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The couple faces a second major expense, too—health insurance back in the United States. Many expats keep their U.S. insurance just in case, especially if they plan to visit the United States from time to time. Let's say U.S. health insurance for a couple in their 50s comes to US$500 each per month, or US$1,000 monthly for the two of them. In addition, they'll have to come up with co-pays, deductibles, and other health-related out-of-pocket costs.

Again, we're making assumptions, but it's easy to imagine this couple's medical costs associated with their time in the United States exceeding US$15,000 a year.

Those medical costs will likely go up under Obamacare. Insurance companies already predict big increases, especially for individuals (as opposed to groups). And Obamacare requires minimum standards of coverage, co-pays, deductibles, and so on, depending on the plan you choose. The low-cost, high-deductible plan that costs only US$500 a month might disappear.

Note that we're assuming this couple of retirees is younger than 65. After age 65, most Americans would be covered by Medicare during trips back to the United States. (Medicare doesn't cover medical costs overseas, but I recommend keeping it even if you do retire overseas as a back-up.)

What's the bottom line of all this? Every year our Seattle couple might spend US$15,000 or more on travel to the United States, plus US$15,000 or more on U.S. health insurance (at least until they reach Medicare age). They could easily find that these costs, US$30,000 in total, exceed the cost savings of moving to Ecuador in the first place.

So what to do? Expats and retirees overseas can easily get around these two big costs by skipping those trips back home and by opting for medical care abroad, which can be significantly, dramatically less expensive than coverage in the States.

We know retired expats on strict budgets who do exactly that.

Many of us, though, want the freedom to travel back to the United States to see the grandkids, attend a wedding or two, visit the old neighborhood and friends, whatever. In that case we should be realistic about what we'll spend on travel and, if we're under age 65, on health insurance. Otherwise, travel to the States and health insurance while in the United States could easily be the two biggest costs in an overseas retirement.

This isn't a reason not to retire overseas, of course. It's a reality check to help with your retire overseas budget planning.

Kathleen Peddicord

P.S. We'll discuss more on how you can best prepare yourself for your new life overseas—and introduce you to our top retirement havens (all 21 of them), along with the people on the ground who can help make your dream a reality—at our Retire Overseas Conference, coming up Aug. 29–31 in Nashville, Tennessee. This is the only time this year we'll run this event. Grab your seat here.

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A poll conducted by Ecuador's expat link GringoTree asked foreign residents who moved to the country before Correa took office in 2007 if they supported the amendment that would allow him to run again. Of the 19 long-time expats who responded, 14 said yes, although many of those had reservations. When asked if Correa has improved their lives as expats, 18 of 19 said yes.

One respondent who described himself as a libertarian said that things were "definitely" better because of Correa. "Ten years ago, the highways were full of potholes, you had to keep a generator for when the electric service went down, the campesinos were blocking the highways with protests, hospitals were in bad repair, and sometimes you had to bribe government employees to do any official business—basically, it was typical banana republic business as usual. That's mostly all changed. Today, the main highways are good and there are no protests blocking them, hospitals are a lot better, you can get things done with the government without paying off somebody. Public services in general are better too."

The respondent, a Cuenca expat, added: "Even though I worry that Correa is making Ecuador a 'nanny state,' I understand there are lots of poor, uneducated people who may need a nanny. They've been screwed over for years and now things are better and I've come to understand that it's in my best interest if the poor folks are happy."

One expat from Quito admitted that she has serious reservations about "life-time presidents, a la Venezuela and Nicaragua. On the other hand, I worry about someone from the 'old guard' being elected again and the country going back to the way it was before. There have been so many improvements and I would hate to see those stop."

Others reported that they benefit directly from new programs introduced during the Correa administration. "My husband and I joined the new social security health plan and pay about $80 a month," said one respondent. "We had to use the services of our local clinic two times and the services were very good. Before Correa, we always worried about what we'd do if one of us had a serious health problem. Now we don't."

The main complaint about Correa from several of those answering the survey was the rapid growth of government and what they considered "overreach" in some cases. "I don't like all the government authority going to Quito and I don't like all the socialist jargon," said an expat from Loja who has lived in the country for 22 years. "But I also know that I need to focus on the things that are important to me personally, like property rights, taxes, personal liberties, and infrastructure. Those things are all good in Ecuador."

He added: "I have to ask myself the question you hear in the U.S. elections, 'Are you better off today than you were four years ago?' Or, in the case of Ecuador, seven years ago. My answer is yes, absolutely."

