RPF0676-Medical_Tourism-Real-Life_Experiences_From_Myles_Wakeham_of_Be

00:00:00.000 | [GASP]

00:00:01.000 | [GLASS BREAKING]

00:00:02.000 | [SIGH]

00:00:03.000 | Shop break-resistant glassware at wineenthusiast.com

00:00:06.000 | so you can spend more time--

00:00:07.000 | [DING]

00:00:08.000 | --and less time--

00:00:09.000 | [GLASS BREAKING]

00:00:10.000 | --ugh, I'll get the broom.

00:00:12.000 | Shop our Black Friday and Cyber Monday deals

00:00:14.000 | for the best prices of the season on wine storage, gifts,

00:00:17.000 | and more.

00:00:18.000 | Plus, get free shipping on orders of $99 and more.

00:00:21.000 | At wineenthusiast.com, we bring wine to life.

00:00:24.000 | [DING]

00:00:25.000 | Exclusions apply.

00:00:26.000 | See website for details.

00:00:27.000 | [DING]

00:00:28.000 | Welcome to Radical Personal Finance, a show dedicated

00:00:30.000 | to providing you with the knowledge, skills, insight,

00:00:32.000 | and encouragement you need to live a rich and meaningful life

00:00:35.000 | now while building a plan for financial freedom

00:00:37.000 | in 10 years or less.

00:00:39.000 | My guest on today's show is Miles.

00:00:41.000 | Miles Wakem, welcome to the show.

00:00:43.000 | Thank you.

00:00:44.000 | Great to be here.

00:00:45.000 | So I've had you on.

00:00:46.000 | We're going to have a chat about finances.

00:00:48.000 | You blog over at beunconstrained.com,

00:00:51.000 | talking about your journey to financial independence.

00:00:54.000 | And specifically, I've had you on because you

00:00:56.000 | have been doing a recent series, but also having

00:01:00.000 | some recent experiences specifically

00:01:03.000 | on the topic of medical tourism.

00:01:06.000 | You've been doing some work in Mexico,

00:01:07.000 | and I want to hear all about that and talk about it,

00:01:09.000 | because I think it's a very key financial strategy that more

00:01:12.000 | and more of us can and should implement.

00:01:15.000 | But begin with just a little bit of your background.

00:01:17.000 | How did you wind up in the United States doing

00:01:19.000 | the kind of work you're doing, and how did you

00:01:21.000 | wind up interested in finance?

00:01:24.000 | It's a very interesting question.

00:01:27.000 | I've always been a-- when I was a kid,

00:01:30.000 | I was always into business.

00:01:32.000 | I always liked businesses.

00:01:33.000 | When I was eight years old, I ran paper rounds,

00:01:35.000 | and then I decided to get two of them and three of them

00:01:38.000 | and scaled it up and became like the king of paper rounds

00:01:41.000 | in my suburb in Australia.

00:01:43.000 | And that led into all different various businesses

00:01:48.000 | and part-time jobs when I was a teenager

00:01:50.000 | all the way through to getting out of school

00:01:53.000 | probably way earlier than I should have and going

00:01:55.000 | into business on my own.

00:01:56.000 | And I got lucky and got into the computer world in 1978,

00:02:02.000 | right when the personal computers first started coming out.

00:02:06.000 | Built one of the first software companies in my hometown,

00:02:10.000 | employed a dozen people and sold it when I was 24, 23, 24.

00:02:18.000 | Got out, came to the United States because I was working--

00:02:21.000 | one of my clients was a defense contractor building submarines

00:02:24.000 | in Australia, and I met a lot of guys from the States

00:02:26.000 | when I was working there.

00:02:27.000 | And one of them said, you sound like a smart guy.

00:02:30.000 | Why don't you come over and work for me?

00:02:31.000 | And I ended up in Los Angeles.

00:02:35.000 | I ended up doing a little bit of work there

00:02:37.000 | and then stumbled into a company that got into this thing

00:02:41.000 | called Biotechnology, which I had no idea what that was.

00:02:45.000 | And that company became Amgen.

00:02:47.000 | So I was one of the first, I don't know,

00:02:49.000 | hundred and something people to stay there.

00:02:52.000 | And I ended up staying there for about five years

00:02:54.000 | and left with a ton of stock options, which I didn't even know

00:02:58.000 | what they were, and retired.

00:03:01.000 | And I was about 32, I think.

00:03:04.000 | I went back to Australia and that didn't end well.

00:03:08.000 | I kind of followed in your-- I'm kind of like the poster child

00:03:12.000 | of what happens when you retire too early.

00:03:16.000 | And I know you've spoken about that before.

00:03:19.000 | I can attest to the fact it's 100% correct.

00:03:21.000 | Don't retire too early.

00:03:22.000 | Don't retire.

00:03:23.000 | Actually, I hate that word.

00:03:25.000 | It's something that doesn't resonate well with me.

00:03:28.000 | But I did find myself going from zero to hero to zero

00:03:34.000 | in that world.

00:03:35.000 | And then I ended up with the dot-com boom sort of happened.

00:03:40.000 | I found myself sort of, I don't know, not getting anything

00:03:43.000 | really substantial done in life back in my hometown.

00:03:47.000 | So I decided to get back on a plane and came back to California

00:03:50.000 | and then eventually moved to Arizona.

00:03:53.000 | And I've been here for-- ever since, what's that, 20 years now.

00:03:57.000 | How much money did you have when you retired at 32?

00:04:03.000 | Geez, I don't remember now.

00:04:04.000 | It was in the hundreds and hundreds of thousands of dollars.

00:04:07.000 | I bought a house freehold, so I never had any costs.

00:04:12.000 | I had a lot of money.

00:04:13.000 | We ended up buying some rental properties as well.

00:04:15.000 | And what did you do with yourself?

00:04:18.000 | I got really bored.

00:04:20.000 | I built a recording studio.

00:04:22.000 | I've always been a musical kind of guy.

00:04:24.000 | I always liked recording engineering.

00:04:26.000 | I learned a lot about that when I was living in California.

00:04:28.000 | And I built a studio and I was recording bands, albums,

00:04:32.000 | because I had nothing better to do.

00:04:35.000 | The funny thing is I got divorced, probably because I found myself

00:04:39.000 | in this what do I do now point of life.

00:04:42.000 | And my wife at the time was looking at me going,

00:04:45.000 | well, where does life go from here?

00:04:47.000 | And I didn't have an answer because I was-- the journey had come

00:04:52.000 | to an end at that point for me and I didn't know what my next chapter

00:04:56.000 | was going to be.

00:04:57.000 | And she didn't want to wait around, try and wait for me to find that out.

00:05:00.000 | So I ended up losing pretty much most of what I had gained.

00:05:04.000 | So you go from financially independent to financially divorced very quickly.

00:05:10.000 | And for anybody out there who's had to go through that,

00:05:13.000 | I don't wish it upon anyone.

00:05:15.000 | But that kind of also led to my-- I don't know,

00:05:20.000 | it's kind of a weird thing and it's the segue that goes

00:05:22.000 | into the whole medical thing.

00:05:24.000 | I found myself alone and in pretty dark time at that point.

00:05:29.000 | And I might not have needed money, but that was the least

00:05:32.000 | of my concerns back then.

00:05:33.000 | And some friends of mine said to me one day, do you want to--

00:05:37.000 | it was about just after Christmas time.

00:05:40.000 | It was like the day after Christmas.

00:05:42.000 | They had planned this epic road trip to go up into the Queensland,

00:05:47.000 | which is like the tropical area of Australia,

00:05:50.000 | to have New Year's Eve up there.

00:05:52.000 | And they said, look, you don't want to be sitting around here sort

00:05:54.000 | of wallowing in your misery.

00:05:56.000 | You want to come with us.

00:05:57.000 | So I said, yeah, all right, sounds like a plan.

00:06:00.000 | Jumped in the car and we drove two days to our destination,

00:06:04.000 | had a week there and we're driving back, got one day through it,

00:06:08.000 | got in the second day and then really bad things started to happen,

00:06:11.000 | which is kind of where the whole medical journey begins.

00:06:15.000 | What happened?

00:06:17.000 | Well, we were driving back across the outback of Australia,

00:06:21.000 | pretty sort of desolate area.

00:06:24.000 | And I had driven the first few hours of that day.

00:06:29.000 | It was our second day on our way back home.

00:06:32.000 | And we stopped for lunch.

00:06:35.000 | It was myself, a friend of mine who was in the car and his girlfriend.

00:06:39.000 | And we were driving back.

00:06:42.000 | We got about halfway through it.

00:06:43.000 | We had lunch.

00:06:44.000 | We got back and it was like, okay, he says it's my turn to drive.

00:06:47.000 | So I said, sure, here you go.

00:06:48.000 | Here's the keys.

00:06:49.000 | I get in the back of the car.

00:06:50.000 | I'm in the rear seat.

00:06:52.000 | And off he goes.

00:06:54.000 | We drove for about 20 minutes.

00:06:55.000 | I'm in there happily reading a book and just, you know,

00:06:58.000 | there's not much else you can do when you're in the middle of nowhere in the

00:07:01.000 | outback of Australia.

00:07:02.000 | You sit there reading a book, letting him do the driving.

00:07:04.000 | We went over this crest.

00:07:06.000 | You know, the road just crested over the top of the hill.

00:07:09.000 | And I didn't think much of it.

00:07:11.000 | Next thing you know, I'm hearing -- I hear water, which is weird.

00:07:15.000 | I mean, I'm in the middle of the outback of Australia.

00:07:17.000 | It's a splash.

00:07:18.000 | I look up and we're in a lake.

00:07:21.000 | I mean, all I could tell you was this vast water.

00:07:25.000 | He'd like driven us into a lake.

00:07:28.000 | And it wasn't his fault.

00:07:31.000 | There was a flash flood.

00:07:32.000 | It washed out the road and no one had put any signs up to tell anybody.

00:07:36.000 | And, you know, I guess maybe it was because we just had lunch and he was

00:07:39.000 | traveling probably faster than he should have.

00:07:41.000 | But he didn't see it.

00:07:43.000 | We hit the water and like a stone skipping over, you know,

00:07:47.000 | if you throw a stone across the ocean, it bounces across the top.

00:07:51.000 | We became that stone.

00:07:53.000 | We hydroplaned at rapid speed.

00:07:55.000 | And I just remember in the back of my mind -- because everything slows down,

00:07:58.000 | right?

