Older Americans repatriating to the USA -- where is good?

[sirineou]

Crime is a concern anywhere in the world,

Depending on where you live,in the US I think it is less of a concern than most places in the world

In Palm Coast , FL , I never had a problem with crime, not even once, My cars are always unlocked in the driveway, and my home is locked only when I am not there.

As far as food is concerned, as I said we have two Asian markets,there are is Hispanic markets, a farmers market every Friday and Saturday, four major supermarkets, a super Walmart and a super Target all at competitive prices, and restaurants of every description from Mex to Thai,

So as far a food is concern I never had a problem finding anything I ever wanted. My wife jokes that she can find more and better Thai ingrediance here that she can in Thailand

I talk about Palm Coast a lot because that's what I know, I am sure there are hundreds if not thousands of similar communities in the US.

[jellydog]

If you want the heat and humidity of Thailand then try Orlando. Awful.

So it's more humid than Jacksonville?

In my experience, absolutely. You're baking in the middle of the state. Jacksonville has the ocean and the river to cool things off a little.

[NeverSure]

What about Austin, Texas?

Housing prices much higher than Dallas/Fort Worth. Just enough closer to the coast (Gulf of Mexico) to be more humid. State Capital.

[sirineou]

If you want the heat and humidity of Thailand then try Orlando. Awful.

So it's more humid than Jacksonville?

In my experience, absolutely. You're baking in the middle of the state. Jacksonville has the ocean and the river to cool things off a little.

Florida has a unique geography, it is a relatively narrow peninsula, with the Atlantic ocean on one side and the golf of Mexico on the other side.

large bodies of Water changes tamperer slower than land, so given the time of day there is always a large temperature differential between the water and land and at a close proximity.

That's why Florida has more lightning strikes than any place in the world.

IMO if you are going to live in FL you need to be near the water.

At night when the land cools faster than the water, there is a low pressure area over the water creating a convection air current out to see, if you go to the beach at night you will see all the flags waving towards the sea.

During the day, as the Sun rises the ground begins to heat up , much higher than the ocean

creating a low pressure area over the land and the wind direction reverses. Now the flags are blowing inland.

If you are near the water there is always a breeze.

[55Jay]

Is the price of house insurance a lot more in Florida due to the potential hurricanes?

[sirineou]

Is the price of house insurance a lot more in Florida due to the potential hurricanes?

I Pay about $1200 a year

"Floridians are paying the highest homeowner insurance rates in the nation even though the state has not been hit by a hurricane in nearly a decade. A national report shows the average premium for most Florida homeowners is $1,933 a year, or nearly twice the national average of$978."

[Jingthing]

I glossed over the good point of some aspects American culture being very ANNOYING to many of us, including me. For example, the materialism (judged by the car you drive, OK similar to Thailand, but there it is), the disrespect for older people/youth culture emphasis, the strong CALVINIST streak in the culture, the high stress rush rush rush super efficiency thing (a plus if you're buying a service and it's competent!), the lack of mai bpen rai which has its bad side but also its charms. So when looking at this choice rationality you have to consider the pros and cons. I am reminded of interviews I've read with expats in Cuence Ecuador who often say stuff with how people aren't judged by their material possessions there, most people don't have flash cars or any cars, or anywhere near the latest electronics, etc. That's charming. But having to pay double or triple for the computer or car if you want -- NOT charming!

Edited April 29, 2014 by Jingthing

[55Jay]

I glossed over the good point of some aspects American culture being very ANNOYING to many of us, including me. For example, the materialism (judged by the car you drive, OK similar to Thailand, but there it is), the disrespect for older people/youth culture emphasis, the strong CALVINIST streak in the culture, the high stress rush rush rush super efficiency thing (a plus if you're buying a service and it's competent!), the lack of mai bpen rai which has its bad side but also its charms. So when looking at this choice rationality you have to consider the pros and cons. I am reminded of interviews I've read with expats in Cuence Ecuador who often say stuff with how people aren't judged by their material possessions there, most people don't have flash cars or any cars, or anywhere near the latest electronics, etc. That's charming. But having to pay double or triple for the computer or car if you want -- NOT charming!

