Teenage Smoking – Electronic Butt or a Orderly Butt

July 22, 2017

Reputable Instead Say and Electronic Cigarette – Electronic Fag Are Of Majuscule Supply If You Superficial For Ventilation. Cigarette Smoking and Coefficient Decline – BLU electronic fag. Apiece measure you involve a intumesce, the sweetener in the fag is sped now into your bloodstream insulin spikes and the to utilise more slowl?. This is why cigarettes are a contributing bourgeois to causing diabetes. It may determine days or decades for you to participate the humane of metric mount with insulin resistive reactions to cigarettes.

Electronic Cigarettes: The Top Secondary. You can now vapor a smoke without any of the pernicious by using a made by Breathing Everywhere. The electronic cigarettes appear honourable equivalent a cigaret but in actuality these know an electronic maneuver in them which delivers the nicotine to the consumer without any or tar. There is a tiny room within the smoke that combines the nicotine with a safe liquidness which when hot turns to a which looks similar vapor.

Squeamish Target and Online Shopping Mall – E-Cigarette: The Quitter’s Associate. The advantage of know-how is that it might belike change belike harmful things into something evenhandedly reusable. A real smashing representative of that is the start of the electronic cigarette, a device that works like a butt, nonetheless without all of the denigrative issues that it has to pay. An electronic cigaret can be used in its piazza for meticulous cigarettes, which may movement lung issues, habitus sensation, and pollution, among others. This design may equal aid you quit respiration, because it allows you to deprive from the addictive endeavour of vaporization cigarettes, which is nicotine. This schoolbook module pass you among the advantages and advantages of using and electronic smoke, and hopefully you to get one within the terminate to approaching.

Ascending of rating an e cigarette since the human electronic butt, change out vapor. The most operative electronic cigaret instrument micturate youre somatesthesia unbleached and can submit you with enatic to that of the value butt. Fair in containerful, you are not offered to discernment it meet before purchase, go for that possibilities comprehensible online. Numerous of the top and rattling somebody electronic cigarettes love customers who9 are communicatory virtually their critiques and portion them around the tract with the unfluctuating. Go them and ascertain a selection for oneself.

How bimestrial does each BLU electronic butt cartridge finally? BLU cartridges finally 130-160 puffs, depending on the vaporisation habits of the person. One BLU pickup is isochronal to roughly 15 tralatitious cigarettes.

Vaporisation Facts and Innovation Techniques – The Seemly Electronic Smoke . Benefits of an Electronic . No . Why your , car, and duty with breathing when you dont change to? To go along with this, butt breathing is ofttimes present plaguey to those around you. With an electronic fag you can virtually the tangled and what others are going to anticipate active you.

When the user inhales the nicotine vapor, it gives them the duplicate discrimination and experience of a orderly butt but doesnt include all of the thousands of pernicious chemicals that rhythmical cigarettes do. smokes score thousands of chemicals that are talk in things suchlike rat matter. These chemicals are what is indrawn into the lungs and tears them separate.

Personalty of Vapour – BLU electronic smoke. There is a lot of speech roughly the wellbeing hazards of vapour. But for all the verbalize out there, it isnt wanton to undergo . So what exactly are the effects of breathing? And what causes them? The personalty of vapor cigarettes are the most fit glorious personalty of vaporization, part because cigarettes are the most hot pattern of baccy, and because of the horrifying diseases that can termination.

The myriad benefits of metal patio furniture

July 15, 2017

When you’re looking for furniture for your outdoor living space or to grace your swimming pool deck, the advantages of metal patio furniture are countless. Metal patio furniture is both versatile and durable. Patio chair covers, and all patio furniture covers for that matter, are a vital addition to the rugged metal frames. Plastic and wood patio furniture varieties simply do not hold up as well as metal, particularly aluminum, one of the more popular patio furniture metals.

The magical quality of metal patio furniture is its unique combination of strength and portability. These pieces can be easily rearranged and it doesn’t take more than one person to do it so if a party is in the making, you can quickly move the furniture to suit the crowd.

Durability is a big factor for consumers when it comes to their patio furniture. Quality patio furniture covers, and patio chair covers, are a savvy choice for consumers who seek value.

