Panama City, Panama

At the heart of Central America, which ties together North and South America and the Pacific and Atlantic Oceans is a small, quirky country being hailed as the next “Singapore of Central America” – Panama.

Panama is the fastest growing economy in 2013 for Latin America

This that has many experts comparing it to Singapore, another rag-to-riches success story.

But Panama isn’t booming just because of lucky geography, it’s booming because of smart free-market, investment-friendly policies which have sharpened its advantages:

• Panama’s currency is the U.S. dollar. This makes investing in the country easy.
• Banking and communication services are world class.
• Panama launched a five-year, $13.6 billion investment plan, focusing on schools, hospitals, sewerage, roads, and metro transit system.
• Panama’s import tariffs are among the lowest in Latin America. Also, the country has received foreign direct investment worth nearly 9% of GDP.
• Panama is a well-regarded tax haven and its banks offer a high degree of privacy.
• There is no tax on interest earned from bank accounts for locals or foreigners. There are no corporate or personal taxes on offshore activity. Residents pay no local taxes on their foreign-earned income.
• The result: an economy that’s grown at an 8% or more clip over the past five years.
  

  Bocas del Toro, Panama

  Booming Expat Paradise

  Panama earned the number 2 spot on Forbes’ The 10 Best Countries to Retire to in 2013 who say:

  “Panama is just plain easy, Panama City is a vibrant, cosmopolitan city with great restaurants, and excellent hospitals. It’s a banking and commercial hub so you find a real international community there. Panama is committed to attracting foreign retirees and offers the world’s best incentive program to do so, making it convenient and easy to get residence there.”

  Things will cost you significantly less in Panama than what you’d expect back home. “A budget of $1,700 to $2,500 a month, housing included, would see you eating out, perhaps with a housekeeper a couple days a week, movies a few times a month, and so on.”

  Panama Canal and Ports

  A construction boom is also changing the landscape of Panama City. Office towers go up as fast as men can build them, including the Trump Ocean Club and Latin America’s first Waldorf Astoria hotel. But let’s not forget the work being done to double the capacity of the Panama Canal.

  The Canal’s annual revenues have grown to over $2 billion (7.5% of GDP). Traffic and revenue were up about 25% in 2011. This produced a ripple of growth in many related businesses, such as insurance, ship maintenance and repair, trade finance, and banking. The canal and Panama’s business-friendly regulations have expanded big insurance, finance, and legal offshore industries.

  Last year, the free-trade zone in Colón – on the Atlantic end of the canal – and Balboa, Panama’s Pacific-side trade gateway, became Latin America’s two busiest ports. These two ports are set to explode soon after the canal’s $5.25 billion expansion project is completed in 2014. This is one reason Colón’s become the regional base of firms like Procter & Gamble (NYSE: PG)… Two-thirds of the traffic through the canal is coming from or going to America.

  Get ready for more growth. Panama is booming.

Healthcare is just one of the many aspects that a would-be expat might, and should, take into account when researching the retirement destinations they’re considering. Those hoping to relocate to Panama can go ahead and breathe a cautious sigh of relief.

While the country’s healthcare system is certainly not without its flaws, many expats have actually cited it as one of the best things about living in Panama.  However, like almost anything else in Central America, it can vary greatly depending on where you go.

As a general rule, the best facilities and physicians are located in Panama City.  However, some other areas are starting to catch up.  For instance, Hospital Chiriqui, which treats many expats from the mountain haven of Boquete, provides an even better level of service than many in the city.

It is a smaller facility and may not be equipped to treat certain specialized cases, but is quite capable for most procedures.

Private Hospitals’ Healthcare

Panama boasts several state-of-the art private hospitals, many of which are associated with renowned facilities in the U.S.  Punta Pacifica, located in Panama City, is considered the most technologically-advanced hospital in Latin America and is affiliated with the Johns Hopkins Hospital in Baltimore, Maryland.

The hospital is equipped with features such as videoconferencing capabilities to allow for information sharing and education.

Punta Pacifica Panama – photo by Maleg

Panama City is home to three other major hospitals, and there are two modern facilities in David as well.  Still others are scattered throughout the country.  Because the nation is small, it’s difficult to find yourself more than one to two hours from a modern hospital.  The more heavily populated areas are also home to other health care providers such as dentists and eye doctors.

Public Hospitals’ Healthcare

Panama also has a number of public hospitals, which are funded by the Ministry of Health and the Social Security System.  (Read: They’re nearly free.)  However, those who can afford private health care often choose to go that route for various reasons.

The reason many expats do not opt to obtain services from public hospitals is because they can be a bit of a toss up.  At best you may have to wait a few extra weeks for an appointment and may not get the same specialized attention you receive at a private facility.  At worst you may wait hours to be admitted to an ER, only to deal with staff members who are tired, overworked, or rude.

But don’t let the few negatives turn you away from this viable option.  For every understaffed facility with outdated equipment, there is another public hospital with modern technology and physicians who will take as much time with you as you need.  Our recommendation is that, if you plan to take advantage of Panama’s public hospitals, check them out in advance.  Make sure you understand what you’re getting into before you find yourself in a situation where you need urgent care.

