#741 – The Expat Files: Puerto Rico’s Crisis, Nicaragua’s Challenges, and Cuba’s Healthcare Realities

Automatically transcribed from the original recording; names and wording may contain errors.

[00:00] South of the border, down Mexico way That's where I fell in love when the stars above came out to play And now that I wonder Hello there all you expat wannabes I'm Johnny Mueller and you're listening to The Expat Files, living in Latin America The show that tells you just what it's like to live, work, play and or retire down here in Latin America It's a mix of the good, the bad, the ugly and the great And it's all right here so let's get started Before we get to the juice, the dirt and the details of Expatity's love life Continued from the last Expat Files show That was show number 740 by the way This being show 741 That is for anyone who's actually counting

[00:47] Anyway, I have to admit, I get a lot of emails about Puerto Rico You know, it is a Latin country However, don't recommend that place at all You know it was pretty much completely destroyed by that gigantic hurricane And still half the island does not have power Not to mention even before the hurricane The government was completely bankrupt And the hurricane dug them an even bigger hole Multiplied the bankruptcy problem by three If that's even possible, I mean, bankrupt is bankrupt, right? Yes, I know, I know you've heard Doug Casey and the guys with Sovereign Man And many other of the newsletters The good ones, the alternative newsletters Saying if you've got any kind of business at all If you incorporate it in Puerto Rico, you pay no federal tax Which is true And for the longest time, it sounded like a great deal And it was Except, like I said, the country's bankrupt

[01:34] The whole place is a bloody, flooded out mess And half the island doesn't have electricity So what's the point of incorporating your business And moving down to Puerto Rico under those conditions Where every Puerto Rican and his brother is trying to leave And you know, they can go to the States legally Since they're a U.S. protectorate But why do you think In big cities like my jammy in Nueva York There's such huge populations and barrios of people With Puerto Rican ancestry Because they have U.S. passports and can get in completely legally Nothing wrong with that I mean, every U.S. protectorate has that privilege But what I'm saying is Everyone who lives on that island is trying to get the hell out All right, so you know my opinion on that If you think I'm wrong Isn't it funny how those alternative newspapers and blogs That were so high on Puerto Rico not so long ago

[02:20] Have you noticed they've completely clammed up about it And the silence is deafening It reminds me of big bloated rags like International Living Who were touting Panama, Mexico, and Costa Rica Oh, they had real estate to sell all right And they did it for years But now the silence is deafening And now International Living's out to destroy Ecuador And Nicaragua and Colombia for expat gringos too Because you see with their help and promotion Their gringos file in and soon enough Destroy the gringo advantage I'm always talking about As well as greatly escalate the cost of living too And you know I used to live in Costa Rica That was one of my first stops many years ago When I first took off from your Uncle Sam's big brotherland So I do have a lot of gringo friends still living there Because well they bought and invested a long time ago

[03:07] And they aren't free to just pick up and leave The point here is Every last one of them regrets moving to Costa Rica In fact as soon as they open their mouths I know I'm gonna get a barrage of complaints But at least as a couple of them as mentioned They'll be out of harm's way when the dominoes fall And the reset button gets pushed up in the states So I've got that going for them anyway And you know one day I was sitting around With a bunch of those guys and gals And I said Man with more than half the gringos and expats Living in Costa Rica and that's a huge number Retired, receiving pensions, social security, disability payments In some ways it's kind of like a high functioning Geriatric holding pen What are they gonna do when the feces hits the ventilator up in the states And those payments just don't come steadily like they once did

[03:53] And every last one of them looked at each other Then looked at me and said Why we'll just move to Nicaragua In fact practically everyone who's been in Costa Rica A long long time will tell you that Nicaragua is like Costa Rica was 25 years ago And believe me for the last couple of years There's been a steady flow of disgruntled gringos Who can make the break flowing into Nicaragua Because it's cheaper and it's a lot less regulated That's reason number 426 why I'm not hot on Nicaragua either First of all they've got a socialist pedophile dictator running the place But you know that already right Secondly the place is a furnace it's dead hot They've got no comfortable high elevation altiplanos to speak of Thirdly they've got mainstream rags like international living Pushing the place as the next latest greatest retirement haven And that'll affect the cost of living and kill your gringo advantage in a hurry

