Single payer, Medicare-for-all, universal healthcare: a rose by any other name

Whatever you call it, will we ever have a national healthcare system in the United States that ensures access to adequate care and services for everyone, without anyone left out or going broke if you get sick or injured?

If you are such an optimistic person that you believe the answer is yes, or even maybe, or maybe someday, I salute you. My own hope is currently dead in the water.

I spent much of last evening with my spouse watching YouTube videos on retirement in Mexico, where it turns out they have a national, very low cost healthcare system that is open to not just their citizens but also to non-Mexican legal residents, and they are welcoming of US refugees who can't afford life or health services here, and Canadian retirees seeking warmer climate. Assisted living, long term care, dental and eye care, all available and significantly more affordable than here.

In this country, we know we will not have enough money to ever "retire" and feel like the medical system is a giant sucking leech that will inevitably wipe us out, one way or another. We're already just one major accident or illness from financial ruin, and we have more than a decade before retirement would even be on the radar. It's so anxiety-producing, we've reached the point of seriously looking at moving to Mexico. The exploration is in its infancy, so we'll see what happens.

I found the videos on the national healthcare in Mexico quite by accident, as I was searching YouTube looking for videos with information, presentations, speeches, etc. supporting the movement toward such a system here. Looking, I suppose, for hope that it might not be impossible after all. Looking for a way forward that might work. In my lifetime. Something I could get into supporting and working on. Which it should go without saying, isn't through electing democrats, regardless of their rhetoric.

Unfortunately I didn't find a lot to shore up my optimism. Which is why the evening veered into margaritas and fantasies of life in Mazatlan. Smile

However, in the light of day today, and with years to go before any such exit plan could be implemented, I'm still looking. I'm not entirely ready to give up the fight. I keep reading how it's closer than ever now. With the ACA floundering and the republicans floundering to do anything about it, the time is ripe - so they say.

If this is true, then widespread public support and demands would have to be key components. Neither party of the duopoly will ever act on it in the absence of such demands. Whether they would act even with such demands is obviously questionable. But they surely won't without it. So to push or advocate for it, public education is key and focusing first on electing this or that politician or party is a waste of time.

Creating more and stronger public support and demand, by consistently explaining a clear vision of the goal, would be essential. Language is the only real tool we have to try to move this forward. The democrats have evidently chosen "Medicare for all" as the supposed magic words that will bring about this demand. A sure thing, slam-dunk winner. This is because a poll last year showed this term was perceived more favorably than others by more people.

I've mentioned recently my own questioning and then ultimately disagreeing with that approach. I started researching the subject. Here's a little of what I've found. I'll keep this to two links.

First: Want National Health Insurance? Dump the Term ‘Single Payer’—and ‘Medicare for All’ Too

This is a good article that covers a lot of ground, I'll try to limit the pull quotes but it's worth a full read.

The Kaiser Family Foundation’s June tracking poll found that a majority of Americans now support getting insurance from a single government plan, indicating a slow but steady increase in support since 1998, with 53 percent now favoring a single-payer plan while 43 percent are opposed.
...
Still, the Kaiser poll revealed that the public’s opinions “are quite malleable,” meaning people can easily be persuaded not only by the usual arguments from doctors, hospitals, drug companies, and other sellers who fear a national health plan would mean they’d make less money.
...
All this calls for a new way to talk about a national health system. A Kaiser poll conducted in 2016 found that the public was more likely to react favorably to the term “Medicare for all” than to “single payer.” The latest poll showed that support was similar no matter which term was used.
...
Medicare for all” is also a better phrase because Medicare is a popular social program. On the other hand, what does it mean to people in their 20s or 30s? Many people on Medicare don’t even know what it means. How are 35-year-olds going to understand Medicare’s complicated inner workings and relate them to their own health-care needs? Using “Medicare for all” could still be a tough sales job.

