As one of America’s baby boomers, I am acutely aware of how little time we spend preparing for our retirement.  We tend to spend much more time planning our vacations than our retirement. In my book Making the Golden Years Golden I provide the reader with many tools and guidelines as to how to prepare for the retirement years. Here are some steps to help you prepare and protect yourself.    

1. Wills: Every American should have a will in place, eliminating any ambiguity and misunderstanding among the people you love. This Legal Instrument need not be expensive. You can find many sites on the internet that cost no more then $49. All you need is two witnesses that will attest that you signed it of your own will. Make sure to review your will every 2-3 years to make sure that it still reflects your wishes. Choose executors that will follow your wishes.

2. Health Proxy:  Designate a person to make medical decisions for you in the event that you are unable to do so. If you do not have a health proxy representative to speak for you, strangers will make decisions about your  care, such as doctors who do not know you or your wishes. Review your Health Proxy every 2-3 years to make sure that your representative is still available.

3. Medical Records: Keep all your medical records, from all specialists who are providing you with health care services. Ask for copies of all tests and reports. It is your right. Keep copies of all medical records in a file, and let someone you trust know where you keep the file, so they can retrieve it in a time of need, such as a medical emergency.

List of Medication: Keep an up to date list of all medications that you are taking, including dosages, and times of taking them. You can include added information such as: with food, before your meal, etc.

 List of Doctors: Make a list of all the specialists that provide you with  health care. List them by name and specialty. Make sure to include their phone numbers and addresses.  Take with you the List of Medication to all doctors’ appointments, so each will know what the other prescribes.

 4. Make Your Home Safe: Review your home for safety.  Install safety bars in the bathroom. Keep a chair in the bathtub or shower. In the kitchen and bathroom, make sure that items that are used daily are placed low and within easy reach. Remove all area rugs, etc. Keep a list of emergency phone numbers, such as family members, friends and neighbors, pharmacy, etc. Keep on hand extra food and medication, that will serve you if you are unable to leave your home.

5. Financial Plan: Create a financial plan early. When investing keep an eye on future needs when you retire. Be careful when giving someone Power of Attorney.  Estate Planning should be developed, regardless of the size of your estate. Check if Trusts are appropriate for you.

Protect yourself from Scams: If you do not initiate a call, and you do not know the caller, hang up. The longer you stay on the phone the greater the chance that you will give out more information than you need to. Check solicitations from fund raising organizations carefully. Many are scams to get your money. Never give out your Social Security Number or your bank account number over the phone.     

For more information:  www.goldenyearsgolden.com

Author of “Making the Golden Years Golden”

The numbers reflecting incidents of abuse in the senior population vary depending on the source that is reporting them. Definitions of what constitutes as “abuse” are also diverse: some sources define elder abuse as only physical abuse, while other sources include emotional abuse, sexual abuse and financial abuse. Accurate numbers are also extremely difficult to compile since many incidents of abuse go unreported. Many elderly are afraid or ashamed to report incidents of abuse, especially if the perpetrator is a family member. Seniors at times are emotionally or physically abused by a familiar person, and are often unable to recognize it as abuse or rationalize it. 

What can be done to eliminate incidences of abuse? Society should shoulder the responsibility to protect the elderly, but it begins with the family of the senior. Many of the children and other relatives of the elderly feel that once they have a care giver to care for the elderly their work is done. Far from it, they need to remain vigilant in directing and overseeing that good care is in fact what is provided. 

When visiting an elder loved one, you should be alert to the warning signs of abuse:

 Emotional or Psychological Abuse:

Are there insults or threats directed at the elder? Are they living in social isolation? The elder may be extremely upset, withdrawn, unresponsive, or exhibiting other unusual behavior. He or she may have a vacant look in their eyes or exhibit fear; they may not always express those verbally, so look for signs in their face or behavior.

Physical and Sexual Abuse:

Look for suspicious bruises or other injuries. Look for signs of restraints, such as a rope burns.  See if he or she shows sudden changes of behavior, such as unexplained anger, fear, withdrawal, or has become very quiet. Note if a worker or caregiver refuses to let you visit the elder, making all kind of excuses.

