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Millionaire Expat - Book Review

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  • Millionaire Expat - Book Review

    Picked this up from my library. It’s a decent book that was released in the last 12 months, and most of the interesting stuff is in the last three chapters, discussed at length below. The vast majority of the book talks about accumulating wealth, and his advice for that is mostly spot on but nothing new for most of us. His advice to invest primarily in TD funds has not aged well after the Vanguard fiasco this year, however.

    Is anyone thinking of retiring abroad after they’re done practicing? This book has really piqued my interest, especially in Spain or Portugal. The only thing that I think would hold me back would be wanting to be close to friends and especially family. It certainly sounds like a net positive financially considering the costs of health care in the US between 50 and 65.

    Latin America

    Mexico - “The top doctors and dentists are as good in Mexico as they are in Canada and the United States. But the average doctor in Canada and the US adheres to higher standards….” He also talks about how he paid $24 to have a filling then had to have it redone in Canada a year later. Not a ringing endorsement.
    Higher crime (6x the homicide rate of US), but LCOL than the other Central American countries profiled ($1800 - $2500 a month).

    Costa Rica - The book makes the Caja socialized health system out to be the best thing since sliced bread and interviews two 60 year olds who pay $500 a month for comprehensive medical/dental/vision. A lot safer than Mexico but more expensive housing.

    Panama - I’m not sure what stands out about Panama compared to Costa Rica. Book profiles how easy it is to get residency as long as you can guarantee $1000 a month in income. They say it’s a little more expensive than Costa Rica.

    Ecuador - way cheaper than anywhere else, but it sounds like the health care system is the crummiest. The book profiles a couple who paid $1500 for hospitalization after the husband’s heart attack, but that was after they couldn’t get an ambulance to come to their small village on the coastline. Crime rates not quantified - “you’ll find petty crime anywhere.”

    Europe:

    Portugal - Interesting chapter as it explains the NHR program. .You have to show passive income covering the minimum wage in Portugal to get the D7 visa and that is about it. Profiled couple renting villa on the coast for 1000 euros a month, “best weather in Europe.” Visa gives access to free healthcare. Very low crime rate. What’s not to like?

    Spain - reread this chapter and it sounds like everything is mostly the same as Portugal with a different language.

    Eastern Europe - Latvia and Georgia. These sections are pretty short, and not much to write home about. Basically they’re even cheaper than Spain and Portugal, especially Georgia. Everyone says the health care systems are awesome (yeah, sure they are). The language in Georgia is a pain to learn.

    SE Asia - I really like these countries but probably would opt for elsewhere due to the distance from family and US as well as language barriers. The following two countries were profiled because author thinks they have the best medical systems in the region.

    Malaysia - “Top quality medical,” hotter than Hades, cheaper than most other countries profiled (including Mexico, Portugal, Spain). Possible increased income requirements for residency ($10k per month).

    Thailand - I went there four years ago and my observation was they treat Westerners like kings. It has something for just about everybody who likes outdoors and tourism. Crime, medical, COL seem similar to Malaysia.

  • #2
    Thanks for the review! I don't want to retire, retire outside the US ( I don't think) but I'd love to spend 3-12 months in various places, so definitely something to think about for the future . . .

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    • #3
      "“The top doctors and dentists", mostly will be limited in location. Sometimes transportation will be difficult if you have an event. The run of the mill healthcare is different than if you need a top sub-specialist. I have has several acquaintances and friends move back do solely for healthcare. A similar caution as residency, rent for a year before you buy.

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      • #4
        One dream I had as a CA resident now is to spend 2-5 years living abroad and traveling during an earlier retirement. Lower cost of living, not old enough to need a lot of healthcare and great time for Roth conversions.

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        • #5
          I do not plan on expatriating, but I do plan on extended trips abroad. As an attending, my longest trips have only been a month; I'd like to extend that out to a year at a time.

          Paying attention to health care is something I had not considered before. My experience during travel bas been that between a little medical knowledge and an essentially unlimited credit card, health care is a non-issue.

          Maybe that is just an opinion based in anecdote:

          In every country that I've needed it (except for Australia), when the pharmacist realized I was a doc, I could order whatever I wanted.

          I had US friend living in Mexico, classic S&S of appy...the hospital was like "It will be $5000, how would you like to pay for that?" [For everything]

          I smiled when you brought up Ecuador. When I was there as a resident (and not yet able to speak Spanish), after seeing a trauma case at a public hospital, I asked one of the med students what would happen if I was unconscious and couldn't say "Soy gringo, tengo dinero"...he told me not to worry, the ambulance would figure it out and take me to the private hospital, where they would just start charging my card.

