As hard as the MediCare  issue within the United States might be, it could be that offering off shore medical care could help balance the high coverage costs.  Currently, the government of Panama has been re doubling their efforts into getting their commercial trade agreement signed with the United States, including the extension of the medical benefit.

Countries like Panama, where finding  US graduated doctors  is common, costs for operations are significantly less and where hospitals like John Hopkins backing up a high quality level, offer the best platform to extend the coverage.

Panama, is only 5 hours away from New York and less than 4 hours away from Miami.  According to Yanahir Diaz,  from the John Hopkins Medicine International there are several medical insurance plans that are already accepted in Panama such as Tricare, Vanbreda and Cigna.