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Columbia's overall murder rate is 250% higher than Panama. You can find a location in Panama that's safer than anywhere in Columbia. From what I have heard and your link shows that Bogota is safer than most places in Columbia but then you still have to deal with a pretty cold spot with high elevation issues and little sunshine. For the right person, I think Bogota is a nice option.
Colombia is a country the size of mainland France, Spain and Ireland combined. Its access and quality of healthcare is unparalleled in Latin America which has to be a major consideration for the OP. Rural places do not have the best healthcare you should be near a hub known internationally for global leading healthcare.
A high homicide rate in conflict ridden Tumaco skews the national picture and doesn't affect Tunja or Bucaramanga which is thousands of kilometres away.
Does Newark affect Asheville? Or Memphis affect Austin?
The hospital infrastructure and healthcare system in Colombia outranks that of any other Latin American country even in second tier cities. Of course it has its faults but for the price you'll be hard pushed to get a higher standard anywhere else as backed by the World Health Organisation.
The HIC in Piedecuesta near Bucaramanga
The healthcare system explained.
Again these are just options that may serve as work around for the OP if he doesn't find suitable RA treatment for his wife in Panama. The relocation to Panama may still be able to go ahead depending on the wife's ability to travel briefly by air.
Last edited by Pueblofuerte; 02-27-2021 at 10:26 AM..
Thanks for the guidance and facts. Very useful. We are retired, I can afford to live well in the USA and have a good health policy from my 38 year employer as a retiree of theirs. But I find the division and hateful cancel culture to be high stress for us. We are homebodies and spend most of our time home only out to shop for food or go to Drs for wife. I came close to moving to Costa Rica after retiring. But accesso to RA experts and meds wife was taking then was very limited in CR>. I also found property there to be pricey by Texas standards. We only considered mountain locations such as Escazu, Santa Ana and Atenas. IF we can find a country that checks most of our health care boxes with a cooler higher altitude climate, say like 4k ft above seas level we will visit multiple times stay for a month or so to check them out.
We have no children so family ties are not a barrier. We get our meds via Express Scripts mail order as required by my retiree medical policy. I can transship meds to a US address then forward them to another country providing the country allows that and I'm sure duty might apply. RA treatments for my wife are infusions and have in the past included shots shipped to us on dry ice to refrigerate. That was the barrier to CR, keeping it cold enough for as long as it would take to get there via shipping. Also wife has pain meds that are controlled here in the USA requiring ID for me to pick them up for her. I know those will be an issue any where but need to see what if any options I have for those. Her current infusion is two infusions within 2 week once a year so we could travel back to the USA for that. I prefer Texas as we have great doctors who know her situation here. Fla or other locations are not my cup of tea. Many Latin American locations have non stops from Houston where lived a few decades that would work for us to fly back to for unique or complicated needs. A good ER is key for us as wife has complications that has landed us in ER once at year at least for the past 5 years. Some of the ER staff work was life savings for her as her Calcium level was dangerously high as well as she had C Diff that had gone septic.
Hi John it does sound quite advanced complications. My cousin is the leading doctor that oversees epidemics in the coffee region of Colombia. As you can imagine she's extremely busy now but I can relay your situation to her and ask for reccommendations. She is currently based out of Armenia, Quindio. A popular retirement city. Also there is no import duty as far as I'm aware. Colombia has an FTA with the US and Amazon's regional hub is actually just outside Bogota.
There's an older US vlogger based out of Armenia who has moved around Ecuador, Panama and Colombia who could maybe help you with the more mundane basic stuff. His content is very varied some are more like podcasts where he talks for hours and interviews people. Others are just showing you what's around.
Here he is:
For healthcare though my hunch is that Medellin, Bucaramaga and Bogota will be your best bet. Saying that however, the highest ranked hospital is in Cali which is a 3 hour drive from Armenia. Some people consider Cali dangerous, it's more or less on par with Baltimore in crime but like Baltimore also has good infrastructure and neighbourhoods. Then again maybe Armenia has the RA infrastructure you need but I would need to ask my cousin or research further.
In any case you have options even if you find obstacles to RA facilities in Panama. There are top-notch, global leading facilities in the region.
Last edited by Pueblofuerte; 02-27-2021 at 11:30 AM..
Thanks for the guidance and facts. Very useful. We are retired, I can afford to live well in the USA and have a good health policy from my 38 year employer as a retiree of theirs. But I find the division and hateful cancel culture to be high stress for us. We are homebodies and spend most of our time home only out to shop for food or go to Drs for wife. I came close to moving to Costa Rica after retiring. But accesso to RA experts and meds wife was taking then was very limited in CR>. I also found property there to be pricey by Texas standards. We only considered mountain locations such as Escazu, Santa Ana and Atenas. IF we can find a country that checks most of our health care boxes with a cooler higher altitude climate, say like 4k ft above seas level we will visit multiple times stay for a month or so to check them out.