[04:40] And finally you've got tens of thousands of disgruntled gringos Living in Costa Rica that say their plan B Actually it'll be their plan C would be to move there And you know a couple of years ago that'd have been a good idea But things do change unfortunately in Nicaragua's case for the worse Okay well that's just my opinion And I've only been down here 28 years now I speak the language built 13 houses Lived on the beach and in the altiplano Been to every Latin country I think except Guiana Lived on the gringo tourist trail Had a couple businesses there too for three solid years And for the next 25 years I've been by choice well off the gringo tourist trail However I'm not disconnected from the modern world Where I live and hang out is first world all the way Anyway sometimes an entire week or two will go by and I won't run into a single gringo

[05:28] Now for the average new arrival the green gringo expat that might sound like torture Not having any gringos to shoot the breeze with face to face Hey I understand that long time ago I was exactly in that position too When your Spanish really sucks just doing basic things can be awkward Which is why I always recommend when you first come down Wherever you're going to rent And I always recommend renting at least six months before you buy anything Make sure you're close enough to a tourist area or tribe of gringos That you can get there within an hour's drive That way you can get your gringo companionship fixed Then you can do what a lot of smart gringos and expats do Slowly but surely as you learn Spanish Wean yourself away from all those gringos And move away from the tourist area Problem is a lot of people fall into the gringo dependency thing Which is why 90 to 95% of all gringos live on or near the tourist trail

[06:18] And that's also why so many gringos and expats never learn their Spanish well enough To really understand what's going on in the culture Though you'd be surprised how many gringos and expats end up jumping right back on some kind of treadmill Once they get down here and find out they've got a lot of time on their hands Though admittedly it's a different kind of treadmill Up in the states you are on that treadmill because you needed to be to exist in that society You know to have all the toys and goodies SUVs paid a big rent and everything Whereas down here if you end up on some kind of treadmill It's of your own making and a lot of gringos will tell you It's an enjoyable kind of treadmill Hmm go figure huh? I mean look as for intelligent kind of enlightened people They always have to have a goal And when they reach it you know it's cool But sometimes they go into a slump They need another goal

[07:03] But I'm preaching to the choir I know So I started the show today talking about how people send me emails regarding Puerto Rico And I stated it's my opinion that it's not recommended Not even for a nice beach resort vacation Because the place is pretty much destroyed Well I also get lots of email inquiries asking about Cuba And you know it's been a long time since we've checked in on that subject Of course you know O vomit opened the doors a bit Then Trump came in and closed them And you long time listeners have probably heard me mention that I've been there a couple times Even checked out a variety of business opportunities with a buddy of mine from Costa Rica Who is a hotel developer? A half Costa Rican half Dutch guy Who decided that getting in bed with the Cuban government on a hotel project was just way too complicated Unless you were a big well-known hotel chain like Marriott or Hyatt

[07:51] But coming in as a private hotel owner and doing a one-off for a smaller hotel wasn't worth it Especially now the Airbnb thing is taken off Man that's a development that's taken its toll on traditional hotels That's for sure And in a way you know you gotta love it Especially in tourist areas where hotel prices are almost always much higher than they really should be So anyway I get a lot of emails about Cuba And many many of them probably 40 or 50% of them come from the older 50 crowd People who are worried about healthcare and have medical issues And talk about all the great things they've heard about the Cuban medical system And how Cuban medical schools are cranking out so many highly skilled doctors That they are now Cuba's number one export I'm not kidding For example Argentina they have lots of medical schools too

