I shouldn’t be smug about this. Being smug tempts fate. But I can’t help it, because I don’t have to sign up for Obamacare! That’s right. Because I am an expat I can completely ignore all the nonsense and overreach of the U.S government as it forces everyone residing in the U.S. to purchase a product even if they don’t want it. As an expat who resides more than 330 days per year outside of the U.S. I am presumed to have “Minimal Essential Coverage” under the ACA so I am not required to purchase health insurance and am not subject to any penalty for not doing so.
So now that I have tempted fate by gloating about this I will worry that the USG overreach will extend further, and in the future they will force people like me who don’t even visit the U.S., and therefore cannot receive medical care in the U.S., to purchase U.S. health insurance anyway. They could very well do that since they already do many things that are completely unreasonable. Perhaps if they do force that on expats they will make some sense of it by requiring insurance benefits to be paid to where we actually use medical services, which is at our local medical facilities outside the U.S. That might be reasonable, although it is likely that the cost of insurance will far exceed any benefit we receive. That’s because I can meet my “Minimal Essential Coverage” by paying out of pocket since I get better health care at a fraction of the cost compared to the U.S. Here’s a good example, my foot surgery at Siriraj Hospital.
After I had that surgery I wondered how much would it cost in the U.S. Questions like that have long been tough to answer due to the sleazy evasiveness of the U.S. medical industry who won’t quote prices and just drop a bomb on you afterwards with outrageous fees. For this post I did some Googling and found something interesting called HealthCareBluebook.com. They list a “fair price” of US$16,398 for foot surgery consisting of $2,074 for physician services, $13,855 for hospital services, and $469 for anesthesia services. Here is the link. Interesting. That is 20 times the price I paid when I had my surgery at Siriraj Hospital in Bangkok by one of the top foot specialists in the country. Let me just say that I am a bit surprised the multiple is that high. I was expecting a multiple of 5 to 10.
Now what would happen if I had to buy insurance under Obamacare? I’m guessing that a single year of premiums would be more than the US$709 I paid for the surgeon + two nights in a private hospital room + anesthesia that I paid for my foot surgery. And of course I would have some deductible, probably at least 10% of the bill which would be at least US$1,600 for that surgery in the U.S. So probably at least, I mean the very least, I would be US$2,500 out of pocket for that procedure if I had U.S. insurance and did it in the U.S. And of course I would not have enjoyed the warm care and hospitality of the Thai medical staff; they are so nice and make you feel so comfortable even in difficult circumstances.
So no thanks America. I will stay right where I am. I just need to keep working on how to protect my hard-earned assets from the next attempted grab by the USG. We all do, no matter who we are or where we are.