00:07:59.000 | It goes down to everything seems like a slow motion experience, like a movie.

00:08:04.000 | And I remember saying to myself -- his name's Lindsay.

00:08:07.000 | And I said, "Lindsay, don't lose it, buddy.

00:08:09.000 | Don't lose control of the car."

00:08:12.000 | And then black, nothing.

00:08:15.000 | And that's all I remember.

00:08:17.000 | The next thing you know, I wake up and there's this guy cutting the car apart

00:08:24.000 | with the jaws of life.

00:08:26.000 | And I'm in the back.

00:08:27.000 | And then on top of me is the car seat from the front passenger seat.

00:08:32.000 | And on top of that was my buddy's girlfriend.

00:08:35.000 | And these guys are cutting me out of the car.

00:08:37.000 | And I'm literally going to say to them, "Hey, forget about me.

00:08:40.000 | Get her.

00:08:41.000 | She's sitting on top of me.

00:08:42.000 | You know, get her."

00:08:43.000 | But they wouldn't touch her.

00:08:44.000 | And I'm like, "What the heck?"

00:08:46.000 | Anyway, they pulled me out of the car.

00:08:48.000 | It was kind of gruesome.

00:08:49.000 | They got me out, put me on a stretcher.

00:08:51.000 | And it was at that point I looked back and realized she was dead.

00:08:55.000 | And, you know, waking up with a dead body on top of you is kind of not

00:08:59.000 | something I'd suggest to anybody, but it happens.

00:09:01.000 | And anyway, they put you on a stretcher and put you on a medical ambulance

00:09:07.000 | and drive you back to the closest country town with a hospital and put us

00:09:13.000 | in the emergency room.

00:09:14.000 | And then I remember at that point they must have injected something into me

00:09:19.000 | because I was out for I think about six days in a medically induced coma while

00:09:25.000 | they tried to put me back together again.

00:09:27.000 | And, yeah, after that I woke up back in my hometown.

00:09:31.000 | They must have airlifted us to our local hospital.

00:09:35.000 | And I found myself in the bowels of the socialist world of medicine,

00:09:42.000 | of Australia, and I'm in a room with six other people and I'm getting some

00:09:49.000 | level of treatment and I'm on morphine and, you know,

00:09:52.000 | it was like that for a few days before they started treating me.

00:09:55.000 | So, yeah, what ended up happening was I broke my right femur,

00:10:02.000 | snapped it in half.

00:10:04.000 | They pinned that back together before I woke up, which was good.

00:10:08.000 | And then my left shoulder and humerus had been broken in five places and the --

00:10:16.000 | so without getting too medical, everyone in their, you know,

00:10:20.000 | their top arm has a humerus, a big bone with a bowl on the top that slots

00:10:24.000 | into your shoulder joint.

00:10:26.000 | In my case the bowl had completely broken off from the bone,

00:10:29.000 | completely severed, and then the bone itself had broken in five places.

00:10:33.000 | So they pinned the bone back together as best they could,

00:10:36.000 | but they couldn't put the bowl on the top of the bone anymore because they

00:10:39.000 | had these pins sticking out of it.

00:10:42.000 | Well, when they do that, the best they could do was to stick it on the side

00:10:45.000 | of the bone.

00:10:47.000 | So I ended up walking around with this deformed shoulder and that was kind of,

00:10:52.000 | you know, I remember the doctor coming into the hospital and saying, well,

00:10:55.000 | I'm sorry, buddy, but this is what you've got for the rest of your life.

00:10:58.000 | This is what you're going to be dealing with.

00:11:00.000 | And I'm like, you're kidding, aren't you?

00:11:02.000 | Come on, you can do a better job than that.

00:11:04.000 | And he's like, no, that's it.

00:11:05.000 | That's the best we can do.

00:11:06.000 | You're going to have arthritis.

00:11:08.000 | You're going to have limited motion.

00:11:10.000 | You know, you'd be lucky if you can raise your arm above 90 degrees on a good

00:11:14.000 | day.

00:11:15.000 | But, you know, hey, you didn't die.

00:11:17.000 | You know, we're all patting ourselves on the back here because you didn't die.

00:11:20.000 | And I'm like, well, thank you for that, but maybe you can fix this thing?

00:11:25.000 | And he's like, no.

00:11:28.000 | So, you know, no medicine for you.

00:11:32.000 | And that was what I've been living with for the last 22 years.

00:11:36.000 | Wow.

00:11:37.000 | So what precipitated your deciding to have fresh surgery and then going

00:11:43.000 | through the process of trying to figure out where and how to get that surgery?

00:11:46.000 | Why now?

00:11:48.000 | Well, there was a sort of a period post-surgery in Australia when I had this

00:11:55.000 | before I decided to come back to the U.S.

00:11:58.000 | I found myself battling against the insurance company, which connects the dots

00:12:07.000 | to tell the story.

00:12:08.000 | So in Australia, when you register a motor vehicle, at least in the state where

00:12:12.000 | we lived, it was mandatory as part of your registration that the state government

00:12:17.000 | provides a third-party liability policy, and it comes with the insurance.

00:12:23.000 | So your insurance is much higher than it would be in the United States,

00:12:26.000 | but you've got this liability policy built into it.

00:12:30.000 | And that policy is supposed to cover anybody who has some sort of medical,

00:12:35.000 | you know, impact from an accident, of which clearly I was that guy.

00:12:40.000 | I was in the rear seat passenger here.

00:12:42.000 | I had no control of the vehicle.

00:12:44.000 | I had no control of destiny here.

00:12:46.000 | I wore it.

00:12:47.000 | So the way the medical system works in Australia is you get put into the

00:12:53.000 | government medical system, whether you like it or not, with accident

00:12:57.000 | and emergencies.

00:12:58.000 | And in my case, they put me in, they patched me up, they shipped me out,

00:13:03.000 | and then all the post-surgery stuff was all supposed to be covered by the

00:13:09.000 | insurance that we were given by mandatory, you know, they push it on you,

00:13:15.000 | you don't get a choice.

00:13:16.000 | It was supposed to pick up all the post-op, all of the physical therapy,

00:13:20.000 | everything.

00:13:22.000 | And after a few weeks, they weren't paying.

00:13:25.000 | And I, you know, I'm like, "What gives, guys?"

00:13:28.000 | And the answer was, "Well, there was an accident that involved a murder."

00:13:34.000 | I'm like, "No, it wasn't a murder.

00:13:35.000 | She was killed.

00:13:36.000 | It was an accident."

00:13:37.000 | It's like, "Well, no, we are going to charge the driver with negligent

00:13:41.000 | homicide."

00:13:42.000 | So the next thing you know, my buddy is being, you know,

00:13:47.000 | going into state to attend court proceedings because his girlfriend's family

00:13:52.000 | were obviously completely distraught with everything that had happened.

00:13:56.000 | I mean, I get that.

00:13:57.000 | But they were throwing all the blame on him, which I don't know if -- I don't --

00:14:02.000 | I would not say that was his fault at all.

00:14:04.000 | I mean, I was in the car, but they wouldn't let me testify in court.

00:14:08.000 | They just kept wanting to throw it on him.

00:14:10.000 | And because there was this pending murder case, that's how they classed it,

00:14:16.000 | homicide, they wouldn't pay my medical costs.

00:14:20.000 | So eventually that case was dismissed as you would expect it to be.

00:14:25.000 | And then at that point I had already engaged with a lawyer to say, "Hey,

00:14:29.000 | you guys better pay my medical."

00:14:32.000 | And, of course, now there was litigation, so they wouldn't pay me either.

00:14:36.000 | And this went on for eight years.

00:14:38.000 | I had no covered medical for eight years while I was waiting for all of these

00:14:43.000 | things to blow out.

00:14:44.000 | And meanwhile I got sick and tired of waiting around.

00:14:47.000 | I got remarried.

00:14:48.000 | I had a daughter.

00:14:50.000 | I wanted to give my family a better life.

00:14:52.000 | I couldn't do it in Australia.

00:14:54.000 | It just wasn't economically feasible.

00:14:57.000 | And the dot-com boom was calling.

00:14:59.000 | So we all got on a plane and came to the United States and landed,

00:15:02.000 | and it took another three or so years before they eventually paid

00:15:06.000 | out on that claim.

00:15:08.000 | Meanwhile I come to the U.S., no health care,

00:15:13.000 | pre-existing condition.

00:15:15.000 | I got to build everything from nothing.

00:15:17.000 | I mean I've literally gone from zero to millionaire to zero again,

00:15:22.000 | and now I entered back into the United States for a second time.

00:15:26.000 | And thankfully within about six years I was a millionaire again.

00:15:30.000 | And that was just because I was a business guy and I just don't take no for an

00:15:36.000 | answer.

00:15:37.000 | I just wouldn't put up with being told no, no, no on everything.

00:15:42.000 | That just permeated into my life in money and finance,

00:15:46.000 | and eventually it permeated into my life in medicine.

00:15:51.000 | So there are a number of interesting trails we could go down.

00:15:55.000 | I want to talk about your financial independence journey and a little bit on

00:15:58.000 | your expatriation experience because that's part of this.

00:16:04.000 | But let's start with the move to Mexico to get the surgery that you had

00:16:10.000 | recently.

00:16:11.000 | You came to a point, as I understand the story,

00:16:13.000 | you came to a point now recently where you said,

00:16:16.000 | "I want to get this taken care of."

00:16:17.000 | Were you experiencing further symptoms that were exacerbated recently somehow

00:16:22.000 | and that kind of pushed you over the edge or what happened?

00:16:25.000 | Yeah, it did.

00:16:28.000 | A year ago my wife and I were just bumming around Mexico because in the

00:16:33.000 | summer you don't want to stay in Arizona where we live.

00:16:36.000 | You want to get out.

00:16:37.000 | So we went down to Mexico City for a week.

00:16:41.000 | We were in Puerto Vallarta for a week, and we were just doing the tourist thing.

00:16:44.000 | I'm in Puerto Vallarta going, "You know,

00:16:47.000 | I just don't feel like I'm getting the Mexican experience here."

00:16:51.000 | So I said to - I'd watched some YouTube videos of this magical place that

00:16:55.000 | everybody was retiring to called Ajijic, and it was on Lake Chapala,

00:17:02.000 | which is in Jalisco in the center of Mexico.

