Possibly not much but in Panama, you can get a whole lot!

Jessica was out and about with her dollar bills recently—see her report below.

P.S. Speaking of good value…the Panama Owner’s Manual is discounted by 20% for the next 3 days during the final fling of our big Holiday Sale.

* * *

Panama for a Dollar (Yes, Really)
By Jessica Ramesch

I’ll admit it. I became a bit obsessed with Facebook a few months back. It has turned into a great way for readers interested in Panama or International Living to share tidbits or post questions for the IL community. My favorite recent post on the International Living Facebook page asked: “What can you buy for $1 where you live?” At first I thought: “Not much…what can anyone get for $1 these days?” But after a few seconds of brainstorming I realized I was wrong.

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Turns out, I could go on and on about all I can get for $1 here in Panama! At a deserted island in the Bocas del Toro Archipelago, I can get a sweet green coconut full of water. The sellers are usually members of the Ngobe Bugle indigenous tribes that live on the islands. They’ll take a sharp machete to the coconut, hacking off the top so you can enjoy the cool water. Then they’ll crack it open so you can scrape out the slimy innards…delicious!

You can also get a beer for a dollar at most beachside shacks, a gold and green papaya with sweet orange flesh, or a cheap pair of flip-flops if you forgot yours back home. Even the roadside stalls sell trinkets and souvenirs made out of natural materials like the ubiquitous tagua nut for $1 and up.

In the Panama Highlands, I found multiple things for $1 or even less. I had good, strong coffee for $0.35, a filling empanada for $0.50 (more than enough to fill me up for a quick breakfast), and a small pizza for $1.75. Taxis to most anywhere were only $1, as were the colorful mixing bowls I bought at a small store called La Cocina (“the Kitchen”).

At another shop down the road I bought four souvenir postcards of Panama for…you guessed it, $1. In fact, I could come up with long lists for every town I’ve visited in Panama. At the hot springs in El Valle, $1 entry fee gets you a packet of mineral-rich mud for your face…rub it on, lower yourself into the hot water, and relax for as long as you like!

And I’m not just talking about rural areas. In Panama City, most gas stations are full-service (something I really love). I can get a quick check for my car for free…but I usually tip $1. The attendants will check all fluids…motor oil, coolant, wiper fluid, etc…and even make sure your tire pressure is good.

My favorite vegetarian restaurant is a Chinese buffet/cafeteria called La Casa Vegetariana. I can choose four different items from the buffet line for $1. The vegetarian ham pao is $0.50, as are the empanadas filled with either chopped veggies or sweet fruit.

My dad found a small “wholesaler” where he can buy ten packs of platanitos (fried plantain chips) or peanuts for $1. He refuses to buy corn in supermarkets. He points out that vendors sitting right outside the grocery stores sell you corn on the cob…already cooked…for $0.35 each. They also sell boiled and prepared pixbae, a delicious, starchy palm fruit that’s said to be highly nutritious: four for $1.

My favorite, though, is when they have changa for $1 each. The masses of fresh corn, shaped like a skillet bottom, are big enough to feed four. I cut them into pizza-like wedges and serve with garlic and herbs on top. With a salad, the wedges make a delicious dinner for under $1 a person!

Editor’s note: If Panama sounds like your kind of place, there’s a free Panama report called The World’s Best Retirement Program that you can pick up here ->
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Panama’s Casco Viejo is the oldest city on the Pacific Coast of the Americas. A few hundred years ago, several fires destroyed most of the colonial buildings. That’s why so few true examples of Spanish colonial architecture exist today.

This part of the city, the so-called “second city,” is steeped in history, with a real sense of tradition. See what Jessica found there, below.

Music, History, Art: A Day in Colonial Panama City

Guest post By Jessica Ramesch

It’s Jazz Festival “free day” in Casco Viejo. Every year, a week of concerts all over the city culminates here, with a free concert to beat all free concerts. A big stage has been erected in the Plaza de la Catedral. The crowd is “eclectic Panama”…surfer types, preppy soccer-moms, kids from the neighborhood…a human hodgepodge swaying to the music.

A sonorous bass sends vibrations over the cracked concrete to where I stand; it makes my feet buzz. Vendors in the plaza are selling smoky kebabs. There’s even raspao, fruity snow cones you can get topped with sticky condensed milk (for five cents extra) and the powdery crunch of malt. The man making mine has no machine to crush the ice; he scrapes it with a big shaver, packing the fine crystals into a conical cup. I pay him 30 cents.

