It’s the people, the climate, the charming streets, the healthy lifestyle, and dozens of other traits that makes this country First in the world for that most important of rankings.

Faithful reader, allow me to present the unrivaled Best Place in the World to Retire…

* * *
Special Alert: The Best Retirement Haven in the World
By Eoin Bassett
Managing Editor, International Living Magazine

We’re constantly on the lookout for those countries around the world where you can live cheaper, enjoy better weather, pay less tax, be healthier, happier… where you can start a new life, start a business, retire…

But which country is best of all?

That’s the question we answer in this month’s issue of International Living magazine with our 2011 Global Retirement Index.

Every year we take masses of facts and figures, crunch them, mull them over, and then—for that unique ingredient—we go to our far-flung team of experts and editors to get their judgment. These guys know what life is like on the ground…and they have years of experience to draw on to make their calls.

And we have this year’s winner…a champion among the world’s best places to retire. A country that scores high marks in every one of the categories we use.

For the third year running, our winner is Ecuador.

“No matter where you choose to live in this country, there is no better place on earth to discover the simple abundance of health, tranquillity, adventure, and beauty,” explains expat Patricia Farmer, in this month’s issue.

For Douglas Willis and his wife Lisa, the Old-World feel and quality of the health care make Ecuador special. “In our experience, the health care is superior in almost every way to the U.S.,” reports Douglas in this special September issue.

“Doctors here are more accessible and hands-on, seem to really care about their patients and are very well-trained and qualified. There are a number of new medical facilities that rival anything available in the U.S.”

But the best thing about Ecuador is the cost of living. For less than $600 a month a couple can live well here…and $1,200 a month gets you a luxurious lifestyle.

The low costs create options you just don’t have in most other places. Like two homes for the cost of one. As Dan Prescher reveals on page 16 of this month’s issue, a total of just $120,000 can buy you both a beachfront condo and a mountain home… a rich man’s retirement, indeed….

But Ecuador’s not your only choice.

There are a total of 23 top retirement havens in the world. There’s something to recommend each one. Some have the ideal climate, others the cheapest real estate. Our winner scores highest in cost of living, but our runner up has the best special benefits for retirees…and where is the healthiest place to live?

You can learn everything you need to know about the best retirement haven in the world…and get the ratings and rankings in every category for every other country in our 2011 Global Retirement Index… in your latest issue of International Living magazine.
Of course, that’s not all that’s in IL magazine. You’ll also learn about…

The Updated Panama Owner’s Manual

How to Live the Caribbean Dream…for Less

How to Escape to Wine Country

Learn all about retiring in France

The Ultimate Portfolio for Triple Digit Returns: Global Real Estate Investing Made Easy

Buying Your Own Second Home In The Sun

And much more!

Incoming search terms:

• 2011 Global Retirement Index
• global retirement index for cost of living 2011
• international living survey on best retired place
• international living retirement index 2011
• international livings global retirement index 2011
• international living\s global retirement index
• Global retirement index
• global retirement index 2011
• international livings global retirement index
• international living\s global retirement index 2011

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.

–Recommended by IL–

Cash in on World’s Greatest “Mega-Trend” for a $1,429,000 Payday

America’s consumer boom of the 1950s created a generation of millionaires. 60 years later, a brand new unstoppable trend is kicking off … only this time YOU could be one of the investors who gets mega-rich as a result. Don’t wait. Because it’s happening right now. Two minutes from now you’ll know exactly which “New Horizon” stocks could give you quick and easy returns of 347%, 673% … even 2,765%.

For details, please go here now ->

The Ultimate Portfolio for Triple Digit Returns: Global Real Estate Investing Made Easy

*********************************************

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 ->
International Living Free Report

Incoming search terms:

• best place to retire panama or philipines
• Megalopolis in Panama
• museums in bouqete panama
• Panama Boquete
• Risking Everything: Coming Out in Coffee Land buy
• what can you buy for a dollar in panama

Now the market in Boquete does offer some good buys again but one of the best buys is right next door – this area is just like Boquete but offers pre-boom prices!

Panama’s highlands are spring-like…their hillsides covered with wildflowers.

Look in the right places (like Volcan, below) and you’ll also find quiet village streets with homes that start at $37,000…

Find the Most Affordable Retirement in Panama

It’s a stunning drive to Volcan—and that’s not just travel writer hype. As the road winds up into the mountains, one vista after another unfolds. I have driven this road many times over the past four years, and it’s still as invigorating as ever.

As I reach 3,000 feet, I turn off the air-conditioning and roll down the windows; the air is fresh and clean. The roadsides are festooned with thousands of red, pink and white impatiens. They look like they were carefully planted by a talented landscaper, but they’re a simply great gift of nature.