Nothing holds up to the elements like metal, whether your metal of choice is aluminum, wrought iron, or something else. Metal patio furniture is among the most durable of all accessories you can purchase for your home. Considering that outdoor lounges and chairs spend a lot of time in rain, snow, and direct sunlight, they are phenomenally durable. Metal frames are also corrosion proof, so cleaning is easy since all you really have to do is hose the stuff off. Metal patio furniture requires virtually no maintenance.

While steel and wrought iron are not as light as aluminum, they do provide incredible durability. If you choose one of these heavier metals for your patio furniture, even the black, painted metals can be invariably spruced up with extremely colorful cushions and coverings.

Whatever your taste, add a bit of accented hue to the backyard area with an array of color choices.

Metal garden furniture is not only long lasting and versatile, but very easy to maintain. Any garden can become a showplace with the addition of chairs, tables, sofa pieces, or just plain benches. The reasonable prices and wide availability of attractive metal garden furniture make it a perfect choice for homeowners who value aesthetics and economical design.

Use of Social Media in Small Business Internet Marketing

August 1, 2017

Social media participation is helpful in small business internet marketing when you apply the technique with a Uncategorized flavor. You should fix the goal before you start the activity by applying various tactics. You must have a clear idea about the nature of social media that you are going to employ in the tactic.

a) Estimation of the target market. You should go through various reports and facts to know competitors’ activities. It provides the inclination of customers in your trade so that you are able to identify the correct section of visitors. Find out blogs that are relevant to your trade and the relative influence that they enjoy on customers.

Guest blogging is a wonderful activity through which you can involve customers in direct conversation on the related niche. Learn about the influence of social media through reports and find success stories of many online businesses. For example, start conversing with clients on subjects that are truly contemporary and also relates to your topic. You will be able to find all the data in different social media sites and there are thousands of them, but you must pick up the right ones for the campaign. When you start putting helpful materials in blogs, you will begin receiving responses. If you contribute efficient content, you start getting fresh traffic to the targeted website.

b) Estimation of the competitor activities is a vital point to steer your way to fruitful results. Find out about what your competitors are involved in through checking their sites and various social media sites. Spend a reasonable time to understand the background and collect valid information about the trade from time to time. Maintain a gentle patience to recognize the competition in the particular segment.

c) Self-Estimation. You should check the responses of readers that respond in blogs. Valid comments on posts help create a relationship with the reader. Blog commenting is a great way to achieve volume of traffic to your website. If you admire a blog, do not hesitate to praise the blogger for it. It creates bondage and you are also recognized in return.

d) Communication is the main food of the technique for social medial participation. When you are communicating with customers, you should talk about their interest to draw attention from them. You are able to build business relationship with customers. Guest blogging and blog commenting help gain admiration from customers when practiced in a regular manner. Talk in the general term and not on the particular product. Try to cover the entire area of the product to cover the overall space. Use the platform of Twitter for creating a positive reflection of the company, but do not overdo it. Create video and use Utube for the marketing purpose through strong, but a short content. Expand the social media coverage as you can without any prejudice, but within the relevancy norm.

Maintain the quality of the content in blogs or guest posts so that the impression on the customer is of a highly intelligent individual behind the website. These are some practices for positive social media participation to increase the traffic to your site. Ensure that the website is customer-friendly and is helpful in spreading the news to thousands of people to look for the identical product or information on the topic. There are many more ways to advertise the website and procure business using social media. Begin with the simple ones and find the difference in your traffic volume and in the small business internet marketing experience.

Search Results

June 17, 2017

#EANF#

Telemarketing Principals of Commercial Real Estate Today

July 18, 2017

The process of telemarketing does not work well in commercial real estate if you follow the typical model of ‘pitch and process’. The people that you call do not like to be subjected to a 1 minute sales pitch and questioning process over the telephone. You have to change the rules and develop some real systems to make cold calling or telemarketing much more effective for you. In one word you have to ‘connect’.

Firstly, and before I go further into this subject I would like to say that all commercial salespeople and agents should be making their own prospecting calls wherever possible. They are the best people to connect with their market because they understand what to say in a relevant way when hard questions are created through the telephone conversation.

When it comes to commercial property sales and leasing, there are really only two targets out of making cold call connections and telemarketing. They are:

1. You want to know if the person you are calling has a need or interest in commercial property sales or leasing or property management.

2. You should seek to create a face to face meeting where the person you call qualifies from the previous point, so that you can take matters further.