Today’s Casco Viejo is a mix of the contemporary and the crumbling, a study in contrasts. You find over 300 years of history here in the colonial sector, often referred to as the “second city.”

In fact, locals say Panama City is three cities in one. Modern Panama is the third city, famous for its skyscraper skyline. The first Panama City, founded in 1519, was burned to the ground by the dreaded Captain Morgan (not just a brand of rum). In 1673, the city was rebuilt here as Casco Viejo, where fortress walls high above the water made a good defense. The architecture here is the nation’s prettiest—with French, Italian, and, of course, Spanish influences.

I’ve spent the day taking in this second Panama City. The coolest thing I’ve ever seen is…

Editor’s note: Subscribers to the IL magazine can read on in the The September issue of  International Living Magazine

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On 27 March La Prensa reported that the government has allocated $283 million dollars to expand several highways. The size of the expenditure and the location of the changes broadcasts the intent. Panama wants more residential tourism, more immigration of people with money into the interior of the country.

Divisa to Chitre gets four lanes, this is the gateway to the Azuero Peninsula, a rapidly developing area of beaches.

San Felix to David gets four lanes, this part of the Interamericana between David and the Capital currently has no passing lanes. This will make the trip to David from Panama City much faster and safer.

Finally four lanes from David to the little mountain pueblo of Boquete Panama. I can report the survey crews are all over this project already.  I have no idea how or even why they are doing this unless they also plan to eventually continue the road on to Bocas del Toro.

Boquete is now a dead end and although four lanes will make the ride to David faster and less dangerous the current need is not there. This is an investment in Boquete.

If you are here and can remember 3 years back in time and look at the changes and investment in both David and Boquete over three years the effect is startling.  David has a major shopping center with a large three story department store, Conway. It has new hotels, it has new restaurants, now retail stores. I notices today a BMW dealer is opening, Honda opened last year. The cow town is in transition, fast.

This government is following through on the expansion of the David Airport so Copa and other airlines can stop here. They want the wild west of Panama to grow, fast.

If you are  from the school of thought that says get in when things are about to explode and profit from it, this is the time to jump on Western Panama. If however you are from the group that came here because it was not Florida or Arizona, it might be time to start looking for alternatives.

When I arrived I felt I had entered a time machine and went back fifty years, now it is only thirty, soon there will be continuity with North America. I am not sure if this is good for anyone, except the investors and the people who want to terraform Panama into another mini USA. Panama is an opportunity now but the change might destroy the very essence of why I am here.

By Lee Zeltzer of boqueteguide.com

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Volunteer Boquete has developed a campaign that was officially kicked off on December 24^th with the first Community Cleanup in Boquete. With the new campaign, the foundation will be hosting a community wide event on Earth Day (April 22). “We have found a need in the community and we plan to address it because it needs to be done” said Kaytee Hoverson, project coordinator. In the meantime volunteers from the program, as well as local volunteers, have targeted areas of litter and attacked them head on.

A group of dedicated volunteers picked up litter on Christmas Day and then again the first week in January. While this hearty band of volunteers separates recyclables out of the trash picked up, they plan to further coordinate with Boquete’s recycling program ReALBoquete.

Project plans include researching joining forces with Boquete’s workforce for a more concerted effort, placing trash cans around the city in problem areas, building a regular volunteer base to pick up litter on a regular basis, and working with schools to educate young people about the litter problem.

As of this writing, a meeting was scheduled with Mayor Manolo Ruiz, to present him with a very concise 17-point topic list, outlining detailed solutions to litter problems in the Boquete area.

This is not just a group picking up trash, states Hoverson, but “…a long term project to make Boquete the cleanest, most beautiful town in Panama.”

More information about how you can be a part of this important program is available at www.unexpetctedmomentsofmagic.org or by calling 720-1025.

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I was going to do a complete review of what happens when you get sick in Panama – hospitals, emergency care, health insurance, etc. but then I was reading Richard Detriches Blog, a fellow ex-pay who lives on and off in Panama, and I discovered Richard had done a great story on all of those things. What is cool is that he focused on health care services in Chiriqui, Panama so you can get a good idea of what it is like to get care when you live in Boquete or somewhere between Boquete and David, the Panamanian provincial capital.