We have no children so family ties are not a barrier. We get our meds via Express Scripts mail order as required by my retiree medical policy. I can transship meds to a US address then forward them to another country providing the country allows that and I'm sure duty might apply. RA treatments for my wife are infusions and have in the past included shots shipped to us on dry ice to refrigerate. That was the barrier to CR, keeping it cold enough for as long as it would take to get there via shipping. Also wife has pain meds that are controlled here in the USA requiring ID for me to pick them up for her. I know those will be an issue any where but need to see what if any options I have for those. Her current infusion is two infusions within 2 week once a year so we could travel back to the USA for that. I prefer Texas as we have great doctors who know her situation here. Fla or other locations are not my cup of tea. Many Latin American locations have non stops from Houston where lived a few decades that would work for us to fly back to for unique or complicated needs. A good ER is key for us as wife has complications that has landed us in ER once at year at least for the past 5 years. Some of the ER staff work was life savings for her as her Calcium level was dangerously high as well as she had C Diff that had gone septic.
You should definitely check out Boquete. Panama as a great location. Pueblo has some points about Columbia that I wasn't aware of so maybe check those out as well.
Many Latin American locations have non stops from Houston where lived a few decades that would work for us to fly back to for unique or complicated needs.
Both Houston and Dallas have direct flights to Bogota there used to be a direct Houston to Cali, which may be reinstated in future.
Air travel within Colombia is inexpensive especially with budget airline RyanAir (Viva).
It's usually much cheaper to fly AA from Dallas than Houston and even cheaper with a connection in Atl, Orlando, MIA or FLL with direct routes to Armenia, Pereira, Bucaramanga, Barranquilla, Bogota, Cartagena, Santa Marta and Medellin in a choice of airlines airlines: Jet Blue, RyanAir (Viva), Spirit, AA, Delta, Avianca and Latam.
Hi John it does sound quite advanced complications. My cousin is the leading doctor that oversees epidemics in the coffee region of Colombia. As you can imagine she's extremely busy now but I can relay your situation to her and ask for reccommendations. She is currently based out of Armenia, Quindio. A popular retirement city. Also there is no import duty as far as I'm aware. Colombia has an FTA with the US and Amazon's regional hub is actually just outside Bogota.
There's an older US vlogger based out of Armenia who has moved around Ecuador, Panama and Colombia who could maybe help you with the more mundane basic stuff. His content is very varied some are more like podcasts where he talks for hours and interviews people. Others are just showing you what's around.
Here he is:
For healthcare though my hunch is that Medellin, Bucaramaga and Bogota will be your best bet. Saying that however, the highest ranked hospital is in Cali which is a 3 hour drive from Armenia. Some people consider Cali dangerous, it's more or less on par with Baltimore in crime but like Baltimore also has good infrastructure and neighbourhoods. Then again maybe Armenia has the RA infrastructure you need but I would need to ask my cousin or research further.
In any case you have options even if you find obstacles to RA facilities in Panama. There are top-notch, global leading facilities in the region.
Yes my wife's RA is pretty advanced. We have an appointment with her RA here in DFW tomorrow. I want to explore this idea with him before I go much deeper. I think you for your offer to get some guidance from your relative but think doing so after our RA visit tomorrow. I found some medical articles indicating her infusion med is being used by some top RA DRs in latin america now. Is the elevation or armenia as high as Medellin and therefore as cool temp wise?
I am also thinking given the best Colombia hospital is in Bogota that if I can find a suburb not higher than 7000 feet above sea level and not too long a drive to the hospital that might be a better choice for us. We are from a 15k population town in Oklahoma but have lived in Houston, Pittsburgh and NYC and now DFW after I graduated and got a job that lasted 38 years.
A good ER hospital might be more important to us than a great RA Dr we may be able to come back to see our current RA expert in DFW wice a year and maybe able to get access to him by phone if needed, I will discuss these options with him when we have her next visit. But the ER for unexpected things are my top fear. We believe the suburban Baylor system hospital saved her live when we took her in for her first C Diff experience when it had gone septic on us.
The best hospital appeals to me as we never really know what issue can drive our needs for say a cardiologist or an infectious disease specialist for her serial CDiff and a body minerals expert who solved her high blood calcuim serial issues. So leaning toward Bogota if we can get a lower elevation.
We had a home at 8500 feet above sea level which she could not handle so we have given up going there.