Not to mention certain groups who make others' lifestyle and sexual prefs their business.

[sirineou]

I glossed over the good point of some aspects American culture being very ANNOYING to many of us, including me. For example, the materialism (judged by the car you drive, OK similar to Thailand, but there it is), the disrespect for older people/youth culture emphasis, the strong CALVINIST streak in the culture, the high stress rush rush rush super efficiency thing (a plus if you're buying a service and it's competent!), the lack of mai bpen rai which has its bad side but also its charms. So when looking at this choice rationality you have to consider the pros and cons. I am reminded of interviews I've read with expats in Cuence Ecuador who often say stuff with how people aren't judged by their material possessions there, most people don't have flash cars or any cars, or anywhere near the latest electronics, etc. That's charming. But having to pay double or triple for the computer or car if you want -- NOT charming!

Like any country in the world the , the US has it's positives and it's negatives, and these can vary given different peoples personal preferences.

Personally I would rather live in Thailand than the US , but that could be mainly because I lived in the US all my life and enjoy something different,

and or that I dont live in Thailand full time, give me a few years of living in Thailand full time and I might sing a different tune.

But this thread is about repatriating to the US do to Old age and or health condition, and would hate to see it evolve to a US Versus Thailand cost or quality of living thread.

God knows in my long membership to this forum, I have seen my fair share of those.

PS: after a certain age regardless of our sexual orientation most of us tend to develop the same preference,

Asexuality

Edited April 29, 2014 by sirineou

[jellydog]

I glossed over the good point of some aspects American culture being very ANNOYING to many of us, including me. For example, the materialism (judged by the car you drive, OK similar to Thailand, but there it is), the disrespect for older people/youth culture emphasis, the strong CALVINIST streak in the culture, the high stress rush rush rush super efficiency thing (a plus if you're buying a service and it's competent!), the lack of mai bpen rai which has its bad side but also its charms. So when looking at this choice rationality you have to consider the pros and cons. I am reminded of interviews I've read with expats in Cuence Ecuador who often say stuff with how people aren't judged by their material possessions there, most people don't have flash cars or any cars, or anywhere near the latest electronics, etc. That's charming. But having to pay double or triple for the computer or car if you want -- NOT charming!

A lot to agree with there !!

The obverse regarding materialism in much of South America and Central America is that you will often be held in suspicion if you have possessions that indicate any semblance of wealth. Make no mistake, there remains a caste system to some degree and the poor are much disrespected by the rich and considered a group of people to be mocked. As a result, most expats I know make a conscious effort not to appear "better" than the locals. No fancy duds, no fancy jewelry, etc. If you live in a gated community and have little reason to interact with the regular folks then this is not a daily issue. If you do not, then it is an issue. In fact in many of these areas it is considered poor form to dress above others. Even the locals who may have "nice clothes" wouldn't think of wearing them on a regular basis so as not to "show up" their neighbors and invite criticism.

There is a lot to learn !

[keemapoot]

I glossed over the good point of some aspects American culture being very ANNOYING to many of us, including me. For example, the materialism (judged by the car you drive, OK similar to Thailand, but there it is), the disrespect for older people/youth culture emphasis, the strong CALVINIST streak in the culture, the high stress rush rush rush super efficiency thing (a plus if you're buying a service and it's competent!), the lack of mai bpen rai which has its bad side but also its charms. So when looking at this choice rationality you have to consider the pros and cons. I am reminded of interviews I've read with expats in Cuence Ecuador who often say stuff with how people aren't judged by their material possessions there, most people don't have flash cars or any cars, or anywhere near the latest electronics, etc. That's charming. But having to pay double or triple for the computer or car if you want -- NOT charming!

