A few days ago, I posted the results of International Living’s 2010 Annual Retirement Index. Topping this prestigious list are

1. Ecuador
2. Panama
3. Mexico
4. France
5. Italy

Today I’m looking at a very different list: this one includes the 10 Most Suitable Countries for American Expatriates.

According to the website Expatify.com, they considered these important criteria:

• How receptive is the local culture to Americans?

• How popular is the country for American expats already?
• Can you manage speaking only English?
• Is there overlap between local and American customs?
• Ease of finding jobs and affodability?

If you truly want to immerse yourself in a very different culture, this is not the list of countries you should consider. But if you want to go someplace where you can fit in fairly easily, consider the following countries:

1. Argentina

2. Thailand
3. Czech Republic
4. Australia
5. Italy
6. Brazil
7. Spain
8. Mexico
9. South Africa
10. Costa Rica

In a few days, my youngest child is going off to college in another state.

photo by Robert S. Donovan on flickr

Theoretically it won’t matter to them whether the plane takes off from Orlando or from Panama City, Panama, Quito, Ecuador or Cancun, Mexico.

Unfortunately, it’s not that simple — when is it ever?

We do have one big hurdle to jump before we go anywhere. You see, we’re driving her up to her college, and stopping on the way to spend a couple of days with my husband’s parents. They’re the family members who seem to be having the hardest time with our plans to leave the country.

Either our plans will be the 800 pound gorilla in the room, or we’ll (hopefully) be able to talk honestly with them and leave them feeling more comfortable with what we’re doing.



I’m certainly hoping for the latter.

Frankly, their attitude has surprised me so far. Perhaps it’s because I’m hearing what they say through a filter, since it’s my husband who’s been speaking with them about it. I definitely want to hear from them directly.

There are several reasons I’ve been surprised at their attitude:

• My in-laws are seasoned travelers. In just the past couple of years they’ve been to several European countries, Mexico, Panama and Canada. Years ago, my father-in-law worked for a number of months in Saudi Arabia.
• They’ve also lived all over the US: upstate New York, California, Georgia, North Carolina and Washington, DC.
• My mother-in-law uses Skype more than I do, so they know how easy it is to communicate via internet.
• We already live a good 8 hour drive away from them, and flying time isn’t much less when you add the time to and from the airport.

So I’m hoping we can defuse whatever fears they may have. Wish me luck!

For a change of pace today, I thought I’d share with you some YouTube videos about expats and their new homes. A quick YouTube search of “expat” turns up over 4,000 videos. As you’d expect, some are good, some are terrible and most are in between. Some are slick, commercially produced efforts, most are not. The ones I find most interesting are individuals who shares specifics about their new homes.



I’ve chosen 14 videos worth a look. We’ll come back to this from time to time, so please don’t think I’m ignoring large chunks of the world.

Latin America

1. Retire Early in Mexico

2. Live, work and retire in Mexico. This video looks specifically at Merida, on the Yucatan Peninsula.
3. Living in Mexico, Moving to Mexico and Retiring in Mexico. An American couple moves to San Miguel de Allende.
4. A Retirement in Panama: Everything Under the Sun. This is a professionally created video by International Living.
5. Ecuador – One Man’s Dream
6. To Live in Cuenca, Ecuador
7. Cuenca Day and Night
8. Costa Rica Expat interviews w/Wayne

Asia

1. The Expat Life: Dumpling 101 An adventure in Chinese cooking. This is a really cute video of a US expat in China trying to make Chinese dumplings, to his daughter’s disapproval.

2. Life in Korea. The first month’s of a young American teacher’s adventures in Korea.
3. Life as an Expat in Thailand: Getting a Job
4. How to Live and Work as a Teacher in Thailand
5. Why Malaysia? A British expat explains his reasons.
6. Expat Women in Hong Kong Society. This video gives a glimpse of the down side of expatriation — what do you know when the society you’re living in doesn’t want to mingle with you?

