What If You Have To Get Out Of The Country?
Marketwatch profiled a retired teacher who concluded "it is an act of insanity to continue to stay in the U.S." because of how she views how the country has evolved in the last couple of years. She upped and moved to Panama, although she apparently researched several other Latin American countries before deciding Panama was her best option. The point is not to agree or disagree with her statement, this is the conclusion she drew for herself and then acted on that conclusion.
The idea of retiring to another country has long been a fun topic to explore and write about. While I have never had an interest in permanently moving to another country the idea of going someplace for six-12 months and really experiencing life there and then maybe doing it again somewhere else does intrigue me. Moving to another country can be a viable option for folks who think they will come up short, financially. I've written many times about young retirees who are relatively healthy moving to another country, keeping their mortgage free house in the states, renting it out and living off that rental income and maybe a side gig or two while they allow their savings and Social Security payouts to grow. By keeping their house, they wouldn't be priced out if they decided they wanted to come back or they had to come back.
Yahoo had a health-related article that said among other things "6 in 10 of the roughly 252 million adults in the U.S. have a chronic illness and 4 in 10 have two or more." Examples of chronic illnesses would include Type 2 Diabetes, high blood pressure and so on. It also said that healthcare spending is $10,739 per person but that is an average that I would suppose is skewed downward but either way the dollars being spent are staggering. Think about your retirement planning and having to factor in $1500/mo (for a couple) in fixed costs for prescriptions and the like. Excluding our mortgage, $1500/mo would be about 50% bump in our fixed monthly costs. Think about that in portfolio terms. If a 50-ish year old couple plans on needing $25,000 from their portfolio and saves toward that objective. Assuming a 4% withdrawal rate, they'd be working toward a $625,000 nest egg. Now envision that chronic medical issues appear around 60 costing $1500/mo or $18,000/yr. That's potentially a 72% jump in what they'd need from their portfolio which works out to needing another $450,000 accumulated. Social Security won't help in that the plan was needing $25,000 from the portfolio which would be on top of Social Security.
The likely outcome is a lot of sacrifices in lifestyle. In terms I've used before to make this point, every aspect of your life is more difficult in this situation and would say unnecessarily so if the chronic conditions in question could have been prevented by changing behaviors.
Where the teacher felt she had to leave for what I will call social reasons, what if you feel you have to leave for financial reasons? Being able to move to another country is a form of optionality. A very, very long story short (I've touched on this before), my father moved to Spain when he was 54, he felt he had to. He was physically capable at that age and all the way until just past his 88th birthday when he got sick and died six months later in Spain. In all those years in Spain, he never had chronic issues. A couple of things happened along the way that he got taken care of but he always said how lousy the medical care was. He was very lucky that his existence into a reasonably old age did not rely on regular interaction with the medical system for a chronic malady. In the six month window where he was sick up until his death, I visited twice and I saw how bad the medical care was, he was right. Now keep in mind, if you look you will find that Spain fares well in quality of care rankings but still, it is not very good.
My father was lucky that he only needed minimal checkups for the vast majority of his time there. Relative to dying, being sick for a few months and then succumbing wouldn't seem to be the worst possible outcome, not the best either but better than needing the kind of advanced care for years that might go with complications from T2D, hypertension and obesity.
I am seeing more and more studies connecting everything to sugary diets (follow me on Twitter @randomeroger, I retweet a lot of it); metabolic syndrome (you knew that already), cancers and Alzheimer's. Lifting weights can also have a role in staving off some of these medical problems. These are behavioral fixes to serious problems and while I do not believe in absolutes, people can put the odds of a better outcome more in their favor and enjoy a much longer healthspan in the process.
As difficult as being sick with chronic conditions would be here in the US, I believe it would be even more difficult in another country but I concede N=1 is shaping my views.