Like any country in the world the , the US has it's positives and it's negatives, and these can vary given different peoples personal preferences.

Personally I would rather live in Thailand than the US , but that could be mainly because I lived in the US all my life and enjoy something different,

and or that I dont live in Thailand full time, give me a few years of living in Thailand full time and I might sing a different tune.

But this thread is about repatriating to the US do to Old age and or health condition, and would hate to see it evolve to a US Versus Thailand cost or quality of living thread.

God knows in my long membership to this forum, I have seen my fair share of those.

Yes, you're right. I think the major issue for old age and repatriation is health care. For those of us who have good programs in Thailand and are fully integrated linguistically and culturally, Thailand has all the advantages. For those expats who don't have those advantages, I would think it would be a good thing to return to America.

[Jingthing]

It is true that this thread should not be about USA good Thailand bad or v.v. But on the other hand returning long term expats from Thailand are going to have culture shock issues some possibly specific to their experiences in Thailand. So many really like missing the bum gun.

Sent from my Lenovo S820_ROW using Thaivisa Connect Thailand mobile app

[keemapoot]

It is true that this thread should not be about USA good Thailand bad or v.v. But on the other hand returning long term expats from Thailand are going to have culture shock issues some possibly specific to their experiences in Thailand. So many really like missing the bum gun.

Sent from my Lenovo S820_ROW using Thaivisa Connect Thailand mobile app

The bum gun is the greatest contribution to the world. Sadly, the US has largely declined. How can they live with themselves?

[jellydog]

It is true that this thread should not be about USA good Thailand bad or v.v. But on the other hand returning long term expats from Thailand are going to have culture shock issues some possibly specific to their experiences in Thailand. So many really like missing the bum gun.

Sent from my Lenovo S820_ROW using Thaivisa Connect Thailand mobile app

The bum gun is the greatest contribution to the world. Sadly, the US has largely declined. How can they live with themselves?

I was back in the states and missed it everyday ! And, much better than a bidet.

[CWMcMurray]

Although easy to install the bum gun... In the US they sell them, but are normally used in the kitchen

http://m.aliexpress.com/item/1644762707.html

Sent from my iPhone using Tapatalk

Edited April 29, 2014 by CWMcMurray

[CWMcMurray]

I am happy with my life in Thailand but have tossed around the idea with the wife about moving back to the US when we are older and the kids finish at University... But as the youngest is only 4, that's still a ways a way

Sent from my iPhone using Tapatalk

[Jingthing]

Although easy to install the bum gun... In the US they sell them, but are normally used in the kitchen

http://m.aliexpress.com/item/1644762707.htmlAre they even legal under local codes? Some visitors would be grossed out which is crazy because not having one is gross.

Se nt from my iPhone using Tapatalk

Sent from my Lenovo S820_ROW using Thaivisa Connect Thailand mobile app

[Jingthing]

Sorry for the bad format above. I wrote the part starting with ... Are they even legal ...

*****

Anyway, back to the idea that many people are motivated by the economics of medical care and the fact that you need to be in the U.S. to use Medicare, this little factoid might throw some ice cold water on that idea:

Adding to the problem is a struggling Social Security program and big gaps in Medicare that have caused the average couple to amass $220,000 in extra medical costs during retirement.

(From a promotional ad from newsmax.com)

Did you get that? 220K dollars cash (presumably in today's dollars) out of pocket even with Medicare!

Arguably it might often be cheaper to pay everything out of pocket in Thailand (or another lower medical care cost country) and come out way ahead!

The plot thickens or sickens, whichever you like.

Now for me the medical access and cost thing isn't yet my main motivating interest in leaving Thailand, but it's definitely a factor and likely to be a bigger factor later.

It may very well be that a whole lot of us older Americans are totally screwed economically by health care costs no matter where we live.

Edited April 29, 2014 by Jingthing

[jellydog]

Sorry for the bad format above. I wrote the part starting with ... Are they even legal ...