Here’s  Richard’s explanation of health care in and around Boquete Panama -

Hospitals: David, Panama

In David, the third largest city in Panama, 45 minute drive from Boquete, there are four large hospitals. The Maternal & Child Hospital is a National Hospital focusing primarily on material and pediatric care. It is only two years old and was a gift from the people of Taiwan, with whom Panama has diplomatic relations. Almost next door is the Social Security Hospital which serves people who are working in Panama and paying into the Social Security system. Just down the Pan American Highway is Hospital Mae Lewis, a private hospital that is used by locals and gringos. And a few blocks off the Pan American Highway is Hospital Chiriqui, a private hospital that is generally preferred by expats because of their “insurance” program (more on that later). Hospital Chiriqui. Additionally, scattered around David, there are almost a half dozen tiny private hospitals owned and run by a consortium of doctors. In some ways it isn’t very efficient, yet the hospital costs are low. A private room runs about $60 a day! Of the private hospitals, Hospital Chiriqui has the most “bells and whistles” including a state-of-the-art MRI machine, one of two in Panama.

Unlike in the US, in Chiriqui any doctor can practice in any hospital and you are not limited to only certain hospitals where your doctor happens to be on staff.

Emergency Care in Panama

Here is where things can get a little dicey.

If you happen to be one of the very few people to get bitten by one of our famously poison snakes, like the fer de lance which is fairly common in Chiriqui . . . and let me quickly add that your chances of getting bitten by a poisonous snake are about the same as your chances of getting struck by lightening or winning the lottery! . . . if you are bitten by a snake anywhere in Panama you are generally about 45 minutes from a Social Security hospital which is where the anti-venom is kept. So you have plenty of time to get to the hospital where you will find that rather than immediately giving you anti-venom there is a long waiting/observation period while they test your blood and wait to figure out what kind of snake bit you and what type of anti-venom you need. Almost everyone, except for Indians living in very remote areas, recovers. So although the fer de lance and bushmaster can be “deadly”, your chances of dying if you get assistance are very slim.

OK, we got that out of the way!

When we first came to Panama my wife asked our Boquete doctor, “So if I’m having a heart attack, what do I do?”

His response: “First you call me. I’ll come to your house and call an ambulance. We’ll stabilize you in David, and if necessary, once you are stabilized, we will fly you to the Panama City where the hospitals and doctors who specialize in invasive procedures are located.”

Good enough . . . but when we say “ambulance” do NOT think of ambulance service in the US! There have been times in Boquete when we had four different ambulances . . . and none were working! And an ambulance here is primarily a means of transportation. Don’t think a team of trained “EMTs” on call . . . or an ambulance with any sort of equipment on board. Over the years we’ve been in Boquete the expat community has worked hard and raised money to improve ambulance service, but it still is nothing like what we were used to in the States.

One Couples Panama Health Care Experiences

One afternoon my wife started having some kind of episode. She was dizzy, had no feeling in her arms, was weak, and couldn’t stand up. It looked like some kind of allergic reaction and I feared she was going into anaphylactic shock. (We have experience with this: I am highly allergic to shellfish of any kind in any amount, and my daughter is highly allergic to chocolate.) Without 911 or any similar kind of emergency help, I called our friend Brad, and together we carried Nikki to my car, and I went to the doctor’s office (the same guy who treated her when she was thrown off the horse . . . the story I told yesterday). It turned out the good doctor was on vacation and the gal who was filling in not only didn’t speak any English, but wasn’t that familiar with his office. Eventually she found the oxygen mask, started an intravenous drip, got Nikki stabilized and agreed we needed to get to the hospital in David. She called the ambulance . . . and the “fun” began.

The doctor called the ambulance, then said to me, “They don’t have any gas. They want to know if you can pay for the gas?” Yes!!!

So the ambulance and attendants arrived . . .

First problem: the doctor’s makeshift treatment room and the gurney that wouldn’t fit in.

Second problem: the ambulance crew hadn’t the slightest idea how to move a patient from a bed onto a gurney. Somehow we managed.

