#913 – The Expat Files: Medical Costs, Job Markets, and Real Estate Warnings

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 I wonder Hello there all you ex-pat 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 All right time to plug away at some of these emails. They're really stacking up. In fact, I just eliminated 10,000 emails that I've accumulated over the past two or three months and you know Eventually, I do read them all and I do answer some of them personally and some of them right on the air

[00:47] So don't quit sending them because they don't just end up in the ether Someone actually reads them yours truly like for example, here's one That's certainly of general interest everyone. He says Johnny. I have listened to the podcast for a few years now I alternate listening to both new and old episodes and hopefully we'll meet in the middle soon My question and comment is I hear a lot about Cosmetic surgeries in regards to both the quality and affordability aspects when compared to the US. I Was wondering how I could go about finding actual current pricing for certain procedures and any recommendations for the best country and or clinic to contact And Johnny, thanks for your time and effort in relaying quality informative information that actually betters people's lives Thanks for everything Sean. All right, Sean. Thanks for that

[01:35] But wait just a second. Are you accusing me of being a do-gooder? Are you perhaps saying I'm doing all this because I get helpers high you remember what that is, right? It's that so-called do-gooders high that I make fun of all the time, but don't get me wrong I'm not making fun of the help that they give to people. I'm making fun of them Because so often you see that when they come down to a third-world country go out into the boonies and build solar outhouses for Jesus Many times in the end after the do-gooders are long gone a lot of those outhouses never get used or end up as chicken coops Like for example, I know personally of a guy who put together a team of people to hand out Thousands of free five gallon bucket water purifiers with little ceramic element in them Well a year later when they came back to revisit some of the families they handed those things out to they found a good

[02:24] percentage of them were filled with dirt and being used as flower pots and Isn't it funny after that failure when the do-gooders got together to try to figure out a solution? For their next round of good deeds They decided to charge just a little bit of money for each little purifier and guess what when the do-gooders came back around a Year later to check on everyone. Well nearly all the units were still in use as water purifiers Surprise surprise, so what's that tell you? Well a lot of things. Are you listening Bernie Sanders and miss occasional cortex? Because one of the really stark and obvious things it shows us is that people don't put much value in things they get for free But when they've got a little skin in the game, it's a completely different story, huh? It's the simplest little example of why socialism does not work in practice only in principle and theoretically speaking

[03:15] So then why do so many supposedly intelligent people fall for it easy because it's all centered around that magic word free Which always reminds me of those two favorite phrases. Nothing is for nothing and you get what you pay for But then again when you think about it, how much did you pay for this show? Nothing, right? But I digress anyway as to Sean's questions about cosmetic surgeries, etc He asks about the quality and affordability aspects compared to the United States. Well Sean is like this There's a general rule of thumb you can follow for pretty much any kind of medical procedure You have done here in Latin America be it cosmetic surgery dentistry Whatever turns out if you're well off the gringo tourist trail

[04:00] And there are lots and lots of small medium and large cities well off the gringo tourist trail that have absolutely first world private hospitals And clinics note I said private and many many of the doctors and specialists are trained in the first world You can see that by looking at their diplomas on the walls In fact, most of them just love to brag about that It's a huge feather in their cap if they did specialty work outside of their own Latin countries Because as it turns out only the top docs in their class have that privilege because they're the only ones that are accepted to foreign medical school graduate programs anyway, Sean The rule of thumb is when you're off the gringo tourist trail That is medical and dental procedures are anywhere from 15 to 30 percent the cost of what they are up in the states about one-fourth

[04:45] to one-six the cost Here's an example. I've got dentists in my family up in the states and the other day I was talking to my sister who's a cosmetic dentistry specialist. She has one of those very expensive CEREC machines that's C-E-R-E-C CEREC computerized porcelain ceramic milling machine in her office and she can turn out a beautiful 100% ceramic crown in about an hour right in the office that way if you need a crown you don't need a temporary You don't have to come back. It's completely done at one appointment. Now. She tells me the newest machines 125,000 bucks and believe me the look of pure ceramic teeth is Absolutely natural because there's no metal behind them like there is with a traditional crown and she says they last from 10 to

