That exchange jogged my memory back to an article Dr. Elizabeth Lee Vliet wrote in July: 10 Reasons Why Obamacare Is Going to Ruin Your Medical Care… and Your Life. Dr. Vliet is an acclaimed expert on the enigmatic law, and one of our featured speakers at this week’s Casey Summit in Tucson. She wrote (all emphasis in original):
“Higher expenditures to provide medical services lead to rationing of medical care and treatment options to reduce costs. This is the mandated function of the Independent Payment Advisory Board (IPAB): to cut costs by deciding which types of medical services to allow… or disallow.
“If you are denied treatment, you have no appeal of IPAB decisions; you are simply out of luck, and possibly out of life. This is a radical departure from the appeals process required for all private health insurance plans. Further, the IPAB is accountable only to President Obama, and cannot be overridden by Congress or the courts. IPAB is designed to have the final word on your health.
“Under current regulations, if medical care is denied by Medicare, then a patient is not allowed to pay cash to a Medicare-contracted physician or hospital or other health professional. Patients who need medical care that is denied under Medicare or Medicaid will find themselves having to either: 1) look for an independent physician or hospital (quite rare these days); or 2) go outside the USA for treatment.”
Huh. So my cash won’t be good enough for US doctors or US hospitals. Good thing I was gearing up to interview Nick Giambruno, editor of International Man, for the August issue of Money Forever, when I first read those frightening statements. It’s strange how Nick’s comments on currency controls wound up speaking to my healthcare worries. Here’s what he had to say:
“Currency or capital controls are a favorite option in the tool box of a desperate government and are fairly common in the world today. Though they come in many shapes and sizes, capital controls are government regulations that prevent you from taking your money in and out of a country. The imposition of capital controls usually precedes some form of wealth confiscation (a currency devaluation or deposit confiscation among other measures) and always comes as a surprise to the average person. By their nature, capital controls have to come as a surprise in order to be effective. …
“There were many… [Cypriots] who saw the writing on the wall and had previously moved to diversify a portion of their savings internationally—most commonly with a Swiss or other European bank account. …
“This concept of diversifying your sovereign risk through internationalization is universal and applies to everyone in the world. It is especially urgent for those who live under a government whose fiscal health is in bad and deteriorating shape. Of course it is only an effective strategy if you act before the capital controls and other restrictive measures are imposed.”
It’s clear how currency controls can cause one to lose a lot of money, but there can be far worse consequences, too.
As seniors, Jo and I will likely find our care denied or delayed under the new law. What happens if one of us needs a knee replacement or a quadruple bypass and care is denied? We won’t have the option to pay cash here at home, so that leaves two choices: go offshore, or go without treatment. I know what my choice would be.
Nevertheless, what if I had the means to pay out of pocket offshore, but I couldn’t take my money out of the country? How sad would it be to need a quadruple bypass, be denied care, and still be unable to pay for the procedure offshore because of currency controls?
Here’s where things get really sinister: Our government would have no incentive to allow a medical loophole in its currency controls. If we die, we are off the Social Security payroll, and maybe it can even snatch some of our wealth through the estate tax.
While I am not qualified to discuss the pros and cons of health care in individual foreign countries, I can say that you will need money to pay for it. That means money you can easily access offshore. Remember, if IPAB denies treatment, there is no appeal process. You are simply up a creek without a paddle, so to speak.
Moving money offshore—now—could be the most important medical decision you make for yourself and your family. International investments make sense for a lot of reasons; protecting your life is sure one of them.
If you want to learn more, Nick and his team have published an inexpensive special report, Going Global 2013. While it does not outline healthcare options, it is the best, most comprehensive report on internationalization I have ever read. First things first: we need a safety net with money offshore. Then we can determine the best countries for health care and hope we never have to go there for treatment. Better safe than waiting penniless in a foreign ER.