*****

Anyway, back to the idea that many people are motivated by the economics of medical care and the fact that you need to be in the U.S. to use Medicare, this little factoid might throw some ice cold water on that idea:

Adding to the problem is a struggling Social Security program and big gaps in Medicare that have caused the average couple to amass $220,000 in extra medical costs during retirement.

(From a promotional ad from newsmax.com)

Did you get that? 220K dollars cash (presumably in today's dollars) out of pocket even with Medicare!

Arguably it might often be cheaper to pay everything out of pocket in Thailand (or another lower medical care cost country) and come out way ahead!

The plot thickens or sickens, whichever you like.

Now for me the medical access and cost thing isn't yet my main motivating interest in leaving Thailand, but it's definitely a factor and likely to be a bigger factor later.

It may very well be that a whole lot of us older Americans are totally screwed economically by health care costs no matter where we live.

If you can find a decent opium den in Phnom Penh when "the time" comes all your problems will be solved. Easy as she goes through the rough water matey.

[NeverSure]

Sorry for the bad format above. I wrote the part starting with ... Are they even legal ...

*****

Anyway, back to the idea that many people are motivated by the economics of medical care and the fact that you need to be in the U.S. to use Medicare, this little factoid might throw some ice cold water on that idea:

Adding to the problem is a struggling Social Security program and big gaps in Medicare that have caused the average couple to amass $220,000 in extra medical costs during retirement.

(From a promotional ad from newsmax.com)

Did you get that? 220K dollars cash (presumably in today's dollars) out of pocket even with Medicare!

Arguably it might often be cheaper to pay everything out of pocket in Thailand (or another lower medical care cost country) and come out way ahead!

The plot thickens or sickens, whichever you like.

Now for me the medical access and cost thing isn't yet my main motivating interest in leaving Thailand, but it's definitely a factor and likely to be a bigger factor later.

It may very well be that a whole lot of us older Americans are totally screwed economically by health care costs no matter where we live.

That number could apply only to those who make cheap choices in medicare coverage. One more time:

A is free but covers only care that requires and overnight hospital stay.

B for most people is about $104 and covers doctor visits and office procedures, but with a deductible and co-pay.

RX is about $25 and covers prescription drugs but with a co-pay for the more expensive patented ones.

C also known as medicare advantage will cover more, depending what is chosen from a menu. It is purchased from a private insurer and heavily subsidized by the government. It will also have deductibles and co-pays.

F is medigap and pays all of the deductible and co-pays that the others miss. If you have F you never pay a dime for health care.

A,B,RX and F-Medigap cost me about $270 or $280 a month and I never pay anything else for health care.

[TallGuyJohninBKK]

NS, of all those different Medicare related elements you mention above, I assume the first couple have federal government standardized costs across the country, regardless of what state you may live in.

But I'm also guessing, the Medicare Advantage plans are going to have widely varying costs depending on the provider and issuance state, and perhaps Medigap too.

Assuming I'm correct about that, it would be interesting to get a sense of how Medicare Advantage average rates compare in various of the likely retirement target states we've been discussing above.

[sirineou]

Although easy to install the bum gun... In the US they sell them, but are normally used in the kitchen

http://m.aliexpress.com/item/1644762707.html

Sent from my iPhone using Tapatalk

I have installed them on every bathroom in my US home,

It was very easy,and inexpensive to do

all that it required was one of those kitchen sprayers, and a T fitting coupling installed on the line that supplies water to the toilet water tank

Not only is it more hygienic, it saves a lot of money on toilet paper,and a few trees in the process

[Jingthing]

Sorry for the bad format above. I wrote the part starting with ... Are they even legal ...

*****

Anyway, back to the idea that many people are motivated by the economics of medical care and the fact that you need to be in the U.S. to use Medicare, this little factoid might throw some ice cold water on that idea:

Adding to the problem is a struggling Social Security program and big gaps in Medicare that have caused the average couple to amass $220,000 in extra medical costs during retirement.