Last October I asked the question, “Is US health care driving Americans to move abroad?” You can read the original post here.

I followed up the question and post with a poll. When the poll closed, 19% of respondents listed health care as the “most important” reason for their move and a whopping 69% rated is as “very important.” Not a single respondent indicated health care was not a consideration.



The prestigious magazine for expats and would-be expats International Living has now weighed in. Their June issue, which arrived in my mailbox yesterday, is billed as a Special Health Care Issue, and includes a number of articles dealing with health care at home and abroad. If you’re concerned about health care, this issue is jam-packed with useful information.

What really got my attention, though, was an article at the very back titled “Health Care Reform: Why All the Fuss?” by Lee Harrison. After describing the “raging health-care debate” and law change in the US, Lee wrote:

“Many of the world’s citizens are wondering what all the fuss is about. To them, we may as well be debating whether we should have public education, highways or a postal system. In other words, we’re arguing about something that they thought everyone had all along.

“And that’s a luxury that you may have, too, when you make the move abroad: the ability to take quality, affordable health care for granted.

“In fact, many expats who take up residence are motivated by their adoped country’s health-care system.”

Thank you, Lee. I don’t always agree 100% with what International Living has to say, but here I do.

Affordable, quality health care is certainly one of my biggest reasons for wanting to become an expat.

As I’ve pointed out here before, Mexico is working hard to attract the US retiree, and health care is a big selling point. Add to that the move — gaining more traction — to expand Medicare into Mexico and our nearest neighbor south of the border is poised for an influx of US baby boomer and older expats.

But Mexico isn’t the only country where expats can enjoy quality health care at affordable prices. More on health care abroad is coming in future posts, so stay tuned.

Do you have a health care story you’d like to share? Click the Comment link below.

Did you miss some of our previous posts about health care? Click here for a complete list.

Writing for International Living today, Dan Prescher described a meeting he recently attended with “government officials, local entrepreneurs and international consultants” in Merida, Mexico a few days ago. I thought this was interesting enough that I postponed the post I was planning for today to bring you Dan’s report:

El Castillo, Chichen Itza, Maya Ruins, Yucatan Peninsula, Mexico

“Mexico’s Yucatan state is a tropical paradise and a paradise for history and archeology buffs… but a retirement paradise for U.S. Baby Boomers?

“Developing Yucatan into a Mecca for Americans 50 year of age and older was the action plan being discussed at a meeting of government officials, local entrepreneurs, and international consultants held in Merida, Yucatan, on Wednesday April 7 titled ‘Adults Over 50 – The Housing, Attention and Service Industry.’

“Coordinated by the Governor’s Office of Finance and Development, the meeting brought together movers and shakers from around the state and the globe to determine how best to make Merida and Yucatan State a top destination for a future flood of U.S. retirees looking for a quality life at a lower cost.

“According to speaker David Collins, consultant and managing partner of Active Living International, there will be 100 million Americans 50 years of age or older by 2012.

“Collins said that meeting the needs of this huge group will be a major economic driver for the housing and health care industries for years to come.

“He said Yucatan state is uniquely positioned to meet those needs at a fraction of the cost for similar services in the U.S.

“ ‘Merida (Yucatan’s capital) is safe, welcoming, has good transportation and energy infrastructure, a great climate, and is close to the U.S.’ said Collins.

“ ‘Real estate and labor prices here are very inexpensive compared to the U.S. If the right combination of residential properties and health care facilities are available, then all the elements are here to draw retirees who are looking for alternatives to higher-priced U.S. retirement options.’

“Collins warned, however, that few countries seeking to draw U.S. retirees to their shores understand the radical shifts that the 50+ housing and health markets have gone through in America.

“ ‘If you’re still building rows of half-million-dollar beach and golf course homes for wealthy American retirees, you don’t understand what’s happened,’ said Collins.