Neglect:

Look for signs of malnutrition, if there is noticeable weight loss, dehydration, bed sores, or if personal hygiene is noticeable neglected. Note if the elder is sitting in soiled clothing, unshaven, unkempt, without dentures, or with long or dirty nails, are they walking around at midday still wearing pajamas? Listen to complaints from the senior as to whether or not their aide is listening to them or following their wishes and follow up on them.

Financial Abuse:

Keep an eye out for unexplained bank withdrawals, unauthorized use of bank and credit cards, reports of stolen or missing checkbooks and bank cards, or if your parent or elder writes checks as a loan or gift to the aide. Be on the lookout for valuables suddenly disappearing. Monitor any sudden changes in the will or banking documents, and be alert if assets are suddenly transferred to a family member or to someone outside the family.

 If you discover any of the above warning signals, you should correct them and/or notify the police. The above warning signs should be looked for not only in the home of the elderly, but also if they reside in a nursing home, assisted living facility or a residential care facility. If the elder does not have a family member to protect him or her, the responsibility falls on the society, all of us – doctors, social workers, friends, neighbors and local clergy. For more info:  www.goldenyearsgolden.com

Dr. Eva Mor author of “Making the Golden Years Golden”

Just like millions of other baby boomers, my friend Judy lives quite a distance from her parents. She has lived far away from them since she completed graduate school and started her professional career. During regular visits to her parents, things seemed well, and as they aged, they seemed able to handle their affairs without needing Judy’s help.

In recent years, however, she noticed changes: in the beginning the signs were mild and not alarming, but eventually she could not dismiss the symptoms of trouble ahead. Judy’s parents called her repeating the same anecdotes, and there were car accidents — nothing major, just scrapes and dents, and always someone else’s fault.

Judy flew out to her parents’ home after receiving an urgent call from her father’s doctor that her father fell and broke his leg. It was clear to my friend that her parents needed help and, like it or not, she needed to step in. Although Judy’s father was released back home, her mother was unable physically nor mentally to attend to his needs.

What you need to do if you find yourself in a similar situation?  

If you need to oversee your parents care from a distance, as Judy needed to do, you have to set up a plan — a situation which I cover extensively in my book Making the Golden Years Golden. It is wise to set up this plan early, before a crisis occurs.

 Start with evaluating the apartment or house for safety hazards. Install safety bars in the bathroom, remove all area rugs to prevent tripping, check all chairs for steadiness, remove all lose electric cords. All items used daily such as plates, glasses, cups, etc. should be placed low and easy to reach. Establish support system around them. Find someone that lives near your parents and is willing to step in to help or alert you when an emergency occurs. This may be a relative, no matter how distant, a friend or a friend of a friend — anyone that is willing to be the extra pair of eyes. You may want to notify the local police office that an elderly person is living there on his or her own, and if they could look in and check on them during snow storms or heat waves. The local utilities company may have a program for elder protection. You may want to check out local home care agencies that may step in if help is needed. You may want to have information handy such as cost and contact person. 

Schedule regular visits to your parents, and regular phone calls. Keep your parents’ information readily available in case you need to provide it to care-takers, such as hospital, medical specialists, home care agencies, etc.  Have a copy of their Medicare card, supplementary insurance card, list of medication they taking, the names and phone numbers of the doctors that see to their medical needs, phone number of a car service, to be able to arrange a ride for them when needed. If such preparatory plan is put in place ahead of time, it will help you direct care for your parents from a distance. For more info-  www.goldenyearsgolden.com

Last year over 60 billion dollars were lost to the scamming of Americans of all ages. 35% of them were seniors, according to the AARP, though in all likelihood the numbers are higher. Many of the elderly do not realize that they were scammed, or are too embarrassed to report the scamming, thinking it is their fault. It is not. We all are fairly easy targets. The key is to be alert to the techniques of the scammers and prevent becoming a victim.

