“Read almost any article in the mainstream press about retiring overseas,” writes Intrepid Correspondent Paul Terhorst from his current base in Chiang Mai, Thailand, “and the writer almost invariably starts by evaluating the local health care situation. ‘Country A offers high-quality, low-cost health care…Country B allows expats to buy into the national health plan.’

“I’ve long been puzzled by this emphasis on health care.

“Sure, most overseas retirees are older…and we older folks buy more health care than young people. But we buy other stuff, too. We buy transportation, plumbing, electricity, and lodging. You never read that ‘Country C offers high-quality, low-cost sewage treatment.’ Yet the levels of sanitation, water quality, electricity, and air conditioning arguably mean more to our well-being than the level of health care available in a country.

“I grew up in Los Angeles. When I was small, I used to cross the border into Mexico with my parents, brothers, and sister. In my teenage years, I went with brothers, friends, and cousins, most often to fish off the coast of Ensenada.

“One day, my brother, cousins, and I were on a Mexican fishing boat out in the Pacific Ocean. The boat was taking on water, and deck hands used coffee tins to bail us out. We made jokes about it. We opened bottles of Carta Blanca beer with fatalistic pops.

“Yet a serious thought occurred to me, too. I had put my life in the hands of the captain of that Mexican fishing boat. Driving down to Ensenada, we’d put our lives in the hands of Mexican drivers. Every time I boarded a bus, I put my life in the hands of the Mexican bus and driver. Every time I ate something, I put my well-being in the hands of the Mexican cook. Every time I touched a light, I relied on a Mexican electrician to have done the job right.

“I asked myself whether I should trust Mexicans–or anyone else–with my life and well-being. I quickly concluded that Mexican bus drivers–or bus drivers from any other part of the world–probably value their lives as much as I value mine. I concluded that the fishing-boat captain wanted to make sure his boat stayed afloat.

“I was young and healthy, and I never saw a doctor in Mexico. But there, too, I would have been putting my life in Doc’s hands. And I figure a doctor in Mexico would be at least as concerned about my well-being as any other Doc, anywhere else in the world.

“I decided, finally, that I needed to take care of my own well-being. In a perfect world, I’d never have to trust my life to any chef, captain, or cab driver. But distrusting everyone seemed impractical. Instead, I decided that, to the extent possible, I’d remain in charge. Whether Doc happened to be from Mexico or some other country made little difference, I figured. What made a difference was me. I’d ask others I trusted to recommend a doctor or hospital. I’d look over the clinic, find out if Doc spoke my language, pay attention to the way he conducted himself, and look at how he charged.

“Since those youthful days off the coast of Ensenada, I’ve traveled to some 90 countries. I still try to take responsibility for my own safety and well-being anywhere in the world I go. Before getting on a bus, I consider what shape the bus is in and what shape the driver is in. Before jumping into a pool, I check whether the water has electricity running through it. Before getting on an airplane, I consider the safety record. Before seeing a doctor, I find out what I can about said Doc.

“We risk our lives, liberty, and pursuit of happiness whenever we hire a plumber, electrician, driver, doctor, architect, dentist, contact lens provider, maid, or caterer. We risk our lives and well-being when we choose friends, travel, or cross borders. We need to recognize these risks, and deal with them, rather than obsess over health care.

“View with suspicion expats, or writers on the expat life, who focus on health care. Doubt the averages, as in, ‘live in France because of good health care.’ Sure, as we get older, we become more concerned about health care. As I said above, we buy more of it than do younger people.

“But this is but one risk to our well-being, and I’d argue that others deserve much more attention when determining where to spend our time.”

Kathleen Peddicord www.liveandinvestoverseas.com