This hits on part of why Medicare-for-all doesn't ring my bells. Heck, I'm 58, not 20 or 30, and I don't "love" Medicare, or understand it, other than to know it's inadequate enough that I'd be better off living in Mexico.

The article also hits on another key point:

It’s also behind a lot of those media stories featuring anecdotes from 60-year-old women complaining that they have to pay for maternity coverage when they will never become pregnant. The stories never mention that the 60-year-old may need eye surgery or cancer treatment. In foreign systems, there’s a lot of cross-subsidization going on, and no one I’ve ever interviewed in another country talks about their health systems in such narrow, self-interested terms as Americans do.

Getting past this attitudinal barrier is a huge problem. No magic term fixes it. And the insurance industry and their minions will use every rhetorical tool they can to fight against the turning tide. If it is turning. People are easily swayed by the opposition language, and we will need much stronger weapons to fight back than the milquetoast Medicare-for-all "slogan" the democrats are pretending to support.

Along those lines, here is the detail on that recent poll, and the wavering of public opinion:

Data Note: Modestly Strong but Malleable Support for Single-Payer Health Care

There is a ton of interesting information and data in this summary of the polling, but beyond the initial findings that we now seem to have a small majority that support, for either term, the thing I want to emphasize here is the malleability of that support:

For example, when those who initially say they favor a single-payer or Medicare-for-all plan are asked how they would feel if they heard that such a plan would give the government too much control over health care, about four in ten (21 percent of the public overall) say they would change their mind and would now oppose the plan, pushing total opposition up to 62 percent. Similarly, when this group is told such a plan would require many Americans to pay more in taxes or that it would eliminate or replace the Affordable Care Act, total opposition increases to 60 percent and 53 percent, respectively.

Ok, just sit and look at that for a minute. One negative message and the majority no longer likes Medicare-for-all. Or single payer. Or whatever you call it. That's what we're up against. Taxes! Government takeover! And we're done. No magic words make this a slam dunk. Voting for democrats and using this slogan for sure isn't going to get us anywhere. Do not be fooled by this game plan.

I'm still leaning toward Mexico and margaritaville for my exit plan, because I feel it's simply beyond us in this country to do the right thing for our citizens. Mexico has us beat. They care about their people, and immigrants, so much more than this selfish country. My husband joked maybe Mexico will pay to build a better wall, to keep out the flood of US refugees. Ha. But so far, they are welcoming the influx and medical/dental tourism, as well as retirement homes, etc., are booming. It's currently the best idea on our list of options. Which I admit has only that one idea on it right now. Since I just finally gave up on a viable future here in the past few days, it could grow.

In the meantime I still believe in comprehensive universal healthcare for all, and will support any group or cause truly fighting for it and changing minds. For whatever it's worth.

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Comments

dkmich's picture

playa del Carmen and Tulum. The problem with Mexico is getting from here to there. If we fly, we still need a car. Living near/on 5th Avenue in playa gets us close to the downtown and the beach. Tulum is more problematic.

My grandson went to London for a study abroad. He got sick with something viral or like that. So he went to see the doctor. Walked in, got treated, handed his drugs and sent on his way - no charge. We are just an ugly country.

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CS in AZ's picture

@dkmich

We looked at videos on mazatlan and a place called lake chapala. Both looked interesting but we agreed much more research is needed on the best locale. I love the ocean -- but I also fear it. Tsunami and hurricanes, tidal waves are down sides to beach side living. We will be looking at a lot more places too, and hopefully someday make some exploratory trips. We can actually drive to Mazatlan from here in a two-day road trip, although it's a very long two days. A coworker just made that trip last month and said it was not a bad drive. I'm actually kind of excited by the idea. But I have a lot of homework to do! Gracias!

(The videos say everyone speaks English, no worries, but I'm still going to start brushing up on my Spanish.)

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CS in AZ's picture

@dkmich

This clip is fascinating to me, one for how Trump speaks so glowingly of the free, excellent treatment his friend received in Scotland, and two, for the way David Letterman quickly changes the subject! Instead of pushing him about how he just said Scotland is better than the United States, and shouldn't we fix that, Dave cuts him off to make jokes about his hair and make "subtle" digs at him.

