Health Care in Panama – High Standards Yet Awesomely Affordable

If you’re wondering if it really is worth the trip to go to Panama for health care, then the answer to this question is YES! Health care in Panama is comparable to that in the US and Canada yet you only need to spend very little. It is a place where one can experience quality and dependable health care at a fraction of a cost. Here’s one story about a friend of mine who has experienced affordable health care in Panama.My friend needed two to three tooth implants so he went to a dentist in New Jersey who said that one tooth implant would cost him $4000+. He found this to be quite expensive so he let it pass for a while and joined a Panama relocation tour. He then found out about Panama’s medical tourism and decided to get his implants there. He was able to get it at $1200 for each tooth. That’s equivalent to about $5000 to $9000 savings even after airfare and hotel expenses.My friend was so pleased that he decided to also consult with a Panamanian doctor about his basil cell skin cancer. Previously, he went to a doctor in New Jersey who charged him $1200 for consultation and lab fees. He also underwent basil cell freezing in America to eight of his cell spots which further cost him about $100 per spot. My friend needed further treatment so he decided to go to Panama for basil cell freezing. The cost was only $100 for 25 dime to nickel spots that would have otherwise cost him $2500 in NJ. Thus, having medical treatment in Panama is really worth it even if you have to spend for airfare and hotel fees.When I talk to my American friends about the high standards of health care in Panama, the reaction is mostly of shock and disbelief. It’s like they picture the place as a backward third world country where voodoo practitioners abound and not the modern hospitals that I usually talk about. They can’t believe that Panama City alone has 14 hospitals where the standards can match those in America. The country’s Hospital Punta Pacifica (affiliated with the John Hopkins group of hospitals) is in fact the most state of the art and technologically advanced hospital in Central America. Other popular hospitals include Hospital Santo Tomas, Hospital Nacional and Clinica Hospital San Fernando.There are a lot of doctors in Panama who have earned their degrees from US universities like Harvard. These people are well-trained medical practitioners who compare favorably with US and Canadian doctors. The expertise of Panamanian physicians coupled with highly advanced medical technology has boosted Panama’s medical tourism and has become one of the reasons why many American expats retire in Panama.Health insurance is likewise very cheap in Panama as you can get it for as low as $60 per month. Doctor’s consultation, prescription medication and over the counter drugs are also priced affordably. You can consult with a highly trained specialist for as low as $10. Thus, you get a huge cut down on your medical expenses when you either choose to live in Panama or go there for medical treatment.Health care in Panama is so cheap at amazingly high standards. Yes Panama is still considered as a third world country yet it continues to accelerate positively. The country has a booming economy thanks to its famous Panama Canal where most of the action in trade and business takes place. Go to Panama and enjoy huge savings in health care. You not only give yourself a favor by getting big savings but also visit a country that’s truly worth seeing.

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Things You Should Be Aware of in Commercial Property Purchases