[08:38] But their MD graduates want to practice in the big city where the money is So they can buy cars, houses and such They don't want to work out in the boonies Where they just might get paid in free hollies and driveway chickens Which is why every medium and large Latin city has plenty of doctors and specialists Probably just as many per capita as you have up in Cleveland But out in the boonies in Latin America there's a huge shortage of doctors and medical professionals Because no one wants to get paid in pineapples and avocados Or marijuana and cocaine Though I could be wrong about that Anyway those little towns and pueblos out in the third world boonies have become a huge market For the export of Cuban doctors So when you graduate from medical school as a Cuban doctor You can practice in Cuba for a salary of something like 60 to 80 bucks a month

[09:27] Or go to another country and make their minimum wage Which is three or four times higher Those are deals that the Castro government has worked out with other countries Again like Argentina, Belize, Bolivia, whatever And the Cuban government gets paid by the other country And the doctor gets shipped out to the Argentine boonies Where he's told he'll be paid that country's minimum wage Which is fantastic to him It's usually four times what he's getting in Cuba And after his two or four year contracts up He's got to go back home Which is why the Cuban government rarely lets a single Cuban doctor, man or woman Enter into one of those contracts They want to marry it preferably with kids Because wouldn't you know it once they've had a taste of the outside world They don't want to go back So if you're a single doc you're generally stuck in Cuba So what's really the story on Cuban health care in the country?

[10:16] Well on my last visit I was hanging around Havana And I stopped into the big national hospital I should clarify that That's all they've got in Cuba Is national hospitals and clinics They have no private ones Anyway I checked this hospital out It had everything First world all the way A lot of Russian equipment Still very impressive Till I found out later That hospital is first rate Because it's their show place hospital That's where the party members and ailing tourists go It's the poster child hospital For their so called superior medical system However I found out later The hospitals in the medium and smaller size towns Were just like third world government hospitals everywhere Shortages of practically everything Paper products, medicines, disposables

[11:02] As well as scratched and dented machines And diagnostic equipment Decades older than the stuff I saw in the big Havana hospital And as usual Most of the stuff was poorly maintained Or they didn't have replacement parts So a lot of the stuff just sat there riding away So bottom line As long as you're a tourist or party member You get sick around Havana You'll get really top notch first rate medical care But as for the other 400 or so hospitals in Cuba Well let's just say if you're going to get sick You better get sick in Havana So just to dispel any popular myths you might have About this great healthcare system in Cuba I want to read you this little op-ed piece From a guy named Nelson Rodriguez Chartrand He graduated from a Cuban law school But was not allowed to practice there

[11:48] Because the Cuban government regime Decides what your job is going to be Not you Alright this is translated and I'll paraphrase a bit The title is The wonders of Cuba's one horsepower ambulances Then they show a picture of a Cuban ambulance Being pulled around, you guessed it, by a horse And that's not unusual There's a whole fleet of them Now later When we get around to posting this show on YouTube You'll see these one horsepower ambulances Alright it says It's an insult to human dignity and intelligence To listen to Cuban dictators preach loudly And without hesitation that Cuba Is a healthcare powerhouse When if you've ever lived or been in Cuba You'd see that anyone with a single shred of dignity Would find it very difficult

[12:33] To live with Cuba's healthcare hypocrisy If you live there it's certainly revolting To hear Cuban leaders speak of the virtues Of their healthcare system Knowing that they sell this idea worldwide With great success How they're able to whitewash a really disgusting image And sell it and export it so successfully is a mystery In fact I've been told and read over and over again That other countries would love to emulate the Cuban example Wow if they only knew the truth Obviously they've never been to Cuba And if they have they've only been in the tourist areas So I won't talk about poor hygiene And the lack of even food in the local hospitals Nor will I discuss the severe shortage of medicines The unreliability of all the medical equipment

[13:18] Or the discontent of the professionals and workers In the healthcare business Due to low wages and terrible working conditions In Cuba it's never healthy to show you discontent You have to put on a happy face You'll learn that quickly Then he says I won't talk here about the deficit of doctors Due to excessive exports of all of our healthcare professionals To other countries Whose true purpose is to paint the dictators in Cuba In a false image of philanthropy and goodwill Not to mention it's a great source of desperately needed foreign income It's not hard to see that their major export is socialism And up to now its biggest buyer has been Can you believe it? Though in an odd sense it's really capitalism