David Morrill

Editor's Note: Ecuador is the top place in the world right now to retire well on a very limited budget...even to live the adventure of your lifetime on a Social Security check alone. If you're serious about this part of the world, don't miss our upcoming Live and Invest in Ecuador Conference. Registration is now open (with an easy payment plan)…

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Medical care is practiced almost entirely in public, government-run hospitals. As a foreigner, there are two choices: you can pay a steep price to go to one of the few private, English- or French-speaking hospitals or, if you have a Vietnamese interpreter, you can go with them to a government hospital and receive ridiculously inexpensive tests and treatments.

The doctors, at least in Hanoi, are skilled regardless of the hospital you attend—and the government hospitals have modern equipment and competent technicians. Whether you're Vietnamese or a foreigner, medical care in government hospitals is inexpensive but not free. An X-ray costs about US$1.50, an ultrasound is less than US$5, and a consultation with a physician costs about US$4. The staff are all government employees—even the physicians earn meager government wages. The care at the public hospitals in Hanoi has improved to the point where most illnesses and injuries can be treated in the city.

We're often asked what it's like living in a police state. It's a common misperception that a communist country is the same as a police state. Vietnam doesn't have a totalitarian dictatorship, nor does it have a military government. It has a president and a cabinet with powers and problems that are similar to those of so-called democratic governments. There aren't federal elections—the president is chosen by the Communist Party—but there are local elections.

What you don't see in Vietnam are CCTV and red light cameras, signs everywhere announcing prohibitions and fines, or any overt police presence. You'll see traffic police but rarely, if ever, see police on the beat or patrolling neighborhoods. They don't even carry guns. The police presence isn't just subdued. In many places, it's practically nonexistent.

People will ask us if we feel as though we're being watched by the government. The answer to that is a resounding "no." We are monitored much less closely than we were in the United States. Here, if anything, we're watched less than the locals...

Take driving a motorbike for instance. International drivers' licenses are not recognized here. Few foreigners (or Vietnamese, for that matter) go to the trouble of trying to navigate the bureaucracy to get a Vietnamese license, and the police are well aware of it. But this rarely creates any problem, because the police don't stop foreigners unless they can explain to them—in their language—why they're being cited. Since few police speak English—and even fewer speak other languages—they simply turn the other way when they see a foreigner driving.

In all fairness, the Vietnamese police will stop Vietnamese. And Vietnamese citizens must adhere to certain laws and regulations that do not affect foreigners. If they want to move from their town or city to another part of the country, it involves a lot of red tape. And, of course, they can't have more than two children. But as foreigners, these restrictions don't affect us.

Vietnam falls short on political rights and civil liberties, but this doesn't affect expats who wisely stay away from the local political scene. As foreigners living here, we have no problem accessing any news or social network website—though if this ever became an issue, we could always use a VPN. Censorship is minimal. There are churches and temples throughout the country and we are free to practice any religion we choose. Yes, there is corruption, but this isn't something that's exclusive to communism. And again, as foreigners, it doesn't affect us. We don't have to budget for bribes.

The Vietnam that existed in the 1960s and early 1970s only exists in memories. The country has moved on toward a much brighter future. According to the Global Peace Index, Vietnam is the 45th most peaceful country in the world (as a point of reference, the United States ranks in the 101st position). According to HSBC Holdings, Vietnam is among the most optimistic countries in the world in terms of business expectations.

What's it like to live here as a foreigner? It feels extraordinarily free. The government sincerely wants Vietnam to attract more tourists, and it has taken measures to see that foreigners who come here want to return again and again. From our perspective, it's an extremely foreigner-friendly country. It's exciting to be here as we watch the country emerging from the grips of war and economic depression to join the global community. As foreigners living in Vietnam, we can say, in all honesty, that its "communist" status is a nonissue.

Wendy Justice

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Here in Thailand, I've yet to hear of expats leaving because of the
coup: we've had a lot of coups here, too. But curiously, tourism dropped off dramatically. I speak from personal observation here. I figure hotels in Chiang Mai, where Vicki and I stay, should be more than half full in early June (shoulder season). Yet, in my survey, occupancy rates came out closer to 10% or 20%.