Here are some tips to help you and your parent stay protected:

1. Learn to say NO. You do not have to be liked by everyone, especially salespeople. It is okay to say no.
2. If it seems too good, it is. Nothing is given away for free. If someone is trying to sell you a bill of goods, stop them from continuing; they’ll sound more convincing the more time you give them to talk.
3. Protect your personal information: never give any information if someone calls you. Even if you initiate the call, limit the amount of information you are giving out. It is especially important not to give out your Social Security number.
4. Never give your credit card information over the phone, except if you’re the one initiating the call that involves paying a bill or making a purchase with a company you know and trust.
5. Be very careful buying from companies you are not familiar with, your purchase item may never arrive and your credit card information may be illegally used and sold to others.
6. Never use your credit card as a verification of your identity: crooks try hard to get your credit card information, even if you are not purchasing anything.
7. Do not let anyone pressure you to make a decision on the spot. Do not believe that the deal is only good for “now”. Take your time to think it over. Even if you intend to make the purchase, always leave yourself a day or two to think the deal over.
8. It is your right to ask as many questions as you need to. You should not be intimidated by anyone. If they are dismissive, not answering your questions or refusing to divulge information, hang up the phone. Believe me; you do not want to deal with this person.
9. Before you commit yourself to anything or sign anything, ask to see everything in writing. Read and reread everything before signing.
10. Seek out advice of a professional, a friend, or someone you know and trust before you commit your money,
11.  Discard all mailing informing you of “prizes” you have won. They are just trying to trick you to purchase something you do not need. As the old saying goes, there’s no such thing as a free lunch.
12. Never open your door to strangers. If someone knocks on your door telling you their car broke down and they need to make a phone call, or they need a glass of water because they do not feel well, do not open the door, especially if you are alone. Tell the person behind the door that you will call the local police to assist them and then do so. It is unfortunate that we should need to be so untrusting, but it’s better to be safe then sorry.
13. Trust your instincts. When you have a bad feeling about something, it’s usually right.

Popular destinations for dental care

Mexico and Central America

Quality dental care is available in many countries around the globe.  For Europeans and people in the UK, Hungary is a popular location, though a bit distant for many Americans. India and Thailand also offer excellent care at considerable savings, but are really, really far away making them impractical for North Americans.

People in the States find Mexico and Central America to be the best bet. Those in border towns often drive to Mexico for dentistry, though the escalating drug wars are cutting into trips. Frequent flights, short flight times and inexpensive ticket prices make other Central American destinations attractive for dental travelers from the States.

Central American locations are popular choices for more than their proximity to the US and their temperate climates. Countries in that part of the Americas, being closer to the US, are more likely to dentists who speak English fluently, come here for training and maybe even have practiced here at some point in their careers.

Quality care can be found in all three countries. As the table illustrates, there are differences between the destinations. Overall, Pan American Dental Tours chose Panama because of its overall superior profile.

Comparing Dental Travel Locations

Flags (top to bottom): Costa Rica, Mexico, Panama

Why Panama

1. English-Speaking Dentists

The English-speaking tradition is a strong one. Many dentists have trained, or even practiced in the States  and belong to the American Dental Association.

2. Safety

Panama City is a modern, bustling metropolis. Forbes Magazine and Business Week, among many other sources, consider Panama to be a top choice for Americans choosing to retire to a safe country.  Headlines of drug wars, kidnappings and death make Mexico a dicey place to visit. San Jose, the Capital of Costa Rica, where dental tourists go, is in many ways a Third World city. The US State Department warns the visitor.

3. Ease of Travel

On the ground, you can drive comfortably in Panama.  Roads do not abruptly end and turn to rubble (you can lose your fillings driving in many parts of Costa Rica).

4. Eco-tourism

Lonely Planet says, “Panama’s biodiversity is staggering – the country is home to 218 mammal species, 226 species of reptile, 164 amphibian species and 125 animal species found nowhere else in the world. Panama also boasts 940 avian species, which is the largest number in Central America.

5. US Dollar

From the capital city to the smallest villages, you can pay with the US dollar and even get change in dollars and coins. No fumbling with conversion rates, and hefty credit cards exchange fees will not affect you.

How to Find a Dentist Abroad

As this quote from a respected travel authority notes, the prospective dental tourist must be prepared to spend time to locate dentists. It’s even more than locating the dentists. A patient needs to have a fair amount of knowledge about dentistry and the specific procedures they require, which takes even more time. The typical patient is looking to get quality care at a savings, not a dental degree. Sometimes language gets in the way. Frustrating long distance calls to offices where English is not spoke is costly, time consuming and sometimes nerve-wracking.

The dental tourist can simplify the process and reduce their anxiety about making choices.