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At least until the US ends the drug war. Corrupt police and judges, open assassinations in broad daylight, drug and kidnapping cartels and mass murders, it'd be like living in America, only worse.
I hope I'm wrong, but I don't see single payer/ universal health/ medicare for all ever being allowed to pass. TPTB can't allow it. That'd be the first stepping stone to nationalized pharma, nat'l internet/cable, nat'l energy, and nat'l banking. Any essential need for a working society where they have you by the short and curlies so they can gouge you to death.

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There is no such thing as TMI. It can always be held in reserve for extortion.

CS in AZ's picture

@ghotiphaze

We do hear a lot of scare-mongering, and there are certainly parts of Mexico that are not safe places to live. Of course the same is true here in the US.

Here's one relatively short video with a good overview, and it does address the safety questions, to my initial satisfaction anyway.

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Unabashed Liberal's picture

@ghotiphaze

our former colleagues have assured us that some regions are safer than stateside.

In our case, we're looking at Mexico a third time for a part-time retirement residence, partly because we can circumvent having Mister B 'pet quarantined.' (He suffers from severe separation anxiety, as it is.)

Anyhoo, we've lived in both Mexico City, D.F., and the State of Puebla. Can't deal with almost 25 million population of the metro Mexico City area (today), so we're looking at our old stomping grounds--the suburbs, or small towns surrounding the beautiful and historic city of Puebla. It may not be the least expensive part of the country, but, because of the high educational level, it has one of the highest standards of living in the country.

Hey, CS, please post what you find out about medical benefits, if you should check it out. We got our medical care through a University system, so we never needed to look into their regular, or civilian, health care system. Actually, we were so young both times, that medical care--other than for a cold or something--never came into play. Wink

Mollie


"Being deeply loved by someone gives you strength, while loving someone deeply gives you courage."--Lao Tzu

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"The power of accurate observation is commonly called cynicism by those who have not got it."
--George Bernard Shaw, Irish Dramatist & Socialist
"We [corporations] are the government!" Actor John Colicos (1978)

CS in AZ's picture

@Unabashed Liberal

That's one of the things I was wondering about. I would not leave my dogs and wouldn't want to quarantine them either.

Here's a good short clip, just over three minutes, that briefly describes Seguro Popular, the Mexico universal healthcare program, including Americans being able to use it.

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Unabashed Liberal's picture

@CS in AZ

fairly recent adoption of an universal healthcare system. Since we've just qualified for Medicare, and have first dollar coverage, we're not considering dropping our current coverage. At least, not any time soon.

OTOH, considering that lawmakers in both Parties seem to want to strike a 'Grand Bargain' as far as entitlements go, it would be a 'real relief' to have other options.

If I find anything more on this topic, I'll post it at EB.

Have a nice weekend!

Mollie

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"The power of accurate observation is commonly called cynicism by those who have not got it."
--George Bernard Shaw, Irish Dramatist & Socialist
"We [corporations] are the government!" Actor John Colicos (1978)

CS in AZ's picture

@ghotiphaze

I found this article helpful in thinking on this question.

Are Americans safer in Mexico than at home?

What you don’t get from most reports in the US is statistical evidence that Americans are less likely to face violence on average in Mexico than at home, particularly when you zero in on Mexico’s most popular travel destinations.

Most of Mexico appears safe for tourists and expats. Statistically it's safer than many places in the US. For some reason the news media doesn't want us to know that.

I have a coworker who recently drove with his girlfriend from Tucson to Mazatlan and back. It's about 800 miles I think, driving through Mexico. He said they had no problems of any kind and felt safe throughout the trip. In Mazatlan, he says they spent one whole day hanging out at the hotel pool, eating and drinking whatever they wanted from breakfast to sunset, and the bill at the end of the day was around $40.