[05:30] 30 years depending on how you take care of them and when they're done, right? No one I mean no one but the dentist new knows that they're an actual crown. They look so good Why because they're naturally translucent just like real tooth enamel because they're 100% pieces of ceramic No metal at all. So anyway up in the Chicagoland area. She charges something like $2,000 per tooth that is per crown Meanwhile back in Central America about three weeks ago I was helping a fellow green gringo expat out a guy who spoke almost no Spanish and has some pretty snaggly looking teeth He's looking at somewhere around six crowns or a combination of crowns and veneers You know what? They are Ceramic facings for teeth that are in pretty good shape that give you a much better look

[06:18] Basically when you get veneers done and it's pure 100% cosmetic dentistry and in the states They cost about half as much as crowns around a grand Anyway, that's Iraq computerized milling machine also produces ceramic veneers that if done Right are absolutely indistinguishable from real perfect teeth In other words only you and your dentist know for sure so as luck would have it for him Anyway, I took this snaggle tooth gringo to a dentist here in Latin America who has one of those machines now I have to know that most dentists in Latin America could never afford a machine like that But when you're in a medium or large size Latin City There are gonna be some dentists who have them and they'll advertise as such all you have to do is go on olx.com You'll find that any dentist who's got access to a machine like that

[07:03] Will advertise it right up front in your face and some dentists have pulled their money and they have kind of a co-op and share Such a machine unlike my sister who shelled out the hundred twenty five grand down here There may be five even ten Latino dentists who've pulled their dough and set up a lab So they all have access that way they all can get first-world cutting-edge results The difference is my sister charges two grand for one of these pure 100% ceramic teeth and the dentist whose office I walked into with my snaggle tooth friend charges 300 bucks a tooth and so you wonder how is that possible the very same machine the very same technology Two grand in the States 300 here in Latin America. How can that be? Especially since here in Latin America right out in the parking lot. I noticed the dentist's car

[07:50] He had a brand new BMW station wagon Oh, and I also noticed there wasn't a single middle or lower middle class Latin patient in the office either They all seem to be upper middle class Latinos with nice cars and why might that be what's because you can go to a regular Dennis down here and get a regular crown the old style with the metal backing which will protect your tooth But doesn't have that beautiful appearance looks more like a piece of chalk if you know what I mean and the standard cost for one Of those around 150 to 200 bucks versus 300 bucks for the top quality pure porcelain crown made with one of those cutting-edge Computerized milling machines, but still two grand versus 300. How can that be? Well, here's the breakdown Now get this and it's something most people will never know besides that expensive machine

[08:38] What do you think it costs the dentist to make one of those crowns? This will shock you but my sister tells me it's cost $75 to make each tooth because that's the cost of a little ceramic block they start with you have to buy it from the manufacturer So if you got that machine you keep the little blocks on hand and there's 75 bucks apiece. That's it So how does the machine make that thing? Well, it gets a computer scan that the dentist makes of your prepared tooth and the other teeth in your mouth to make a match So the cost of the dentist is obviously the cost of the machine and in the $75 Tiny ceramic block that's precision milk. So the margin or markup for the Latin dentists is 225 bucks 300 bucks for the crown minus 75 bucks for the little ceramic black and for the US dentist the margin is

[09:23] 1,925 bucks seems like here we're not even talking about apples and apples But we are and the reason why a Latino dentist can charge so little Something like a sixth of the cost of having it done in the States is because his rent is $600 a month and my sister's rent is 10,000. Yeah, that's right. And it flipped me out when she told me that 10,000 bucks a month and because the Latino dentist does not have Malpractice insurance because it's just not needed That's another game-changer because my sister pays 40 grand a year for hers and my sister pays 40 grand a year for hers Oh and Latino dentists don't have any school loans because they don't exist and my sister walked out of dental school with around a hundred grand in debt Another important cost factor is that Latino dentists do not have hygienists. They don't exist down here

[10:15] Instead they either clean teeth themselves or hire another dentist right out of dental school for five to six hundred bucks a month Yep, you heard me right five or six hundred bucks a month In fact, that's how almost all new dentists here in Latin America get started Working as a hygienist so to speak for an established dentist Then there's the US where almost all dentists have hygienists and my sister pays hers 70 grand a year So when you add all that up and do the numbers a Latino dentist with that high-tech machine takes home about as much dough when he Does a $300 ceramic crown as an American dentist charging two grand So in the end my snaggle-tooth buddy who was quoted $12,000 by a US dentist to have his teeth all fixed had it all done here in Latin America in a week's time