00:17:06.000 | It was one of these places where people could go down there and retire on the

00:17:10.000 | U.S. Social Security and live a rich life.

00:17:13.000 | I mean, they were - these people were great.

00:17:15.000 | I said, "I want to go there.

00:17:16.000 | Let's go on a bus for five hours.

00:17:18.000 | I don't speak any Spanish.

00:17:19.000 | I don't know where I am.

00:17:20.000 | Let's just go."

00:17:22.000 | She's adventurous, so she said, "Okay, let's do that."

00:17:25.000 | So we get on this bus.

00:17:26.000 | We go to Guadalajara, and then we get an Uber up to Ajijic.

00:17:30.000 | I got out of the car, and I saw this beautiful little town.

00:17:35.000 | These people were - everyone was old.

00:17:37.000 | Now, old is the subjective term, but the average age of people in Ajijic is 65.

00:17:44.000 | What I saw with my own eyes, and I noticed this in the first 15 minutes of being

00:17:48.000 | there, was that everybody was skinny, and I say skinny as in svelte.

00:17:53.000 | They were not overweight.

00:17:55.000 | There was no obesity at all.

00:17:57.000 | Everybody was happy.

00:17:59.000 | Everybody was healthy.

00:18:00.000 | Everybody was social.

00:18:02.000 | It was like, "Oh, I want to live here."

00:18:06.000 | This is utopia, right?

00:18:09.000 | I remember we went up to the town square, and there were these people sitting on the -

00:18:14.000 | and nobody's afraid to talk to anybody, right?

00:18:16.000 | So there's this couple of guys sitting on a park bench, and I walked past them,

00:18:20.000 | and I just sparked up a conversation.

00:18:22.000 | I said to the guy, "You know what?

00:18:24.000 | You look really happy.

00:18:25.000 | Tell me about what your life's like."

00:18:27.000 | This guy, who was about 70, tells me he used to live in Wisconsin,

00:18:31.000 | and he couldn't afford to retire in America, and he couldn't afford the healthcare,

00:18:36.000 | and he came here, and his life has been fulfilled, and he's been there for 10 years.

00:18:40.000 | I thought, "Wow, that's a really interesting story."

00:18:43.000 | He says, "Yeah, because the medical is so affordable."

00:18:46.000 | I'm like, "What do you mean?"

00:18:47.000 | He goes, "Well, you can get private health coverage in Mexico for less than the cost

00:18:53.000 | of your deductible in America."

00:18:55.000 | I'm like, "Nah, come on.

00:18:57.000 | That might be for the citizens here, but it wouldn't be for us, you know, for expats."

00:19:02.000 | He goes, "No, no, no.

00:19:03.000 | You can get it."

00:19:04.000 | He says, "Yeah, there's a public system as well, and if you get a permanent residency,

00:19:08.000 | the easier you get access to that," but he said, "I don't need it.

00:19:11.000 | I can afford to go to my doctor three times a week because, you know,

00:19:15.000 | I'm paying, I don't know, a couple hundred pesos, which is like 20 bucks,

00:19:20.000 | and he's getting all the best care proactively, and that's why they're healthy."

00:19:26.000 | This resonated with me.

00:19:28.000 | I heard this message.

00:19:29.000 | We go back to Arizona, and we're back for about a year, and last March,

00:19:35.000 | I woke up in enormous pain from my shoulder, and I couldn't work out why,

00:19:41.000 | but it was really, really sore.

00:19:46.000 | I ended up…it dissipated after about three weeks, but it was the sort

00:19:50.000 | of pain that was really…and to be honest with you, I got scared because here

00:19:55.000 | I am going, "Well, you know, this operation was 20 years ago.

00:19:59.000 | Maybe it's got like an expiration date on it.

00:20:02.000 | Maybe I have to get it done again," right?

00:20:03.000 | Maybe the pins are rusting out inside your arm.

00:20:06.000 | Exactly, yeah, exactly, and it's scary because you don't know,

00:20:12.000 | and I thought, "Oh, I've got a problem here because I don't have health coverage

00:20:16.000 | in the U.S.," and Australia says, "Well, once you became a nonresident

00:20:21.000 | for tax purposes, you don't get any health care from us either, buddy."

00:20:25.000 | So I'm like, "Okay, well, what do I do?"

00:20:28.000 | And that's when I remembered HAHEEC.

00:20:31.000 | So I got on the internet, and I went to some of these expat forums

00:20:36.000 | of the people who live down there, and I said, "Look, does anybody down there

00:20:39.000 | know a good orthopod, a good orthopedic surgeon?"

00:20:43.000 | And everybody on the forums, and these people are getting hip replacements

00:20:49.000 | and knee replacements and the whole bit, and I told them what I needed,

00:20:52.000 | and three people gave me the same guy's name, and I thought,

00:20:57.000 | "That's interesting."

00:20:59.000 | So we ended up in June.

00:21:01.000 | We're back in Mexico, and we went to Guadalajara where this doctor practices,

00:21:06.000 | and I went and saw him, and he speaks perfect English,

00:21:10.000 | and we sat down, and the nicest guy, you could never imagine a guy

00:21:13.000 | as nice as this, and he said, "Well, first thing we're going to do

00:21:17.000 | is send you for some x-rays."

00:21:19.000 | So okay, so he sends me.

00:21:21.000 | He's in a very rich medical area, kind of like Beverly Hills almost.

00:21:26.000 | It's beautiful, tree-lined streets, expensive cars, the whole bit,

00:21:30.000 | and he says, "Go over there, two doors down.

00:21:34.000 | There's an x-ray clinic.

00:21:35.000 | Go get me some x-rays."

00:21:36.000 | So they took 15 x-rays, and the first thing I noticed was it cost me $15.

00:21:42.000 | I thought, "What?

00:21:44.000 | Fifteen x-rays for $15.

00:21:47.000 | Okay, that's great."

00:21:49.000 | So we go back into his consulting rooms, and he puts them up on the wall,

00:21:54.000 | and he goes, "Mm-hmm, okay, well," he said, "Look, I can probably fix this.

00:21:59.000 | I'd have to do a complete shoulder.

00:22:01.000 | I'm going to have to do a total prosthetic, complete new shoulder for you,

00:22:06.000 | but what I can do is I can't give you any guarantees, and surgery has risks,

00:22:11.000 | and all the normal stuff doctors say, but I can guarantee that I can get you

00:22:15.000 | better motion than you've got right now.

00:22:17.000 | You won't be limited in movement like you have been."

00:22:20.000 | And I said, "Well, okay, how much?"

00:22:23.000 | And so he gets the calculator out, and he runs all these numbers,

00:22:26.000 | and he gives you some massive number, but it's in pesos.

00:22:29.000 | Well, I said, "Well, you know, what's that in U.S. dollars?"

00:22:31.000 | And he goes, "About 9,000 bucks."

00:22:33.000 | I'm like, "Are you kidding me?

00:22:35.000 | Of course I'm going to take that deal," right?

00:22:38.000 | And my wife, who's a nurse, is looking at me going, "You better take this deal."

00:22:42.000 | So, okay, we go ahead and say, "Sign me up, doc, when you want me,"

00:22:46.000 | and then he puts a date on the calendar of somewhere in September and says,

00:22:50.000 | "Come back and see me then, and we'll get this done."

00:22:53.000 | He says, "Since you've decided you want to get it done,

00:22:55.000 | and since you're here right now, I'm going to send you three doors

00:22:58.000 | down the other way to this another imaging place,

00:23:01.000 | but they're going to do a full MRI on you."

00:23:04.000 | I'm like, "Okay, I've never actually had an MRI done

00:23:06.000 | because no one could afford it."

00:23:09.000 | They go down there.

00:23:11.000 | I pay for it, $270 U.S. dollars for an MRI, which is pretty good.

00:23:17.000 | I'm in there for about 20 minutes.

00:23:18.000 | They took image after image after image.

00:23:21.000 | I go back to the doctor's office.

00:23:22.000 | He gets the MRI images up because now he's got the detail, and he goes,

00:23:26.000 | "Oh, we better get this done."

00:23:29.000 | I'm like, "What do you mean?"

00:23:30.000 | He goes, "You see that?"

00:23:31.000 | I said, "Yeah, what's that?"

00:23:32.000 | "That's a tumor."

00:23:34.000 | "Okay."

00:23:36.000 | He goes, "It's benign, so you're okay, but you've got to get this thing done.

00:23:42.000 | By the way, the reason why you've been in so much pain is there's all these

00:23:45.000 | bone spurs on this deformed shoulder you've got that are just cutting

00:23:49.000 | into what's left of your muscle.

00:23:50.000 | If you don't get it done, you won't have any chance of getting

00:23:53.000 | this done properly at all."

00:23:55.000 | "Okay, doc, sign me up."

00:23:59.000 | That's where it all started.

00:24:01.000 | Wow.

00:24:02.000 | Do you have a sense--let's go ahead and just continue it.

00:24:06.000 | Then in September when the date came, you and your wife went back to Mexico.

00:24:10.000 | Tell us about the process and your experience because you don't speak

00:24:13.000 | Spanish, you're not Mexican, you come from Western, white Australia

00:24:21.000 | and the United States, so it's not that you're spending all your time

00:24:25.000 | in Latin America.

00:24:26.000 | What was your experience as a patient crossing that cultural divide

00:24:31.000 | and what was your experience?

00:24:34.000 | Well, the one thing that was really interesting was a different motivation

00:24:43.000 | that was in the spirit of what was being offered to me.

00:24:46.000 | You see this really quickly.

00:24:49.000 | There's a sense of--I guess the Mexicans would call it--the Hispanic

00:24:54.000 | or the Latin community would use the phrase "la familia," the family.

00:25:00.000 | The one thing that's really noticeable to me is that when you go

00:25:04.000 | into a doctor's office or you enter a hospital or a nurse comes

00:25:09.000 | into your room, you have been welcomed into their family.

00:25:15.000 | You're like Uncle Miles who's in the family, and they're going

00:25:19.000 | to treat you like they were treating their uncle.

00:25:22.000 | They're going to give you the best focus, the best attention,

00:25:26.000 | the best care, and they don't leave any stone unturned with this.

00:25:33.000 | And I've never experienced that before.

00:25:36.000 | Now, in Australia--and a lot of people have very good experiences

00:25:40.000 | of health care in Australia, even though it's kind

00:25:43.000 | of the socialized medical system and it's free.