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Unabashed Liberal's picture

@CS in AZ @CS in AZ

just came down on my phone news feed about the most 'dangerous' cities. Two in the US--Baltimore and St Louis--and 3-4 towns/cities in Mexico. (Gotta run an errand--will post a link to the piece later today, when we return.)

Neither the City of Puebla and/or the campus that I referred to (UDLAP) are among them. I'll be calling the Mexican Embassy soon--already got Mexico phone service on one of our cell phones!--so, I'll let folks know exactly what they say about the region, today. Now, I have seen numerous references, including at my old university's website, that the region is not on the US State Dept's 'no travel' list, as are some parts of the country (due to drug cartel activity/violence). And, I would totally trust what UDLAP posts, officially.

Having said that, "Trust, but verify."

Wink

BTW, I should amend/correct my previous comment about the State of Puebla having (overall) a very high standard of living. Our experience was based upon living on the campus of a top private university in the country (twice)--thirty to forty years ago. As one might expect, it was a very safe environment. Have returned only once, since then. Also, UDLAP was actually down the road a few miles (from Puebla City) in Cholulu, Puebla--the home of the Great Pyramids.

From what I'm gleaning, today there is a lot of inequality--some of the worst in the country. (Of course, that might mean that the cost of living is lower than I would have expected. Dunno.) Anyhoo, I'll find out more as I speak to folks we know, and/or to Mexican officials, and pass it along to you Guys.

Have a good one!

[Edited: Added country; deleted also/state.]

Mollie


"Being deeply loved by someone gives you strength, while loving someone deeply gives you courage."--Lao Tzu

"I think dogs are the most amazing creatures--they give unconditional love. For me, they are the role model for being alive."--Gilda Radner

"You can lead a horse to water, but you can't make him drink."--Old English Proverb

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"The power of accurate observation is commonly called cynicism by those who have not got it."
--George Bernard Shaw, Irish Dramatist & Socialist
"We [corporations] are the government!" Actor John Colicos (1978)

So What is a Good Name?

In your first sentence you say, National Healthcare System.
"We need a National Healthcare System."
Sounds like a great way to talk about healthcare in America.

btw~ the retired teacher in me had to look up the grammatically correct usage:
health care or healthcare
It seems the English language it well on its way to using healthcare as a noun. As someone who celebrates the evolution of language, I will adapt.
Smile

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CS in AZ's picture

@IdahoDiane

I tend to type healthcare as one word because that's the in-house editorial style at my job, so I've adapted to it as my default. I think at this point both usages are common and are considered correct, or a matter of style preference.

I don't think the name is really the important thing, although I do think we need a clear concise way to frame the goal or desired outcome. But getting through and changing the attitude problems and the fear of government and false beliefs that "we are the greatest country on earth" -- so our current system must be the best -- this is the bigger lift than coming up with the right name. I actually wouldn't choose anything with the word system as part of a slogan.

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@CS in AZ Just National Healthcare sounds better.

We need National Healthcare that covers everyone...

I am just trying to think of a way to say it that is descriptive and gives people information but isn't easily co-opted for political reasons.

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CS in AZ's picture

@IdahoDiane @IdahoDiane

Perfect explanation of what is needed to start changing the conversation. Thanks!

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Pluto's Republic's picture

...if you get a Resident's Visa. And just about every nation has some form of national health care because it happens to be a human right, declared and unanimously ratified at the United Nations.

Most nations even treat you while you're visiting at no or low cost, for illnesses or medical emergencies. So, you aren't stuck with Mexico if you don't love the place.

Leaving is not a bad Plan B to have in place. There are reasons other than health care that a comfy foreign residence could come in handy.

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Mark from Queens's picture

and, to go to law school.

We just had this conversation in the car and I told him most people in America would probably react by flat-out refusing to believe it.