[11:00] For slightly under two grand about a fifth to a sixth as much as a US dentist would charge him So then a very good question to ask is how do you find a first-rate medical doctor or dentist one that keeps up with the technology? Takes continuing education courses is cutting-edge and has all the right equipment Well, there are lots of ways to investigate that and find out for yourself Even if you don't speak Spanish normally, it will take a lot of time and boots on the ground However, there is a way a fast-track way of figuring it all out how to find the right doctors hospitals clinics, etc And of course at non gringo prices Because you know when you're on the gringo tourist trail You can get really high quality medical and dental care, too But it's very unlikely you'll get it for a fifth or a sixth off the US prices

[11:46] Oh, it'll be a lot less expensive for sure Maybe half to a third of stateside prices But the fact is you don't have to settle for a third to a half off though for some people that might be Just fine, but I can tell you this you'll truly kick yourself if one day you're off the gringo tourist trail And you see you could have got that dental work tummy tuck or facelift for thousands less than what you paid in Costa Rica Or one of those little clinics in Mexico slightly south of the Texas border Though again getting a big expensive procedure done for half off might sound like a great deal to you But to me it doesn't make sense and it shows you really haven't done your homework and the best way to do your homework Well, you longtime listeners probably already know I've written a hundred page Latin American health care report Which outlines everything you need to know if you're thinking about medical tourism here in Latin America

[12:35] And you want to save a ton of money and I can tell you this No one else has ever written a report quite like this And if you want to copy just go to www dot the expat files calm and click on Johnny's health care report All right enough said about that. Here's another email in the title box. It says my employment search And this is from Taylor. She says hello I'm a teacher who has a job offer at an international school in Mexico for the coming academic year, August 2020 I was wondering if you had any advice for my husband's employment search in our potential new country of residence Given the fact that we won't be in our new location for another eight months It's challenging to find opportunities in his field of work Where an employer would agree to such a delayed start date of eight months in the future

[13:22] My work visa will only cover my relocation and such He needs to secure his own visa independently before we can commit to the expat life So Johnny any insight recommendations or thoughts would be greatly appreciated signed Taylor All right, Taylor. There's a lot of places we can go with this. It's just too bad. We're going to Mexico more on that later All right. First of all, let me ask you this question Does your husband speak Spanish and if so on a one to ten, what is it? Because you see employment in a foreign Latin country, especially in a professional job Depends a hell of a lot on how well you can speak Spanish and write Spanish because actually as it turns out No matter how fantastic your qualifications are big companies here in Latin America that higher professionals are looking for bilingual people

[14:10] I mean fully bilingual people not bilingual like me I mean I can speak Spanish, but I write like a fourth grader But then again, I'm not looking for a job Now as far as your upcoming job as an international school teacher in Mexico Normally, it makes no difference at all whether you can speak even 10 words of Spanish because international schools are those high priced What I call helicopter schools catering to the entitled children of the wealthy and of course the entitled children of thieving political scumbags Now you see their parents pay a high buck to have their kids taught by actual first world teachers like you and of course Most of the time practically 100% of the time you'll be teaching your classes in English. That's what they want It's one of the best examples of the gringo advantage. I can think of

[14:55] That all the wealthy and stuck up latin rich people want their kids to be taught by real gringos So when you get a job as a teacher here in latin America You don't necessarily need to know any Spanish at all But for your husband, man, if he's not an eight or nine right now in Spanish, he better start cracking So the fact is anyone that's a professional up in the states Other than a teacher who's looking for a job here in latin America in their chosen field Will have two big obstacles during that job search. Number one. You have to know your Spanish Well, in fact employers will often make you take an international spanish language aptitude test And the diploma you get when you pass the spanish has a foreign language called de le And the international spanish language evaluation service Si e le are two of the test services that big latin company employers will use

[15:46] Now as far as being a professional gringo up in the states job hunting For a job in your chosen career in latin America Here are two of the best ways to go about that hunt number one check out Olx.com.mx in the case of mexico. Remember olx.com is the universal craigslist throughout latin america To pinpoint the country where you're going to focus your search Just go to your search engine. I hate google. You know, so I use duck duck go start page.com You put in olx.com Dot whatever the country's initials are. For example, if it's guadamalets olx.com. GT if it's mexico It's olx.com.mx You get the idea and once there you'll see it's just like craigslist They sell everything and anything and there are job offers that number more than you can imagine