Third problem: Nikki was too big for the ambulance. Panamanians are shorter. So they couldn’t close the back doors of the ambulance all the way. She wouldn’t fit! So the creative solution was for the ambulance attendant riding in the back to wedge himself between the side of the ambulance and press his feet against the gurney to keep Nikki from sliding out the back doors, which were flapping in the wind.

Fourth problem: Nikki had an IV drip going and there was no place to hang the drip in the ambulance. The attendant in back was busy trying to keep the gurney from flying out the back, so Nikki had to hold her own IV bag.

OK, we stopped and got $20 worth of gas. Then we began racing down the mountain to David with lights and sirens going.,

Fifth problem: Nobody in Panama is going to move for an ambulance! Only the expats will pull over out of force of habit. So I’m in front, the driver is laying on the horn so people eventually will move out of the way.

Sixth problem: We start to get one of our famous, afternoon “rainy season” cloudbursts when the water is coming down in torrents. In front the windshield wipers are barely working and in back the doors are flapping in the wind and the water is coming in soaking Nikki and the attendant who is bravely still holding the gurney in place with his feet.

The reality: Supposedly “laughter is the best medicine” and Nikki, although the center of the drama, couldn’t help but find the humor in the situation.

Fortunately we arrived at Chiriqui Hospital and into the tiny emergency ward. It took a while, but Nikki was stabilized and a team of internists eventually discovered that she had developed an allergy to aspirin. She spent two nights in the hospital, before coming home. The ambulance ride:(for those of you who remember the original Disneyland . . . definitely an “E-ticket” ride!) $20 for gas, and another $5 (in gratitude) for beer for the guys. Hospital: emergency room, two nights, and physicians $225.

Yet another story . . . my wife keeps things interesting!

Nikki was experiencing tingling in her arms, chest pain, yada yada . . . with her history . . . “Come on, Nikki, don’t be a hero! Let’s get it checked now. If it’s nothing, fine . . . if it’s not, “golden hour” and all that stuff.” So we go to Boquete to the new clinic for such emergencies that Hospital Mae Lewis has opened. The only problem is there’s only a receptionist staffing the clinic. No doctor . . . not even a nurse . . . receptionist and janitor. The receptionist informed us that the doctor was going to be coming in an hour and that we could sit and wait. OK, so this is to be an “Emergency Clinic” . . . right. And if it is a heart attack, we’re going to sit here and twiddle our thumbs for an hour and hope that the doctor actually does show up as scheduled . . . which, in itself, would be somewhat of a miracle anywhere, let alone in Panama. And I’m about to have a “Richard-goes-ballistic” attack . . .

I remembered that a friend I had met because he had read this blog, lived in an apartment upstairs. He is a retired neurosurgeon who still consults via video cam in complicated surgeries around the world. Although he wasn’t a cardiologist, I knew he had his own personal encounter with a massive heart attack and open heart surgery, so I went upstairs and asked him if he could just come down and take a look at Nikki. Gracious friend that he was he put on his slippers, found his stethoscope and came down and took a look. His verdict, “I can’t say what is going on, but I can say with 99.9% certainty that she is not having a heart attack.”

So . . . forget paramedics and 911.

As “oldsalt1942? commented about yesterday’s post, “You get better or you die, and that’s the reality of health care in the vast majority of the world. You get better or you die. Period. And let’s face it, you can’t take life too seriously because none of us are getting out of here alive.”

Health Insurance in Panama

Folks handle insurance in different ways. People who worked for the Canal or the US military in Panama have their own insurance. Some people worked for companies who still provide their retirees with the insurance they were promised when they retired. Some have their own policies from the States or some international insurance policy. Like most insurance when you are trying to get insurance after retirement you find that the insurance companies don’t cover preexisting conditions, which is exactly what you are worried about. And by the time most people reach retirement age they have preexisting conditions.

When you turn 65 of course and are collecting US Social Security you have Medicare. However, Medicare only covers treatment in the US. So unless you want to return to the US when you need medical care, which some folks elect to do, you are not covered. When I looked at the cost of Part B for me, and what all was not covered by Part B, I decided that for me it was cheaper to just pay the full amount for the procedure in Panama. So we, basically, self-insure . . . with a couple of exceptions.