Medical Professionals

One of the highlights of the Panamanian healthcare system is the quality of its medical professionals.  The doctors are well trained, often in the U.S., and most are bilingual.  The quality of medical care you’ll receive rivals that of many hospitals in the U.S., Canada, and Europe.  This isn’t due to any regulatory standards being imposed by the government.  But it doesn’t seem to matter.

While nurses do not receive the same level of training as those in the U.S., expats describe both them and the physicians as having an attitude of compassion that is not often seen in their first-world counterparts.  In fact, the personal attention they receive from their doctors often comes as a shock to those unaccustomed to such dedicated care.

As opposed to U.S. physician visits where you’re usually worked over by a nurse and then visited briefly by a doctor who whisks in for two minutes before rushing off to see another patient, it’s not uncommon for a Panamanian doctor to spend 30 minutes to an hour with you in his office.

In addition to this one-on-one attention, you may be given your doctor’s home or even cellular phone number, as well as his or her home email address.  While this easy access shouldn’t be abused, it’s not at all uncommon for a physician to allow patients to contact him or her after hours for pressing issues.

photo by Panama Health

Availability of Treatment

Something that’s important for expats to understand about Panama’s healthcare system is the disparity between the well-trained, well-meaning physicians and their ability to meet wide-ranging needs with the limited resources available to them.

Collectively, Panama’s hospitals have all the know-how and equipment they need.  Individually, they may be unable to treat some of the more unique situations that might arise.

So the good news is that, whatever your condition, there’s probably a hospital that specializes in it. The bad news is that you will need to be more proactive in choosing your physician than you may be used to.

Inconsistencies in Care

Another common frustration among expats is the inconsistency among Panama’s healthcare providers. We’ve mentioned the differences between public and private health care, but even among privately-owned facilities the care can often vary greatly.

A good recommendation is to consider this fact when planning your move to Panama.  If you need a good pediatrician, make sure you like the ones located near the area where you plan to relocate.  If you have a heart condition, you may want to consider meeting with the nearest cardiologist before you sign on the dotted line of a bill of sale on a remote property.

A good idea is to ask around for recommendations on physicians.  Again, because Panamanian doctors aren’t subject to a lot of the same scrutiny as those in the U.S., it can’t hurt to do your research. Don’t take for granted that they can be trusted simply because they’re physicians.

In addition, while many physicians may spend the better part of an hour with you alone in their office discussing your health concerns, there are also a few (especially those in public hospitals) that seem to hardly slow down to give you the time of day.  If you’re concerned with being left in the dark regarding your health conditions, it’s best to consider your options ahead of time.

The language barrier is often another area of concern for many expats.  While many doctors speak English, not all do.  A visit to the hospital administrator’s office can quickly answer the question of whether the hospital offers a translator and whether those services are included in the hospital fees.

Health Insurance

Although many would-be expats are probably beyond tired of hearing health insurance debated in their home country, it’s nevertheless something they’ll need to consider when shopping for their Central American retirement home.

The good news is that there are many affordable options available.  Even some U.S. health insurance plans are accepted in Panama.

Locally, there are HMO plans, which offer total reimbursement of services from in-network providers, as well as international plans, which allow patients to obtain treatment anywhere including places outside of Panama.

Many private hospitals also offer membership plans, which give participants hefty discounts on procedures performed at that facility only.

Cost of Healthcare

When comparing the different aspects of health care in Panama, low costs are another big plus for the “Pro” column.

Prices are drastically less than those of first-world countries, with procedures costing as little as one half to one fourth of the cost of what they would run in the U.S.  While this may seem absurdly low, the ratio of health care costs to wages is quite proportionate, since many Panamanians earn around $400 per month.

One major reason for the low cost is that the overall health care system is far less litigious than in many other countries.  With fewer frivolous lawsuits to threaten their livelihood, doctors pay less for malpractice insurance.  The savings are passed on to the patient.

For instance, a visit to a specialist costs about $50.  A trip to the ER runs around $100, which is less than a U.S. co-payment for the same visit.  Procedures such as MRI’s are a mere $500, and a facelift can be performed for only about $1,700.  Prescription drugs also cost less, and many medications that must be dispensed by a pharmacist in the U.S. are available over-the-counter in Panama.

photo by Panama Health

As a result of the low costs, insurance is also much cheaper for a good amount of coverage.  As previously mentioned, public hospitals offer free routine care, but those who can afford private facilities will likely choose to pay the minimal cost instead.

Medical Tourism

Because of the low costs of treatment and the many attractions the area has to offer, Panama is becoming a hotspot for medical tourism.  Many foreigners travel to the country to undergo expensive or even elective procedures, since they can be obtained at such a great value.  Additional benefits are its proximity to and ease of access from the U.S., as well as its use of the U.S. dollar as its currency.

In addition to the low cost and high quality of Panama’s health care, foreigners are also clueing in to the fact that it’s just not a bad place to recuperate.  Its many spas and resorts are quite conducive to the recovery process, making it awfully easy to turn your medical procedure into a much-needed vacation.

Medical tourism companies make the process a simple one by arranging for practically every aspect of the trip.  They can book everything from air travel to hotel accommodations to the procedure itself.  As this segment of the tourism industry continues to grow, it’s sure to have only positive effects on the quality of the health care system as a whole.