Another reason for Chiang Mai

The earlier post in which I discussed 5 good and cheap places to retire had Chiang Mai listed at number two. Reading this post on Chiang Mai for long stay medical tourism raises another interesting plus about the city. It could be a very good choice for someone who needs a long stay medical treatment destination. I am aware of those two hospitals that are mentioned, Chiangmai Ram and Lanna, and they seem to be very good. The story had something else besides the usual private hospital as health care destination. It was a specialty treatment center in Chiang Mai for Alzheimer patients.

Now that sounds quite interesting if have a loved one in need of the special care Alzheimer patients need. Chiang Mai is very popular with foreigners, both tourists and expats. Lots of amenities there. It seems to me that specialty care centers could be big business in Thailand and Chiang Mai may have a leg up on it because of the infrastructure and environment in that region, although the Thais are seriously trying to ruin it with the rampant burning each year that causes pollution so bad the airport gets shut down. Unless they clean it up the area may become another trash dump like so many other places in Thailand that started out so nice.

I was thinking that the Khao Yai area would be another hot spot for such specialty centers to develop. It has much of the same mountain weather and environment that makes Chiang Mai attractive but has the advantage of being only a two hour drive from Bangkok, making for easier access to many major services that only Bangkok has. The problem in Khao Yai is the lack of top shelf private hospitals. Chiang Mai has two of them and Khao Yai/Pak Chong has none. Even if Bangkok Hospital Group does build a new facility next year in Pak Chong there are real doubts about the quality of care to be had there (re my earlier post about overpriced fluff versus true quality care). A world class hospital would be the anchor and then specialty care centers could develop in the surrounding area. Maybe it is possible without the hospital anchor.

5 good and cheap places to retire

I saw a little article on MSN titled “Retire overseas on $1,200 a month”. I always like to read this type of article mostly to see what is used as criteria for deciding a location is a good place to retire. This piece was mostly about decent places to live that would be affordable if you are receiving a monthly $1200 check from social security.

Chiang Mai was the second city on the author’s list. As she said, it’s a city that has been discovered by thousands of expats. Whether that makes it a good choice is a matter of opinion (I don’t like it) but if you want lots of services tailored to expats (read overpriced) then you might go for it.

In small fluff pieces like this you can’t expect a lot of detail so I won’t pick on it much for overlooking the awful truth about Chiang Mai air quality, which is that dry season burning by villagers and farmers results in a choking haze of smoke trapped in the valley where Chiang Mai is located. During those months the air quality is worse than the much larger and more polluted Bangkok.

But the author should get the basic facts straight. Chiang Mai is not the second largest city in Thailand as she says, at least not by population. It is around number 5 or number 7, depending on which year population estimate you use. Even if you discount the cities close to Bangkok as really just Bangkok suburbs you still have Udon Thani, Chonburi and Korat well ahead of Chiang Mai in size.

I thought Penang, Malaysia was an interesting choice. Urban Malaysia is definitely ahead of Thailand when it comes to technology and infrastructure. But mentioning Malaysia as a medical tourism destination without mentioning Thailand which is far and away the leader in this part of the world is a rather glaring oversight. The author says that Malaysia is also determined to become a “first world” country by 2020. That wouldn’t be good news for retirees since that means costs will rise to first world levels as well.

Retire overseas on $1,200 a month

“What do you do with all your time?”

That’s one of the questions friends ask me since I have been retired. The answer is “Whatever I want, whenever I want, and wherever I want”.

The question sort of goes to the same root problem as a lot of others, and comments like “I would be bored if I retired so I just keep working”. You need to know for yourself the purpose of work, and have a broader understanding of work itself. If you are not self-directed and need to be bossed around…maybe you need to work on that first before considering quitting your job regardless of whether or not you have hit your number.

Healthcare costs: looming obstacle to retirement

A friend recently updated me on her progress toward early retirement. She’s got just about everything in place for her and her husband to retire and move to a nice piece of land in New Mexico. One obstacle is looming – the cost of health insurance. She has a medical condition that requires expensive medications. She has investigated all the angles to reduce her out of pocket costs. She’s particularly angered at how much cheaper the medications are from Canada, yet insurance companies will cover none of it when purchased from those sources. Her present and forecasted health insurance costs are substantial. It’s the one thing holding her back from retiring now and enjoying life on her ranch.