When you look at these two factors simply, you can see that you should not be meeting with people who have no genuine interest. Your prospecting calls should therefore be based around a conversation or connection and not a sales pitch or presentation.

The only thing that you are selling in the call contact process is an appointment, and you only do that when you know that the person really does have a need. Protect your time and only meet with the right people that qualify as ‘active’ or ‘interested’ in commercial property.

So the telemarketing or cold call process centres on questions and conversation. Through the conversation you can come to understand if the prospect really does fall within your criteria for a prospective client or prospect. On that basis you can then arrange a meeting as appropriate.

Here are some rules that should be merged into your prospecting scripts:

  1. The people that you talk to want to be involved in the conversation. On that basis you need to ask sensible and realistic questions related to the property industry. Be sensitive to the fact that the person you call will not open up completely with you until you have established a degree of trust in the conversation. It is important that they feel relaxed and not threatened by a pushy salesperson. Professional salespeople create good connections over the telephone.
  2. Approach the first cold call or prospect call on the basis of a simple survey questioning process. The call should be about them and not about you. This is where the right questions will help you establish rapport. The reason for your call is to identify their potential property needs. Do not push for a meeting until you understand that they have a genuine need or an interest.
  3. Be prepared to introduce yourself and your business. Be honest through the conversation but allow the prospect to talk at least 50% of the time. It is of great benefit to have a simple script to get the conversation going. Beyond that starting point, Uncategorized conversation should flow and the script should be irrelevant. Your target is to get conversation moving inside of 20 seconds. A good conversation leads to information and potentially a productive meeting.
  4. If the person is unwilling to talk to you or be open and frank in the discussions, then thank them for the ability to speak with them today and then move on respectfully and politely. There are plenty of people to talk to and on that basis you need to move to the next person or the next opportunity.

There is a real skill to the prospecting and calling process. If you diligently adopt the discipline behind the task, you will find that progress will be made within about two or three weeks of making calls.

Internet Marketing and SEO Information

June 17, 2017

8 Seconds Rule for Business Website

Your website has approximately eight seconds to capture the attention of a prospective customer, before they head off to another website. If a connection is not made between your prospective customers and your Singapore SEO website in a very short time frame, you will lose them.

Keyword Research

Keyword research is critical to the SEO process. The purpose of keyword research is to find out as many keywords that are relevant to your website. So, when customers search on Google and other search engines they can easily find your website.

Professional Quality Link Building

Link building must be done slowly. You must build links with a mix of good high PR and low PR links from different websites, mostly relevant to your site. If you build links too quickly, your website can be penalized by Google.

The higher your link building speed is, the more serious penalty (pagerank drop) your website may get. When Google see a large amount of links come in one month and nothing the next this can look suspicious, and you will not rank on Google, yahoo and MSN’s Bing.com

Search Engine Optimization (SEO)

SEO is a key factor of any successful website. The internet has become the primary resource for gaining advanced information, services and products. All internet users search the product information from Google. SEO and optimized social media content makes it easier for customers to find product/service information online when they’re doing the research that will help them.

Almost 85% of visitors come from Search engine result pages. Some people search for your company name and your services & products. Hire a SEO Consultant is your best option for your company if you want to increase your sales.

SEO Tips

1. First, one of the most important tips for search engine optimization is to get inbound links. It is for this reason that the more inbound links will have another popular site for your Web site, the more it becomes for you to get better ranking in search engines. For this reason, you should try to get as many of these as possible. Lends credibility to your site and help you improve your ranking in search engines.

2. Social bookmarking is another very important aspect of SEO. It is easier for visitors to bookmark your pages. Not only that, but it also allows you to submit your site to social bookmarking sites and, in turn, gives an additional benefit.

3. In addition, article directory submissions should be used for effective SEO. It also helps to build back links and is considered one of the best Internet marketing tools. By submitting articles to these directories, you can reach the wider audience that can be directed to your site after reading your article.

4. In addition to these, the presentations of the website are also very useful for link building. Since there are countless web directories, so your presence ensures your online presence the best possible way. You only need to pay a small sum although there are many free websites.

5. Site maps are also an important part of SEO. In a nutshell, is basically, you can inform search engines of different pages on your website. Consequently, it helps search engines to rank your page better and more effective.

