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2mexico


Dec 19, 2009, 8:24 AM

Post #1 of 15 (10529 views)

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Proposed US Health Insurance Mandate

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It is looking like "The Quality, Affordable Health Care for All Americans Act" HR3590 that is making its way through Congress here will mandate private heath insurance coverage (a penalty will be assessed otherwise). While this will probably not take effect for several years, I wonder if anyone has any insight or thoughts about how this will work with expats living full time in Mexico (where presumably such coverage would be of little value).

Probably not a good idea to get into the merits of the bill or process here - plenty of discussion already available elsewhere on that! Just the practical effect and impact if this comes to pass.



Sunnyvmx


Dec 20, 2009, 3:29 AM

Post #2 of 15 (10441 views)

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Re: [2mexico] Proposed US Health Insurance Mandate

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I have been thinking about it for a long time now. I will be filing my income taxes separately from my husband so that I show my only income is my social security payments. Therefore, I will be too poor for health insurance and probably elligible for a subsidy. My husbands health insurance is paid for by his retirement from AT&T.

I hope this works.


autumndream

Dec 20, 2009, 7:34 AM

Post #3 of 15 (10406 views)

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Re: [Sunny1] Proposed US Health Insurance Mandate

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I looked on the internet for the bill. Expats seem to be exempt:

(4) INDIVIDUALS RESIDING OUTSIDE UNITED STATES OR RESIDENTS OF TERRITORIES- Any applicable individual shall be treated as having minimum essential coverage for any month--
        `(A) if such month occurs during any period described in subparagraph (A) or (B) of section 911(d)(1) which is applicable to the individual, or
        `(B) if such individual is a bona fide resident of any possession of the United States (as determined under section 937(a)) for such month.

http://thomas.loc.gov/cgi-bin/query/F?c111:4:./temp/~c111vxH53s:e396126:


Ivester


Dec 20, 2009, 7:55 AM

Post #4 of 15 (10396 views)

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Re: [autumndream] Proposed US Health Insurance Mandate

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The passage of this "reform" bill--actually an enormous bailout of US insurance companies--could trigger an even bigger wave of US expats flooding into MX. I'm certainly not looking forward to a mandate that would force me--under penalty of a fine--to buy unaffordable, worthless private insurance.


Gringal

Dec 20, 2009, 8:17 AM

Post #5 of 15 (10383 views)

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Re: [Ivester] Proposed US Health Insurance Mandate

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It all started well-intentioned enough..........but for the end result, I'm sorry to say it's: FOLLOW THE MONEY.
Sad.
"It's a good time to be living in Mexico".

As for the mad potential rush of folks for Mexican medical care...it's not going to happen. Most people, upon discovering what the IMSS system is like: the good, the bad and the rest, will not want to partake in it. Granted, the rest of the medical system here is less costly than the U.S., but there is much more to becoming an expat than the health care issue. I'm certainly glad to have the medical care I've been getting here and haven't had to use the IMSS system as yet, but I wouldn't move to any foreign country for that reason alone.


2mexico


Dec 20, 2009, 9:02 AM

Post #6 of 15 (10369 views)

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Re: [autumndream] Proposed US Health Insurance Mandate

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Thanks for pointing this out Autumn - I can't find anywhere else in the bill the Section 911(d)(1)A or B referenced, but the part you found suggests that there is an exemption. In any event, it looks like the mandate doesn't take effect until 2013.


(This post was edited by 2mexico on Dec 20, 2009, 9:12 AM)


2mexico


Dec 20, 2009, 9:10 AM

Post #7 of 15 (10365 views)

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Re: [Gringal] Proposed US Health Insurance Mandate

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Good points Gringal. Have you enrolled in IMSS then? I often hear of folks signing up for it, but paying out of pocket for routine care through private practitioners - reserving IMSS for 'worst case' situations.

When I mention my consideration of residency in Mexico, people often ask if I have concerns about health care. I have to laugh as I tell them this is one of the big factors favoring Mexican retirement.


Gringal

Dec 20, 2009, 9:17 AM

Post #8 of 15 (10359 views)

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Re: [2mexico] Proposed US Health Insurance Mandate

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Yes, our family doc suggested we sign up for IMSS to cover "'worst case scenario", so we did. Otherwise, we have paid out of pocket for the routine care and drugs we get here.


Jerry@Ajijic

Dec 20, 2009, 12:23 PM

Post #9 of 15 (10324 views)

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Re: [Gringal] Proposed US Health Insurance Mandate

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Two points. One, I understand that you must have insurance but we have Medicare and that should qualify.

Second, Even though we have Medicare and could return to the USA for treatment we still have IMSS. It is cheap and possibly very handy. A while back I passed out with a seriously bleeding ulcer. I got taken to the IMSS emergency room. They pumped 4 pints of blood in me and stopped the bleeding. I never would have made it back to NOB & Medicare.