With the host of cooling measures rolled out in the residential market by the Singapore’s government to avert a property price bubble, investors are gleaning more investment potential in commercial properties. This segment of properties is exempted from Additional Buyer’s Stamp Duty (ABSD), Seller’s Stamp Duty (SSD) and restrictions on foreigners’ ownership – all of which affect the residential market.In Singapore, there are two ways to buy a commercial property:As an individual or;
As a corporation [via private limited or limited liability partnership (LLP)]The subsequent sections proceed to highlight key points a budding investor in the commercial property landscape should take note of.No utilisation of Central Provident Fund (CPF)If you are making the purchase as an individual, do bear in mind that you cannot dip into the savings in your Ordinary Account of the Central Provident Fund to settle the downpayment or monthly loan instalment for the commercial property.This means the downpayment has to be wholly funded by cash.For the loan repayment, you will have to be prepared to incur cash outlay if the rental yields are inadequate (assuming that you are planning to lease out the property).Property taxSame as for a second residential property, or an only residential property that is wholly rented out or left vacant, the tax is a flat 10% of the annual value of the property.But if you fail to lease out the commercial space, you may apply for a vacancy refund of the property tax. This vacancy refund also applies to a residential property.Goods and services tax (GST)Unlike for residential properties, the buying of commercial spaces from a GST-registered company is subjected to a 7% GST. An individual making the purchase will have to bear the GST himself.However, if you are a GST-registered company – all companies with a turnover exceeding S$1million have to register for GST – you can make claims for the GST incurred on your purchases. Thus shrewd individual investors may set up companies expressly for a financial transaction, termed as Special Purpose Vehicles (SPVs), to circumvent the GST payment.For companies with turnovers below S$1million, GST-registration is on a voluntary basis, subjected to certain requirements. Do note that being GST-registered comes with responsibilities. Check out what these are at IRAS.Notably, the GST cannot be financed by the property loan. Buyers will have to stump up cash for this.Rental yield and capital gains opportunitiesIt is estimated by Colliers Internationals that the yearly average gross yield of commercial spaces approximates 5%, compared to 2-3% for residential property. However, this higher gains can be offset by the steeper maintenance cost and renovation works generally required by tenants. Generally, the maintenance charge for a commercial unit is expected to be higher than for a residential property. Also, more may need to be splurged on basic setup, particularly for shop units leased out for business.An exception are HDB shops with their lower maintenance fees of S$170 to S$250. But these properties tend to come with more restrictions such as the type of businesses permitted. Applications must also be made for renovation.Still, small supply and strong demand can drive up the asset value of strata commercial property, making them worthwhile buys.In land-scarce Singapore, strata-titled shops/offices are in limited quantity because most of the commercial spaces are owned by real estate investment trusts (REITs), and many of these REITs are in turn owned by the Government through proxies. As of 4Q2011, the supply of strata-titled offices in Singapore is estimated to be of 11.05 million sq ft, making up 14.2% of the total office stock (Bright Spot in Singapore Property Market: Strata-titled Office, Colliers International, pg 2). The stock of strata-titled shops also faces a similar small supply.In addition, the slew of regulations in the residential market has diverted investors’ attention to the commercial sector. Together with today’s low interest rate environment, the two have fuelled demand.Thus investors can make capital gains through direct sales.Some investors are also looking toward en-bloc sales to make profit. In April 2012, in collective sales, strata office units at Parkway Centre and Burlington Square sold for $1,043 per sq ft and $1,318 per sq ft, respectively.Besides capital gains, investors maybe hoping to profit from rental yields. However, official statistics on the occupancy rates for strata-titled shops and offices are not available. This makes reliable estimation of rental demand in the past, present and future difficult. Hence investors should be cautious if they are looking to profit from this avenue.All in all, with more supplies coming on-board – either from strata or non strata developments – downward pressure on property values and rental is possible. Hence, only selective buys are recommended.TenureCommercial/shop spaces in Singapore usually comes with 30-, 60-, 99-, or 999-year lease. Some may be freehold. For 99-year and shorter leasehold units, buyers should be mindful that financing institutions may quote a lower loan quantum for units running low on their lease.LoansBorrowers for commercial properties are allowed to take a loan-to-value ratio (LTV) of up to 80%, even with outstanding residential mortgages. The maximum loan tenor typically stands at 30 years. However, loans for commercial property tend to command a higher interest rate relative to residential property loans. Like the latter, these loans come in:Fixed Rate Package
Variable (Floating) Rate PackageThe requirements for a commercial loan, however, are more stringent. For example, the LTV ratio is contingent on whether the property is for owner-occupation or investment, with the latter subjected to stricter criteria by some banks. The next section explains the approval conditions in greater detail.Credit worthiness and approval for commercial loans in Singapore For purchases made under your name only your income, outstanding debts and credit history will be assessed. The maximum LTV ratio for a commercial mortgage is set at 80%, even with existing housing mortgages. But financing institutions will take a holistic approach in deciding whether to grant you a 80% loan.For purchases made under a private limited or LLP company, the financiers will evaluate if the company has a cash flow record over the past few years that is sufficient to fund this investment. For instance, a company earning a monthly profit of S$15,000 deposits it into the company’s account in a timely manner, the lenders can, thus, lend up to 60 to 80% (typically) of this S$15,000. In other words, you can obtain a loan up to 60 to 80% of the debt servicing ratio (DSR). This is much higher than the DSR for residential property bought by an individual.Conversely, buying under a private limited or LLP company without adequate cash flow or profit (or if the companies are special purpose vehicles), may result in the banks requiring that the directors guarantee any loans taken by the company under their individual capacity. The directors may also need to be Permanent Residents or Singaporeans. In many cases, these directors will need to furnish documentary proof that most of their incomes are derived from that company. If they earn their income from elsewhere, some banks will not grant the loan even with them as guarantors. While others may.From time to time, credit officers of the financiers will impose new rules and conduct additional documentation checks. Often, credit officers may ask for more supporting documents if they want to do tighter cross checks.ReferencesMichelle Tee and Koh Siok Hui, Bright Spot in Singapore Property Market: Strata-titled Office, Colliers International White Paper March 2012, Web

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