Next to housing the cost of healthcare and insurance is probably the biggest obstacle to retiring early. As we get older we become more aware of the need for access to quality medical care and its costs. This is one of the factors that makes expat retirement particularly appealing. I retired to Thailand, one of the premier medical tourism destinations. Healthcare here is world class, a fraction of the cost in the U.S., and delivered with warmth and hospitality. It is no exaggeration to say that a trip to the hospital can almost be a pleasant experience here (almost, it is still a trip to the hospital). The fact is that the full cost of many procedures here is less than the deductible alone back in the U.S. That is why literally hundreds of thousands of foreigners per year travel here for heart surgery, cancer treatment, joint replacement, dental work, even face lifts.

This changes the formula a lot when considering retirement. The one item that is not substantially cheaper here is medicine available only from western phamaceutical companies. If a local copy of the drug is not available you pay western prices.

Because costs are so low it makes little sense to carry insurance, just pay out of pocket. However, for those needing the perceived security blanket of insurance it is available, both locally and also from western carriers. In fact, some U.S. insurance companies have begun to add Thai hospitals to their preferred provider lists.

There is a good selection of articles on specific medical centers and costs at Thailand medical centers here.

Some other expat retirement destinations also boast high quality medical facilities, although Thailand is by far the leader in the whole medical tourism business. So it is worth considering expat retirement for the healthcare advantage. You might hit your number a lot sooner.

Expat retirement and the Bush dollar

Where you decide to live has a big impact on your cost of living during retirement (obviously). Choosing to live somewhere that is inexpensive yet provides all the things you want in retirement enables you to hit the magic number sooner. Since you don’t have to work you aren’t tied to any specific location so you can live anywhere. For many, including myself, that choice is in another country.

I’m from the U.S. I traveled quite a bit when I was younger to a lot of places that were, as they say, a nice place to visit but I wouldn’t want to live there. By the time I discovered Thailand I had already reached the magic number and then some. It’s just that I didn’t know it yet. But when I got around to running the numbers I realized I was well over the magic number of 25. I could quit my job anytime.

There is a little thing called foreign exchange rates that can play a big part in your retirement plans if you are considering expat retirement. When I retired the U.S. dollar bought about 42 to 45 Thai baht. I kept most of my money in the U.S., transfering money as needed to Thailand. Then we saw the war on terror expand, U.S. debt balloon, and the dollar weaken. In the short span of a couple of months in early 2006 the dollar fell from over 41 to under 38. That’s about a 10% hit to my retirement nest egg in a matter of a couple of months. Fortunately I was well over the magic number of 25 so no worries. But many retired expats in European countries were hurt much worse by the weakening dollar. Some of them lamented on expat forums about 30% hits to their fixed incomes that were forcing them to make drastic changes in their retirement.

So, if you are considering expat retirement you need to remember that currency fluctuations can be sudden and have a big impact. Making plans to mitigate that is important.

Notes on how to retire early

While I’m waiting for Blogger and Blogspot to come back up I thought I would get started on writing up some notes on retiring early. I’ve been planning to do it for a while but have been so busy being retired I never go to it. So here is the first installment.

You’re ready to retire when you have:

Step 1: Saved $1 million in liquid assets.

Step 2: Become completely debt free.

Think I’m kidding? Think it’s impossible? Think that’s not enough?

Ok, $1 million might not be your magic number. If you do a little searching on the internet you might eventually find some articles on early retirement that mention 25 as the magic number. That is, 25 times your annual expenses in retirement. Once you have that banked you can retire pretty much worry free. The idea is that you can put that money into ultra-conservative low interest bonds and insured savings accounts which have historically over a long period of time paid around 4% interest. That’s lousy, but you don’t care, because your capital will never be lost and the interest income is 100% of your annual expenses in retirement. You can live indefinitely on it, never having to work again, and never running out of money.

So we can simplify steps 1 and 2 into a single step 1. You are ready to retire when you have:

Step 1: Saved 25 times your annual expenses in retirement.

Of course, the devil is in the details, like how to make enough money to bank 25X your forecasted expenses in retirement while meeting your current expenses. And then how to figure out what those forecasted expenses will be. Those are all mostly mundane details. I plan to discuss some of them. But most people will tune out because it is all about self-management, much like dieting.
There are some other issues, however, that are perhaps not so mundane and maybe unexpected that one should keep in mind. And some of them are step zero questions for yourself, like what is the purpose of work, and do you really want to retire. I’ll discuss those as well in future posts.

Ah, it looks like whatever trouble Blogger and Blogspot were experiencing has been resolved. So I’ll go back to finishing up a post on one of the blogs in my vast empire of blogs and websites.