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healthcare

March 8, 2010
Pattaya, Thailand

I managed to pick up some nasty bug that has knocked me into next Tuesday… But while I feel completely miserable at the moment, this little bacterial bout has given me the opportunity to experience, first-hand, the joys of the Thai medical system.

First, doctors make house calls. When you’re as sick as I am, the last thing you want to do is get dressed, sit in the car, and go to the doctor’s office. Not a problem in Thailand… they come to you, all for about $30. And yes, they speak perfect English.

Second, if you’re a believer in medication, you can buy pretty much buy whatever you want over-the-counter– from antibiotics to codeine to Viagra. And everything costs a small fraction of what you would expect. You almost feel guilty, like you’re ripping off the pharmacy.

I paid 80 baht, roughly $2.50, for a 5-day batch of antibiotics, ibuprofen, and throat lozenges.

Third, if you so choose (and I do), you can have a team of nurses attending to your every need while you’re getting better. I’ve got a couple of ladies whose sole mission in life is to take care of whatever I need– changing the sheets, making a bowl of soup or tea, giving me a massage, or just sitting next to the bed with a wet washcloth over my forehead.

It’s funny what kind of misperceptions people have about medical care overseas. I’m frequently asked “What happens if you get sick overseas? Aren’t you concerned about the quality of medical care?”

Trust me, if/when I get sick, especially in an emergency, I truly hope that I’m in a place like Thailand or Panama instead of wasting away in waiting room back in the US, or paying through the nose for medicine.

Anyhow, I’m going to cut this short today for obvious reasons… depending on how I feel tomorrow I may or may not post something, so don’t be surprised in case you don’t hear from me.

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February 5, 2010
Mexico City, Mexico

Greetings once again from Mexico; I’m sure many who listen to the mainstream press would be amazed to find that I have spent 48 hours on the ground here with nary a swine flu infection nor simple mugging to report.

I did, however, miss my flight to Canada.

What can I say… Mexico City traffic has got to be the most dangerous thing in this country. I was able to change my plans and will be in Vancouver this evening.

Before I get started on answering your questions from the mailbag, I wanted to mention a brief administrative note– if you ever have difficulties opening or reading the daily email in your inbox, you can always read it online at www.SovereignMan.com; in the meantime, my staff is working on resolving all readability issues.

Moving on to questions.

To start off, John asks: “Hi Simon- you don’t talk about politics much, though I have a feeling where you stand by reading your letter each day. Can you give me a better idea of how you see the world, politically?”

First and foremost, I want to make an important distinction. I am an avowed anarchist. Just the word itself has an incredibly negative connotation– it conjures images of subversion, treachery, and treason… or at least crazy guys hoarding guns in Montana.

People too often confuse ‘anarchy’ with ‘chaos’, usually citing examples like “if there were no laws, what would keep people from driving on the wrong side of the road?” or “who would come and put out the fire when your house is burning?”

These arguments are weak and only serve to indicate the extent to which governments have brainwashed people. Most citizens now believe that the political establishment is vital for their own survival, as if we would all spontaneously combust were it not for the FDA.

Anarchy is not chaos. The political establishment is chaos. Politicians have a horrific track record managing wars, finances, education, health care, and just about everything else they put their hands on… all at the expense of public resources.  Very little changes for the better, at least thanks to the government.

And yet, every few years, we still put on a charade to cast our vote, as if this ridiculous exercise has any meaning whatsoever. It’s an unpopular thing to say, but participating in the political process is a complete waste of time… particularly since we have a much more powerful voice.

The most important votes we cast are as consumers, not constituents… we vote with our dollars every single day. The best candidates, i.e. the producers, win our votes, and the worst candidates go bust. No amount of baby-kissing can save a defunct company.

Hell, not even a government bailout could keep Chrysler and GM alive.

Personally, I would prefer to have all of my tax dollars back in my pocket and pay a usage fee for privatized roads, or an annual subscription for a privatized library, rather than have some bureaucrat funding pet projects with my hard-earned money.

I recognize that this is all just a pipe dream, at least for now. Political institutions are here to stay, and the trend is bigger government, not more limited governments.

That’s one of the reasons why I have chosen this lifestyle– with a multiple flags approach, I minimize the impact that any single government has on my life.

Betty sends along the following comment: “You wrote that hospitals in Boquete, Panama were substandard. You are badly misinformed. Hospital Chiriqui is a modern hospital with excellent doctors who speak English for the most part; I should know, I was in intensive care there for three weeks and had five specialists attend to me.”

Noted, Betty. Thanks.

Captain asks, “Simon, do any ex-US real estate markets employ US-style mortgages?”