Passing through the small village of Cuesta de Piedra, I get a glimpse off to my right of the majesty that is Panama’s highest peak, the 11,400 foot Baru Volcano (pronounced “bah-ROO”). The jagged peaks of this sleeping giant carve through a swirl of clouds and mist.

Volcan sits in a valley that opens westward onto a wide plateau. At 4,200 feet, it’s easy to see why the town is famed for its “eternal spring” climate. It is framed to the north by the Tizingal Mountain and to the east by the slopes and volcanic plain.

The combination of spring- like weather and abundant fresh fruit and vegetables has led some writers to describe the area as the “Shangri-La Valley.” A brief look at the gravestones in the local cemetery reveals that many residents lived well into their eighties and nineties.

Volcan is a bustling town of about 10,000 people, of which about 250 are expats from the U.S. and Canada. The town has four supermarkets, four hardware stores, three banks (two with ATMs) and over 30 places to eat. If there is a global recession, the people in Volcan haven’t heard.

The local economy has been buoyed in part by nearby hydroelectric projects. This will soon make Panama virtually energy independent and pump millions of dollars into the local economy. But agriculture is the real driving force behind the provincial economy. Chiriqui provides up to 80% of all the milk, meat and vegetables consumed in Panama.

The greatest savings here stem from the climate. There is no need for air conditioning, fans or heating. I use an electric washer, dryer and dehumidifier, but my average power costs stay low at around $68 a month. I cook with gas that costs me about $2 a month; my water bill is $4 a month; and garbage pickup is also $4 a month.

At Dalys’s restaurant a bottomless cup of coffee will cost you 40 cents. A hearty breakfast is about $2.50. Dalys’s is famous for serving an enormous glass of wine for $1.35. If you want to eat tipico, or “typical fare,” for lunch, a tasty mound of beans, rice and chicken will set you back a princely $1.75.

Volcan’s supermarkets offer just about everything that would expect to find in North America. And at the local organic kiosk you can walk away with a bulging bag of vegetables—the freshest in the county—for less than $8.

Prices for homes range from $37,000 to $150,000, and there are also lots available on  which you can build the retirement home of your dreams. If your pocket book is well funded, then the clear blue mountain sky is the limit; there are large land tracts, trout-bearing rivers and streams, and views to die for. If you are spending over $150,000, you’ll have a selection of North American-style homes to choose from.

Note: This is the very last day you can sign up for the Ultimate Overseas Retirement Plan. It’s the complete package for anyone interested in Panama, including the new edition of the Panama Owner’s Manual…a special report detailing a step-by-step guide to The World’s Best Retirement Program…and a collection of recordings from a special seminar held in Panama.

The recordings are a real bonus—they include presentations from expats, experts, doctors, and retirees about living in Panama.

This entire package is worth more than $170…but you can get it for just $79 if you sign up with this link -
Ultimate Overseas Retirement Plan

Incoming search terms:

• boquete panama buy computer
• what is in fashion in panama
• what could $37 000 buy?
• what can I buy with $37000?
• what can i buy for £37000
• what can i buy for 37000
• places to buy in volcan panama
• Government healthcare in Panama City Panama
• buy boquete panama
• what is the true weather like in boquete panama

A few weeks ago I suggested some dates for getting a group together to tour Panama.

Well, I heard your feedback loud and clear!

The consensus for the best date is the week of November 28.

So, that’s when we’ll go!

Check out all of the details here -

http://www.learnaboutpanama.com/tropical-pathway-to-panama.html

Oh, and you’ll find the tour e-mail and phone number on that page. So, if you have questions about anything at all related to Panama give us a ring. We’ll answer all of your questions and I guarantee ‘NO pressure’ – we’re just here to help.

This is a great time of year to visit Panama!

The time to invest and do your research couldn’t be better!

I often tell people ‘Green Season’ is the best time to visit Panama and we’re just at the tail end so you will get a chance to experience a little of our Panama rain.

• It’s off-season so you can typically save money on air fare.
• It’s quiet in Panama so you don’t have to worry about the tourist crowd.
• Plus, it’s the “Green Season”. You can see for yourself why the locals love and prefer this time  of year and why you will too!

Learn all of the reasons and the best strategy I know to make it happen.

GO HERE -  http://www.learnaboutpanama.com/tropical-pathway-to-panama.html

You’ll discover how to Safely and Quickly get in on the ‘Best Place to Retire in the Western Hemisphere’

…All Without Spending years of research, countless return trips and thousands of dollars figuring it out on your own!

And some more exciting news!

But I’ll leave that for you to read…

HERE – http://www.learnaboutpanama.com/tropical-pathway-to-panama.html

See you in Panama soon!