[16:33] However, again olx.com is in spanish But you'll find in time if you hang out on that site and check things out Your spanish will improve day by day and olx.com is not the only place where there are posted thousands of jobs You should also have a look at a site called www.locanto.com.mx. That's locanto locanto.com.mx the mx part being mexico, of course It's a site that specializes in job announcements job searches and classified ads right now They say there's more than 10 000 jobs posted there Ranging from maids gardeners and ditch diggers all the way up to medical doctors surgeons and ceos But again, everything is in spanish there However, one of the best ways to find a job, especially if you've pinpointed a town or a city that you for sure want to live in

[17:24] Just go online and check out one or two of the largest newspapers in that country And generally, I don't know why this is the case monday has the biggest job classification section So for example right now i'm looking at guatemales pretzelibre. That's the biggest newspaper in guatemala and on monday I'm noticing here. They have at least 150 Management or middle management job offers in the corporate sector So there is a big demand for corporate professionals and with some of them believe it or not the wordings in english Which of course means you're looking for a 100 bilingual person to fill that slot These are self-selecting ads. Otherwise, they wouldn't be in english And the thing is, you know, if you interview with a company and they select you They'll make sure you get your work visa. You won't have to worry about it yourself In fact, if you're a newcomer to the country, that's the only way you're going to get a work visa

[18:11] Even though you see lots of gringos and expats in a country like mexico working various jobs usually on the tourist trail bartending Working restaurant jobs and front desk jobs at hotels But you see those are very low-end jobs off the books for cash and tips The fact is almost all those gringos and gringas are backpackers on an extended vacation Almost all of them fell in love with the country and didn't have enough money to stay on unless they picked up a job somewhere And thus they pick up a bartending job It's crap money, of course But enough to continue with the backpacker low-budget style of living which is fine If you're young and out for adventure and don't mind living in hostels That is watching someone else's hairballs bounce around in the drain while you brush your teeth or take a shower

[18:56] But you know that kind of lifestyle was never for me. I've got different standards Like having a private room with a bath Anyway, taylor says in her email She won't be starting her job in mexico for around eight months and she says that would be challenging for any employer To hire someone her husband for instance with a timeline that far out Well, that's true, but I think your husband better start looking now It certainly won't hurt Oh and one last thing if you're a professional up in the states coming down to latin america working for a company And not being your own boss. Don't ever expect to make first world money. For example, i'm looking at the job classifieds right now In the prince of libra. That's the big guadamala newspaper and they've got a cpa job opening The ads in english show they want a bilingual guy and the starting salary 35 g's a year now you should know that's really big money here in latin america in the states

[19:46] It's the edge of poverty but down here man 35 g's a year is pretty much unobtainable By 90 percent of the population and I know you long-time listeners have heard me talk about the salaries for medical doctors and dentists here In latin america the fact is you could hire a fresh green doctor right out of medical school To be your personal doctor. No one else's that means he works exclusively for you for something like 10 000 bucks a year. I know it sounds ridiculous, right? But it's true. In fact, I know a young lady who's in middle management at a big costco She has loads of responsibility and makes around 21 000 bucks a year and get this she's got an mba She loves her job and loves the salary too Which again is below the poverty line if she were up in the states

[20:31] So think about it She with her mba's making around 1600 a month and the average costco grunt worker on the floor She told me to make slightly over 400 bucks a month, which is why she's happy to make 1600 a month Four times the salary of the average stock boy or cashier So the point is taylor whatever your husband's making up in the states right now He'd be extremely lucky to make half that much doing exactly the same job for a corporation here in latin america I mean after all why do corporations relocate to latin america? Because they can pay those crap salaries But then again, you got to remember the cost of living is so low here in latin america At least if you're off the gringo tourist trail 35 g's a year is a fortune to the average latino Well taylor enough said about that and thanks for the email and if you're that young lady

[21:19] Who got her master's degree at the university of chicago not so long ago. I think I know you and your family Oh and one last thing Hmm. There's always one last thing after I say one last thing, huh? Well, it's my show so I guess I could do that Anyway taylor i'd be remiss if I didn't tell you going to mexico would not be my first choice at all It's truly a failed state and getting worse Sure, there are little gringoized islands of peace and tranquility But if you listen to last week's show You'll see the narcos are losing market share and getting desperate and now gringos and previously off limits tourists Are fair game for extortion kidnapping etc And though I truly recommend getting the hell out of dodge ever since i've been doing this show I've been saying forget mexico set your sights on south of south of the border