In June, Vicki and I played tourist here in Thailand. We took a week-long road trip with friends to Doi Ang Khang (a national park), went to Mae Sai (a border town snuggled up to the Myanmar border) and to Phayao (a popular lakeside town). We mostly shared the scenic sites with a handful of Thai tourists. We noted the almost complete absence of foreign tourists.

I can think of a few reasons for the decline in tourism. The western world remains mired in no-or-slow growth with young tourists having less money to spend. Until recently, Bangkok and other nightlife venues were under curfew, discouraging those who come to party. The Chinese came in large numbers after a Chinese movie called Lost in Thailand became a hit a few years ago. The movie was filmed in Chiang Mai, giving Chinese a special reason to come to town. I figure the movie tourism may have run its course.

Perhaps the major blow to tourism was the coup and street violence that preceded it. Beginning late last year, those thinking of coming to Thailand saw riots on TV. Middle-aged tourists crossed Thailand off their list as they planned ahead for their summer holidays. And I suspect Chinese, in particular, stayed away because of the coup. Young Chinese have only ever known a stable home government. They may never have heard of coups, much less understand them. Ditto the Japanese.

In spite of apparent misgivings abroad, the coup here has had little impact on the tourist experience, in my opinion, for Chinese or Japanese or anyone else. Street life has pretty much returned to normal, and more tourists are showing up. Meanwhile, those of us who spend time here enjoy less crowded restaurants, better prices, lower airfares, a slower pace, and special deals.

Paul Terhorst

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Laughing, I spoke to the lady at Information, explaining that I was told police clearance could be attained here at the mall.

"Oh yes," she laughed, "it's right behind you."

Two years of living in this part of the world and knowing how these people work, I asked her if she could explain in Arabic to the policeman—who was pretending he couldn't understand me—the reason for my presence before him.

Only after this lady's intervention did he reluctantly take my ID, employer details, and payment...and process the paperwork.

To his credit, he did it all with a smile. But he'd rather not have had the bother. If I hadn't showed up that day, he could have sat and chatted with his friends without the hassle of clicking, typing, printing, or stamping.

This is typical of doing business in the UAE. For all its futuristic construction, modern infrastructure, and cupcakes of edible gold, customer service here is Third World (and slower).

Trying to get a phone or Internet connection can be excruciating. "The system is down" is a common reply. Or the assistant abandons you indefinitely to pray or use the toilet. You are constantly turned away because of higher personal priorities.

Then, there's inshallah—the most overused word in this part of the world—meaning "God willing" or "if Allah wills." For customer service staff, inshallah is the favorite get-out-of-jail-free card...

For example, you hand over your passport to have your paperwork processed (as I've had to do a number of times) and ask when you'll have it returned...

You'll likely hear: "Tomorrow, inshallah!"

In other words, "If Allah allows everything to run smoothly, then you'll see your passport tomorrow. If you come tomorrow and it's still not ready, then it wasn't meant to be. (And, if I don't show up, it's because Allah wanted me to do something else.)"

This is simply the way of life. A way you gradually adjust to.

Why am I still here? Two reasons...

First, the UAE offers some of the most attractive benefit packages to skilled expat workers. On top of your base salary (which, as a teacher, works out a little higher than my Irish salary), it's not unusual to find your annual rent, health care, visa for you and any dependents, annual return airfare to your home country, and your children's education costs covered as standard. Note: Rent in this part of the world is high. One friend rents a standard three-bed villa for 200,000 dirhams per year (about US$54,500), payable a year in advance in one lump sum.

Second, you don't pay any tax on your income. With your rent, health care, and other big expenses covered, this means your take-home salary can be your disposable income.

This is how I get to live in a luxury villa in the best part of Dubai. I can afford to drive a car that would cost a fortune to run at home. My income can be spent on dining out, entertainment, and trips to the salon. I've had dental braces fitted for a fraction you'd pay in the United States or Europe.

It's like being on vacation every day: nice weather, beaches, and restaurants. Realistically, most of us couldn't live this way in the long term. For now, though, I can live with the inefficiency, the crazy traffic, the inescapable calls to prayer five times a day (starting before dawn). And, don't get me started on Ramadan...

Emily Carson

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Kathleen Peddicord

Kathleen Peddicord is the founder of the Live and Invest Overseas publishing group. With more than 25 years experience covering this beat, Kathleen reports daily on current opportunities for living, retiring, and investing overseas in her free e-letter.

Her book, How To Retire Overseas—Everything You Need To Know To Live Well Abroad For Less, was recently released by Penguin Books.

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