Finding a dentist

Friends

Recommendations from satisfied friends who have been treated abroad is always a great way to start a search.  You should find out the work that was done, the factors that appealed to your friend and their impressions of the place where he/she was treated. Their needs may be very different than your own, because they had different work done or prefer a personality that you do not like.

Internet

Web searches for “dental tourism” will yield results, in fact at last count, 1.240,000 results. The top results will include many medical tourism companies, and even the sites of dentists who offer to treat dental tourists. There must be an easier way.

Dental Tourism Facilitators

A new industry has sprung to help the dental travelers find the care they need. Dental Tourism facilitators can help the patient looking for care.  These facilitators often have relationships with dentists and sometimes tour companies in one or more locations and they work to make the process easier.

Facilitators are usually paid by the dentists, so the patient can save time and also get the knowledge base of the facilitator at no cost.  Although the facilitator has a vested interest in promoting the professionals they are partnered with, they depend on satisfied clients and referrals, so their interest is in satisfying clients.

Travelers should vet the facilitator they choose. Many facilitators work across the spectrum of medical procedures, making it unlikely they have met dentists they recommend or ever inspected their offices. Ask how they chose the dentist they recommend and when they met.

Even then, the dental traveler should exert caution. Some facilitators are travel agents and may not have specific healthcare and dental experience.

Can the facilitator provide any references from patients treated by the dentist they recommend? Do the credentials of the dentist themselves meet a set of criteria—where and when were they educated and trained? What professional societies do they belong to?

On the Ground: What a patient needs to consider

How do I know exactly what work will be done when I get in the dental chair?

Reputable facilitators will only work with patients who provide Treatment Plans and x-rays from a US dentist. Why? A patient wants/needs to know what something will cost before flying to another country. The dentist who will do the work must be able to see what is needed. As professionals, they may recommend the same, more, or less work. So the patient will know what they are getting when they arrive for treatment.  (Note: Some patients are embarrassed or afraid to ask their dentist for a copy of records. Dentists get these requests often. Federal HIPAA law says that patients are entitled to copies of medical and dental records.

How much time will it take?

Different procedures require different amounts of time. Work such as veneers, root canals or fitting for bridges or dentures can be done in one trip, with time between fitting, lab work and placement.

Implants require two visits, each about a week in length. The first visit will be for the surgery. During that visit, the dentist will see a patient upon arrival to confirm the necessary work, do the surgery on Day 2, and then check the patient as needed before they leave for home. During the second visit, crowns are made and fitted.

Can a patient travel after the work?

Patients will be free to travel between appointments or even arrange appointments to maximize travel days. In the case of implants, the second trip is only for the fitting of the crowns, which allows for ample travel time. (author’s note: I recently had implants and was pain-free after leaving the office)

What if there is a problem after arriving home?

Most dental procedures are time tested and relatively uneventful. Even major procedures like dental implants are more than 95% successful. Most problems will be detected between the time of the surgery and the visit before returning home. Still, apossibility always exists that a problem may occur after arriving home.  There is no reason a patient cannot a local dentist if necessary. Extremely cautious patients may want to purchase low-cost insurance policies from their facilitator. These policies provide ample coverage for anything that may occur when the patient gets home.

Who is the Ideal Dental Traveler?

Although every dental patient wants quality dental care at the best price, not everyone is cut out for dental travel.  Let’s paint a picture of the ideal dental tourist. He or she:

1. realizes that the US is not the only country with qualified dentists. Dental “authorities” may downgrade the quality of care abroad, or claim that sanitary conditions are inadequate. The same authorities would not dare repeat those claims to International colleagues when they meet at the American dental Association meeting or at a post-grad class at NYU!

2. has the time.  Some people may find that travel is preferable to the routine of running off to the dentist at lunch hour and returning to the office. As the author of a feature on dental tourism in the New York Times said “Remarkably, some patients argue that a flight and a few hours in the dental chair is less hassle than having to rush back to the office half-sedated. For others, turning a trip to the dentist into a family vacation takes their mind off pending procedures.”

3. feels comfortable traveling.  People who like to travel find the “free” vacations in a spot they may have overlooked to be a bonus. And as noted above, the anticipation of a vacation may take some of the fearful anticipation from a dental visit. If you have never been out of the US, this may not be the best time to start.

