Things fall apart for people abroad, and generally they escape back to the USA to hide and die. They seldom just die gracefully abroad, unless they are lucky enough to just drop dead in the street.
Never, ever, take advice from expats living abroad until they have survived abroad for at least seven years. This is the threshold number. The number of Americans living abroad for longer than seven years is such a small minority that they can be difficult to find, but they are the only source that really understands the realities. Newbies, the less-than-seven-year group, dominate the Internet; they write, romanticize and tempt people to move abroad, as if they truly understand. They are cruel and insensitive bunch. Maybe they are unaware of their naïve views, or maybe they just are greedy, but for the most part, they are delusional in believing that they understand how to live abroad.
In the end, it is about a stream of cash coming in. A person living overseas needs to have approximately U.S. $1,000-2,000 per month in never-ending cash arriving at the door. This person can then give custody of that money to a wife, a husband or a boyfriend who can piggyback on the money and live also. The two people can easily survive, as husband and wife, in a semi-parasite relationship.
Personally, the end game is this: Most expats will need to figure out a way to check themselves into U.S.-government-paid housing inside the USA in order to die gracefully.
International living, and that group leads you to believe you are safe, in essence spends all your available cash abroad on a home. Cash money is the only insurance you have living abroad. Foreign house equity cannot be given to a U.S. nursing home, and selling a home abroad, especially the monstrosities built by expats, takes 2-10 years.
In the end, we will die – but never as gracefully and with dignity, as we wish – but we get the job done … we die.
As a person who plans to die abroad – now age 57 and in incredibly good shape, happy and healthy – I strive to have U.S. $1,000-2,000 in an endless, monthly cash stream. And I’m on the lookout to capture a wife who will suck my cash until I die while assisting me and taking care of me. This is crass, harsh and realistic; it is the tradeoff of all humans.
In the end, do the young care about the old? Generally, they do if there is a financial reward given upon death. Without an inheritance, we stuff our parents into nursing homes, allowing the medical industry to suck up all the value of their homes, sell everything that’s left, and try to not think about it.
I guess I will pray to die suddenly and quickly.
This is the one subject that elusively is avoided, and I feel morally obligated to address it. I will now leave the USA and try my best to hide my head in the sand like the rest of my expat friends.
I've been reading your site for about 2 months now and really enjoy your perspectives on many things. i am retired and dream of buying a place abroad and reading your article really puts it on the line......why buy... rent and have a back up plan to return. I live in Canada.
Thanks for the refreshing viewpoints
I love to read the word "backup," it makes me feel safe.
Absolutely your best information since I've been here.
Totally agree that you need to go for 7/8 yrs before you're 60 or so with a viable income.
Having lived in both Europe and Asia I learned where you may be able to live even until you die or realize you need to return when your health begins to deteriorate, in less you have made many friends and possibly new family and can afford to stay and want to.
There are a lot of former military expats around the world who often stayed where they were discharged or soon returned but usually they did so in their late 30's early 40's and had been there for a while. Most have new families as well and a pension income.
They also have VA benefits.
They are as great source for expat info.
The USA medical system keeps making money if the person is alive, and it appears with Medicaid they just keep using tax payers money.
Realistically we use tax payer money for all kinds of things, some good, some ridiculous.
I would rather we use more for health for everybody than stupid wars, but that's government
doing it's thing.
Ha! Not only am I getting ready to take off for Guatemala (first) I am ALREADY SICK and have seen that staying here for the good secure feeling was a crock of crap. I am just fortunate that I am well enough now to carry on with my original plan. Unless you have some special people around, you are s.o.l. wherever your old sick butt gives out. PS: The goal is always to have all the organs go at once. This rarely happens. sorry. 26 years in the ER gives me the courage to tell you this.
I also have finally organized the money thingy. I hope my hubby remembers if he throws me into the volcano eventually someone will notice. Happily making a run to Goodwill with bags and bags of bags.