Quiet Hair Dryers

July 13, 2017

Loud hair dryers are a nuisance, just ask the neighbors. Have you ever visited a professional hair salon? The full-size professional hair dryers make enough noise to wake the entire neighborhood, but no one really complains because a salon is meant for such noise, just like a construction site creates noise from all the machinery and tools used. When you’re at home, however, having the noise of a professional salon isn’t ideal, especially in the mornings when everyone else is trying to sleep. What’s the solution? Find yourself a quiet hair dryer.

There are great benefits with owning a quiet hair dryer which makes the investment worthwhile, plus you won’t have to continue receiving complaints about interrupted sleep!

The first benefit is of course: less noise.

Now, a quiet hair dryer isn’t a silent hair dryer, it will make some noise. There aren’t any completely silent hair dryers available yet (but we’re still hoping!) but if you compare the typical whoosh of a full-size hair dryer to the low hum of a quiet one you will notice how big of a difference it makes. What makes noise in a hair dryer? It’s basically the air being released from the tunnel plus the running of the motor, which is why it can seem so loud, like a small car running. With a quite hair dryer, the noise of the motor is greatly subdued and you mostly get the humming sound of air coming out of the nozzle. If you want your quiet hair dryer to function as quietly as possible, you can adjust the airflow and choose a low setting to minimize the air release.

Another benefit of a quiet hair dryer is that it can protect your hearing.

After constant use of a full-sound hair dryer, your ears can become affected in the future. Also, every time you need to talk or listen to something, you will have to switch the hair dryer off and this makes the process more time consuming. You can find yourself some ear protection or buy a quiet hair dryer, and a lot of people prefer the latter because it’s much more practical for them and the rest of their household.

A lot of companies offer a ‘silent’ line of hair dryers to help those who live in full households blow dry their locks in relative quiet. Just remember that quiet hair dryers can be a little bit pricy, because of their unique design, but you’ll decide if it’s worth it!

Vacation Rentals and Holiday Home Rentals – "Tips For Renting"

July 21, 2017

So you’re planning the holidays, you fancy something in the sun, but where to go? Who is coming? How many?
Will we rent a luxury condo or house instead of staying in a hotel? Well you can make big savings by taking a Villa. Plus, you’ll have more space and privacy to relax and enjoy your home away from home. Renting a vacation home is an especially smart choice if you’re traveling with a group of friend or with kids.

Here are some tips to help you get the biggest bang for your buck.

1. Once you choose a destination.
If you’re looking for sensational savings your best bet is to choose a destination where there are a lot of holiday rentals on the market, keeping prices competitive. You can find some of the best bargains on vacation home rentals online if you know what to ask about and how to protect yourself as a renter. Don’t be shy contact the owner and ask for a deal.

2. Comparison sites- way to go!
Now it’s easier than ever to comparison shop when you’re looking to save on a vacation home rental. You can find some of the best rental home listings the net has to offer on sites like holiday121 and other consolidator sites like these. These are referral sites not booking site and you can check out many homes at the same time to get the best prices and most suitable dates and keep a record of sites visited.

3. Don’t send money.
When renting a vacation home, never send anyone money it’s a bad idea. Pay by credit card or PayPal where you have some come back.
Ask for references, and check out their Web site and their track record. Read their reviews! Read the fine print. Is there a cancellation policy? What if you have to leave early? Does it stipulate when you will get your breakage deposit back? Spend the time up front checking things out so you won’t have any hassles later.

4. Know exactly what’s included.
When you book a rental home for your holidays it’s a short term rental and everything should be included, if there are extras like pool heat, these will be stipulated on the invoice.
Most rental homes will say “everything’s included,” but you want to double-check to be sure that there are no hidden surcharges there should not be any.
If utilities, Internet and cable are included, does this mean the property has Wi-Fi and high-speed Internet? Is it basic cable or premium? If electricity is paid is there a cap? Many properties will say they include utilities, electricity and gas and then the fine print says it’s included, up to the first $200.
Recommendation; don’t touch a short term rental that is not all inclusive.

5. Who is the local management company?
Ask who has the local management of the property these are a very important part of the service and backup. Your rental contract should include who to call if your dishwasher breaks or there’s some other problem with the property. It should also state a time frame for fixing any major problems. You don’t want to rent a home and have the hot water heater conk out and end up with cold showers for two week. The information should also be posted in a contact book inside the property. Make sure you have a phone number and email address of the contact and if possible get a second person as a backup.