(From a promotional ad from newsmax.com)

Did you get that? 220K dollars cash (presumably in today's dollars) out of pocket even with Medicare!

Arguably it might often be cheaper to pay everything out of pocket in Thailand (or another lower medical care cost country) and come out way ahead!

The plot thickens or sickens, whichever you like.

Now for me the medical access and cost thing isn't yet my main motivating interest in leaving Thailand, but it's definitely a factor and likely to be a bigger factor later.

It may very well be that a whole lot of us older Americans are totally screwed economically by health care costs no matter where we live.

That number could apply only to those who make cheap choices in medicare coverage. One more time:

A is free but covers only care that requires and overnight hospital stay.

B for most people is about $104 and covers doctor visits and office procedures, but with a deductible and co-pay.

RX is about $25 and covers prescription drugs but with a co-pay for the more expensive patented ones.

C also known as medicare advantage will cover more, depending what is chosen from a menu. It is purchased from a private insurer and heavily subsidized by the government. It will also have deductibles and co-pays.

F is medigap and pays all of the deductible and co-pays that the others miss. If you have F you never pay a dime for health care.

A,B,RX and F-Medigap cost me about $270 or $280 a month and I never pay anything else for health care.

Thinking about this a little more, maybe that 220K figure isn't that bad.

Why?

People often live decades after retirement age.

It's for a COUPLE, so half that for each person.

So annualized not so shocking an amount.

Most medical money is spent end of life ... who cares by then if you die broke?

It's an average.

If lucky, it's less.

You still need some luck though.

[NeverSure]

Sorry for the bad format above. I wrote the part starting with ... Are they even legal ...

*****

Anyway, back to the idea that many people are motivated by the economics of medical care and the fact that you need to be in the U.S. to use Medicare, this little factoid might throw some ice cold water on that idea:

Adding to the problem is a struggling Social Security program and big gaps in Medicare that have caused the average couple to amass $220,000 in extra medical costs during retirement.

(From a promotional ad from newsmax.com)

Did you get that? 220K dollars cash (presumably in today's dollars) out of pocket even with Medicare!

Arguably it might often be cheaper to pay everything out of pocket in Thailand (or another lower medical care cost country) and come out way ahead!

The plot thickens or sickens, whichever you like.

Now for me the medical access and cost thing isn't yet my main motivating interest in leaving Thailand, but it's definitely a factor and likely to be a bigger factor later.

It may very well be that a whole lot of us older Americans are totally screwed economically by health care costs no matter where we live.

That number could apply only to those who make cheap choices in medicare coverage. One more time:

A is free but covers only care that requires and overnight hospital stay.

B for most people is about $104 and covers doctor visits and office procedures, but with a deductible and co-pay.

RX is about $25 and covers prescription drugs but with a co-pay for the more expensive patented ones.

C also known as medicare advantage will cover more, depending what is chosen from a menu. It is purchased from a private insurer and heavily subsidized by the government. It will also have deductibles and co-pays.

F is medigap and pays all of the deductible and co-pays that the others miss. If you have F you never pay a dime for health care.

A,B,RX and F-Medigap cost me about $270 or $280 a month and I never pay anything else for health care.

Thinking about this a little more, maybe that 220K figure isn't that bad.

Why?

People often live decades after retirement age.

It's for a COUPLE, so half that for each person.

So annualized not so shocking an amount.

Most medical money is spent end of life ... who cares by then if you die broke?

It's an average.

If lucky, it's less.

You still need some luck though.

Others get an illness rather early in life that isn't life-threatening, but that's very expensive to treat.

My medical bills in December were US$20,000. I won't have to see a doctor about it for another year for a checkup. Another $20K for various tests, MRI, etc. I'll go through about a 3 day routine at a medical university and teaching hospital.

Suddenly around $280 per month seems cheap. It covered everything.