Gringal

Dec 20, 2009, 12:56 PM

Post #10 of 15 (10315 views)

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Re: [Jerry@Ajijic] Proposed US Health Insurance Mandate

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Excellent point. I've heard so many expats say they'll go to the U.S. if anything serious comes up. What you described is the classic reason for having emergency care right where you actually live. Except in the case of diseases like cancer where there could be opportunity to go NOB for treatment, so many of the serious conditions need action immediatly.

For those expats who have truly cut their ties to the states; who don't have relatives whose homes and addresses can be used; who don't have a doctor any longer who takes Medicare patients....just what are they going to do if faced with a serious illness? Go rent a room and start hunting for a doctor when they are already sick? Sounds like a logistical nightmare. Meanwhile, I have a doctor who lives in the same town as I do, who knows my medical history and who even makes house calls. This feels good enough. Besides, I don't get abandoned in a cold office waiting room wearing a paper excuse for modesty while waiting endlessly for a fast five minutes with the doc. Anyone else remember those moments in U.S. medical care? Betcha you do.


2mexico


Dec 22, 2009, 8:49 AM

Post #11 of 15 (10199 views)

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Re: [Gringal] Proposed US Health Insurance Mandate

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I certainly do identify with that 'fast five minutes' observation. I recall during an HMO doctor visit for an annual checkup, I was asking the doctor a few questions when they finally arrived after I had been 'processed' and sat waiting for a while in the exam room. She frowned, looked impatiently at her watch, and curtly told me I would need to schedule another appointment if I wanted to venture beyond her minutes-long checkup routine.

There is a commonly mentioned amount now that retirees should anticipate spending out-of-pocket in the U.S. for medical care if they live to their nominal life expectancy - $240,000 with Medicare (http://www.ncpa.org/pub/ba660). Given the fact that the average 50-year old in the U.S. is reported to have about $50,000 in retirement savings to augment Social Security and Medicare, Mexico will have to appeal to many, despite the real challenges that you previously pointed out Gringal. It's not just a matter of accessible, affordable, quality care for routine health concerns - it is one of few options I can see that offers a decent quality of life and standard of living for many given the resources available.


Vince3n


Dec 22, 2009, 3:26 PM

Post #12 of 15 (10148 views)

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Re: [2mexico] Proposed US Health Insurance Mandate

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There is nothing to worry about the U.S. Health Care Reform.
When and if the bill passes the House on the way to the Presidentís desk, it will be a water down version of the originally intend it reform. What a shameÖ
Pharmaceuticals and Insurance company lobbyist are spending an unprecedented amount of money to ensure that the health business will continue to be as profitable as ever. This amount goes into the billions now. At the same time, they managed to lower the Presidentís popularity ratings to the lowest of his administration.
A compassionate country cannot play politics with the health and well being of millions of our fellow citizens. Some are left to die in hospitalís emergency room halls. Also, pregnant women should not wait for the paramedics to finish their lunch before they help her to labor. Yesterday, in NYC they let a woman and her baby die before they assisted her, their lunch came first. Something is terribly wrong with this picture, donít you think so? When enough is enough?.
Why do we have to search for health care in other countries? Why do not we concentrate these efforts in changing what we must in our own land? IMO, Health Care should not be a privilege of a few but a right for all.
Should an influx of NOB patients into IMSS occurs, the institution may not be able to sustain additional cost and government bailouts can be halted. The streamline in services have already began while their fees increased .
In the long haul, IMSS is not the answer for the NOB health care issues but, I could be wrong as I have in the past.


Judy in Ags


Dec 22, 2009, 3:50 PM

Post #13 of 15 (10134 views)

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Re: [Jerry@Ajijic] Proposed US Health Insurance Mandate

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Hey, Jerry, I've been there with that bleeding ulcer bit. You're right--no time for a trip to the U.S. My husband drove me to the hospital (at a high speed) and we had a police escort.


frosti

Dec 22, 2009, 7:01 PM

Post #14 of 15 (10093 views)

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Re: [2mexico] Proposed US Health Insurance Mandate

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Living here in the hills of Tennessee I watch the billy goats to tell me what the weather is going to be like everyday. I listen to the Donkeys and the Elephants to tell me how my health care is going to be decided everyday. The Donkeys and Elephants keep secrets while Medicare runs out of money. They take the carrots from their moneychangers who control them until there is no more Medicare. We are then forced to buy insurance from the moneychangers or pay a fine to the master. Can we run from the master and live in Mexico. I hope so.


MazDee

Dec 22, 2009, 8:19 PM

Post #15 of 15 (10064 views)

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Re: [frosti] Proposed US Health Insurance Mandate

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Frosti, You won't like the Mexican system either. I can tell ;) You be betta off staying where you are.
 
 
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