“ ‘In the wake of the global economic crisis and the health care debate in the U.S., Americans are no longer focused on status, exclusivity, luxury, amenities, and golf,’ said Collins.

” ‘Their focus now is on smaller residential properties with long-term value in places that have a sense of community and an active social life. They are focused on what I call ‘QTR’… Quality Time Remaining.’

“ ‘They want lower-cost properties in desirable locations that they can use now for vacation homes and rental income. They want them to be good quality and low maintenance, preferably with on-site rental management. And they want to be able to retire comfortably in these properties when the time comes, knowing that they are near top-quality assisted living and long-term health care facilities.’

” ‘The nature of those assisted living and long-term facilities is crucial,’ said Marco Álvarez, director of Dabvsa, a Mexican company that builds and operates adult care facilities.

“ ‘We’re talking about something called continuing care retirement communities,’ said Álvarez. ‘These are places that offer a spectrum of care, from independent living to assisted living to around-the-clock nursing care. They make the transition between these care levels as easy and natural as possible for consumers and their families.’

“ ‘Americans assume the presence of these facilities in the U.S., but not in Mexico. Having facilities like this in Merida, with the accompanying cost savings in labor over the U.S., could complete the picture of the Yucatan as a high-quality, low-cost retirement destination for that huge number of future U.S. retirees.’

“The meeting was held in cooperation with Universidad del Mayab and Instituto Cumbres in Merida and COPARMEX Merida, an association of businessmen, real estate professionals, and developers. All present agreed that it would take the combined effort and cooperation of state government, economic education and research facilities, and the local business community to successfully develop and implement a strategy to make Yucatan a real ‘paradise for the retiree.’

“ ‘Here in Yucatan and Merida we have everything going for us right now,’ said Sergio Raimond, professor of Economics at the Pan-American Institute of Business Policy (IPAD). ‘This is our opportunity to take advantage of or ours to lose.’

“Merida is already home to several hundred U.S. expats, many of whom moved for better weather, lower cost of living, and more affordable health care. “

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Interested in Moving to Mexico?
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Mexico: The Owner’s Manual

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About 500 people are gathered in Quito, Ecuador right now for International Living‘s Ultimate Event 2010. They’re learning about life in a bunch of countries where it’s possible to live well on $2,000 a month or less. Can’t be there with them? They’re offering the Ultimate Event 2010 Conference-At-Home Kit, and guaranteeing satisfaction. “If This Information Doesn’t Help You, Pay Nothing” they state. Substantial discounts are available if you order now.

by Suzan Haskins, International Living

Back in the U.S. another winter storm threatens the east coast, stock prices are diving thanks to high unemployment rates, the painful health care debate continues to make us all sick, and Conan O’Brien is in the news. For joining Twitter.

Who cares…about any of it?

Nothing works back home any more…from health care to child care, from banks to politics, from cars to bars. OK, the bars still work. But who really wants to pay $8 for a draft beer these days? Not me, and especially not when I can get a 22-ounce bottle of Pilsener, a mighty fine beer, here in Ecuador for $1. (And a full four-course meal for $2. And a three-bedroom condo for less than $50,000.)

Wouldn’t it be nice to fall in love with your life again? To find a place with better views out your windows, better weather, a lower cost of living, and where things really work?

According to Lee Harrison, who has lived in Ecuador, Brazil and Uruguay:

“Everything [in Uruguay] runs like clockwork. All the roads are safe and well-kept, the parks are clean, the hardware stores and grocery stores are well-stocked, trains and buses run on time….”

And the cost of living is low. In Montevideo, Uruguay’s famous colonial city, Lee showed us photos of a two-bedroom apartment in a building offered for $65,000. “This is a nice apartment—I would happily live in it,” he said.

Glynna Prentice acknowledges that Mexico, where she lives, isn’t the least-expensive country. But, she says, in Mexico you can get government health insurance for $300 or less a year. And that includes all your prescription medications.

A private insurance plan, she says, is half the cost you pay at home, as are out-of-pocket expenses.