[22:09] Meaning except for a nice vacation package to cancun or another resort skip mexico That means focus on guatemala and every place south of it Oh and taylor as long as you've already committed to doing that english stint in mexico And I guess it's mexico city, right? You didn't say it all might work out just fine and you could fall in love at the place But take my advice my two cents don't buy any land apartment or condo south of mexico Yes, but not in mexico don't want to scare you taylor, but mexico is truly Dup and being that you're new at this and I think I know your family Why don't you shoot me another email and we'll do a little skype consult and i'll set you straight All right. How about this email comes from andrew? He says hey, johnny. Love listening to your podcast

[22:55] Very informative and I find myself nodding in agreement all the time Perhaps unfortunately, I did my plan b and c some 12 years ago and I made a few wrong picks I picked nicaragua and that overpriced isstancia in argentina that doug casey was pushing so hard Talk about two pathetic governments argentina and nicaragua. Why'd I have to pick both? But anyway, johnny Laestancia in argentina is not so overpriced anymore and doug casey is pretty much gone Along with all the folks that came down thinking they were gonna hang with doug all day smoke cigars and pick his brain Well, that didn't happen, but the peso did crash It went from 34 or so to the dollar last march to the current 66 to the buck today

[23:45] That johnny is 100 inflation in less than a year However, that means if you have dollars living expenses are indeed cheap But if you work and make the local argentine peso, you're screwed Everything since last march is twice as expensive But I will say that cafe at argentina is indeed a very special little town with many good restaurants hotels and tourist shops Not many gringo tourists. Thankfully, it's hard to spend more than 10 bucks at the best steak houses I'm talking dollars now including dessert and plenty of great wine Thankfully, we are so far off the buenos iris beaten path that we don't even notice the politics and no one seems to care much around here That said johnny we live most of the year in nicaragua in a development called grand pacifica

[24:31] This is a little struggling gated community, which is nice because not many people are around here with no towns nearby Even the recent unrest had no real effect on us In fact some locals we know were even sent to this area during the contour wars As even then our area was safe because there was nothing here except an incredible oceanfront with few if any surfers It's paradise for a crappy old man surfer that I am We surf trollfish in our little sailboat and share meals with neighbors because there are no restaurants within 45 minutes drive We're way out in the boonies. It's not for everyone. I understand but we love it Anyway johnny, I would love to get your info on the solar stuff you're talking about I know alibaba has many power wall type units too many to choose from i'd like to get your take

[25:21] Also, we have a huge buried propane tank. We fill once per year But our generator has been having issues and i'm considering switching to solar I also have five manzanas outside our little development where I have a well and all kinds of edibles mostly for the locals On our dirt road. I figured with solar our giant propane tank well water and growing many fruits and veggies If the poop really does hit the fan we could last a long time here Then if worse comes to worse we switch to plan c we escape on our sailboat And finally johnny, we would like the information on your stem cell hospitals I've not seen a doctor in over 20 years But would like to fix my bad hip that i've had since my 20s at least to see if a stem cell injection would help Or not. That's it johnny. Keep doing what you're doing signed andy

[26:09] Just one thing andy. You see you live so far in the boonies. You're 45 minutes from the nearest restaurant Well, you're a better man than I am, but you're in the right place to survive anything All right enough of the emails. I want to remind you in about a month. My expat inside seminar kicks off That's a week where we're split between the alti plan of guatemala 5 000 feet above sea level perfect spring weather all year round Meaning no heating or air conditioning bills A huge advantage if you're going solar and then we'll be spending a couple of days in the beachfront hot weather of el Salvador you can still sign up and you can still kill two birds with one stone That is get your guatemalan residency started while you're at the seminar Just go to www.theexpedfiles.com and click on the seminar link and you know people say it's the only way to get a

[26:56] Guaranteed two to five year head start on your plan b Because in reality, it doesn't look like you're gonna have that much time to get that plan b going Fact is i've been hearing some dire predictions for the year 2020 and i'm sure you've been hearing them too So what are you gonna do when the next big calamity comes when the hits the fan? Are you gonna panic call 911 and get a busy signal? Or are you gonna just ease right into that plan b that you've had worked out for some time now? You know having a plan b is an insurance policy The question is when things really go south are you gonna be in plan b mode or panic mode? I wonder You've been listening to the expat files living in latin america If you need some help with your own plan b we can schedule a one-on-one phone or skype consult

[27:41] Just send me an email the expat files at gmail.com And if you want to get on the waiting list for my next week-long expat insider seminar in central america Where you're guaranteed to get a two to five year head start on your plan b. Send me an email the expat files at gmail.com nos vamos