[14:04] Oil for doctors In fact he says Venezuela has spent more money on Cuba Than the entire Soviet Union did before the collapse For decades cheap Cuban doctors for cheap Venezuelan oil Made good business sense All the while the rest of the world was thinking What a wondrous thing the Cuban healthcare system They overflow with so many great doctors they have to export them Spreading their so called healthcare wealth To the rest of Latin America and the world However there are so many factors that play in a healthcare system I'd just like to focus on one right now The Cuban Ambulance Service Known as the Integrated System of Medical Emergencies of Cuba Or SIUM What the rest of the world will never know

[14:51] Unless they live in the outskirts of the tourist areas Is that in the great healthcare powerhouse of Cuba The inhabitants of hundreds of little pueblos For example one called Natrogenó A rural community located in the Kamuge province Do not have any access at all to ambulances Or in fact basic emergency services Recently a 90 year old man in terrible health Had to be transferred to a hospital in a neighbor's horse drawn cart Because they were unsuccessful in summoning the SIUM services They just were unavailable So this 90 year old guy suffered a two mile journey Over impassable roads in a horse drawn cart Finally arriving at the hospital And then when the well intentioned neighbor The owner of the horse cart complained

[15:37] About the lack of hospital transportation services He was fined And his summons said He'd used an unauthorized, precarious means Of transporting a medically compromised person So that's the way it is in Socialist Cuba Even good Samaritans get fined So if you dare to want to help another When the state fails and it almost always fails Don't think it's better to give than receive Instead you must think of the consequences Or as they say up in the first world No good deed goes unpunished So next time you're in a discussion And here's someone going on and on about The wonders of the Cuban healthcare system If you really want to know the truth from the horse's mouth You need to talk to a Cuban doctor But don't talk to a doctor in Cuba You must talk to one of the Cuban doctors Who's been farmed out on contract to another Latin country

[16:25] Because only then they'll feel confident enough To speak freely Even so before they answer frankly They'll look around and tell you No photos, no recordings, no names please I'll speak, but off the record Alright, me, Johnny here again You know, I pay close attention when people speak off the record That's how you get down to the nitty-gritty and the dirt Speaking of real and very good information My next Expat Insider seminar will take place in Central America In and around Guatemala again Why? Because I've really got some fantastic connections down here And secondly, it's only one of the 2% of the physical locations in Latin America That's in the Altiplano Meaning you really have spring-like weather all year round So if you plan things right, whether you're building, renting, or buying

[17:11] You won't have an air conditioning or a heating bill Now I know some gringos come down and say Man, Johnny, you know it can get down to 50 degrees at night sometimes And it's true, every once in a while a cold front comes through And you get some pretty cool temperatures Though never freezing, you still should pay attention to the orientation of your house or rental If it's out in direct sunlight all day, well You'll probably have the windows open to get some breezes so the place doesn't overheat And it'll be somewhat the reverse if you're in the shade all day That means your house or rental whatever will always be a little cooler But I can tell you for a fact that, for example, the house that I'm in right now In the middle of the coffee fields is always at a very comfortable temperature That's one of the good things about cement block construction The only way to go The sheer mass of it really helps to stabilize the temperature

[17:57] I have a good thermometer mounted on an inside wall in the house And I can tell you for a fact over an entire year And this place is right smack dab in the altiplano around 5500 feet above sea level Yet the temperature all year round only swings between around 62 and 74 degrees Mostly hovering right around 70 degrees But it's true, for the two or three months it's in the 60s You do occasionally have to wear a sweatshirt or a sweater Unless you're a Canadian, then you drag out the speedo and the string bikini So I admit for a month or two out of the year I wear a sweater or sweatshirt around the house But never ever have I had an air conditioning or heating bill Now of course I run into fresh green gringos Rather delicate fresh green gringos who come down and say Johnny at night it gets so cold, where can I buy a space heater?