But that's just how fucking bad we've been beaten down by relentless American Exceptionalism propaganda and resentment politics, stirred up by the MSM and their collusion with the Powers That Be to obfuscate, mislead and outright lie to keep people from dwelling on these facts. We can't face it that we might just not be the best at something.

I say it ad nauseum but it really is the linchpin, I think: the power of American Exceptionalism propaganda, tied together with the purposely elusive lie of the American Dream that one can achieve if one works hard enough, is channeled first through our school system and then finished off by the tag team of government propaganda and the distractions of MSM manufactured controversy, to reduced us to soft, obedient consumerists easily dazzled by a proliferation of cheap goods which function as bribery for the increasingly shittier jobs with low pay.

If we only had honest conversations and debate about this we would face the elephant in the room of stories like yours, but moreover of folks who actually have gone to Mexico and Canada for prescription drugs and surgery, and admit that there are enough stories just in our midst of people pushed to the limits of desperation to have done so.

Don't expect to ever have these conversations in the corporate MSM. Which is why places like C99 and our ilk, as well Jimmy Dore and Lee Camp, and a once-in-a-lifetime candidacy of plainspoken truth-speaker like Bernie, taking public stands to do so are so important.

When we hosted an Occupy protest action in front of the Citigroup building in LIC a black man in a suit approached me and wanted to talk. He told me he was from Barbados. And that if he needed open heart surgery, for instance, he could go back home and not pay a dime for it. Barbados!

Practically the entire rest of the world considers this to be one of the primary functions of government, to pay for its citizens' healthcare. What are taxes supposed to be for? Oh, that's right...if you're American, it goes to propping up the World's Greatest Military too.

We've been totally duped, through relentless conditioning from the time we're required to memorize the Pledge of Allegiance on up through the halls of higher academia, where the corporations and oligarchs use their blood money to further condition young malleable minds to have fealty toward the great lie of "Free Market" Capitalism, to a point where as adults we're incapable of dissenting from or criticizing our government for the obvious transgressions against us, because they are in slavish servitude to their campaign donors and not The People.

I'm sorry to hear that you feel pushed to contemplate such a decision, CS, but I understand. You're definitely not alone.

When I hear things like this I often wonder: where's the indignation from the rest of the populace? I defy any working/middle class person to say they don't know of anyone contemplating such a move, or know of someone in such a bad place with rising and unaffordable cost of living/healthcare/school tuition/mortgage costs/debt.

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(thirty three and a third at TOP)

"If I should ever die, God forbid, let this be my epitaph:

THE ONLY PROOF HE NEEDED
FOR THE EXISTENCE OF GOD
WAS MUSIC"

- Kurt Vonnegut

CS in AZ's picture

@Mark from Queens

Very well said. Thank you. I'm actually kind of happy about this idea, as is my husband. I was surprised when he became interested in the stuff I was watching and got into the idea. I think he wanted to leave this weekend. The grind gets to us both sometimes. American exceptionalism is exactly the problem. People just need to get how exceptionally bad we the people are treated here. Instead we've just accepted that we don't do that here, take care of the people, for the common good. It's weird.

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Alligator Ed's picture

@Mark from Queens

When I hear things like this I often wonder: where's the indignation from the rest of the populace?

For most citizens, having been brainwashed from kindergarten or pre-school, the idea that the US is "the land of opportunity" and progressively improving quality of life, has eroded so gradually as to not have been noticed. Are there not many opportunities by which to become aware? Yes, now probably more than ever. But the vitality of this nation has been stolen from us and also not-cultivated. Hence, most of the 99% do NOT have the intellectual curiosity to avail themselves of readily available alternate information and ideas. News papers are moribund. Mainstream press is bought off.

Without concentrating on negatives (quite easy to do, sadly), it IS the messaging! To promote healthcare, a strong but simple name is essential. Just for example: Obamacare, a word indelibly associated with one of the most divisive presidents ever had, gets unfavorability ratings far higher than the same program named ACA. The taint of Obama is not so overt when speaking about ACA.