00:25:46.000 | Well, it's not free.

00:25:48.000 | It's taxed, but it's freely available, shall we call it.

00:25:52.000 | The problem is that it's rationed.

00:25:55.000 | And what that means is that even when you come out of a motor vehicle,

00:25:59.000 | horrific motor vehicle accident like I do, you don't get a private room.

00:26:03.000 | You're put into a ward with six other people.

00:26:06.000 | And, you know, you don't get that premier level of care.

00:26:11.000 | If I could pay for it, I would have.

00:26:14.000 | But when you're, you know, lying on a stretch and no one's asking you

00:26:17.000 | what sort of insurance you've got, you just get shoved into the system.

00:26:21.000 | And, you know, don't get me wrong.

00:26:23.000 | I have so many friends who are doctors, and I think doctors have the most--

00:26:27.000 | they're the most admirable people.

00:26:29.000 | They represent, to me, the pinnacle of what we as humans can be in the world.

00:26:33.000 | I mean, they save other people's lives.

00:26:35.000 | I mean, you know, I'm a software engineer by trade.

00:26:38.000 | I don't save people's lives.

00:26:41.000 | I mean, I'm not important.

00:26:43.000 | The guy who saves somebody's life, he's important.

00:26:46.000 | And so I raise them on high.

00:26:48.000 | I look at them as, you know, important people and valued people.

00:26:53.000 | And yet everybody I spoke to in Australia who are doctors would complain about the

00:26:59.000 | limited resources they were given to be able to do proper patient care.

00:27:03.000 | And then in the U.S., I mean, I even was having a conversation with my

00:27:07.000 | physiotherapist this morning about this, and he's telling me, yeah, he says,

00:27:11.000 | "Yeah, I hate the medical system here.

00:27:13.000 | I have to do 20 hours a week of coding just to be able to put my stuff through

00:27:18.000 | for insurance and for, you know, all these things."

00:27:21.000 | He says, "I want to be helping patients.

00:27:23.000 | I didn't go to medical school to become a coder."

00:27:27.000 | And I get that.

00:27:28.000 | Now, down in Mexico, they don't have to deal with that stuff.

00:27:32.000 | I mean, maybe they do to some degree, but it seems like patient care is the first

00:27:37.000 | and foremost focus, and they--

00:27:39.000 | if you're willing to go in there with money and you avail yourself to the private

00:27:43.000 | system there, you get a hospital environment where there's no stress,

00:27:48.000 | there's no one running around.

00:27:50.000 | When I was in hospital after the surgery, I could press a button because maybe my IV

00:27:55.000 | was running low, and a nurse was in my room within 30 seconds.

00:28:00.000 | I mean, I don't get that sort of treatment at the, you know, at the Western.

00:28:05.000 | I mean, this is crazy good.

00:28:08.000 | Five-star first-class treatment.

00:28:12.000 | The hospital room, I was in a single room all to myself.

00:28:15.000 | It had a balcony with beautiful, you know, like tropical outdoor area.

00:28:21.000 | I could go out and sit in the sunshine if I wanted, like a private terrace.

00:28:27.000 | They treated my wife so well while she was there.

00:28:29.000 | They gave her the-- we had the best food, the best coffee, the best anything you want.

00:28:35.000 | And it's not-- maybe that was part of the bill, but I don't think it was.

00:28:41.000 | I thought it was cultural.

00:28:43.000 | They see somebody who needs help, and they give help, and they're not motivated

00:28:48.000 | with their handout asking for money every five minutes or limited by some insurance

00:28:53.000 | company saying, "No, we're not going to-- we're going to deny that claim,"

00:28:57.000 | or, "This is not medically necessary," or whatever.

00:29:00.000 | They just do it.

00:29:01.000 | It's beautiful.

00:29:04.000 | Yeah, it's certainly-- there's so many ways that you can think about that,

00:29:10.000 | but I like Mexicans.

00:29:11.000 | I've always had good experiences in the Mexican culture, and there is certainly,

00:29:15.000 | as you say, in the Latin cultures, there is a greater appreciation of family

00:29:23.000 | and of relationship, and that does have ongoing effects in other areas of life.

00:29:29.000 | And then I think also one of the challenges or one of the things I've observed--

00:29:33.000 | I've never figured out why this is, but it just seems like, to me,

00:29:37.000 | from personal experience, it seems like you just simply get better customer

00:29:42.000 | service in some cultures than you do in others.

00:29:46.000 | I don't think the United States is the worst place in the world,

00:29:49.000 | but I'll tell you, if I have the choice ever to fly on either a Latin airline

00:29:54.000 | or an Asian airline, I always choose that instead of an American carrier

00:29:59.000 | just because the experience that you get with the customer service,

00:30:03.000 | from the flight attendants, the way that you're treated is night and day different.

00:30:08.000 | And I've heard-- I haven't really traveled in the regions of the world where they

00:30:13.000 | say the customer service is legendarily worse than the U.S.,

00:30:16.000 | but it is refreshing to go into other cultures where you get much more of a sense

00:30:22.000 | of warmth and caring than you often do in the United States.

00:30:27.000 | I would also add to that that, I mean, I've noticed this coming from Australia

00:30:32.000 | to the U.S. is that, you know, you go to a restaurant and the table service you get

00:30:36.000 | from the waiter or the waitress is outstanding, I mean,

00:30:39.000 | way better than we would ever get back in Australia.

00:30:42.000 | I mean, it's absolutely over the top amazing.

00:30:45.000 | But then the motivation is they want the tip.

00:30:47.000 | And that's okay.

00:30:48.000 | I don't mind paying for quality because, at the end of the day,

00:30:52.000 | we all work hard.

00:30:53.000 | And so if we get to keep our money, we can choose where we want to spend it,

00:30:58.000 | and we're going to reward quality service.

00:31:01.000 | That's just the free market at work.

00:31:02.000 | And I'm a huge free market advocate.

00:31:05.000 | So that, to me, is core to success here.

00:31:10.000 | The problem is when you don't have a free market, when it's being controlled

00:31:15.000 | by like a corporatized environment or it's artificially manipulated

00:31:22.000 | by government policy like it is, say, in medicine,

00:31:25.000 | and that's where things break down.

00:31:27.000 | And for that reason, I came up with this sort of methodology when it comes

00:31:33.000 | to healthcare for myself, and I've been using it for a while,

00:31:37.000 | and that is to not try to think of healthcare as a one-size-fits-all system

00:31:43.000 | but to break it up into three segments, which I call preventative,

00:31:48.000 | and that's the stuff that we all have responsible for our own biology,

00:31:52.000 | our own bodies.

00:31:53.000 | So you eat right, you go to the gym, you don't smoke,

00:31:57.000 | all the stuff that's good for you that we know is going to extend your life

00:32:02.000 | and is going to keep a high quality of life.

00:32:05.000 | And that stuff, look, I can go to 15 gyms within a 10-mile radius

00:32:09.000 | of my house, and I can choose price and quality individually.

00:32:14.000 | So they all have to compete with each other,

00:32:16.000 | and consequently my monthly gym membership fee is fairly affordable.

00:32:20.000 | I can find -- you know, I can go to the country club gym if I want

00:32:24.000 | to spend that money, or I can go to, you know, 24-hour fitness.

00:32:27.000 | It doesn't matter.

00:32:29.000 | I have the choice.

00:32:30.000 | So that's great for preventative.

00:32:33.000 | The second section I would call elective, and that's surgery that I'm going

00:32:38.000 | to choose to have on my schedule, which is what the case was

00:32:41.000 | with my shoulder.

00:32:42.000 | But it might be somebody, say, a hip, or it might be a knee arthroscopy,

00:32:47.000 | or it might be some other, you know, maybe cataract surgery, maybe dental.

00:32:53.000 | They can choose to get that done on their schedule,

00:32:56.000 | and they're in control of when to get it done.

00:33:00.000 | And this is where I think there's a problem because 90% of the people

00:33:04.000 | that I've spoken to in the U.S., when it comes to elective surgery,

00:33:08.000 | the first thing they do is they go to their health insurance provider

00:33:11.000 | and find out, well, who's going to cover me for my hip replacement?

00:33:17.000 | Well, firstly, here's the interesting dynamic,

00:33:21.000 | and I've done the math on this.

00:33:23.000 | An average cost of a hip replacement in the United States,

00:33:27.000 | and I've done research across about 10 different cases in hospitals

00:33:31.000 | and so on, the average cost works out to about a $50,000 cost.

00:33:36.000 | If you go to Mexico in Guadalajara and you go into an orthopedic surgeon's

00:33:41.000 | office, he will give you a menu, much like going to McDonald's, you know,

00:33:45.000 | you want the number two burger or whatever it is.

00:33:49.000 | He will give you a menu, and he will tell you a hip replacement

00:33:52.000 | is $4,400 U.S. cash, and that's his fee.

00:33:57.000 | And if it takes longer, he eats it.

00:34:00.000 | You don't eat it.

00:34:02.000 | And when you look at that price differential, it's less than a tenth

00:34:08.000 | of the cost of the U.S., and all of a sudden it's like that guy,

00:34:12.000 | what's your business?

00:34:13.000 | And the reason is you can go into that market and you can compare him

00:34:17.000 | against the guy next door, against the guy in the hospital over there,

00:34:21.000 | against the guy over here, and you can choose based on price

00:34:26.000 | and quality and outcomes.

00:34:28.000 | You can even look at Yelp reviews on surgeons down there and find out

00:34:32.000 | who's got the best review.

00:34:34.000 | And that's important to me.

00:34:36.000 | Again, it's a free market which keeps competitive pricing down

00:34:40.000 | and quality up when it comes to elective.

00:34:43.000 | And insurance, who cares when it's $4,400?

00:34:47.000 | My deductible's $10,000.

00:34:49.000 | My entire shoulder replacement was less than my deductible here.

00:34:54.000 | So at that point, the power's back in you.

00:34:57.000 | Now, God forbid you end up in an accident much like I had or you have

00:35:01.000 | some chronic condition, you were born with a condition, you get cancer,

00:35:05.000 | you have a heart attack, all those things that none of us want anybody

00:35:09.000 | to ever have to go through.

00:35:11.000 | But it's life.

00:35:13.000 | We're biological entities.

00:35:15.000 | We have a shelf life.

00:35:16.000 | We are going to go through those things to some degree.