4. needs more than $10 thousand of work in the US. Patients who need more work will save more money. A patient who needs one implant may pay for their vacation with the amount they save, but the patient who needs six implants will pay for their travel and realizes large cash savings. Summed Up

Summary

Escalating dental costs are making many Americans consider treatment alternatives.  The global economy has made it easier to get equivalent care at substantial savings.  And, dare we say it, dental tourism is an option that may make treatment more fun than a white-knuckled drive to the dentist’s office at lunchtime. It’s not for everyone, but if you do your homework, this may be a chance to combine the work you’ve been delaying with a great vacation.

Driving into Panama City, Panama

In Part 1 of this series we looked at factors surrounding the escalating cost of dental care and its burden on patients without dental insurance (for expensive procedures like implants, most of us).  The focus of Part 2,  presented here, is to provide strategies for saving money when the cost of care goes through the roof,  First, the best thing you can do to save money on expensive dental is to spend it now. Regular dental visits, cleanings and attention to small problems before they become big ones is the best strategy. Still, heredity, lifestyle and disease has made some of us prime candidates for big time dental work. Short of extractions and full dentures, what can the financially-strapped patient do?  Let’s start with the most obvious.

Bargaining and Dental Schools

Many dental practices are slow these days, so your timing is good. Ask your dentist to give you a better price after the Novocaine wears off.  Dentists don’t like to bargain (why would they?)  and their marketing gurus have taught them to counter-offer financing, often with a “no interest” teaser.  Extended payment plans  are not reduced fees. They just pain spread over time, often 12 months. The piper must be paid, and after a set period, finance fees usually kick in. So ask. You may not save thousands, but every little bit helps.

Dental schools can be a great place to receive treatment. Students hone their skills under the watchful eye of experienced teachers. When the work is done correctly the first time,  you have a great experience. The problem is that there is no way to gauge students’ skills until after the fact. Treatment at a dental school is a money saver to be sure, but the time commitment can be deadly. You may wind up having multiple appointments, even for a simple dental.  A hygienist we know describes it, “A basic cleaning took some patients as much as 8-12 hours and three separate visits.  This is not a viable option for most people who could go to their dentists and have the same work done in a one-hour session.  I can only imagine the time involved in having more serious work completed.  You will need to decide if multiple trips to the school and hours in the chair while a dentist-in-training tests his skills is worth the savings.

With the cost of care going up annually, many Americans are pursuing a different alternativee for quality care.  Combining a vacation with a trip to the dentist can save them large sums of money, and might even make a trip to the dentist fun (well, almost fun).

Dental tourism

Traveling abroad for care is part of a growing trend called “medical tourism.” Whether leaving the US for a hip replacement or a dental implant, the patient leaves the U.S. to receive care from qualified practitioners abroad at substantial savings.

Of all the different medical tourism procedures available, dental tourism is the most popular because:

• quality dental care is widely available around the world
• most patients pay for dentistry largely or completely out-of-pocket in the US
• savings will be substantial
• dental procedures are generally minor compared to many medical  procedures.

After treatment, dental patients can be true “tourists”, and can enjoy a relaxing post-treatment vacation. A patient who goes to India for a joint replacement is unlikely to be touring for some time.

Quality dental care is available outside the US

The “American-centric” myth that quality care is only available in the States is exactly that.

“Every year we bring to NYU 110 dentists from 33 countries, train them in advanced procedures, and then they go home. There is no reason to assume the quality of care is any lower overseas.” Dr. Stewart Hirsch, associate dean of New York University College of Dentistry “

Schools outside the US produce their quotas of qualified dentists as well. Practitioners around the world have access to the same information, the same training and the same equipment. As in so many areas of science and medicine, the global economy has leveled the playing field.

The American Dental Association (ADA) has a vested interest in protecting their US-based members, and has recognized that the global economy poses a threat. Still,  they do not dispute that quality care is available abroad.  How could they? Large numbers of international dentists belong to the Association, attend its meetings and receive training through their member institutions. Of approximately 15,000 dental professionals attending the annual ADA meeting, about 1,800 are from outside the US.

Americans traveling for dental care

More and more Americans are going outside our borders for dental care. A recent New York Times article quoted a source that said 40% of all medical tourists are traveling for dental care. When the total number of all medical procedures is considered, that percent becomes even more impressive.  The total number of dental travelers is difficult to pinpoint but estimates range from approximately 200,00 to 750,000 annually. Most reports (including those of the ADA) project that number to be on the rise. The think tank Deloitte Center for Health Solutions projects a 35% annual growth rate despite, or perhaps because of, the current economy.