Obviously, certain words must be avoided in denominating as new health plan which I have been content to call MFA / SP (Medicare for all/single payer). But as pointed out clearly in the essay the term "Medicare" is inextricably linked with being for the old only. So Medicare (for all) is not desirable as a plan / meme.

Not being such a gifted PR person, I can come up with some titles for healthcare but not likely the most effective. MFA/SP NEEDS to be marketed--just like everything else in our capitalistic society.

This idea, picking a positive, memorable name is extremely important. One thought I have is calling it "Universal Health Guarantee". I am sure that better titles exist. Remember the Edsel? Nothing wrong with the car--it's the name that killed it. Remember the weight-loss candy Ayds? It's the name that killed it. The need for a message is just not confined to the Democratic party, but for the successful promotion of ANY idea or service.

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CS in AZ's picture

@Alligator Ed

Appreciate your comments and ideas.

One consideration I've been thinking about is consolidation of efforts, outside political parties.

There is already Physicians for a National Health Program

Their materials use several terms, including single payer, universal healthcare, but not MFA. What I also love is that right in the mission statement on the front page it directly includes "Eliminating the profit-driven private insurance industry with its massive overhead."

Other groups use other wording, including the nurses union who is heavily promoting MFA. Getting everyone on the same page about wording may be impossible. Different messages work for different people, so there may not be any one perfect way to name it. I personally like "comprehensive universal healthcare for everyone" and often shorten it to universal healthcare.

The real challenge is getting a solid majority on board with a shared goal and desired outcome. What do we want? For me I answer it with, I want this country to provide comprehensive universal healthcare for everyone.

I think it's interesting that the Mexican version is called Seguro Popular -- in English "popular insurance" -- ha ha, there you go, it's already popular from the start! I've been trying to find more info on how Mexico did it. But most articles just say, half the population didn't have health care or insurance, it was a problem, so they passed this Seguro Popular program to address the problems. Like that's what governments just do -- address problems! What a concept.

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I would guess, rather than building a whole new system from scratch. From what I understand, the cost per patient of Medicare is much cheaper than private insurance and its already covering millions of people. It was designed to eventually cover everybody, back in the sixties when Democrats had a little more idealism. Medicare for all would surely beat an Obamacare based solution.

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When a true patriot says anything United States, there is a puffed chest, maybe an erection, and an immediate sense that whatever it is, it is exceptional.
And the BEST.
I have friends that have moved to Panama, to Cambodia, to Columbia, and Mexico. One of them is in playa, mentioned by dkmich. I have explored most of those places, as well as Ecuador, Peru, and Guatemala.
I would need someone to go along to share expenses. If my husband were still alive, we would be outta here.
If I hit the Lotto, it's gonna be Austria.

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CS in AZ's picture

@on the cusp

I saw JtC and some other folks talking about intentional community recently, which is something we're also very interested in. We all need a community of more than just ourselves and our immediate loved ones for long-term stability and resilience. I'm keenly aware of that, because we do have that here. We don't physically live with our community of friends/loved ones, but we have a strongly bonded group of friends. Who will take care of each other as best we can. We don't imagine that is easy to replace. But a migration is not out of the question.

A new community can regroup in a new place, if it's best for us. Having grown up in Tucson, Mexico culture is familiar and I have positive memories from my youth when going to Mexico for a day of food and shopping was a fairly regular event and always fun.

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@CS in AZ Count me in.
I have one brother. That's it for family.
I need to do more research. What I do not want to do is have to leave every few months to come back to the States, as Panama requires for years, just as an example.

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CS in AZ's picture

@on the cusp

I need to do more research too, but from what I've seen there's no need to return to the US. I need to find out if we still can collect social security as ex-pats, but I believe you can. Then it's what we bring with us and possibly earning money in Mexico if needed.

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Unabashed Liberal's picture

@CS in AZ

Screening Tool.' Looks good!