Panama Travel Health Insurance

Since we travel a lot, we purchase annual travel policies from a company in Scandinavia that cover us when we are away from Panama for emergency medical care except in the US. When you include the US the cost is prohibitive, and at least when I am in the US, I could use Medicare. My wife is too young for Medicare! Since we are on ships a lot, it is important for us to have insurance that covers medical evacuation. I think anyone is crazy who takes a cruise without having travel insurance that includes coverage for evacuation. The cruise line wants you off the vessel and into a hospital as soon as possible, firstly for your own medical welfare, and secondly to avoid legal responsibility. A medical evacuation from a ship by helicopter can easily run $10-15,000! Get insurance!

Hospital Chiriqui does have an insurance scheme called Medical Services Chiriqui, or MSChiriqui which we use. It is not really “insurance” but more of a discount plan. A doctor visit that usually would cost $40 with a MSChiriqui coupon costs us $20. There are discounts on almost all hospital services and treatment, somewhat akin to a major medical plan in the US. In our case when my wife required an angioplasty and stents, because the procedure is not available at Hospital Chiriqui, we went to Hospital Paitilla in Panama City and the MSChiriqui plan covered half of the cost. After you have belonged to the plan for 2 years it does cover pre-existing conditions. The plan now costs us about $1200 per year for both of us.

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As more and more people catch on to what Boquete proper has to offer, you need to look elsewhere in the region for the best deals.

That said, you can still find good deals on older, established farms and tiny pockets of property near Boquete, but sellers can have unrealistic ideas of what prices should be. Remember, in markets like this one, you’ve no reliable way to do comps. So owners don’t have any real idea of what their land is worth. They take their chances when a gringo buyer presents himself.

Some believe the market has gone beyond itself in Boquete. I’m not so sure but still I think it’s important to stay informed and why I’m looking beyond Boquete.  I’d like to  introduce you to another town in Panama’s inland Chiriqui region offering the same pleasant, spring-like climate of Boquete it’s called –Volcán.

Volcán doesn’t have all the amenities and infrastructure of Boquete…but neither does it have the developed (some might say inflated) pricing. You’ll spend half as much to own here as you would in Boquete…and you’re buying the same spring-like climate year-round, the same fresh mountain air, and the same beautiful scenery.

The small mountain town of Volcán doesn’t boast a big expatriate community, grand housing developments, golf courses, or a thriving social scene, but, at 5,000 feet elevation, it does offer a cool climate (something that can be a welcome escape from hot, humid Panama City) and great outdoor activities. It has a comfortable and refreshing small-town feel. This is an area I’ll be paying close attention to in coming months…and that I think is worth a look from you, too, if Panama’s interior is of interest.

I explored this area recently and here’s what I found:

* An old, rustic blue house on a 1/2-acre lot just outside town–on the market for only $10,000. It’s in need of repairs and restoration, but it’s just off the main road and a two-minute drive to town.

* A 2 1/2-acre lot along the roadside a bit closer to town. This one isn’t dirt cheap (it’s priced at $120,000), but it could be the perfect site for a restaurant or small cantina.

* Just outside town in an area called Paso Ancho, with a view of Volcán Barú, I saw 15 acres for sale for only $200,000. With that much land, you could create your own private haven…or invest in your own small development.

* Right in the town of Volcán, I saw 1 1/4 acres, on which is sitting an old, bright green, three-bedroom, two-bathroom house in desperate need of a paint job. But it’s priced at only $50,000. You’d pay at more than twice that in Boquete right now.

I’m going to be watching this little town and its emerging market closely. I’m sure that, in the coming months, I’ll find even more and better deals.

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This contributes to the safety of Panama and continues to make it the Best Place to Retire.
A preliminary agreement on the bases was reached recently in New York between Panamanian President Ricardo Martinelli and US Secretary of State Hillary Clinton.

A final treaty is expected to be inked in the coming days, reported Panama’s La Prensa newspaper, according to Russia’s RIA Novosti.

“The US and Panama will sign before October 30 an agreement on the deployment of two naval bases on the pacific coast of our country to fight international drug-trafficking,” Minister of Government and Justice Jose Raul Mulino said Sunday.

“One of the bases will be located in Bahia Pina…450 kilometers [280 miles] east of the capital, Panama City, and another one – in Punta Coca about 350 km [217 miles] west of the capital,” Mulino added.

The US dismantled all its bases in Panama and withdrew its military forces from the country at the end of 1999 in accordance with the Panama Canal treaties.

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