You Don’t Have to Put Up With Crappy Health Care Options

costa rica dentist

The USA has some of the most developed health care equipment, some of the best-trained specialists, and some of the best-equipped hospitals in the world. There’s just one big problem: the average American can’t afford access to those shiny superlatives.

A recent study that compared 11 of the wealthiest, most developed countries on the planet found that the United States ranked dead last—and it wasn’t even close.

The Commonwealth Fund focused on care process, access, administrative efficiency, equity and health care outcomes, studying 72 indicators within those fields. The 11 countries analyzed were Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States. In addition to ranking last or close to last in access, administrative efficiency, equity and health care outcomes, the U.S. was found to spend the most money on health care.

It also found that the U.S. system is the most unfair and unbalanced. If you have a good insurance plan supplied by a corporation or the government (like Congress gets), then you think everything is rosy. For close to half of low-income people though, decent health insurance is either unaffordable or not available. The heartless proposed bills that recently died in congress would make this disparity even worse. In some markets they would close the one and only clinic doing healthy screenings for women. The bills would do nothing to ease the burden on self-employed people or help them buy into large group plans (like the current Affordable Care Act does).

One way to bypass the bloated U.S. system and its chain of middlemen is to go abroad for anything expensive. There are great dentists—many of them trained in U.S. universities—who practice in Mexico, Costa Rica, and Panama. You’ll also find great ones in Hungary or Thailand, all charging 1/4 or 1/3 the price but providing more personal service. A root canal in Hungary averages $123, just to give you an idea.

At this moment there are people getting knee replacements, heart surgery, hip replacements, and eye surgery in other countries around the world and saving tens of thousands of dollars. I know someone whose father got a hip replacement in Queretaro, Mexico and the price was 1/9 of what my father’s insurance got billed in small-town South Carolina. Plus the Mexico cost included two days in the hospital with the patient being monitored.

If you do some digging around on the web, you’ll find that certain countries are known for certain procedures. If you’re not going to move but you’re just going to fly there and get a procedure done, you might as well pick the best spot. Depending on the procedure, it might be Turkey, Thailand, India, Singapore, South Korea, or Brazil. There are matching services out there with vetted members and patient reviews. Do some research, take a trip, and you could save tens of thousands of dollars.

Health Care Option 2: Move Away

I’ve taken this option twice with my family and will do it again in mid-2018, this time with no return date in mind. What I spend for one month of medical care and insurance in the USA will last us close to a year in Mexico. That’s paying everything out of pocket and having a catastrophic health insurance plan in case of serious emergency.

“This is my health care card,” one retired expat told me when I interviewed him in Granada, Nicaragua. What he held up was a Visa credit card. “My credit limit on this would cover weeks in the hospital here,” he said.

When you go to a hospital in Bangkok, you pay a fraction of U.S. prices and end up at a place like this:

Medical care abroad - Thailand

In most countries of the world, if you pay out of pocket for routine care or even a specialist appointment, it’s not going to be a major expense. You can see a clinic doctor for the price of lunch in Mexico and when we go to our English-speaking dermatologist for a full head-to-toe exam and consultation, it’s less than $60. My dentist is the highest-priced one in town because he trained in Houston and a check-up with cleaning is less than $40.

In some countries you won’t even pay that. I’ve heard stories from friends where they went to a doctor in Europe or New Zealand and when they asked how much to pay, the doctor got flustered. There was not even a system in place to accept funds or a list of what to charge–it’s covered  by the government via taxes. In Argentina, even if you’re just there on a tourist visa, there’s no charge for doctor visits, just for (subsidized) medicine. A private hospital stay there will cost you 1/10 of a stay in the USA. (Plus you’ll be able to understand the bill.) In Ecuador you’ll pay a little, but the doctor gives you his cell phone number and will make house calls.

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In most of the world, health care is seen as a basic right, something you should naturally get in exchange for being a citizen—or in some cases just a person on that country’s soil. It would be illogical to tie health care to your employment status or the quality of the company you’re working for. It’s in the government’s best interest for treatment of contagious diseases to be stopped quickly and for everyone to have access to inexpensive care for malaria or dengue fever.

Being self-employed or running a small business shouldn’t be penalized, but encouraged. So everyone is covered equally. If you want to go have liposuction or teeth whitening you’re going to pay, but it won’t drain your savings to have a baby. This is true across almost all of the cheapest places to live around the world.

Want to learn more? Sign up for the cheap living abroad newsletter or just pick up a copy of A Better Life for Half the Price. If you want to get some personal consultation in the mix, there’s an all-in plan that includes two one-on-one calls.


  1. Emily J.

    When I’m traveling around the world and tell locals I pay $780 a month just for health insurance because I’m not working for a company that provides it, they have trouble believing it. Then they are doubly floored when I add that I have to pay loads more on top for co-pays, dentists, etc. They can’t believe we put up with a system like that. More than one has told me “there would be riots in the street” to change a stupid policy like that.

    I’m hoping to get to a point soon where I can be nomadic and just stay out of the country most of the time. It makes me angry beyond belief when I see the old white men in the GOP congress trying to take us back to the time when we could get denied (on top of all this madness) for having pre-existing conditions.