Mr M and I enjoyed visiting many of the coastal towns/cities, but because we don't care for extremely hot weather, the central plateau locations are more appealing [to us]. Luckily, we don't have any medical conditions which would be aggravated by living in high altitudes.

(Especially, since I'm 'assuming' that temps there have warmed considerably, as they have here, since we were last there.)

Mollie

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"The power of accurate observation is commonly called cynicism by those who have not got it."
--George Bernard Shaw, Irish Dramatist & Socialist
"We [corporations] are the government!" Actor John Colicos (1978)

@CS in AZ

the Warren division is selling very cheap. 30% vacant.

Bisbonian comment, please.

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My partner and I have talked along similar lines. She is fluent in Spanish so that influences things a bit. We have friends in El Salvador and Chiapas so that helps too.
One point though is when (or whether) you would like to come back to the US. A good friend retired to Canada several years ago. They wanted to keep their US citizenship though because of aging parents. For them, it turned out to be untenable since they were taxed by both countries on their earnings. According to them, once a US citizen, you will be taxed, unless you completely renounce citizenship. Their financial situation could well be different than yours and mine though. I'm guessing that their "earnings" were primarily from dividends and the tax situation changed the calculation on how much they had per month to live on. They also weren't willing to give up easy travel back to the US to visit their parents at short notice (multiple health crises etc.). They moved back here a few years back.

Anyway, a long way of saying, make sure you know your particular tax situation and how easy and how often you could return to visit friends and loved ones if that will be necessary.
Keep us posted on what you find.

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CS in AZ's picture

@peachcreek

Thanks, we will definitely be looking at all this kind of information before making any move. Mexico seems to really want retiree immigration, and there are all kinds of services available to help with planning every detail. If and when we get close enough to actually making such a move, we'll be looking for something like that to make sure it's all dealt with.

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LeChienHarry's picture

Medical bills were eating us alive; disagreement with the pull yourself up by the bootstraps and if you can't it's your fault atitudes; WAR; not real elections; untenable costs during retirement on fixed incomes.

We saw a HuffPo list of ten lists, everyone had France on it. We had frequent flier miles so started to investigate. Checked with several UK expats to find out the cost of living for buying or building then running a household. Rural France with good train, bus and taxi service is very affordable: at least a third less if not more once separation from the US is accomplished.

Some things you all could learn from our experiences: The US will not make your Medicare portable. And we don't get a refund for the years we had it deducted. Essentially be prepared to be treated as a traitor by your government. One of only three or so countries in the world that does this.

Your Social Security (as you live and have residency in France) can be directly deposited to your local bank. My state pension requires a US bank. This assured income is allowing us to buy a house here. We had some residual from our house sale in the US but the medical bills and other reasons we had to borrow to live away from our house plus the rehab it needed drew down our equity. If you can sell your house and have at least $200,000 a very nice house can be had.

Residency is relatively easy to come by. People complain about the paperwork, but crossing "Ts" and dotting "Is" just require a good checklist and do it all. Then things seem to work well. They ask for extra documents sometimes, but provide them, and boom, the stamp is on the document and you get your residency permit. Get copies certified of your birth certificates, marriage licenses; a review of your driving record with clean record or low items like moving violations signed by the local sheriff or jurisdiction.

We just got our Carte Vitale and can sign up for relatively inexpensive Top Up or 'assurance complementaire' then we will be in the systems. We had to show proof of medical insurance and bought a full coverage plan through a Swiss company recommended by Association of Americans Residing Overseas (AARO). It's about 750 €/month for two of us. This will go down.

Taxes: most countries have a reciprocal tax agreements - you pay in your country of origin and they have you file a return in your new country, but they account for what you have already paid. French are shocked that we taxes on Social Security or pension, but we file with them and so far as we are on retirement income, haven't paid anything to France. This will change a bit next round as we are now on their health system and we will be billed for the premiums with our tax bill.