00:35:19.000 | And at that point, what I would say is that's the choice when you don't

00:35:24.000 | get to shop around for your physician or your hospital.

00:35:27.000 | It's like just take me somewhere and patch me up, please.

00:35:31.000 | And that's going to be when you need to lean on insurance.

00:35:36.000 | And if we can somehow create a situation where we take control of our own

00:35:40.000 | preventive responsibilities and we live a good life that way,

00:35:43.000 | and we take control of when we need elective surgery and we're willing

00:35:46.000 | to pay for it ourself and we save money up to cover ourselves

00:35:50.000 | and we only need an insurance for adverse events, well,

00:35:55.000 | if you count the number of times in your life that you've had an adverse event,

00:36:00.000 | then all of a sudden our insurance would drop down dramatically

00:36:03.000 | if it only needed to cover that.

00:36:05.000 | Yeah.

00:36:06.000 | Yeah.

00:36:09.000 | Do you label that as acute care?

00:36:10.000 | What do you use for category number three in terms of your labeling?

00:36:14.000 | I've been calling it adverse or chronic.

00:36:17.000 | Okay.

00:36:18.000 | Adverse or chronic, preventive, elective and adverse or chronic.

00:36:22.000 | Yeah, I think, and interestingly,

00:36:24.000 | I think that is one of the areas where the U.S.

00:36:27.000 | American healthcare system really shines.

00:36:30.000 | I don't know this from data.

00:36:32.000 | This is just an impression.

00:36:33.000 | But it seems to me that if I'm in a car accident,

00:36:36.000 | I'd like to be in the U.S., right?

00:36:39.000 | The surgeons and the life support and systems and whatnot are world class.

00:36:44.000 | It seems to me that they're really world class.

00:36:47.000 | And that seems to be where I think the -- where I have tremendous admiration

00:36:52.000 | for the medical systems, the ER surgeons,

00:36:55.000 | the people who are involved in that kind of high-level acute care.

00:36:59.000 | And the other areas seem to be -- the preventive certainly seems to be where

00:37:05.000 | we don't do very well as a culture, and then the elective is kind of in and of itself.

00:37:10.000 | I don't know enough to categorize it on that.

00:37:12.000 | It is very frustrating being an advocate of free markets myself.

00:37:17.000 | It is often so difficult and frustrating to talk about the medical system

00:37:21.000 | because it's not any one thing, right, especially in the U.S.

00:37:26.000 | It's not a government-run, taxpayer-run system with all of the associated problems

00:37:32.000 | but advantages, but neither is it a free market system

00:37:35.000 | with all of the associated advantages.

00:37:37.000 | It's like this monstrous hybrid that has a few good things

00:37:41.000 | and a whole lot of bad things all mixed up together.

00:37:44.000 | So finding solutions to that is very daunting.

00:37:49.000 | Well, I've always found in life that when I lose choice as a consumer

00:37:54.000 | or as a purchaser of something, that that's when pricing is out of control,

00:38:00.000 | and that's when I have really no say in the matter.

00:38:02.000 | So, you know, it might be, say, my internet service provider.

00:38:05.000 | If I only have one to choose from, they can charge me whatever they want,

00:38:09.000 | and I've got no choice in the matter.

00:38:11.000 | I have to pay it.

00:38:12.000 | And it's the same with most sole source markets.

00:38:17.000 | They're kind of things that if you can, you want to avoid them.

00:38:20.000 | You want to go to places where there's choice and price competitiveness

00:38:24.000 | and quality competition and all of that.

00:38:27.000 | And medical has so much of that except for adverse.

00:38:33.000 | And I think it's fair to say that adverse is not likely to be a good fit

00:38:40.000 | for the free market economy.

00:38:42.000 | And for that reason, I do see a role of government

00:38:46.000 | or some third party, insurance, whatever it might be,

00:38:50.000 | playing a role in provision of that care as long as it's never rationed

00:38:55.000 | and it's not the – but there has to be conditions on this.

00:38:59.000 | You cannot use an emergency room as your entry into a healthcare procedure

00:39:05.000 | unless you need to be there because it's an emergency.

00:39:08.000 | And that's where we've lost it because people who don't have insurance,

00:39:13.000 | who don't have, you know, money, well, they don't go to their urgent care

00:39:17.000 | or their local GP or their, you know, family practitioner.

00:39:21.000 | They go to the ER room and they end up getting between a $5,000

00:39:25.000 | and $2,000 bill for walking in because they've got, you know,

00:39:29.000 | bronchitis that could just need some antibiotics or something.

00:39:32.000 | I mean this is a drain on an industry that shouldn't be used that way.

00:39:38.000 | I agree.

00:39:39.000 | I don't know how to solve it, but what I do think is that as individuals –

00:39:43.000 | so I don't know how to solve the whole economy, right?

00:39:46.000 | But I do believe, I do trust that individuals can make intelligent decisions

00:39:50.000 | for themselves in the midst of it.

00:39:52.000 | And so two comments.

00:39:53.000 | One, if I could – I was shopping health insurance prices

00:39:56.000 | with a health insurance broker recently, and we were talking about it

00:39:59.000 | just to see because I've grown rusty over the last few years

00:40:02.000 | on the health insurance marketplace.

00:40:04.000 | But I was able to work out and get one quote on a policy with one broker

00:40:09.000 | for something like a $100,000 deductible.

00:40:12.000 | And I've forgotten this now because it's been a few months

00:40:15.000 | because I can't quote the prices.

00:40:17.000 | But I looked in and said, you know, how high could we get the deductibles?

00:40:20.000 | Is there anything available in the marketplace?

00:40:22.000 | And the best thing that I would like to see, especially for people

00:40:27.000 | who have money, have savings, et cetera, is you just take on preventive

00:40:31.000 | and elective care yourself and you self-insure through all of the

00:40:36.000 | even major stuff, right?

00:40:38.000 | Most wealthy people, you can self-insure a $10,000, a $20,000, a $30,000,

00:40:41.000 | a $40,000 risk.

00:40:43.000 | But if you can just have that coverage from $50,000 to $5 million, right?

00:40:47.000 | That's the coverage that you need.

00:40:49.000 | And that's where insurance is the perfect fit.

00:40:51.000 | It's the perfect solution.

00:40:53.000 | That's where insurance really shines is protecting from catastrophic,

00:40:56.000 | very unlikely, very--well, things that only affect a few people

00:41:01.000 | but are catastrophes, that's where insurance is the perfect design.

00:41:04.000 | And then everything else can just be out of pocket.

00:41:07.000 | But I think that that's only accessible to people, especially in the U.S.,

00:41:10.000 | if they understand that there are other options.

00:41:12.000 | You can go to Mexico for your elective surgery.

00:41:15.000 | You can go to Costa Rica for your dental work.

00:41:20.000 | You can go to Brazil for your plastic surgery.

00:41:24.000 | You can go to Malaysia for your heart treatment.

00:41:28.000 | And by the time that you factor in, even with all the other costs,

00:41:31.000 | with a lot of these things, you factor in airplane flights,

00:41:33.000 | you factor in hotel and lodging, there's still such a dramatic

00:41:36.000 | price differential that if you're paying for yourself,

00:41:39.000 | you definitely should consider it and price it out.

00:41:42.000 | And I think this will be--it is a growing industry in my understanding,

00:41:46.000 | and I think it'll be a growing industry in the future.

00:41:49.000 | How much did you estimate your surgery would have cost you

00:41:52.000 | if you had just bought it in the United States?

00:41:55.000 | Yeah, that was a very interesting bit of research because I had no--

00:42:00.000 | and this brings up a very good point about insurance versus cash.

00:42:06.000 | And I think--I know in past programs you've talked about this,

00:42:11.000 | but it's absolutely true.

00:42:14.000 | In the case of medicine, being a cash customer is not an advantage at all.

00:42:18.000 | Right.

00:42:19.000 | The problem is you don't have any negotiating power on contract pricing

00:42:24.000 | because you're just a guy with some money in their pocket,

00:42:27.000 | and the medical industry sees you as a good extortion target.

00:42:34.000 | They want that money and everything else you got.

00:42:37.000 | I mean, that's just the way it works.

00:42:39.000 | So in that regard, when I went shopping to try to price this surgery out--

00:42:44.000 | and, look, my surgery required a total shoulder replacement.

00:42:48.000 | It required removal of previous work that was done, the pins.

00:42:52.000 | It required a lot of cleanup work.

00:42:56.000 | So all of those factors were in there.

00:42:59.000 | I shopped around and I went online.

00:43:02.000 | I said, "What's the cost of a total shoulder?"

00:43:04.000 | And the insurance companies who negotiate down the prices will tell you,

00:43:09.000 | "Ah, $25,000 to $30,000, somewhere around there."

00:43:13.000 | That's if you've got insurance.

00:43:14.000 | Well, I don't because it's preexisting.

00:43:16.000 | They're not going to touch it.

00:43:17.000 | They won't even give me access to contract pricing.

00:43:20.000 | I can't do anything like that.

00:43:21.000 | So I went back to a friend of mine who's a doctor in Southern California,

00:43:25.000 | and I said to him, "Look, you're on the inside.

00:43:28.000 | Can you tell me what you think this procedure would cost me?"

00:43:33.000 | And so a day or so later, he got back to me and he said, "Yeah."

00:43:37.000 | I called around.

00:43:38.000 | I spoke to a friend of mine who's an orthopedic surgeon,

00:43:42.000 | and we looked at what you were doing, and we think looking at the hospital cost,

00:43:47.000 | the anesthesiologist, the surgical team, probably $125,000, and I was floored.

00:43:55.000 | Wow.

00:43:56.000 | I'm like, "Are you serious?"

00:43:58.000 | He goes, "Yeah, that would be a normal charge for something along those lines."

00:44:03.000 | And so I said, "But I'm paying $10,000," and then the phone went, like, dead.

00:44:09.000 | Wow.

00:44:10.000 | He had to kind of pick himself off the floor and go, "Are you kidding?"

00:44:14.000 | I'm like, "No, that's what they're charging me."

00:44:17.000 | And this was before I had the surgery.

00:44:21.000 | So the funny thing is after I'd finished the surgery and I was being discharged,

00:44:24.000 | they wheel you out of the hospital and they take you straight to the finance

00:44:28.000 | department, right, because you've got to pay the bill.

