Random ranting is always good for the soul. It is like a pressure cooker value releasing steam. A good rant is cathartic. Sometimes ranting keeps me sane. And living in Nicaragua as an expat, I have some frustrations about my country of birth. It has been a while since I’ve ranted, and Anita of the blog No Particular Place to Go inspired me with her rant-a thon, so here are a few of my random rants.
U.S. Health Care Rant
Don’t get me wrong. I appreciate having Medicare, but we can’t use it abroad! With my first eye surgery in the states, single payer was quick and easy. I paid 20% of the total cost of the doctor, facility, and anesthesiology. When I told my doctor that I needed to fly back to Nicaragua, he said he would have to replace the vitreous in my eye with silicon oil, which necessitates a second eye surgery to remove the oil.
“I am going to see if a doctor in Nicaragua can remove the oil in my eye,” I said to my surgeon. “Good luck with that,” he responded. “I doubt that you will find anyone as competent in Nicaragua as eye surgeons in the states.”
What is it with doctors’ arrogance? Waiting for surgery in the gurney, I watched as a train of gurneys were moved in and out of the operating room. “How many retina surgeries do you do here in a day?” I asked the attending nurse. “Usually 15 per doctor per day,” she said. I quickly calculated that the doctors each made $1750 per surgery X 15 surgeries a day = $26,250 a day!!! That is just the doctor! It doesn’t include the facility or anesthesiology fees.
I made an appointment in Managua at Vivian Pellas Hospital to see a retina specialist. Dr. Juan Rivers gave me a through exam and patiently answered all of my questions. When he said my eye was still extremely swollen, he asked, “Why didn’t the surgeon give you steroid shots to reduce the inflammation before injecting the oil?” I said that the doctor told me oil and water don’t mix, so he couldn’t put steroid shots in my eye. “Well, that is what we do before we inject the oil or gas,” he said kind of irritated. He shook his head and said that I would have to keep the oil in my eye for three months, which could have been avoided if they reduced the swelling first.
Through my tears… in only one eye… I thanked him for his patience and his TLC and scheduled another eye appointment for the end of August. His initial consultation cost $160.89. The surgery to remove the oil and replace my corroded lens will cost $3,000 for everything. Since we have international health insurance, we weighed the cost of airline tickets, a rental car, and at least two weeks of expenses to repair my eye in the states in a train of gurneys vs the cost of surgery with Dr. Juan Carlos Rivers at Vivian Pellas. I opted for a competent, caring doctor in Nicaragua. I can file claims with my international insurance and get some of my money back.
U.S. Online Forms Rant
What’s with the U.S. online forms and telephone numbers?
If you live in Nicaragua, you know that our cell phone numbers have an area code with three digits, then the number looks something like this… 505-8824-4689. I don’t have a number in the U.S. So, when I fill out banking forms, or purchase airplane tickets online, or a number of other forms from the U.S., I am always frustrated because the online forms don’t accept four digits.
For example, we got a new mini iPad and were setting it up. It asked the location and we entered United States. To verify our information, they were gong to send us a code from a U.S. cell phone number we made up because our 4 digits wouldn’t fit in the box. So, we had to change our location to Nicaragua so the number would be accepted and we could get the code.
Most of the time we just make up a U.S. cell phone number. Still, it is frustrating and if they need to send a verification code and don’t provide spaces for international numbers, we are out of luck unless we get a Skype or Google Voice number.
Online Entertainment Rant
Living abroad presents challenges with Netflix, Hulu, Amazon Prime Video, and other online entertainment sites. In order to receive my U.S. subscriptions to these sites and receive the U.S. selections, I have to use a VPN. And…Netflix even blocks some of the most popular VPN companies and certain locations from these companies, so I had to change my location from Miami to San Francisco to watch the U.S. selection.
What about travelers who are passing through countries? If they have a U.S. subscription, shouldn’t they be entitled to receive their U.S. selections?
Anita mentioned this in her rant and it is something we as expats have to deal with on a regular basis. Fortunately for us, we still have a house in the states, so we can use our U.S. address to keep our credit cards, our U.S. bank, pay our taxes, renew our drivers’ licenses, vote, and receive mounds of junk mail at our house in the U.S.
Without a street address, we would not be able to keep our credit cards or our bank because they do not accept a P.O. box as an address. Anita resorts to using a family member’s address, and I suppose many other U.S. expats do the same.
Because of U.S. regulations imposed on foreign banks, many foreign banks are throwing their hands up in the air and refusing to accept U.S. citizens who want to open an account in a foreign bank. Every year foreign banks have to notify their U.S. customers that the U.S. wants to know how much money they have in their banks. I guess they are concerned about money laundering, but seriously?
Here is another reason to have a U.S. address and U.S. bank. If you collect social security and deposit it in a foreign bank, every two years you must fill out a “Proof of Life” form to continue to have your social security deposited in your foreign account. Yep! That is really the name of the form. You must prove that you are still alive and kicking by submitting the form in a timely manner or they will cut off your social security. I guess they are concerned about social security fraud, but seriously?
Believe me when I say, I do try to be transparent in my dealings with U.S. bureaucracy. However, sometimes for the sake of my sanity, I have to be a little deceptive. I pay my taxes, I follow the laws. I am a good citizen in my adopted country as well as my birth country. But, dang it! I wish the U.S. would show a little more flexibility and a more modern approach to a global world with all of its complexities. One can only continue to hope…right?