You can option to pay all your taxes in the country you reside in, but if you are counting on Social Security, be really sure the US will not consider you outside the system and withhold your Social Security as well. Republicans have been trying to get this done for a long time. Nine million expats actually have lobbiests through groups like AARO who stay on top of this sort of thing.

We considered Mexico as I have been down into the country: Guadalajara, one of my favorite places of all time - Guanuato, Puerto Vallarta (and beautiful villages to the south on the coast)...you can live above sea level on the cliffs above the coast. Cost of living is really good. Food is good. What stopped us: you can buy a house with a 99 year lease, but not the land. The government owns all the land, even under your house; drug cartels have gotten much worse, and gun violence, largely due to US buyers of drugs and sellers of guns; nationalization (which can be a good thing) can also create a situation where you can be booted at any time. Too unstable for our comfort.

It came down to France in the end. And so far we have done well here. Leaving the US has been the hardest. We are now on our last step: we bought a house on a river, with an acre, and no ag sprays anywhere around us. Ten minutes from three different towns and the train to Lyon, from where we can literally go anywhere.

But our US moving company would not give us a solid quote and would not disclose what the rate for underestimating our container weight would be. We are not sure but believe the household is in a container in their warehouse in Portland. The quote went from $14,500 to over $18,000. No Invoice, no documentation (did the piano make it out of storage onto the shipment?); said they were pulling in a container and directly loading at our storage facility, but instead sent two 20 foot trailers and had to take the whole thing to a warehouse to transfer to a container. Extra charges. They surveyed the site ahead of time and said they were directly transferring our goods to the container as the units were built for pull through large containers and very close to I-5 north. Movers especially the local companies, no matter which large name, can be the worst. We have had two bad transactions trying to get our things here. All the problems are US.

Banks: the US IRS requires foreign banks to fill out a report accounting for all monies coming into their accounts and from where; all monies going out and where. This is filed along with our US taxes. Credit Agricole hasn't even raised an eyebrow with us, but some European banks have refused US customers because of this draconian reporting requirement. It varies from branch to branch and bank to bank system.

So to sum up: we have banking; we have healthcare and the coverage we need; we have a house; we have good transportation; a very diverse country and access to all of the world within minutes; we are legal residents with most of the privileges of citizens. We are working on our driving licenses.

Our quality of life is superb; the neighbors are always very welcoming, helpful and genuinely nice. There are other details both of daily life and some business and residency items that are things to take care of but would make this entry way too long. They do need attention.

We feel we've made the right decisions and are happy with our choice. Living in the US would not have been possible tactically, but on a morale, contentment scale, we are glad every day we are here and not there.

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CS in AZ's picture

@LeChienHarry

Moving overseas is very unlikely for me. I don't like airplanes. I don't fly if I can possibly avoid it, which I have successfully done for about 20 years now. I like that we can drive to Mexico. Although it's a very large country, so fully exploring it might require some plane rides eventually.

Sorry about your household being trapped in shipping! I hadn't even thought about that. If we relocate, we would probably leave most everything behind and travel very light, I'd imagine. When we relocated from Az to California (and back, six years later), we drove a truck with a small trailer and that was it. Anything that didn't fit, we sold or donated or gave to friends. It made us prioritize what stuff we really wanted to keep, and let go of unnecessary accumulation.

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@LeChienHarry @LeChienHarry

for quality, free, very accessible healthcare. In the US, 9,451 dollars was spent per capita on obstacle ridden, often hostile, personal bankruptcy generating, corrupted, healthcare, that left a lot of people shut out. Mexico spent 1,052 dollars per capita on what appears to be quality, free, widely accessible healthcare.

wikipedia

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Social Security.
That would be essentially all I will have to live on. I just do not have faith that I will receive it sometime in the future. Big Banks want that Trust Fund, and I think they will get it in my life time.
That is what I mean about surviving without it. I have a better chance at providing myself with food and shelter here, since I could continue to work. Texas is the only place I can work in my profession.
My hesitancy about leaving is finding myself stranded.

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