00:44:31.000 | And here I am with my visa card in hand, and the lady, she spoke perfect English,

00:44:36.000 | and she was telling me she must have lived in California for, like, 10 years

00:44:40.000 | and then went back to Mexico, and she was telling me about all this sort of stuff.

00:44:44.000 | And so she's working on the computer and punching all these buttons,

00:44:47.000 | and the next thing you know she presses the button to print,

00:44:50.000 | and I see the laser printer spitting out, like, 10 pages of bill, everything,

00:44:56.000 | just 10 pages of every single thing they ever did in the hospital.

00:45:00.000 | And she comes up and she gives me some huge number, and, of course,

00:45:03.000 | it's in pesos.

00:45:05.000 | Well, U.S. dollar, how much are we talking about?

00:45:08.000 | Now, I'd already paid $1,200 as a deposit to go in there,

00:45:15.000 | and the balance left over was $3850 or something like that.

00:45:19.000 | So let's say $5,000 for the hospital.

00:45:23.000 | And I thought, "Wow, that's incredible."

00:45:26.000 | And I was in hospital for two nights, so three days,

00:45:29.000 | and all the surgical stuff and whatever.

00:45:31.000 | And then so I paid that, and then I got back to the doctor's office

00:45:34.000 | a day or so later, and he was checking on the stitches

00:45:37.000 | and all the stuff they did.

00:45:39.000 | And I said, "Listen, I need to settle up with you.

00:45:41.000 | I mean, how much do I owe?"

00:45:43.000 | And he goes, "Well, the prosthetic, we had to buy that separately.

00:45:46.000 | It was all custom built, and the surgical team need to be paid.

00:45:50.000 | So on your way out, go see the lady at the desk,

00:45:53.000 | and she'll give you the bill."

00:45:54.000 | And here I am with my Visa card in hand again.

00:45:56.000 | I go to her, and I say, "All right, how much?"

00:45:59.000 | She rattles off this massive number in pesos, and we worked out.

00:46:03.000 | The whole thing was like, I don't know, about another five grand or something,

00:46:08.000 | a little bit less than that.

00:46:10.000 | So I paid it gladly.

00:46:12.000 | What's scary about doing business in Mexico is they use the dollar sign

00:46:18.000 | exactly the same as they do in the United States.

00:46:22.000 | So it doesn't say 5,000 Mexican pesos.

00:46:27.000 | It says $5,000.

00:46:29.000 | So you look at the pricing, and a lot of times there's no indication.

00:46:33.000 | It doesn't say USD or MEX.

00:46:35.000 | It just says a dollar sign and 5,000.

00:46:38.000 | Then you have to go and pull out your app and say, "Oh, okay, good.

00:46:41.000 | This is Mexican dollars instead of U.S. dollars."

00:46:45.000 | I remember the first time I was in Mexico, just everywhere I'm thinking,

00:46:49.000 | "They use the same dollar sign.

00:46:51.000 | How do I know the difference?"

00:46:53.000 | I know.

00:46:54.000 | You know what's really funny?

00:46:55.000 | This is kind of not related specifically to the medical side of things,

00:46:59.000 | but you know how I paid for this?

00:47:01.000 | How's that?

00:47:02.000 | I paid for it with Bitcoin.

00:47:04.000 | Really?

00:47:05.000 | Wow.

00:47:06.000 | I had done really well.

00:47:07.000 | I had some Bitcoin investments for a long, long time ago,

00:47:09.000 | and I bought a bunch of real estate when I sold it all in 2017.

00:47:14.000 | I had a few bits of leftover change from this sitting on a hardware wallet

00:47:19.000 | somewhere, and it just so happens that, I don't know,

00:47:23.000 | somebody blessed me with a Bitcoin and went to $12,000 again.

00:47:27.000 | I said, "Well, let me see what sort of loose change I've got lying around

00:47:30.000 | the couch."

00:47:31.000 | I had enough money in Bitcoin to pay for the whole procedure.

00:47:34.000 | That's great.

00:47:35.000 | The funny thing is I said to the surgeon after the surgery, I said,

00:47:39.000 | "You're going to get a laugh out of this,

00:47:41.000 | but I'm paying for the whole thing in Bitcoin."

00:47:43.000 | His ears pricked up, and he wanted to hear the whole thing about it.

00:47:46.000 | He says, "We need to start taking Bitcoin down here."

00:47:49.000 | I'm thinking, "Yeah, you do, buddy."

00:47:51.000 | That'd be great.

00:47:52.000 | That'd be great.

00:47:53.000 | I'd like to make good use of our time and kind of change here.

00:47:56.000 | The net summary, my net summary, you can say yes or no.

00:47:59.000 | My net summary is so far you've had a great experience.

00:48:01.000 | You were able to get a quality surgery that you needed.

00:48:05.000 | You were able to get a great price, and things are better,

00:48:08.000 | and you'd do it again if you had to.

00:48:09.000 | Is that a good summary?

00:48:11.000 | Yes, sir.

00:48:12.000 | Absolutely.

00:48:13.000 | All right.

00:48:14.000 | That's valuable to share, and I think that there are many people

00:48:18.000 | who have family members and who are listeners

00:48:22.000 | who probably have things that they could have done.

00:48:25.000 | They'd like to have that surgery.

00:48:27.000 | They'd like to have plastic surgery,

00:48:32.000 | or they'd like to have a certain procedure,

00:48:35.000 | like you said, a hip replacement or something done,

00:48:37.000 | and yet they've not thought of doing it.

00:48:39.000 | They know they don't have the money for it.

00:48:41.000 | Well, look around the world, because in today's world,

00:48:43.000 | you can get on an airplane, and within 24 hours,

00:48:46.000 | you can be on just about any corner of the globe.

00:48:48.000 | It's pretty incredible.

00:48:50.000 | What that means is that now you have the opportunity

00:48:52.000 | to access these markets.

00:48:54.000 | What I think people are often underappreciative of is they think

00:48:58.000 | that they're somehow falling behind in medical knowledge

00:49:03.000 | in other places.

00:49:05.000 | In reality, sometimes it's the opposite.

00:49:08.000 | Sometimes you'll have great doctors and poor doctors

00:49:10.000 | anywhere in the world, just like with anything else,

00:49:13.000 | but my experience being just simply a layperson

00:49:16.000 | who's not really qualified to address competence has been--

00:49:20.000 | I've been impressed by doctors I've met all over the world.

00:49:23.000 | If you trust yourself a little bit to go with your feelings,

00:49:27.000 | go with whatever external data you can gather,

00:49:30.000 | do the reviews, et cetera, but we're in a world

00:49:32.000 | of increasing competition, and you can use that

00:49:35.000 | to have some solutions to your medical problems,

00:49:40.000 | especially--and you may be able to afford it

00:49:42.000 | if you're traveling around the world.

00:49:44.000 | I remember years ago I read on Bumfuzzle,

00:49:48.000 | on the Bumfuzzle blog, Patrick and Ali Schulte.

00:49:50.000 | They were out traveling around the world for years,

00:49:53.000 | and they came back to the United States,

00:49:54.000 | and they were going to have a baby,

00:49:56.000 | and they didn't have any insurance,

00:49:58.000 | and so they went to Mexico to have the baby.

00:50:00.000 | The benefits of that--and I think in her case

00:50:02.000 | she had a C-section--their C-section bill was,

00:50:04.000 | I think, $3,000.

00:50:06.000 | Those of us who've had babies in the United States know

00:50:08.000 | that if you have a C-section, you're in the tens of thousands

00:50:10.000 | of dollars very quickly, $20,000 to $30,000.

00:50:12.000 | That's just too big of a risk,

00:50:14.000 | especially if you're uninsured.

00:50:16.000 | Obviously, I try to be a prudent person,

00:50:18.000 | but there have been times in my life where I'm uninsured.

00:50:21.000 | I've been uninsured from a health insurance perspective,

00:50:23.000 | and I don't think it's as big of a risk

00:50:25.000 | as it's often laid out to be.

00:50:27.000 | Certainly it's a risk, but in life we take risks.

00:50:30.000 | So if you find yourself in a situation where you're uninsured

00:50:32.000 | or uninsurable, look around the world.

00:50:35.000 | If you're going to have a baby, go have the baby in Mexico.

00:50:38.000 | Get some immigration benefits out of it.

00:50:40.000 | You have a nice Mexican baby instead of just an American baby,

00:50:43.000 | and also it can help you to cover you.

00:50:46.000 | It is really nice, especially if you're coming from a wealthy country

00:50:49.000 | or you're earning in American dollars in the United States

00:50:52.000 | or other places in the world.

00:50:54.000 | It's really nice to go to a place where you can have work done

00:50:57.000 | and not worry about what the bill is that's going to show up,

00:51:01.000 | because it's within your comfort level.

00:51:03.000 | You can be in the hospital for days,

00:51:05.000 | and you're not worried about it.

00:51:07.000 | Now, I can't solve why that is the case in the United States,

00:51:11.000 | but I know I can solve it for you in some circumstances

00:51:14.000 | if you'll expand your ideas around the globe.

00:51:17.000 | Anything else that you'd like to add on medical tourism

00:51:19.000 | before we switch to fire, Myles?

00:51:24.000 | Well, it's interesting that there are some overlaps with medical tourism

00:51:29.000 | and financial independence, because I would not have been able

00:51:34.000 | to have the opportunity to go to Mexico and do the research

00:51:38.000 | if I had to report for work every day at 9 o'clock.

00:51:43.000 | We give up so much of our freedom with this kind of social mantra of work

00:51:49.000 | that we lose the opportunities.

00:51:52.000 | And if you only get a couple of weeks' vacation a year

00:51:55.000 | and you're going to spend a week of it travelling to Malaysia

00:51:58.000 | to get research medical procedures or something along those lines,

00:52:05.000 | it's very difficult to be able to achieve that.

00:52:07.000 | You almost feel like you're stuck in the system,

00:52:10.000 | kind of like a prisoner that can never get out.

00:52:13.000 | And when they get out, they get drawn back in or something.

00:52:16.000 | It's a very, very tough world.

00:52:19.000 | You need to have life freedom to be able to get life in this case.

00:52:25.000 | It's just part of it.

00:52:26.000 | Otherwise, you're just going to fall back on your local hospital,

00:52:29.000 | your local insurance, and you won't get a choice.

00:52:31.000 | Yeah, there's no question.

00:52:33.000 | That absolutely is one of the many costs of working,

00:52:36.000 | being forced to a limited constraint when you go on vacation.