1. Bogota is on an Andean plateau the size of Switzerland or 2 x size of New Jersey so everything around it is at similar elevation. You begin to get at lower elevation in Fusa to the south or Villeta to the west. Due to distance and traffic to get into Bogota and taking "Urgencias" (ER) scenario into account this should be discounted.
2. Cali, Medellin, Bucaramanga are all cities that have hospitals that rank higher than anything in Central America. Cali I imagine would be discounted due to security concerns despite the fact it has the highest or second highest ranked hospital in the country and 3rd or 4th in all of Latin America: Valle del Lili.
3. Armenia is 5,000ft high and has some of the best climate, rural life and pretty villages in all Colombia. BUT None of its hospitals ranks in the top 50 of Latin America so sadly I will discount it for now pending further research. Sister city Manizales does have hospital in the ranking and has high QOL also but is 7,000ft high and has no international airport.
This leaves us with Medellin and Bucaramanga.
4. Medellin has many highly ranked hospitals and a large and diverse expat community. Envigado and Sabaneta within the city limits would best suit a more tranquil lifestyle. There are options of nearby towns which I mentioned earlier such as Rionegro which is 100,000 people + and near the airport. Again I have a concern about traffic of getting to "Urgencias" on time from sattelite towns. Undoubtedly though medical development on RA in the city is a major plus.
5. Bucaramanga is 3,150ft high. I honestly think this could be one of the main contenders. A city of 1.2 million made up of various interconnected towns; namely GirĂ³n (beautiful town), Bucaramanga, Floridablanca and Piedecuesta. Top ranking health institutions, highest ranked QOL of Colombia and one of the highest on the continent. Traffic is less of an issue and there is an international airport. Floridablanca would be my pick but a good look at all the "Urgencias" clinics would be my main focus.
Here's a woman of a certain age on her experience of living in Medellin, she also mentions Bucaramanga.
All the cities mentioned (bar Armenia/Manizales) have hospitals ranked higher than anything in Panama. However, the Punta Pacifica hospital is the best in the country and only one to rank so make sure to get a place nearish to there in Panama.
Thanks perfect you saved me hours of research only to learn all this about elevations and distance to key hospitals. Wife and I are city people now well big city residents but in diverse suburb locations so only Panama City interests me in Panama and having been through the canal a few times I know how hot it in that low. Panama has few high locations that appeal to me as much as Medellin does. It is nice to see other location options for me in Colombia. So I am learning toward it over Panama. Only pluses for Panama is closer to Dallas for our specialists here and family too. I gather Panama is considered slightly safer than Colombia and a more stable gov? So not sure why Panama would really be better for us given it is not that much farther nd I like what I read about the size and economic stability and prospects for growth as we are use to being in that sort of situation, and like change. I travelled globally when working and lived in diverse USA locations so that appeals to us and I do not see an advantage for Panama in that factor either?
Thanks for your time and guidance. I can not express how valuable it is to me
No worries. There is an argument to say Panama has a more stable political climate. Panama as a country has the same population of Medellin or Phoenix, AZ. Smaller countries tend to be easier to manage.
Saying that there has always been regions of stability in Colombia that escaped the instability almost completely. Armenia, Manizales, Tunja and Bucaramanga being 4 such examples. Medellin has also seen quite an amazing turnaround from its cartel violence days 20+ years ago. Bogota had more political violence, you may have heard of the palace of justice siege of 1985. Again this has subsided although there are still undoubtedly post-conflict hangups. Cali is still reeling from cartel violence although things are getting better in the city.
All this should be taken into account of course.
However, there's no contest in regards to the healthcare infrastructure.
I also don't see how Bogota is that much further from Texas. It doesn't look it but Northern Colombia is on the same latitude as Managua, Nicaragua and Cartagena & Barranquilla are both further north than Panama city.
I would say take a month, do a week in Panama, a week in Bucaramanga, a week in Medellin and a week in Armenia/Manizales and visit the best "Urgencias" (ER) facilities in the best hospitals of each place as well as an RA specialist in each place. That will help cement your best options. The whole trip will cost you about $1,500 each including flights from Dallas, accommodation, inter-regional flights and consultations.
I am looking for crime stats for cities or areas in Panama and Colombia for which there are comparable stats for where I am in the USA. We lived in Plano a suburb of Dallas in the DFW metro. Our city is very safe based on crime stats data on Realtor.com. An added dimension to our safety is the neighboring zip codes and cities to our town are also low crime areas. I m not sure what metric realtor.com uses but these neighboring areas are the lowest crime metric they track except for a few commercial areas with one up crime stat. In other words very insulated and maybe 10 miles from cities which are not low crime areas in DFW.
My wife still has a lingering concern about Latin American countries crime levels so looking for some sort of metric to compare the countries under consideration to where we are now.
Thanks in advance for any guidance.
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