Examples of Savings

Savings on dental work depend upon a number of factors including the country visited, the procedure, materials used and the dentist performing the procedure. Dental implants are the most frequently requested procedure by dental travelers because of their costliness in the US.  As Figure 1 demonstrates savings on dentistry can be considerable for extensive work.

Fig 1: Implants

In Fig 1, an implant and crown in the US are estimated to cost $ 4,000 (this can be more or less depending on location).  Travel expenses are variable and include the flight and a week with moderate accommodations in Panama City, a top location for dental work. An implant patient will make 2 trips, the first for surgery and again for the crowns placed on the implant.

For patients needing less work, savings of even one or two thousand dollars may pay for treatment and a vacation, as in Fig 2. Taking care of a couple of root canals and spending the rest of the week touring can be pretty nice.

Fig 2: Root Canals

Are patients satisfied with care abroad?

This survey by the leading non-profit group in the medical tourism field, the Medical Tourism Association, looked willingness of patients to consider repeat care overseas. The percentage who said they would, 88%,  speaks highly for their level of satisfaction. A  dental-specific survey, revealed high levels of satisfaction among the thousands of dental tourists questioned. Patients who traveled abroad to receive treatment had a average satisfaction rating of 84%, a similar percentage to the general medical tourist surveyed by the MTA.

Part 3: What you need to know (coming soon)

Interested in knowing more about dental travel?  In the third and final part, we will share tips and secrets: where to go for treatment, locating the best dentists, and how to save time and money.

Entrepreneurs will find the following to be most useful:

“Knowing yourself is the beginning of all wisdom.” Aristotle said this about 2,500 years ago and it seemed to work for his prized pupil, Alexander the Great.

More and more Baby Boomers are looking at starting their own business. Whether their motivation is to boost a flagging 401-K or to fulfill a lifetime dream, you need to know that a successful business is more than a good idea.

In my six years as, I have no clients whose ideas conquered the world…yet . Whatever the merits of the business, the “big idea” often has less bearing on future success than the personality of the person starting the business. Like the stars that guided the ships of Ancient Athens, there are 10 personal questions the would be entrepreneur should ask him or herself before launching their business. Knowing yourself will help you rise above the competition.

1. Can you afford financial risk?

Because: Many new ventures do not succeed, and you may lose much of whatever money you have.  This may affect your financial goals, such as children’s college expenses, or retirement savings.

2. Are you ready to  give  up your current lifestyle for potentially a number of years?

Because: Unlike working for others, your own business may require longer workweeks, fewer or no vacations and maybe years of scrimping and saving before things take off.

3. Are you good at speaking and persuading others?

Because: In any new business, explaining your ideas—to investors, customers and employees—is a good part of what you will need to do.  You will be selling your idea and product all the time.

4. Are you prepared to run all aspects of your business?

Because: In the beginning you may need to do everything, from sales to marketing to bookkeeping.  You may not like, or feel comfortable, with some of the tasks you will need to do.

5. Are you comfortable with a lack of structure?

Because: In a new business, you will need to feel comfortable making all decisions, without any existing structure or guidance (actually SCORE can help provide guidance).

6. Are you a self-starter?

Because: Entrepreneurs need to be able to take rejection and keep going.

7. Does your “significant other” agree to your plan?

Because: Marriages and relationships can be tested by the time and money a new business requires.

8. Are you passionate about your business idea?

Because: You need to be totally motivated about your business,  and know about what you are getting into (going into a field you are not familiar with makes success more difficult).

9. Do you have a history of executing your ideas?

Because: Successful entrepreneurs usually have a history of coming up with ideas and seeing them through. A past with leadership roles may be an indication.

10. Do you need a business partner?

Because: If you don’t have all the skills you need, you may need a partner who can make up for your shortcomings.

If you cannot comfortably answer “yes” to most of these questions,  you need to think about how  you can overcome your weaknesses (you can change).  Your SCORE counselor can help with free counseling. For an online If you cannot comfortably answer “yes” to most of them,  you need to think about how  you can overcome your weaknesses or whether going into you own business is right for you.  Your SCORE counselor can help.