And this isn’t publicized, but Mexico offers a great retirement program for anyone living there as a resident. Lots of discounts on things like restaurants, cultural activities and medical care.

Glynna says Mexico may be the easiest country for a foreigner to get a resident visa in.

But Lee Harrison says that about Uruguay, where he plans to apply for permanent citizenship. And Dan Prescher says the same about Belize and its famous Qualified Retirement Program, which allows a host of benefits including importing your household goods, vehicle and boat duty-free and tax residency…whether you actually live there or not.

Belize may be the easiest country to relocate to—especially if you’re concerned about the difficulties of learning a foreign language.

There’s so much more to tell you! But of course, I can’t type up everything that’s happened here in Quito. In just two days so far, we’ve already spent 13 hours in presentations and workshops. And we have two days yet to go!

We’ve learned about the best countries for second citizenship, the best countries to obtain residency easily and at little cost, and which provide free or very low-cost health care to residents.

That definitely helps us know where to look to find the location of our dreams. And thanks to our speakers, we now have a very good idea of how much it will cost us to live in these countries, including the costs to buy a home, apartment, or acreage.

Would you like to learn more about all the countries and opportunities we’re discovering here at the Ultimate Event? Let me tell you how you can…

We’re putting together a complete package of nearly everything that’s happening at this event, with audio recordings of all 76 of the presentations.

We’re also making copies of all the speaker handouts, PowerPoint and visual presentations. And, of course, the complete dossier we give to each attendee when they showed up here at the Swissotel in Quito.

It’s the Ultimate Event 2010 Conference-at-Home Kit—and it covers every aspect of the 2010 Ultimate Event.

Would you be interested in attending a conference or workshop to learn more about living overseas? Have you ever attended one? Share your thoughts by clicking the comment link below.

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Guest Post by Brandi N. Grays

I never really decided to live overseas. There was no well-laid plan, no dream destination. I didn’t do any research. When I first got off the airplane in Ankara, Turkey I had no idea what life had in store for me. My boyfriend had been working in Turkey for a little over a year and he asked me to marry him. He was already in Turkey (and it seemed that I had been awaiting this proposal forever), so we decided that I would go there and we would get married right away. I found a tenant for my apartment, packed my bags, and hopped on a plane to Ankara.

Because I hadn’t done any research, I arrived a few days before the start of Ramadan. We had to wait through closed offices and holiday observances; but, we were finally able to get married about three weeks later. So many people ask me, “How did you manage to get married in another country?” It was a challenge, but this experience is what helped shape my perspective about life overseas; take it all in stride.

I have lived all over the world; Turkey, Belgium, Bosnia, Israel, and now Mexico. I am thoroughly enjoying myself. However, I believe that in order to take full advantage of your expat life you have to relax a bit and understand that you don’t have the same amount of control as you do in your home country. I have had many opportunities to work myself into fits of frenzy; however, my outlook on this uncommon life has saved me.

What Do You Mean, I Can’t Buy Groceries Here?

I can remember standing in the checkout line at a grocery store in Belgium. I had a basket full of groceries and was at least 7 months pregnant. I handed the cashier my credit card and my passport and began bagging my groceries. However, I was alerted to the fact that there was some sort of problem with my identification. The cashier explained that my middle name was not on my credit card as it appeared on my passport and therefore, I couldn’t pay for my basket full of groceries. I tried to explain to her that it was just my middle name and didn’t have to be on my credit card, but my explanation was not sufficient. I speak enough French to get through my daily life; but, I can’t go head to head in a verbal battle with a native French speaker.

So, here I was holding up the check-out line in Carrefour and getting angrier by the minute. Had I been in the states, I would have demanded to speak to the manager, asked for the number to corporate headquarters and called them while I sat in the car. In this case, however, I pushed my basket to the front of the store, bought a hot waffle on my way out, and went back later with my husband and his credit card.