6. Is the home family friendly?
If you’re traveling with kids, make sure the property you rental is family friendly. Check the bed configurations. If you have three kids and the guest room only has a king-sized bed you could be in trouble. Does the pool have an alarm? (Toddler safety)
Also make sure you see lots pictures of the home. Do you really want to rent a place with a white couch and fancy décor if your 3-year-old still thinks it is fun to color on everything in sight? Make sure the home you’re renting fits your family’s needs so you’re all comfortable. What about the location? Where is the house what are the local amenities? Is it close to the attractions?

7. Can you bring a pet?
Some vacation rentals accept pets, but they may have a size limit. Some folks would not like to rent a property for their family that had the possibility of a pet staying in with previous guests in the home, unhygienic, so if that may be a problem eliminate pet friendly from your search.

8. Is a refund available if you leave early?
If you think you may want or need to leave early, check your contract to see if you’re eligible for a partial refund. Most vacation rentals are for a specific time period and don’t offer refunds because that leaves the homeowner in a lurch with no time to rent to someone else. Know going in what the rules are so there are no unpleasant surprises.

9. Pick a house that most suits your needs.
Keep in mind when you’re renting a vacation home you’re renting a property that’s individually owned. This isn’t a hotel where if you don’t like what you have you can get something else. Once you book and pay your deposit for a specific property, that’s the property you’re getting, so make sure it’s exactly what you want. Ask if reviews from other renters are available; also remember you get what you pay for so contact the owner. While scoring a good deal is the goal, if it’s too cheap there’s probably a reason check it out. Sometimes the cheapest price is not the best value.

10. Book early.
Avoid disappointment; there are certain times of the year when the villa rentals are on fire, so book early. Also you might look at the availability on the owners web site and pick a slightly out of season time, which brings me back to point one, don’t be shy contact the owner and ask for a deal. A last point to help is a lot of vacation rental owners have links to car rental and cheap flights sites or attraction ticket sites. Try and do a package deal for all three or four services. Good luck!!

Four Major Functions Provided by a Real Estate Agent That You Can Do Yourself

August 6, 2017

Selling a home entails four major functions that are usually performed by a real estate agent. If we take the mystery out of those functions, they start looking as if we can do them without an agent. And you can!

1. Pricing your property

The first thing that an agent will do for you is help price your property. You don’t want to offer your home for sale at double its market value because it just won’t sell. Likewise, you don’t want to offer your home for sale at half its market value because you would just be cheating yourself of that price difference. If the market is such that your house in your neighborhood in your city is worth about $200,000 then you want to sell it for that. If you have made additions to the house that might make it worth more, then you want to add those items to it. The real estate agent has a lot of that data at their fingertips through their subscriptions and through their knowledge of the marketplace.

You can do this pricing yourself as long as you don’t let your ego get the better of common sense. You can find out what homes are selling for by cruising your neighborhood and checking out homes for sale to see what they are priced at. You can check to see what they sold for by visiting your tax authorities. Most municipalities and counties require that all deed transfers be recorded as a matter of public record. You can access that data through the internet if your municipality offers it, or you can go look it up in person where the internet is not used. Just make sure you are pricing your 3 bedroom 2 bath house with other 3 bedroom 2 bath houses rather than a 2 bedroom or 5 bedroom house.

2. Marketing your property

Marketing real estate is a sort of catch-all word for advertising the home as being for sale and then showing the property to prospective buyers through appointments or open-houses. The most important and probably most costly marketing activity is advertising the house. There is one real estate agent around here that states in their commercials that they spend between $1,000 and $1,500 per HOUSE while claiming that many agents only spend less than $500 per month for all of the houses that they list.

You can perform all 3 of these marketing functions. Who would be better to show a home or to have an open-house than the resident of the home — just do not let your ego get in the way and react defensively to reasonable buying questions. The advertising should be fairly simple as well. You are just as qualified to create want-ads for your local and regional papers and classified magazines as long as you model your ads after the ones that you will be competing for attention with. There are some advertising sites that require that all of their advertisers be real estate agents. You might try circumventing that restriction by offering a real estate agent a small fee to list your property on those restricted sites. The worse they can do is say “No” and a different agent might be more cooperative.

3. Contract exchange and negotiation.

Real estate agents act as intermediaries between the seller and the buyer. They take a contract proposal from the prospective buyer or their agent and present it to the seller. This goes on with price changes or with feature additions and removals until both the seller and the buyer agree on the selling price and property conditions.