If you would like a free PowerPoint presentation that covers the 10 Questions in more depth, leave a comment here or send an email to me at japton@panamdentaltours.com.

Calling someone a Boomer is a polite way of avoiding the fact that they are aging. One of the most defining traits of the generation born between 1946 and 1964 may be the inability to acknowledge that they may actually be getting old. So I think eventually those of a certain age will either remain Boomers, which will define their social/political philosophy. Those who opt to be called Seniors will be considered to have a different set of views. Like Liberals vs Conservatives.

In olden days they called you a pensioner, elderly, or just plain old. You were a Senior if you were really really old.

For example, this piece from the Canadian newspaper The Manitoba Free Press, October 1930:

“Today, friends of ‘Dad’ Quick, Vancouver’s senior citizen, congratulated him on the attainment of his 110th birthday.”

Then in 1938, it all changed. Several newspapers reported the ‘Thirty Thursday’ plan by the Commonwealth Party’s candidate for governor, Robert Noble:

“On Nov. 8, the people of California will vote on the scheme as a proposed amendment to the state constitution. If passed, the retirement life payment plan, as it is called, promises to pay $30 a week for life in state script to every “senior” citizen, man or woman, 50 years of age or over.”

When life expectancy was 61, of course, anyone who made it to 50 was a Senior.

What does any of this have to do with quality dental care and saving money in Panama (www.panamdentaltours.com)? They have a a pensionado program there, open to all residents (including ex-pats).

Now, you may be thinking: “Pensioner? Retiree? That leaves me out.”

Not necessarily. The rules for becoming a “pensioner” and qualifying for this visa program in Panama are probably not what you’d expect.

Anyone over the age of 18 may apply and can qualify as a pensionado in Panama. Another defiunition of pensioner! All you need is a guaranteed pension income. And look at the goodies you get:

* 50% off entertainment anywhere in the country (movies, theaters, concerts, sporting events, etc.)
* 30% off bus, boat, and train fares
* 25% off airline tickets
* 50% off hotel stays Monday through Thursday, 30% off Friday through Sunday
* 25% off restaurant meals
* 15% off at fast-food restaurants
* 15% off hospital bills (if no insurance applies)
* 10% off prescription medicines
* 20% off doctors’ consultations
* 15% off dental and eye exams
* 20% off professional and technical services
* 50% off closing costs for home loans and more

Panama has the best of both worlds: being a pensioner and young enough to enjoy it.

I certainly don’t want to be the one who encouraged another boomer to jump into the deep end only for them to nearly drown and never enjoy the pool again. However, in our ever changing economic climate, most of us need to consider some form of second career to maintain our life-style and provide us with the ability to give back in the second half of our lives.

In light of these thoughts, I would suggest three things to look at in choosing your second career:

1. First, and in my opinion foremost, find something to do that you love. If more than 80% of working people don’t like their jobs, then way would you spend your second career doing the same thing? What would you do if money were not an issue? Find a way to do that AND find a way to get paid to do it.
2. Look for something that allows you to begin with minimal risk. Many, if not most, boomers don’t enter their retirement years with “deep pockets.” Most of us are ordinary people who want our second careers to count while minimizing any risk to our hard earned funds. Be careful to consider all the costs in both money and time. Find a way to get started without spending more of either than you can afford.
3. Look for something that can produce high rewards. Now, like success, the definition of “high rewards” varies greatly. You must define what “high rewards” means to you and then align your second career with that definition. When you let someone else define for you what is reward and how much you should have, you become enslaved by their definition rather than liberated by yours.

Many baby boomers spent their first career living out the dreams of those they worked for. We created success for others while putting ours off until later. Well, later has just shown up and now it is time for us to establish our own definition of success and follow after our dreams. Find what you love, work hard and with low risks, and gain the high rewards you deserve!

Talk more later ….

Dentistry in America

The cost of dental care has been rising, no question about that.  If you have been to the dentist recently and needed any major work, the estimates for procedures from root canals to implants can leave you more numb than that last shot of Novocaine.