00:52:40.000 | Everyone else is on vacation too, because especially if you have children,

00:52:44.000 | you're doing things on school calendars and you're limited vacation.

00:52:47.000 | You wind up--that's the thing about travel.

00:52:49.000 | I don't know how it's extremely difficult when you're stuck

00:52:52.000 | in a very short vacation window to travel effectively

00:52:55.000 | because you wind up spending lots and lots of money

00:52:58.000 | to do things at certain specific times,

00:53:01.000 | and you've got to do everything fast, and so you wind up spending tons of money,

00:53:04.000 | whereas those who have built time flexibility into their life--

00:53:07.000 | it can be through financial independence,

00:53:09.000 | it can be through self-employment, it can be through seasonal work, etc.--

00:53:13.000 | you can make the money stretch much farther.

00:53:16.000 | So certainly it's a good point.

00:53:18.000 | Miles, you call your blog Be Unconstrained,

00:53:21.000 | and you've got this liberty-oriented bent.

00:53:24.000 | I think that's why we have some things in common.

00:53:28.000 | How do you look at the world when it comes to your own personal liberty,

00:53:32.000 | and what choices are you making to expand your liberty?

00:53:36.000 | Well, I'm a firm believer that the buck stops on my desk

00:53:42.000 | with anything I choose and decide on,

00:53:45.000 | so that kind of is my starting point.

00:53:49.000 | I also believe that--I don't know.

00:53:53.000 | I mean, it's very easy for people who have--

00:53:57.000 | I come from a country with 25 million people living in it.

00:54:00.000 | It's not a very big place, and in that sort of country,

00:54:04.000 | you kind of make the rules up as you go along.

00:54:07.000 | I haven't lived there for a long time,

00:54:09.000 | but when I grew up in the '70s and the '80s in Australia,

00:54:12.000 | there was no internet.

00:54:14.000 | There was no world travelers so much.

00:54:17.000 | Everybody just sort of worked it out,

00:54:19.000 | and we were an island isolated unto ourselves,

00:54:22.000 | and we had to--there were rules.

00:54:24.000 | I mean, you know, there were government-imposed rules.

00:54:26.000 | There were social, cultural rules or whatever,

00:54:28.000 | but for the most part, everything was a pragmatic decision

00:54:31.000 | based on what's going to fix a problem right now

00:54:33.000 | or what's going to avoid one for the future.

00:54:36.000 | We didn't predispose anybody's future based on education or work or whatever,

00:54:43.000 | and I kind of embraced that.

00:54:46.000 | The other thing which affected my thinking in regards to that,

00:54:50.000 | and particularly regarding liberty, was what I saw my father go through,

00:54:54.000 | and it's not a story I tell all that often, but I'll share it here.

00:54:58.000 | My father worked for the same company for 40-odd years before he retired,

00:55:04.000 | and I remember the day he retired, he got himself, you know,

00:55:07.000 | the traditional gold watch and what they call a superannuation plan down there,

00:55:12.000 | which is like a pension, I guess, or like a 401(k) thing,

00:55:16.000 | and my mother and him managed to go to Europe for six weeks

00:55:20.000 | and had a great time traveling, as you probably would do at the end of retirement,

00:55:25.000 | but two years later, he died, and I had to be the guy to identify the body

00:55:32.000 | and bury him, and I went through that whole process,

00:55:36.000 | and I'm an only child, so it all ended up on my shoulders.

00:55:40.000 | So, I walked through that whole process, and then, you know,

00:55:45.000 | you go through the scientific, pragmatic, well, what killed him?

00:55:49.000 | What did he die of?

00:55:51.000 | And the doctor said we had a heart attack and he died.

00:55:54.000 | Well, what we find out is that many years before that,

00:55:59.000 | he always had problems with his lungs.

00:56:01.000 | He was always coughing, and I never really realized what it was.

00:56:05.000 | I just thought the guy had, you know, he was at a very young age.

00:56:09.000 | He was like most people in the, I guess, in the 30s and 40s.

00:56:12.000 | He was a smoker like everybody was back then,

00:56:15.000 | and I thought maybe that was something to do with it.

00:56:17.000 | Well, it wasn't.

00:56:18.000 | He worked for a very large corporation that was nationwide in Australia

00:56:23.000 | that made building products, and one of the key products

00:56:26.000 | that they were experts in was roofing,

00:56:29.000 | and the particular product he was exposed to was asbestos.

00:56:34.000 | And so, for most of his working career in the 40-odd years he worked

00:56:38.000 | in this corporation, and he subscribed to the, you know,

00:56:41.000 | the company will always look after me and I'm a company man, and, you know,

00:56:45.000 | he was a very loyal employee to that.

00:56:49.000 | The company screwed him over.

00:56:51.000 | I mean, they killed him.

00:56:53.000 | They didn't know they were doing it for a lot of the time, but they knew,

00:56:56.000 | just like, you know, how Philip Morris and all of the tobacco companies

00:57:00.000 | got caught out, they knew for the last, say,

00:57:02.000 | 10 years that they were selling that product, that it wasn't good,

00:57:06.000 | that it was carcinogenic, that it shouldn't have been on the market,

00:57:09.000 | and they eventually pulled it, and he just got the raw deal

00:57:14.000 | and died of asbestosis of the lung, of cancer.

00:57:19.000 | And I kind of watched that, and I guess maybe I was about 20 years old

00:57:25.000 | when I had to, you know, put him to rest and everything,

00:57:28.000 | and I realized I don't want to go down that path.

00:57:31.000 | I don't want that to be my life.

00:57:33.000 | I don't want to be --

00:57:34.000 | it's not about financial independence.

00:57:38.000 | It's about independence.

00:57:40.000 | I don't want to be relying on any third party for anything.

00:57:45.000 | I don't want to rely on government.

00:57:47.000 | I don't want to rely on banks.

00:57:49.000 | I don't want to rely on the Federal Reserve.

00:57:51.000 | I don't want to rely on corporations.

00:57:53.000 | I sure do not want to rely on a boss who I have less respect for, you know,

00:57:59.000 | who's holding my paycheck above my head saying, "You better do this

00:58:03.000 | or you're not getting it."

00:58:04.000 | I mean, I don't want that life.

00:58:06.000 | I want freedom.

00:58:07.000 | And then having made that decision, I looked at this whole social mantra,

00:58:14.000 | this cultural social norm that we've sold ourselves and our kids,

00:58:19.000 | and I realized it just didn't fit me, this go to school until you're, I don't know,

00:58:25.000 | 18 years old and then choose whether you want to go into the trades

00:58:29.000 | or you want to go back into college and then go and do another four or six

00:58:33.000 | or eight years more of tertiary education.

00:58:36.000 | And I thought, well, that's admirable if I want to be an architect or a lawyer

00:58:40.000 | or an accountant or a doctor or something like that.

00:58:43.000 | Yeah, that works really, really well for that.

00:58:45.000 | But what if I just want to be me?

00:58:48.000 | I just want to be a human being and have a good life and look after a family.

00:58:51.000 | And I'm not afraid to work hard and I'm not afraid to be smart and learn

00:58:56.000 | and read and study because life and education doesn't end at the age of 22.

00:59:01.000 | My daughter just graduated this year, and part of the reason I did my blog was more

00:59:06.000 | of a service to her.

00:59:08.000 | I realized, you know what, I'm 54 years old.

00:59:12.000 | She ain't going to listen to me.

00:59:14.000 | She's not going to listen to my life stories and what I've learned because I'm just dad.

00:59:21.000 | You know, I'm not important.

00:59:23.000 | But what she might do is one day, maybe if I could tell everybody else this story,

00:59:30.000 | she might look at it then and go, hey, maybe he wasn't such a dumbass in the end anyway.

00:59:35.000 | Maybe he did have something to say.

00:59:38.000 | Maybe the fact that he lived a life without having to work for a boss and, you know,

00:59:44.000 | he has his freedom.

00:59:46.000 | I kind of grew up with that and thought that was normal.

00:59:49.000 | But now I'm working for American Express every day and I'm stuck in a cubicle somewhere.

00:59:55.000 | I start realizing how it's not normal.

00:59:59.000 | I wanted her to realize that although I put her through college and paid for her education

01:00:04.000 | and everything, that 85% of all of her peers walked out of that college degree

01:00:09.000 | with student loan debt and won't be able to participate with real estate market speculation

01:00:15.000 | and buy gold or, you know, invest in Japanese corporations or whatever they want to do that might be their form

01:00:23.000 | of risk management and asset acquisition or whatever.

01:00:26.000 | They can't participate in that because they've got this albatross on their back that they can't get rid of.

01:00:32.000 | And that's not right because half of the degrees those kids came out with,

01:00:37.000 | they're never going to work in that field or they're going to come out like half

01:00:42.000 | of her class, graduating class of 20,000 at the University of Arizona this year,

01:00:48.000 | that I watched them all come out, a bunch of them got, you know, picked up by Goldman Sachs.

01:00:53.000 | She did a business major.

01:00:54.000 | And so they're going to go to Wall Street and work for Goldman Sachs and they're going to be,

01:00:58.000 | "Whoa, look at me.

01:00:59.000 | I've, you know, got this great job."

01:01:00.000 | Yeah, and you've got an $8,000 a month apartment and you can't afford this and you can't afford that,

01:01:05.000 | but you've got this great job.

01:01:06.000 | And then three or four years they're going to go, "You know, I'm miserable working on Wall Street.

01:01:10.000 | I want to get out of Wall Street.

01:01:12.000 | What am I doing this?"

01:01:13.000 | "Well, because I got student loan debt."

01:01:15.000 | "Well, because I got" -- you know, it's like at what point is this not stupid?

01:01:20.000 | It's just insane to not question this and say, you know, who's responsible for you?

01:01:26.000 | Who makes your life choices?

01:01:28.000 | Is it you or is it social culture and social norms?

01:01:33.000 | Are your parents telling you to do these things because they really don't have the answer themselves

01:01:38.000 | and that they went through that process and therefore they're just trying to do the same thing for you,

01:01:43.000 | stay in school, get a degree, get a good job, work hard.

01:01:48.000 | You know, you'll be fine.

01:01:49.000 | At the age of 65, you'll retire and you'll get your pension and let's God forbid hope you don't die in two years.

01:01:55.000 | Now, I know I'm an outlier.

01:01:59.000 | I know I'm really odd.