These sorts of experiences will happen, especially when you first arrive in a new country. If you don’t fluently speak the language, you will encounter them much more often. But they will give you opportunities to laugh later on. They are simply part of the adventure. There is no sense in getting upset and angry. Take it all in stride.

I could tell you stories about rogue taxi drivers, hostile sports fans, ridiculous apartment deficiencies, and the worst McDonald’s on Earth. Of course, when you are standing face to face with a cashier and can’t buy your groceries, it can be disheartening. If you have to demand that a taxi driver take you back home because he doesn’t know where he is going (and you don’t really either), it can be a bit overwhelming. But when you stick it out and get past these little bumps in the road, the journey is a blast.

Brandi N. Grays is the owner of Eleven Twenty-Three Creative Group, a small business marketing firm. She blogs about starting and growing your small business. She will be launching her own blog dedicated to expat moms in the spring of 2010. You can reach Brandi at brandingrays@1123creativegroup.com.

Tied to concerns about health care, some expats and future expats are also looking into what would happen if they were to retire overseas and then become too ill to take care of themselves. Mexico is working on an answer.

As the US population ages, and as more and more Americans decide to retire abroad, Assisted Living is becoming big business in Mexico. It even has its own non-profit organization! AMAR is the Asociacion Mexicana de Asistencia en el Retiro in Spanish, the Mexican Association for Retirement Communities in English. It’s a not-for-profit company that helps retirees find independent or assisted living communities in Mexico.

Their mission is to encourage the development of the senior living market and to continually improve the quality of life standards among retirement communities in Mexico. It should be noted that assisted living facilities are largely unregulated, although AMAR is committed to creating US-style standards for the industry.

The organization’s founder, Javier Godinez-Villegas, estimates that about 3 million US expats will join the million or so already in Mexico within the next 10 years. Other estimates place the number closer to 10 million by 2025. That, added to the shortage of affordable assisted living facilities in the US, creates a huge opportunity for Mexican developers. The organization held its first convention last September in Mexico City.

Not surprisingly, the first places to see assisted living facilities geared toward Americans are areas considered to be expat havens.

Serena Senior Care opened a center in Rosarito, Mexico, last May, and is targeting two groups: the elderly already needing their services, and their younger, baby-boomer children. Their website states:

“Residents will have lodging, all meals, housekeeping, personal care by trained nurses and caregivers, supervision from a Geriatrician, social activities, physical therapy, and many other services. This new service is a great value, with an affordable monthly fee that is about 50% the cost of comparable services in California, but with the distinctive warm hospitality of Mexico.”

San Miguel de Allende, long an expat haven in the Colonial highlands of Mexico, is home to Cielito Lindo. According to a USA Today article, Oregon retiree Jean Douglas found a studio apartment, meals, cleaning and laundry services and 24-hour care from a mostly English-speaking staff – all for about a quarter of what she would have paid back home.

Laredo native Jean Edwards, interviewed by the Dallas News at Cielito Lindo, felt that the Mexican culture places more value on elderly people and caring for them.

According to an ABC News report, an elderly Alzheimer’s patient receives a place to live, 24-hour care, and a weekly house call from a doctor, all for $1,000 per month. In the US, that level of care would cost about $13,000 monthly.

I’m sure we’ll see more of these in other countries as well, as the US economy continues weak and health care does not improve.

Do you have experience (either yourself or a friend or loved one) with non-US assisted living? Please share it with us! Click the Comment link below.

In the Expat Web group on LinkedIn, a member asked recently, “As an Expat, which countries do you think have the best and worst healthcare systems?”

Belgium, Spain, Switzerland, Canada, Malta and France all received positive comments. One poster said Japan’s was “the worst I ever experienced.” The US was mentioned favorably, but “only if you have good insurance. Prices are about 5 to 10 times the costs of France or Belgium.” This kind of anecdotal information is interesting, but not all that useful.