The eyes of America have been focused for more than a year on healthcare reform. If you are a middle-class Baby Boomer (like I am), you probably have some form of healthcare coverage. That day you go to the dentist and get an estimate for work that can easily top $10,000 or more, you realize,” I have no dental coverage. That dental bill has to be paid, out of my own pocket and likely out of a lifetime of savings.” You were not anticipating that, and you are not alone.

According to the Centers for Disease Control, by the age of 65, 46% of Americans have lost 6 or more teeth. More than 20% have no teeth at all. What can someone do who wants to keep their teeth but who also wants to keep some money in their bank account (assuming they even have that money)?

The rising cost of dentistry

Dental costs have risen, as expected, since the 1950’s, at much the same pace as medical costs (Figure 1).  The increase took a dramatic turn in the late 1980’s, tripling over the past thirty years.

The years have been good to dentists. According to the American Dental Association (ADA), the income of both general dentists and specialists tripled between 1982 and 2000,  and have continued to increase.

Dentists went from being the “also-ran” professionals to the envy of the medical field. Physician workloads have increased with paperwork and reimbursement issues making private practice unmanageable for many doctors. Rather than running faster to stay in place (as many physicians do), dentists are making more than ever working the traditional four-day week.

Dental Insurance in the US: does it even exist?

Looking at the statistics, about 50% of Americans have no dental insurance (80% of Seniors). For every adult without medical insurance, three have no dental insurance according to the US Department of Health and Human Services. Compare this to the estimates we hear about healthcare insurance, which assume 10% of Americans have no coverage. The staggering disparity in dental coverage has not factored at all in the current healthcare debate.

And those who do have dental insurance find themselves largely in the same boat as the uninsured.  For years, most dental policies have been capped at about $1500/year, which pays for a few fillings and cleanings. This is why dental insurance premiums have hardly changed over the years.  Expensive dental care has to be paid out-of-pocket by even the insured. So in effect, few if any Americans are covered for expensive dental care.

The Healthcare Debate Rages, but mouths are closed about dentistry

Why is dentistry not a priority, in fact, not even an issue in the current healthcare bill?

Dental spending by the Federal government accounts for less than 5% of their overall healthcare spending. As such, the Federal government has no more interest in escalating dental fees as it does not affect their deficits. Federal spending is largely limited to programs to get minimal care to the poor. And even less fortunate Americans do not get the care that they need.

Burton Edelstein Professor of Clinical Dentistry and Clinical Health Policy & Management at Columbia University offers a reason why dentistry is not even on the radar screen for the poor. Washington policymakers “tend to come from the segment of the population that has not experienced this type of problem. And if you’ve never had a toothache, you’ve never had a toothache.”

In an April 2009 letter, John S. Findley, D.D.S. president of the American Dental Association makes the case for the need for government to upgrade services to the needy, but pays scant attention to those who have to pay for service.

When questioned at a recent Town Hall meeting about how the government plans to deal with dental care, the President offered this advice, ”Floss. Am I right? You’ve got to floss.

Rich or poor, except for expected reductions in the allowances granted by Medicare Advantage, don’t look for the new healthcare plan to offer any relief.

The Global Economy: Dark cloud for dentists, ray of hope for consumers

In his international bestseller, The World is Flat, Tom Friedman analyzes global competition in the 21st century. The title is a metaphor for viewing the world as a level playing field for commerce. As geographic barriers fall, all players have access to the same information, which in turn provides equal opportunity for all.

Standards of training and care are similar across the industrialized world. Physicians and dentists fly around the world for training and conferences and essentially best practices are similar everywhere.

As Stewart Hirsch, associate dean of New York University College of Dentistry said, “Every year we bring to NYU 110 dentists from 33 countries, train them in advanced procedures, and then they go home. There is no reason to assume the quality of care is any lower overseas.”

Globalization has provided some benefits for dentists. Many use off-shore laboratories as far away as India to get better prices on bridges, crowns and dentures.

The rise of dental tourism is an offshoot of the global economy that may benefit patients but not be as pleasant (for dentists)

In fact, globalization has benefited dentists.

PART II: Dental Tourism: Go Abroad for Quality Care at Substantial Savings: Is it right for you? (coming soon)

Jeffrey Apton is a Boomer and president of Pan American Dental Tours (www.panamdentaltours.com) , a dentistry-only dental tourism company that helps Boomers  get excellent dental care abroad. He may be reached at: japton@panamdentaltours.com.