  2. Keith Mundy

    Well done, Tim. If only this piece could reach every household in the USA and wake up the US population to what an appalling deal it has in health care compared to other advanced democracies.

    One addition: as a Brit, I can relate that the single most important national asset for Brits is the National Health Service providing free-at-point-of-service health care. You only have to listen to BBC news on the radio to be struck by the number of times that NHS matters feature high up on the news agenda almost every day. People really care about what they get from it and have no issues at all about the taxes that they pay to fund it. And that includes conservatives, who value the NHS as much as anybody else does.

    • Keith Mundy

      P.S. As a resident of Thailand, I can confirm that the top hospitals in Bangkok have splendid entrance halls, with Bumrungrad as shown in your picture the most palatial. But the typical hospital countrywide is rather less grand. As to the service given at the top hospitals, it is very good and, yes, comes at a fraction of the cost of that in the USA. Typically, you can get a same day consultation with a specialist at about $30 or less, and any treatment ensuing will be done with the latest technology.

  3. Maus

    Thanks for sharing this post, glad to read this information.

  4. Joyce

    Was hoping to find a Private contact (to the author) to address a question that relates to the content of this blog….how receptive are countries to Americans that have Pre existing conditions? When I mention PEC, I mean without treatment survival is not possible. Do countries turn away Patients that are a drain on their resources? Your statements that healthcare procedures for an average healthy American, and carrying catastrophic insurance, may be focused for those who don’t have life/death scenarios based on needed treatment. I am just hoping to clarify the difference and if countries are receptive of Patients with PEC, that WA plans on killing through their “death spiral”. Desperate and hoping for a realistic option, with medical facilities in tact in other countries who are willing and trained in conditions beyond the ordinary procedures. I’m aware that pharma etc. inflates prices for life saving meds., & treatments, and will continue to get worse, What countries have the ability to treat and understand chronically ill Patients with rare diseases? Is there a communication/translation difficulty getting complete medical care in another country for a complete novice, where to begin w/specialists trained in the USA, and located out of the country? Your mid 18., departure is on par for timing, with the current medical crises. My situation is dire, if possible please help me to understand if I have any options beyond the US.

    • Tim Leffel

      My contact info is linked from the “About Me” page. As for what’s covered, it naturally varies by country. Some cover virtually everything, but of course it has to be a rich country to do that. Others don’t usually discriminate about pre-existing conditions, but there’s a limit to what they’ll cover and you have to pay the rest on your own. The part you’ll pay though is nearly 100% sure to be less than the price tag in the USA, which has the highest medical costs in the world for nearly every procudure.

      • Ima

        Thank you, I sent you an email via on elf the contact form s on your blog.

  5. Staci

    Great job in writing this, Tim. I also cannot believe the cost of the USA Health Care system compared to most of the 103 countries that I have traveled to around the world. It’s still hard for us self-employed folk to afford coverage and treatment here in the U.S. Most Americans automatically assume that the U.S. is best, but they have not compared to know what the rest of the world is doing these days in this field, and the fact is that many doctors in these countries are either educated or take certification classes in the U.S. I have personally worked for and with one Medical Tourism company called MedRepublic, (; it’s a company owned by father and son doctors in the USA and I feel that they are very good for what they do. There are also other options like health care sharing ministries like the ones listed in this article: My own family drives across the border from Arizona to Algodones, Mexico (near Yuma) for dental care, and have had no problems (but enjoyed a lot savings) so far. I recommend that everyone research and compare what they feel is best for themselves, but just realize that there are other options to consider.

  6. Paul

    Good article but just fyi in Canada’s system we have separate systems in each province or territory, each duplicating a giant set of rules and bureaucracy. All a bit different, with agreements between each other. Some things covered or not. And of course a giant federal department which I can’t say does anything useful… The doctors and nurses are great but over worked. Universal access in principal but… If you move to a new town you may or may not be able to get a family doctor, it can take years even if you are 80. Or maybe get lucky as I did. Although you can get seen for urgent items a normal appt is 6 weeks away… And loads of rules such as being at least 5 months in one province, not country, or you can lose access… Even though you must still pay all income taxes for 12 months! That said if you stay inside the rules it can be a good system, but needs a private option like they have in Europe or Thailand. The private Thai system is so fast in comparison, no capacity issues.
    Dental Care is not covered here and very expensive with price fixing… I do that in Thailand at a third the cost…!

    • Tim Leffel

      Every system has it’s flaws, but most of us Americans would gladly trade for yours. If the wait is too long, we’d just go across the border and pay the inflated prices we’re already paying now. But it would be a last resort instead of the norm!

      • Paul

        Hi Tim… Yes I didn’t mean to sound too negative, overall it works and the doctors and nurses do a great job. I just wish the bureaucracy was more open to innovation and competition… But I wouldn’t trade it either.
        PS. Thanks for all your great articles.

  7. mathieu tallard

    Just make sure at home what you want to be done is possible and fine. elsewhere, they take risk to get the money…….

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