Of course to most expats and would-be expats, especially those of us who are approaching retirement age, health care is an important consideration in where we choose to live. What is its quality? Is it at least as good as what I’m used to? How expensive is it? How accessible is it? Will I have to be in a major city to have quality care available?

So what’s a concerned health care consumer to do?

There’s an interesting bubble chart on the Columbia University website, showing the average life expectancy and health care spending by country.

The US is way off by itself as the biggest spender. But our life expectancy (77 years) lags behind Japan (85), Switzerland, Australia, France, Canada, Norway, Spain, New Zealand, Austria, Korea, Portugal, UK, Luxembourg and Denmark, all of whom spend considerably less (around half!) than we do per capita.

The WHO (World Health Organization) has published a listing of medical care by country. Compiled in the year 2000, it’s a bit outdated, but might provide a good starting point. You can see it here.

A Few Considerations

First, I think it’s safe to assume that the care you’ll receive in rural areas will not be as up-to-date or comprehensive as the care you can receive in major cities. That’s true in the US just as much as anywhere else.

If living in a bustling metro area is not your taste, how fast and easy is transportation to those areas you’re considering? Use your common sense – if your dream retirement is on a remote beach or mountain-top retreat that’s an 8-hour drive over mostly dirt roads to get to the nearest city, that will be an issue in accessing quality health care. If it’s an hour or two over good roads, you’ll have significantly better access.

Are there hot spots of medical tourism in the country you’re considering? If so, you can be pretty well assured those doctors will speak English, have up-to-date training and use modern equipment. According to Business Week:

“The low cost and high quality of medical service is a big selling point for Singapore and Thailand, which have heavily promoted medical tourism in recent years. Hospital costs are as much as one-half what they would cost in the U.S.” Read the entire article here

Other popular medical tourism destinations include Panama, Mexico, Argentina, Brazil, Malaysia, South Korea, India and Israel. There are plenty of websites which discuss medical tourism, as any Google search will show.

Once you’ve narrowed down some possible destinations with health care facilities that will meet your needs, conduct your own research. When you visit the area, ask a lot of questions, find out what other expats do for health care, visit the hospitals and clinics if you can.

Ultimately, as with any other aspect of your move, you need to just do it.

International Living’s annual Quality of Life Index. Every year, IL produces a Quality of Life index, which usually differs quite a bit from their recommendations on best places to retire. France has topped the list for several years running.

1. France (was #1 last year as well)
2. Australia (moved up from #5 in 2009)
3. Switzerland (down one spot)
4. Germany (up from the #8 spot in 2009)
5. New Zealand (up from #9)
6. Luxembourg (down from #4)
7. USA (down from #3)
8. Belgium (down from #6)
9. Canada (a big jump up, from #19)
10. Italy (down from #7)

Top Ten Retirement Havens from Live and Invest Overseas

1. Argentina
2. Belize
3. Chile
4. Croatia
5. Dominican Republic
6. France
7. Malaysia
8. Panama
9. Uruguay
10. Vietnam

Mercer’s Best Cities for 2009:

1. Vienna, Austria (1st)
2. Zurich, Switzerland (2nd)
3. Geneva, Switzerland (3rd )
4. Vancouver, Canada (tied 4th)
5. Auckland, New Zealand (tied 4th)

Forbes list of The World’s Most Expensive Cities to Live. According to Forbes, the 10 most expensive cities are:

1. Tokyo, Japan
2. Osaka, Japan
3. Moscow, Russia
4. Geneva, Switzerland
5. Hong Kong, China
6. Zurich, Switzerland
7. Copenhagen, Denmark
8. New York, USA
9. Beijing, China
10. Singapore

2009 Best Retirement Havens, according to International Living:

1. Cuenca, Ecuador
2. Merida, Mexico
3. Coronado, Panama
4. Punta del Este, Uruguay
5. Calitri, Italy

So there you have it. Some highly respected lists from 2009, and one for 2010.

Best wishes for a happy expat New Year!