[18:46] And some of them have told me they search high and low and just can't find one And then they end up ordering one on Amazon And I say, well, you just haven't been to the right places Because they've got Ace Hardwares all over the place here in Latin America They're called Samacos They've got those EPA hardware stores too They're gigantic Latin versions of Home Depot So you can't find them, you just have to be on the lookout I've even seen the oil-filled ones that look like miniature radiators Though oddly enough I've never seen an electric space heater in a Latin person's house Not even in the house of a very wealthy Latin person Which is why I guess only a few hardware stores carry those things Of course, quite a few gringos in the altiplano have one or two of those space heaters And you know, I'll bet a Litecoin that the closer you get to the gringo tourist trail The more hardware stores are carrying those things

[19:33] Of course, everywhere else in Latin America The 98% of the geographic terrain that's not in the altiplano Well, there'd really be no use at all for a space heater of any kind Because those places have the definition of tropical heat Even at night, sometimes you'll sweat your butt off So that info about space heaters is specifically directed at people living in the altiplano As far as I'm concerned, the only place to live Unless of course you truly plan on spending the rest of your life Next to your pool with a Mai Tai in each hand Hey, you know, that is the American fantasy When I was back up in the States many years ago I can't tell you how many times I've heard people say Especially teachers and government workers Man, my idea of retirement is getting a little placed by the beach Laying in a hammock by the pool, looking at the ocean, and sucking down umbrella drinks

[20:20] Well, you know, that gets sold pretty fast For me, it took about two weeks But I'm a Type A personality guy If you're a Type B or C Probably take you a couple of months to get sick and tired of that kind of living I personally don't like the idea that if you live in the low altitudes Or on or near the beach in Latin America You have to live with a continuous fine coat of sweat on you 24-7 And if you do any kind of halfway physical activity at all Man, you spent half the day looking for shade In fact, a gringle friend of mine, a former building contractor Now living in La Saba, Honduras, tells me he likes to tinker He builds furniture and stuff Now, La Saba's right on the Caribbean So it's in the lowlands and dead hot And he tells me the only time he can work on his hobby Is between around sun up and 10 in the morning After that, it's just way too hot

[21:07] By 10, he tells me he's not only got ring around the pits in the collar Unless he's sitting down and immobile He's thoroughly drenched in sweat And by noon, sometimes he's already down to six pack up here I've heard his wife complain about that, too She said, why don't you build your furniture and stuff at night? He says, at night, I like to work in the daytime Out in the sun or in the shade At night, the bugs would eat me alive And you know, if you douse yourself in awe for a raid It's not good for you and you can't get the stink off And it lingers in your bedroom, too Another good reason to live in the Altiplano, huh? There's almost no bugs Unless you live right by a lake or a river or body of water I can't tell you how many gringos and expats have said, Johnny, I can't believe it. There's almost no insects here Yet the media in the States is always talking about dengue, typhoid, and Zika virus

[21:55] Well, here in Latin America, those problems exist, all right? But mostly, they affect poor populations who live around rivers and lakes and in lowlands Though, occasionally, you do hear about gringo backpackers and hikers Picking up an illness from an insect vector By the way, almost all the people infected don't have screens on their windows And most people, especially the poor, leave their windows open all day, you know Because they've got metal roofs If they don't keep the air flowing through all day, the sun will just bake the hell out of them Which is why all middle and upper middle class housing, the kind you'll be in Has either a concrete roof, painted white, or Spanish tile, which has a natural cooling effect That, by the way, is how you spot a crappy neighborhood from a distance Metal roofs, crappy neighborhood, Spanish tile, upscale neighborhood

[22:40] And when you spot a lot of concrete roofs from a distance Well, it's a bit harder to tell just what kind of neighborhood you're in You have to get a little closer All right, so I got off track again I was talking about my expat insider seminar And why I usually have it in and around Guatemala One of the reasons, of course, is smack dab in the altiplano Though there are other Latin countries with altiplano regions Guatemala has the largest continuous stretch of altiplano Compared to its total land mass So anyway, my July 2018 expat insider seminar Starts on Saturday, July 7th, and goes through Thursday, July 12th So if you want to get in on the early bird discounts And on the early bird mailing list Send me an email at theexpatfiles at gmail.com And put the word seminar in the subject box