As an aside, although it covered everything, the hospital sent me a bill with a balance due of 6 cents. It had 43 cents in postage on the envelope not to mention administrative costs. Then I made a long distance call to get it fixed.

[Jingthing]

Bottom line, my feeling is that for older American expats who seek longevity, their odds are better off in the USA than Thailand. I could be wrong but that's my impression. Longevity isn't everything either ..., especially if quality of life ain't there.

[Major4608]

Owned a house near Chiang Mai for 5 years (wife's name), sold it and now live near Orlando, FL. Opportunity knocked and we grabbed it. Florida is a good alternative. Feel like we made a great choice.

Sent from my iPad using ThaiVisa app

[NeverSure]

I just read where former president Bill Clinton has had quadruple bypass surgery in 2004, and just had to have a tuneup done on it. He'll need recurring treatment for the rest of his life. That's expensive stuff.

"We see people who come in like this every four to five years. Essentially, it's a tuneup," said Dr. Cam Patterson, cardiology chief at the University of North Carolina at Chapel Hill.

Surprisingly, this doesn't shorten someone's lifespan or give them a bad prognosis, said Dr. William O'Neill, a cardiologist and executive dean of clinical affairs at the University of Miami's Miller School of Medicine.

"I've done 10 or 15 in a single patient over a period of time," and they still live long lives as long as they don't have a heart attack and suffer damage, he said.

Clinton has not had a heart attack and has done everything right since his bypass — eating well, exercising, keeping his blood pressure and cholesterol in check," said his cardiologist, Dr. Allan Schwartz at New York Presbyterian Hospital.

(emphasis mine) Link

[Jingthing]

Yes of course but I'm pretty sure that it's true that in general end of life medical spending is relatively massive in a large percentage of cases. Medically, ethically, and financially questionable as that might be.

Getting maybe too morbid here, sorry, but another impression that I have which may or may not be true is that the U.S. medical system does not hold back the MORPHINE when it's needed and perhaps in Thailand there is a different moral ethic about pain control and suffering. This might be too loaded for this forum and belongs in medical.

Edited April 29, 2014 by Jingthing

[CWMcMurray]

JT , have seen many posts from Sheryl who is working in Healthcare here in Thailand / Cambodia and is mod in healthcare forum..

She has advised the same many times... That pain management is as easy here in Thailand, also Thai medical officials can be less understanding in many cases of end of life treatment options (or rather instructions not to treat)

Although from personal experience with Father in law a few months ago... He was terminal in the hospital and the doctor did ask my wife for permission for DNR order, so this maybe changing

Sent from my iPhone using Tapatalk

[NeverSure]

Yes of course but I'm pretty sure that it's true that in general end of life medical spending is relatively massive in a large percentage of cases. Medically, ethically, and financially questionable as that might be.

Getting maybe too morbid here, sorry, but another impression that I have which may or may not be true is that the U.S. medical system does not hold back the MORPHINE when it's needed and perhaps in Thailand there is a different moral ethic about pain control and suffering. This might be too loaded for this forum and belongs in medical.

When my mother was either 92 or 93 she fell and broke her back in several places. Of course at that age there's no hope for the back to heal.

They put her in a nursing home where her doctor visited every day and they had RN's on staff. 3 different times they moved her back to the hospital to keep her from dying. She was getting swelling on the brain which required steroids and monitoring.

She spent 12 of her last 14 days in the hospital while they tried to keep her alive. Finally her vital organs began shutting down and she was going to die anyway so they sent her back to the nursing home where she lasted a couple of days.

She never had any pain. In fact she was barely conscious. I got the doctor aside at the nursing home and asked him to give her enough morphine that there was no chance she'd have pain. He promised to increase her dose, and the next day she died. It was a relief.

The US has no "panels" that decide who gets treated, or for what, or at what age. They just do it unless the patient refuses it. So total care is there to the end.

What did she actually die of on that particular day? I'm not sure and I don't care. She needed to go.