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          • #6
            I plan to live part time out of the US. I have no concerns about healthcare, in many ways I have more concerns about what US healthcare may look like in 20-30 years.

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            • #7
              Originally posted by Tim View Post
              "“The top doctors and dentists", mostly will be limited in location. Sometimes transportation will be difficult if you have an event. The run of the mill healthcare is different than if you need a top sub-specialist. I have has several acquaintances and friends move back do solely for healthcare. A similar caution as residency, rent for a year before you buy.
              My daughter had to spend a day in the ER in Mexico City. Good care. She had some Spanish, but docs and nurses all spoke English well. Did have to pay upfront, but it was only ~$1300.

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              • #8
                Will preface by saying I haven't read the book, but now plan to. Thanks for putting it on the radar.

                Wife and I plan for a relatively early retirement, with 8-12 months per year spent abroad for 7-10 years, perhaps longer.

                By abroad, I mean asea. Every continent, every sea, several rivers, as many countries and islands as we can muster. Grand tour of our beautiful little planet, but at our own pace and on our own terms.

                Regarding some of the things you mentioned above, we will certainly be planning for healthcare in the good ol' US of A, when feasible. Or Europe. More expensive, sure, but it's a known entity with predictable quality. Also, we'll be young enough as to not require much (fingers crossed).

                Not sure about the healthcare system in Costa Rica, but it certainly would be toward--or even at--the top of the list of countries to retire abroad in for us if we were to remain in one place (aside from just staying in the States). Got married there, and it's great in pretty much every conceivable way.

                Southern Spain would be excellent, as well as Tuscany. Hard to beat either of these in many ways.

                Southeast Asia is beautiful to visit, but I wouldn't live there, personally. Far, and multiple barriers, as mentioned.

                If you're looking into Eastern Europe, I'd suggest something more like Croatia, Montenegro, or Albania. Beautiful, but depending on how remote you prefer (city versus countryside) the language could make it a little challenging. No different than Latvia and Georgia in that regard though.

                Perhaps also consider Ireland. Not sure how costs compare though.

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                • #9
                  Like others above, I expect we'll always be U.S.-based, but I envision "snowbirding" it in different international locales for a bunch of years once we're empty nesters.

                  Just before COVID, we spent 2 months in Mexico and 2 months in Spain. Loved both, but Spain is clearly a safer, more prosperous country. This year, we spent a month total between Greece, Malta, and Italy. Another month between Florida and Colombia.

                  There are so many places where you could easily spend a few weeks or months, many of which were mentioned above, so I won't repeat them here. I also like the idea of lengthy cruises, but haven't been on one yet. We've got a couple of 2-weekers this spring and fall; we'll see how that goes.

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                  • #10
                    Originally posted by PhysicianOnFIRE View Post
                    I also like the idea of lengthy cruises, but haven't been on one yet. We've got a couple of 2-weekers this spring and fall; we'll see how that goes.
                    A two week cruise is hardly a lengthy cruise. That's just a decent vacation when you're still working full time.

                    Agree with the favorable comments on Portugal, Spain, Croatia, the Baltic states, and Ecuador. I'd add that Buenos Aires was quite, quite nice when we visited. Haven't made it to Costa Rica yet, but plenty of Americans seem to like it. Belize was nice and Cartagena, Colombia was much nicer than expected. (Cartagena, Spain is quite nice too, but more folks are likely to move to Barcelona or Madrid.)

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                    • #11
                      Originally posted by Hank View Post

                      A two week cruise is hardly a lengthy cruise. That's just a decent vacation when you're still working full time.

                      Agree with the favorable comments on Portugal, Spain, Croatia, the Baltic states, and Ecuador. I'd add that Buenos Aires was quite, quite nice when we visited. Haven't made it to Costa Rica yet, but plenty of Americans seem to like it. Belize was nice and Cartagena, Colombia was much nicer than expected. (Cartagena, Spain is quite nice too, but more folks are likely to move to Barcelona or Madrid.)
                      Lived in Buenos Aires for a time—couldn’t agree more.

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                      • #12
                        Has anyone read the Nomad Capitalist? That’s one that sounds interesting but I don’t want to pay for it. I do check my library (and my parents’ library) to see if it’s on the shelf from time to time.

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                        • #13
                          Originally posted by Lithium View Post
                          Has anyone read the Nomad Capitalist? That’s one that sounds interesting but I don’t want to pay for it. I do check my library (and my parents’ library) to see if it’s on the shelf from time to time.
                          I've read a bunch of his blog posts and listened to some podcast episodes. Quirky dude, hates taxes, really knows his stuff.

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