[23:25] And you'll be getting all the details and info shortly All right, I promised in the last show That I'd finish off that story on how expat Eddie met Claudia His Salvadorian fiancé Well, to refresh your memory a little bit If you recall, we were at La Libertad beach in El Salvador Popular little beach town Especially during the holidays When people have time off And there are lots of events organized And the big beer and soda companies Hire beautiful young models and local two-bit celebrities To hand out free product samples on the beach Then they'll have this event Called a bikini open The highlight of the afternoon Now, one thing I might have failed to mention Is that El Salvador has almost no gringos And even though there are some rather nice places there Including La Libertad beach There must have been a thousand people there

[24:11] And expat Eddie and I, I'm sure, were the only two gringos So anyway, if you remember the story from last time I was getting towards the end of the night We were sitting around the beach bar And Claudia, the winner of the swimsuit contest One of the local celebrities In fact, the poster girl for banana boat sunscreen So for the Latin crowd She was recognizable all over El Salvador So anyway, as the story goes Some muscle-bound guy was drunk and hassling her a bit She got jostled and spilled a drink on herself and Eddie By the way, she didn't know us from Adam And we didn't know her Except from the banana boat posters But at the moment, in a huff She commanded Eddie to buy her a drink Wrong thing to say to Eddie And he said, I'm not gonna buy you a drink She went off in a huff And we figured she was just one of those Stuck-up high-maintenance girls Who had been catered to all their life

[24:57] Because of her beauty Then, suddenly as the bar was closing She appeared in front of Eddie And apologized We figured no guy had ever talked to her like that before It figured since being a local celebrity She'd always been surrounded by ass-kissers Well, to make a long story short She'd never gone out with a gringo before How could she? Gringos are rare in Salvador Turns out she was certainly used to Unimaginative Latin macho pickup lines And Eddie was not a BS-er And not one to lay on the syrupy stuff Which intrigued her Now, as for Eddie He told me on their very first date He told her he didn't think they had much hope Of making it a lasting thing He said in a nice way He didn't want to get involved with a high-maintenance glamour girl But as he soon found out She chipped in her modeling job money To help out the family

[25:42] Her mom and two younger sisters So, although she looked and dressed And sometimes acted like she was high-maintenance She was taking money from no one By the way, high-maintenance Latina style Is a lot different than high-maintenance gringo style She and her mom were holding down the fort And supporting the family Since daddy had abandoned them a long time ago Now, if you remember In the last show, an email got us started on The life and loves of expat Eddie And the emailer said, rightly so That he didn't think expat Eddie would tolerate An air-headed Kardashian-esque bimbo Who was only interested in fashion Photo shoots and discos Well, he got that right Except the very first time She invited him to her house to meet the family Which was a very positive and serious sign on her part By the way, they never met a gringo either

[26:28] Anyway, when she showed him Around her little middle-class house And her room In the corner, she had a drafting table A propane torch A soldering iron And a shelf full of various art supplies And on the floor were a half a dozen or so Very nice stained and leaded glass windows Turns out, she had talent and depth after all However, like she told Eddie She'd been in a number of little art shows And sold a few pieces But she could never make a living at it Her dream was to someday Have an art supply shop and gallery So she did have talent And besides that She'd drawn some very nice charcoal portraits of her family And the family dog Come on, why do women always have pictures of their dogs? Needless to say, Eddie was impressed She wasn't just an extremely pretty face

[27:13] He was also quite impressed by The stack of art books she had on the shelf Some were in English Even though she didn't speak English Alright, we're getting towards the end of the show now But there's more to the story The part where it gets kind of dark and tense And intense So we'll pick up where we left off on the next show So stay tuned By going to the expatfinals.com slash academy Los Famos!