Save up to 70% on your airline ticket to Panama booking with Flight Network

Incoming search terms:

• best time of year in Bouquete panama
• panama winter touring
• winter in Boquete panama

From 2005 until the bottom feel out of the US stock market Boquete Real Estate was appreciating at a dramatic rate. Many saw the writing on the wall and knew the escalation of prices couldn’t last much longer. Those who got in early are now enjoying their Boquete Panama Retirement. Those who looked to flip for a quick buck made money until the crash. But for the past year the market has been dead and now more reasonable pricing levels being seen in the area.

Living in Boquete Panama is now attainable for many people and offers some great advantages over the alternatives of high taxes and insurance rates in any of the typical US retirement  spots like Florida and southern Cal. Sure prices have crashed in both those markets but you certainly won’t find zero property taxes for up to 20 years as we have in Panama.

Here’s a great example of price adjustments and some of the fantastic buys you can now find for Panama Property – check out this listing => Jaramillo Boquete Panama Property.

Incoming search terms:

• homes in boquete panama

Of course, it’s not really “hidden.” In fact, some of Panama City’s oldest and most affluent families have been coming here for years.

But if you’re not in-the-know, you’d probably never hear of this place. Jessica gives you the scoop, below.

Panama’s Best Kept Secret

by Jessica Ramesch

A cool breeze tickles my neck as I take in the view from Gaital Hill. The sky is a gingham pattern of crisp blue and white now that the mists have dissolved in the afternoon sun. The fauna is deeply green and seems to cover everything. At the foot of the hill lies my destination…“the valley.”

Panama's Hidden Valley

–Recommended Reading –

Collect a large income from anywhere in the world you choose to live

With today’s economic situation, many readers are wondering how they’ll ever manage to retire or move overseas.

It’s a common problem… yet it can be a simple one to fix. If you’re in that situation yourself, we’ve found an easy solution you can use right now.

In short, it’s a way for  you to collect a great income from anywhere in the world you wish to live. What I like best about it, is that you don’t need years of education, or any special skill to do it.

Click Here to Read the full details…

**********************************************************
The drive into El Valle is my favorite part of visiting here. In the morning mist, the view of the Gaital Hill and Nature Reserve seems to appear out of nowhere as I follow the road that snakes into the town. The houses below are camouflaged by trees, so all I can see is green and more green. That is, until I reach the famous market, a riot of color bursting with flowers and sweet tropical fruit.

From its once-mighty volcano to its minuscule golden frogs, El Valle is a treasure of a town. Residents, many of them retired members of the Panamanian elite, rave about the strategic location and Spring-like climate.

Perhaps the best kept secret in Panama, El Valle is tucked into a crater five miles wide. About 2,000 feet above sea level, El Valle boasts fertile volcanic soil and a misty mountain clime. The combo makes this a gardener’s dream. Best of all, this cool oasis is only 45 minutes by car from Panama’s best Pacific beaches.

A tiny town, El Valle has grown in past years and today hosts a growing expat community, including North Americans, Europeans, and South Americans. Though there’s not much of a night life, the expat community in El Valle and the surrounding beaches has become much more active over the past two years. Expat events in the region include festivals and charity work, concerts and gourmet cooking classes, and much more.

Plus, El Valle is a true paradise for lovers of the outdoors. Whether or not you’re a bird watcher, you’ll marvel at the sheer variety of species. Tanagers, hummingbirds, and rare birds such as the mottled owl are frequently sighted here. It’s also the perfect place for plant lovers; city dwellers flock here to buy orchids at the weekend market.

One of the nicest places to visit is El Nispero Plant Nursery and Zoo. You’ll find more than 200 orchid species, as well as peacocks, storks, serpents, crocodiles, and the famous golden frogs that are unique to Panama.

Panama's Famous Golden Frogs

If the walking trail at El Nispero doesn’t whet your appetite for adventure, there are more challenging trails on Cerro Gaital. Or hike to the 125-foot waterfall, Chorro El Macho. The waterfall empties into a cool creek, the perfect spot for a swim or a summer day picnic. Or seek the therapeutic heat of the thermal springs and mud baths just off the main road to El Valle. Locals sit in the springs and then plunge into cold river water.

If you’re interested in indigenous culture, visit the El Valle Museum or La Pintada, a site where undecipherable petroglyph baffle historians.

Round out the day with a gourmet dinner at the hotel La Casa de Lourdes, known for its tasteful Tuscan décor.