01:02:02.000 | But when I see people coming out of the financial independence or the FIRE movement

01:02:07.000 | and I understand that they're sensing something's not right

01:02:12.000 | and they're trying to do something atypical to break the mold, I applaud them.

01:02:18.000 | I absolutely applaud them.

01:02:20.000 | But I also am so cautious that they don't go into the process of welcoming themselves into a cult-based,

01:02:29.000 | faith-oriented movement that says you too can retire at the age of 38.

01:02:35.000 | Because I can tell you right now, at the age of 38, you don't want to be retiring

01:02:39.000 | because you shouldn't be working for money.

01:02:42.000 | You know, there's so many better reasons for you to work and so many better reasons for you to be a better person

01:02:48.000 | and to really extend yourself and it shouldn't be all about money.

01:02:53.000 | So if they say, "I don't want to retire early, but I want to be financially independent

01:02:58.000 | so I can go out there and pursue the world and be Ernest Hemingway and be Marco Polo

01:03:04.000 | and be these great people who travel and embrace the world and be, as I say, unconstrained

01:03:11.000 | and not shackled down by anything, they can have a life worth living and that's all I want

01:03:17.000 | and that's all I wanted for my daughter and one day maybe she'll listen.

01:03:24.000 | You're in that, if you just graduated from college, you're in that time where you don't get a lot of feedback,

01:03:29.000 | you just got to wait.

01:03:30.000 | And then I think in general, at least if our experience with our parents is any indication,

01:03:35.000 | you start to recognize that your parents get smarter as the years go by.

01:03:39.000 | So it will return.

01:03:44.000 | And I realize that everybody, you know, me sitting here on your podcast talking about all these things

01:03:52.000 | and proliferating my views on what the world is and all these sort of things,

01:03:57.000 | they're not going to resonate with everybody.

01:03:59.000 | People are going to question me and think, oh, he's an idiot, he's crazy.

01:04:02.000 | Who would do those sorts of things?

01:04:04.000 | But I just ask somebody to look in their own backyard and question whether they're living in a house

01:04:12.000 | with a garage full of stuff they never should have bought in the first place

01:04:16.000 | or they're living a life they're not happy with.

01:04:19.000 | They're going to work and they're stuck in traffic, they're stuck in a gridlock

01:04:24.000 | and they can't seem to escape it.

01:04:27.000 | So I say don't question me, question that and find out what the answer to solve that is

01:04:34.000 | and then you'll have your own answers and you won't have to worry about my position and stuff.

01:04:39.000 | It does seem obvious that on – I see examples on every hand that it's more unusual for me today

01:04:47.000 | to find somebody who – most people that I meet question.

01:04:53.000 | Everyone feels like something's wrong, right?

01:04:56.000 | Something's wrong with the way that our modern society is fracturing people up,

01:05:02.000 | is pushing people into certain lifestyles that are just fundamentally in some ways unhealthy for humanity.

01:05:10.000 | And so everybody's looking for solutions to some of these problems

01:05:14.000 | and some people find financial solutions, some people find religious solutions,

01:05:18.000 | some people find familial solutions, but many people seem to be looking for solutions.

01:05:24.000 | I'm optimistic. I think that with the ability that we have to proliferate information and ideas,

01:05:28.000 | from your wacky ideas to my wacky ideas, then more people are trying new things

01:05:34.000 | and there's never before been a time where you could be exposed to more interesting, innovative ideas,

01:05:40.000 | whether that's to live in the city, live in a van, make half a million dollars and retire,

01:05:46.000 | or that's move to the country, live in a self-built hut and retire that way

01:05:51.000 | or in almost any permutation thereof.

01:05:54.000 | So I am excited that I do see a major groundswell of interest in these topics and looking for solutions.

01:06:02.000 | But I just want to close this out here by simply saying,

01:06:06.000 | being a man who retired at 32, went from zero to hero, then back to zero,

01:06:11.000 | then over the years building up another portfolio, as you said, 54 now,

01:06:14.000 | your daughter's graduated from college, that puts you in a new phase of life.

01:06:18.000 | Where do you think you'll go from here and why?

01:06:23.000 | Well, I don't really have, I'm very lucky.

01:06:29.000 | I learned this trick many years ago, which I call financial sustainability.

01:06:35.000 | And it's the ability for you to earn money when you're asleep and to make sure that the amount of money that you're earning,

01:06:42.000 | and people call that passive income, but I do it through real estate or I do it through vending machines

01:06:48.000 | or other forms of investments which generate income on their own.

01:06:53.000 | I don't rely on Wall Street or stock markets or anything like that.

01:06:57.000 | I do everything under my own control.

01:06:59.000 | But I've created a situation where the amount of income that I bring in every month is equal to my burn rate,

01:07:05.000 | what my cost of living is.

01:07:07.000 | So I live neutral.

01:07:08.000 | I don't have any costs.

01:07:09.000 | I don't need to work.

01:07:12.000 | I choose to because there are certain projects in the world that I really want to embrace.

01:07:17.000 | As I get older, I notice my assets grow and they've grown to the point now where I could just sell everything up and go

01:07:26.000 | and live on an island somewhere, I guess, but that would be very boring.

01:07:30.000 | What I'm starting to see is that there's a role for me that isn't about choosing something to do that has a dollar sign attached to it.

01:07:42.000 | It's about an ability to give back.

01:07:46.000 | And my wife is very much of the same belief.

01:07:48.000 | We both were raised as Christians and we're both of the belief that you give when you can.

01:07:55.000 | And in our particular case, we find ourselves in a place where we're lucky.

01:08:00.000 | We've paid our house off.

01:08:02.000 | We've got some rental properties.

01:08:05.000 | We've got income.

01:08:06.000 | Our daughter's already finished college.

01:08:09.000 | We don't need to work, but we still have that yearning need to be of service.

01:08:14.000 | And so one of the things we discovered in our recent trips, we were down in San Miguel in Mexico and meeting up with a bunch of other expats,

01:08:24.000 | which I absolutely enjoyed.

01:08:25.000 | It was fantastic down there.

01:08:27.000 | But we found places where they were providing service back to the community.

01:08:33.000 | There's a long tradition of that down in that town.

01:08:36.000 | And we sort of thought, you know what, there's a role for us here.

01:08:40.000 | My wife is a wonderful clothing designer, and she wants to be able to do work with the local communities of artisans and to encourage people who may not have financial wherewithal.

01:08:53.000 | Or she wants to go and volunteer at an orphanage down there and work.

01:08:57.000 | What I discovered was that with my work in the computer industry, I do a lot of work with school districts, and they turf out thousands of two-year-old laptops onto the auction market, and I happen to have an inroad to that.

01:09:12.000 | So my goal is to buy pallet loads of these computers and ship them down there and start a little operation where I can refurbish these machines and give them out to kids and teach them how to use technology.

01:09:24.000 | I want to give back.

01:09:25.000 | I don't want money.

01:09:26.000 | I don't need money.

01:09:28.000 | But I need something that is more -- I have to transcend that.

01:09:32.000 | I have to -- I'm like Maslow's hierarchy of needs.

01:09:35.000 | I want to get to the top here.

01:09:37.000 | And the best thing I can do is I have to give back.

01:09:40.000 | It's my turn to give back now.

01:09:43.000 | Yeah, as it should be.

01:09:45.000 | Absolutely.

01:09:46.000 | Miles, thank you for coming on.

01:09:48.000 | I've enjoyed your writing.

01:09:49.000 | I thank you for reaching out to me and interacting with me online.

01:09:51.000 | That was how we developed a relationship.

01:09:53.000 | And I'll just point out to you that the way that Miles wound up on Radical Personal Finance today, I get -- just so you know -- I mean, I would imagine -- I don't know if you know or not, Miles, but I get lots and lots of requests every single day from people who are asking me to be on Radical Personal Finance.

01:10:14.000 | I just ignore them all.

01:10:15.000 | I ignore them all.

01:10:17.000 | But what I don't ignore is when people actually engage with something.

01:10:21.000 | And so the way that you ended up here today having this conversation was that you started reaching out to me.

01:10:27.000 | We started chatting back and forth on Twitter, copied me on some of your articles, started reading your articles, enjoyed it, and enjoyed your story.

01:10:34.000 | And then over time, that led to you wrote me an email and said, "Hey, would you like me to come on and tell the story?

01:10:38.000 | It's a story that fits the audience."

01:10:40.000 | And that's why I had you on.

01:10:42.000 | So you're doing a masterful job with your marketing there.

01:10:44.000 | Tell my audience.

01:10:46.000 | Beunconstrained.com.

01:10:47.000 | You also have a podcast.

01:10:48.000 | The podcast is a blog, and feel free to share anything else that you think my audience would be interested in, please.

01:10:53.000 | Yeah, I'm cursed by the -- I talk too much.

01:10:58.000 | So I thought, "Hey, why not turn that into a podcast?"

01:11:02.000 | So, yeah, I created a podcast about probably three or four months ago called The Unconstrained Podcast.

01:11:09.000 | And my goal was to talk about the methods and techniques that I've used that have got me to where I am and to try to create a sense of community where others that are on the same path can tell their stories and can tell their wins and their failures because I think community is what it's all about.

01:11:28.000 | I'm a big believer in decentralization and to make everything a local experience, and podcasts gives you that opportunity.

01:11:35.000 | So, yeah, The Unconstrained Podcast and all the links to it are at beunconstrained.com.

01:11:40.000 | They're on iTunes and Google Podcasts and Stitcher and all that stuff.

01:11:45.000 | Thank you for coming on and telling us your story today.

01:11:47.000 | I appreciate it very much.

01:11:48.000 | You're very welcome.

01:11:49.000 | I enjoy your show every week, and I look forward to all the episodes, too.

01:11:53.000 | Sweet Hop is an online marketplace curating the best in premium seating at stadiums, arenas, and amphitheaters nationwide.

01:12:00.000 | With Sweet Hop's 100% ticket guarantee, no hidden fees, and the personal high-level service you expect with a premium purchase, you can relax knowing you'll receive the luxury experience you deserve.

01:12:11.000 | Visit SweetHop.com today to book your premium tickets to your favorite teams, artists, and all the must-see live events to Sweet Hop Around L.A.

01:12:19.000 | It's more than just a ticket.

RPF0676-Medical_Tourism-Real-Life_Experiences_From_Myles_Wakeham_of_Be_Unconstrained