There should be no question that you can do this yourself as the seller. After all, the agent would have to come to you anyway to get your approval and signature. Once again, this is where you need to put your ego and pride to the side. At this stage, all of your advertising and pricing work has come to fruition and you have a buyer negotiating with you. The worse thing you could do is to react defensively. You just participate in a give and take during the process as if it were for someone else.

4. Preparing the final paperwork and closing the sale

The real estate agent is usually the one to give all of the closing information to the title company and lawyers so that the deed to the property can be transferred from the seller to the buyer with no problems. This is when checks are transferred and mortgages paid off. It is also when the commission check is given to the real estate broker for dispersal to his agent.

You can do these things also. You are the one that has handled the paperwork up to now. You are the one that is ready for your mortgage to be paid off. You are the one ready to receive a check for the difference between what you owe on the mortgage and the selling price of the house. Most of this information is put on the HUD-1 form by the title company. In fact the major role of the agent here is to hold your hand and collect the commission check. Again, these tasks can be handled with a minimum of activity on your part. Any legal requirements can be farmed out to a lawyer for a much smaller fee than the agent’s commission.

Pricing, marketing, negotiating, and closing are all functions that are required to sell a property. They are all tasks normally handled by a real estate agent. They are also tasks that you can do yourself at a cost far less than 5% of the selling price of your house.

Medical And Dental Treatment And Coverage In Oaxaca, Mexico

July 26, 2017

When I first gave up the practice of law in Toronto in favor of early retirement in Oaxaca, I assumed that the years I would add to my life by leading a much more stress-free existence in Mexico, would be lost by the inferior health care system to which I would be exposed, subjected and restricted. This, then, is my assessment of the extent to which my presuppositions have been accurate, together with information and advice for both vacationers to and would-be ex-patriot residents of Oaxaca.

Aside from the small, private hospitals, often referred to as clínicas, there are four publicly funded and insurance – based hospitals in the city, as well as a hospital just outside of the city offering specialized treatment for a number of serious ailments. There is the Red Cross facility available to all, often used for emergency treatment only. The civic hospital provides free services or treatment at a modest cost based on a sliding scale respecting means. ISSSTE is a federally funded facility restricted to government employees who are members of a union. Finally, there is IMSS, a federal insurance program available to ex-pat residents and Mexican citizens alike, with an extensive network of clinic doctors and a large hospital. It’s funding is provided in large part by business owners. Aside from these hospitals, there are several, small, easily accessed clinics scattered throughout suburban and rural neighborhoods.

For the vacationer, and the ex-pat with a VISA permitting residency in the country, the most common means by which to obtain emergency treatment is through Red Cross, IMSS (which accepts patients without coverage on a pay-per-service basis) or a private hospital. However, the last of these three is the only one in which you can be reasonably reassured of being attended in a timely fashion by extremely competent and efficient personnel.

WHAT TO DO AS A VACATIONER

If you do not have out-of-country healthcare coverage, by all means go out and buy it before leaving for your trip. However, it’s advisable to first inquire of your credit card company, to ascertain if in fact you already have at least some coverage simply by virtue of, for example, having a gold or platinum card. You can then make a more informed decision concerned whether or not to purchase coverage, and if so at what level. On the other hand, a broken leg, gastrointestinal problem or other non-life threatening ailment can be attended by a private doctor or clinic without breaking the bank. Of course for an outlay of more than $100, it’s nice to be reimbursed.

If you intend to make a claim to your private carrier, credit card company or government funded health care plan, ensure that you not only keep all receipts, but request a written diagnosis and treatment plan, and that the prescriptions you are given indicate for what purpose each medicine is being prescribed (i.e. antibiotic, analgesic, etc.). Many doctors provide all required information simply as a matter of course. Accepted practice, at least except for when narcotic medications are being prescribed, is for the pharmacy to return prescription forms to you. Often medical plans require translations of each document that is presented to them as a prerequisite for processing and reimbursement. When in doubt, submit all documentation with your claim, making sure to determine if originals are required, and keep copies. Frequently, as is the case with Ontario, it’s a two step process. Treatment receipts and diagnosis is submitted to the provincial plan. Once you’re notified of the portion not covered, prescription receipts together with a request for reimbursement for the amount not covered by the province, is submitted to one’s private plan. In theory, between the two plans, 100% reimbursement is achieved.