Yes. Panama is one of them; foreigners can get a 50% to 70% mortgage, and a better rate if you become a resident. Many European countries also underwrite mortgages for foreigners.

The other thing to consider is developer financing instead of bank financing. This tactic is being used in a lot of places around the world to mop up extra inventory. I see this everywhere now– Spain, Thailand, Morocco, and here in Mexico.

Standard packages generally require 10% to 30% down, and will finance the balance on a 30-year amortization schedule for a 5-year term.

Nathan asks: “Simon- Regarding China, I know a lot of people have been high on the country for some time. But what is the real analysis here?”

To be clear, I am not a blind China bull… but I’m happy to call a spade a spade. The ‘good’ part of the analysis is fairly simple. In the long run, there are two things needed for sustained economic growth: technology and savings.

Technology makes production (i.e. wealth generation) more efficient, and a large pool of savings becomes investment capital to create businesses, build factories, etc… things that add value to an economy.

China has both, and so the foundation for its economic growth is sound. However, there are a LOT of potential problems with China– the economy succeeds despite its government, and I’m concerned about future political instability.

Furthermore, I expect one day that China will go through significant challenges as it finds that it can no longer compete with its neighbors for low-skill manufacturing. The country will have to develop entirely new industries, and that could be painful.

Lastly, the Chinese are become cultural consumers… shop-a-holics really. This consumption depletes the pool of savings, and if sustained, will create long term structural issues.

That’s all for today, I’m off to Vancouver.  Have a great weekend.

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January 29, 2010
Boquete, Panama

It’s a beautiful day in the Panamanian highlands, and I’m taking the opportunity to explore the countryside for undervalued land deals.  The Chiriqui province of Panama, where I am now, is sort of like the Panamanian version of Texas– fiercely independent and proud… locals consider themselves to be citizens of Chiriqui first, and Panamanians second.

As we’ve discussed in previous letters, I have been sincerely exploring the idea of developing a subscribers-only sustainable community, and Chiriqui is on the short list of locations.

On that note, I really want to thank you for providing me with your feedback about the community concept; over 650 people have filled out the survey so far, and I’m convinced that the idea has tremendous merit. More to follow on that in the future– for now, let me get to some subscriber questions:

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I was reading a menu, but I wasn’t in a restaurant.

Liposuction: $625
Tummy Tuck: $1,250
Breast Enlargement: $1,125
Sex change operation: $1,625

I did a double take. Yep, that wasn’t a misprint.

Thailand is renowned for a lot of things– beautiful beaches, crazy nightlife, political instability, etc. One of the things it should be better known for is medical tourism.

People often ask me because I travel so much, “Simon, what would you do if something happened to you– wouldn’t you be scared to go to a hospital in a foreign country?”

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Remember that Croatian commando-turned-entrepreneur from dinner last night?

Well it turns out he’s an aerobatic stunt pilot too… he’s got an old Soviet-made aircraft that is only designed to do one thing– be as unstable as possible. It does the trick.

This morning around 11am Central European Time, we met at a private airfield outside of Zagreb. He strapped me in to the cockpit, took me up to about 2,500 feet, and proceeded to test my manhood.

Let’s just say I’m glad I skipped breakfast.

I have never had to withstand five times the force of gravity before, nor had I much of a clue what that even meant. And yet, over 12-hours later, I am getting queasy all over again just telling you about it.

Fortunately we had the video cameras rolling, and I will be posting footage to the site in a few days for your enjoyment… but first, a little taste of where I happen to be right now in the lovely Italian Alps-

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Now… since this is Friday, I wanted to take a moment to review a few topics from this week:

NATIONAL HEALTHCARE

I am deeply appreciative of the intensely personal anecdotes that were provided on the health insurance piece, particularly those accounts with specific prices and treatments.

Several stand out in my mind, including Mike’s “Chile saved her life,” and Jai’s “About a decade’s-worth of care in Asia spent in one morning.” These are powerful testimonials to overseas healthcare solutions that do not rely on insurance companies or government bureaucrats.

A few readers took umbrage with my characterization of national health plans. Fair enough. For every negative example highlighting the failures of the system (VA, Cannuck, NHS), there are certainly a plethora of examples of patients who have been healed due to the quality of care received.

My intention is not to take anything away from the medical professionals who serve under these systems, but rather to demonstrate that bureaucrats fail miserably at everything, especially healthcare.

I simply don’t think the same government that took the better part of a week to deliver water to New Orleans should be running a national healthcare program. Not to mention the idea of nationalized healthcare makes a mockery of the Constitution.