Incoming search terms:

• el valle and boquete en panama
• hidden valley Panama
• panamanian golden frog
• boquete best place to retire
• where is boquete hidden valley
• what is panama famous for
• secret places panama
• plant nurseries in boquete panama
• plant nurseries boquete panama
• panama hidden valley

**********************************************************
–Recommended  Reading –

Going Fast: $30,000 Homes as Forgotten Peninsula Becomes Exclusive Retreat

A famous French architect is about to transform a quiet tropical peninsula into one of the world’s most exclusive retreats for the rich and famous. New York Magazine has hailed it: “the latest eco-playground with panache.” And now a torrent of big-name Hollywood stars have begun to descend on the area including Mick Jagger, Tom Cruise, Bruce Willis, Mel Gibson, Eddie Murphy, Brad Pitt, and Arnold Schwarzenegger. But you can still buy homes today along this peculiar piece of paradise for as little $30,000! Read More Here!

**********************************************************

Not so. The town of Cerro Azul, where Paul lives, was one of the trendiest places to have a home until the late 1980s or early 1990s. Then, for no apparent reason, the elite turned its attention to beach locations like Coronado, making Cerro Azul feel like something of a ghost town. From 2004 to 2008, when real estate prices all over Panama were steadily rising, Cerro Azul stayed surprisingly affordable. This was probably because expats flooding the country didn’t know about it. They were too busy in trendy locations like Boquete and Bocas del Toro.

But little Cerro Azul couldn’t remain a secret forever. Word got out, little by little, and a small expat community began to grow here. Today, Paul says at least 70 expats live in Cerro Azul. The effect has been a revitalization of sorts. Members of the Panamanian elite have rediscovered Cerro Azul as a weekend destination—just 30 minutes by car and you’ve left the city and its madness behind. And the full-time population continues to grow…

I went recently to check it out. The drive out of Panama City was easy, thanks to the excellent road. As we ascended, it seemed we were driving up, up, up into the clouds. Passing dairy farms and ranches, we came upon a colorful Chinese arch—an exotic accent amid the greenery and a signal that we were there.

Some people say that Cerro Azul is an “energy center,” and that in certain areas you can watch your compass go haywire. Perhaps this is why local groups come here for yoga and other spiritual retreats. Or perhaps they come simply because the pines and mountain peaks are an uplifting sight, complimented by jewel-toned hummingbirds and ginger flowers as tall as a ten-year-old.

You will find plenty of property for sale here, and if you get here now, you’re sure to uncover some real bargains. One lot for sale is just off an unpaved road and has water and energy service already installed. The lot is in a residential zone and is well over a half acre. Asking price: $17,600. For $40,000 you can get a half-acre lot in a gated community. A creek runs through the lot, which is in a cul-de-sac and has a distant ocean view.

If you prefer to buy a house and move right in, you’ll find even more options, from inexpensive cottages to big mountain mansions. One home is on offer for $80,000 and comes furnished. The four-bedroom, two-bath home comes with maid’s quarters with separate bath and a covered terrace. Another four-bedroom home is on offer for $90,000. It sits on a lot of nearly half an acre and comes with a pool, storage locker, and two covered terraces.

If your budget is in the $100,000 to $150,000 range, you will have even more options to choose from. One Swiss-style chalet is $120,000. It has four bedrooms and two baths, a balcony, and a patio.

Almost anything grows in abundance, from orchids to bromeliads that pop up wherever you look. It’s close to Panama City and to the international airport, but quiet and peaceful. Far from the city’s light pollution, you can actually see the stars…and there’s no noise to keep you from hearing the nightly symphony of frogs and crickets.

Most importantly, Cerro Azul may be right for you if you want breathtaking views but don’t want to pay hundreds of thousands of dollars for property.

Where did I find these great property listings? Here!

Incoming search terms:

• arnold schwarzenegger have a property in panama
• boquete panamabest place for expats to live in panama
• emerald monkey eco-luxe resort bocas del toro oficial
• mel gibson boquete panama
• mick jagger boquete
• panama brad pitt house
• paul best panama

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.

Incoming search terms:

• boquete panama health care
• Boquete Panama Hospitals
• hospitalchiriqui
• healthcare boquete panama
• hospitals boquete
• hospitals in boquete
• is there a hospital in boquete panama?
• bonquete panama hopsit
• level of health care in Panama
• mae lewis hospital health insurance panama

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.

Incoming search terms:

• beyond boquete
• beyond boquete real estate
• climate panama boquete
• Panama best places to live only
• beyond boquete com
• boquete panama climate
• art Punta Pacifica Hospital affiliated with the U S s well-respected Johns Hopkins Hospital
• david volcan or boquete panama best to live in
• panama at 5000 feet
• panama cool climate

Boquete did not make this index but it has been a favorite many times on the International Living Best Places to Retire list.

Check out the blog for more details on the 2010 Best Places to Live in the World!