To reiterate, my solution is to build my own network of doctors in places where care is inexpensive– Panama, India, Brazil, Thailand, etc. And if you find it crazy to jump on a plane to seek quality, cost effective, potentially life saving medical care in a foreign country, then you are probably reading the wrong missive.

EURO SHORT

As always, very bright comments from everyone… and Gernot, I am on the way to Germany this weekend to verify what you said. I agree that the euro may likely show signs of stability and even strength in the short-term on the backs of the Germans and BENELUX.

My assessment of a eurozone collapse, however, is a long-term view. And betting in favor of the dollar to take a short position in the euro does not make sense to me in the long-term.

Currency markets are all about capital flows; when risk tolerance is high, institutional wealth pours into emerging market currencies and away from the dollar. When risk tolerance is low, the dollar strengthens and bond yields fall.

When investors begin to lose confidence in the euro, capital will flow away from the eurozone and have to find a home somewhere. At that point, it probably won’t be the dollar. But where?

There are only a handful of instruments in the world that can absorb hundreds of billions of euro in capital flows– and the Japanese Yen is one of them, and my sense is that the Renminbi may be one as well someday.

Long-term contracts for the future values of the Euro/Yen and Euro/Renminbi cross rate are tradable in Chicago, and a variety of overseas exchanges as well.

Furthermore, many online FOREX brokers provide the capability to short the euro against gold and silver (buy XAUEUR and XAGEUR), both of which I expect to perform even better against the euro than the dollar in the longer term.

In the meantime, selling the euro in favor of the dollar in the short-run is too risky for my taste, and I wouldn’t advise it.

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Nationalized healthcare doesn’t work, and I’ll tell you why:

I hold as my personal mantra in life that governments screw up everything they touch… and this goes for all governments, not just the United States Congress.

As I travel the world looking for great opportunities, I always try to understand the quality and efficiency of the local healthcare system. Sometimes I even go through it myself.  My conclusion? Most, if not all public healthcare systems are broken and drowning in red ink.
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You probably know the story of the boiling frog.

The premise is simple.  If a frog is placed in a pot of water that is already boiling, it will immediately sense danger and jump out, relatively unscathed. If it is placed in a pot of cool water, the frog will happily stay in the pot while it is slowly heated to a boil.  By the time the frog realizes the danger, it is too late.

The metaphor is used to describe how society is allowing itself to be slowly boiled– small changes that go unchallenged will lead to imminent danger.

History has seen plenty of examples– everyone always cites Nazi Germany or Rwanda, but there are countless others that don’t involve fascism or genocide.  I think today’s Argentina illustrates this point clearly.

After that country’s 2002 economic collapse, Argentina’s legislative assembly granted extraordinary power to the president on the grounds that unprecedented times call for unprecedented measures.

Seven years later, the president is still holding on to those powers, and usurping even more.  The federal government completely dominates Argentina’s economy, either directly through shareholder control, or indirectly through regulation.  Government sponsored thugs execute a mafia-like grassroots agenda, and now the government is seeking to limit the voice of what little free press remains.

The moral of Argentina’s story is simple: the greater the power given to the government, the less likely they will ever relinquish it.

In the United States, the growing tide of government power over the last decade has been equally disturbing.  Each passing bill– the USA PATRIOT Act, the Emergency Economic Stabilization Act, etc. raises the temperature in our collective pot of water by a few degrees.

One by one, some frogs are wising up and are starting to jump out

I find the recent morass to be especially boiling. The CFTC, under the spurious motive of protecting the people, has announced hearings to discuss limiting oil speculation… this is the first step in price controls, and methinks corn and wheat cannot be that far behind.

Further regulatory developments include a proposal coming from the FDIC to limit the size and scope of commercial banks. Comrade Bernanke has endorsed the idea, indicating that it is ‘legitimate’ to artificially restrict the growth and profitability of a private enterprise.

And now we have, within the last few days, the economic luminaries on Capitol Hill unveiling a special tax on the nation’s top earners to pay for the 1,000+ page health care bill… that no one has actually read.

Without even a cursory understanding of the bill, Congress is proposing to legislate the majority of Americans into health care by legislating a minority of Americans out of their wealth. Perhaps the ’stimulus surtax’ will follow close behind.

Is it getting warm yet?

As a casual outsider who has checked out of the nation-state system, I find myself curiously peering inside from time to time wondering about that boiling point… what will it take for people to finally realize the peril that they are in?

It’s clear to me that subscribers to this letter are a cut above. You are a thinker who will keep working to improve your personal lot in life despite the foolish behavior of politicians.  But each of us has a breaking point… a point where we, like Howard Beale in the film Network (clip below), decide that we’re just not going to take it anymore.

What’s your breaking point?  I’d like to know.  Make your voice heard by commenting below.

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