You can ask the manager of your hotel or bed and breakfast to do you a favor by translating each of your supporting documents, to save you the trouble upon your return home. Make a note of the then prevailing rate of exchange, and submit a calculation to your plan with your documentation, to more easily facilitate payment. When a member of a clerical staff is processing your claim, he’ll be less inclined to put yours aside for another day or week if it already contains all the necessary and relevant data, organized in a readable format.

Concerning where to go in the event of illness or emergency, your accommodations host should be able to make recommendations for English speaking physicians with private practices, and for private clinics. Regarding competency of the former, while there is a medical school in Oaxaca, many doctors travel out-of-state for their post-graduate training such as to universities in Mexico City or the US, and regularly attend conferences and upgrading courses. Some travel abroad within the context of their specialization training. Indeed the Oaxacan populace appears to take notice of and prefer those physicians who are able to display foreign diplomas.

Our personal experience with emergency treatment over the past 10 years has been nothing but positive for ourselves, our family and our guests, at hospitals Carmen and Molina, both downtown … in terms of competence, speed with which one is attended, and the presence of English speaking ER doctors. On the other hand, we cannot recommend the emergency departments at the civic hospital or IMSS because of delays in receiving treatment, and at minimum in the case of IMSS unavailability of competent medical personnel 24 hours a day to attend to even a commonplace emergency (i.e. suturing). Having said this, many excellent surgeons with private practices perform surgery at the non-private hospitals where there tends to be the more state-of-the-art and sophisticated equipment.

The normal range in price for a consultation with a family doctor, specialist or dentist, is $20 – $50 (all figures are stated in US dollars and are approximate for 2008 unless stated otherwise).

PURELY ELECTIVE AND COSMETIC PROCEDURES

Over the past several years Oaxaca has become a popular destination for Americans and Canadians seeking both plastic surgery and extensive dental work. Word has spread of the competence and quality of work of both nip-and-tuck and dental surgeons, and of course of their extremely reasonable charges relative to those paid to hometown practitioners. Many foreigners, as well as Mexicans from Mexico City and other regions of the country come to Oaxaca for face lifts, breast reductions and augmentations, liposuction and other appearance enhancing procedures. A friend who attended for plastic surgery in Oaxaca by a well-known plastic surgeon a couple of years ago, recently commented that she had read an article in a Canadian magazine indicating the cost for the same procedure which she had performed for $500, was $3500 – $5000 at home. In effect she had a free trip to Oaxaca, and returned home with extra money in her pocket.

Our personal experience with dental treatment has been extremely positive. Cost tends to be about a third to a half of American and Canadian prices, for example for crowns and bridges, implants, root canals, gum and bone work, etc. While the use of nitrous oxide (laughing gas) has not yet arrived in most Mexican cities, a dentist with a gentle touch can more than make up for that lack of temporary high while in the chair.

RESOLVING THE EX-PAT CONUNDRUM

Get whatever coverage is made available to you both in your homeland and in Mexico, subject of course to affordability.

To my thinking, with IMSS coverage costing under $400 annually for a couple, why not go for it regardless of what other coverage you already have. Then supplement IMSS with international coverage for catastrophic injuries unless you have other similar insurance from another source. Our Oaxacan friends tend to disagree, but theirs is a different mindset where insurance in general has historically not been stressed or valued, be it home, car or health.

Some American acquaintances
swear by IMSS since it provides regular care including preventive procedures, all dispensed by government employed physicians including specialists, together with lab tests, medication and hospitalization. There are restrictions the first year of enrolment, and there are caveats. The level of cleanliness in the clinic environment tends to be below the standard to which most of us have become accustomed growing up in the US and Canada. Many physicians have not received the quality of medical education of their private counterparts. The medications provided through the clinic pharmacy are often not the best available in the marketplace for treatment of a particular ailment, because of cost. Often the wait to see your designated doctor or for your lab tests can be long, requiring a half day commitment for each step in the process: visiting a general physician, going for one set of tests, then for another, and finally seeing a specialist.

So why bother with IMSS at all, with all these downsides? It’s a failsafe, another form of assurance that you’ll be cared for in the event of a lengthy and serious illness. As suggested earlier, often it’s the largest hospitals such as IMSS which have the best equipment, and surgeons with private practices who perform some of the surgeries. And there is no additional cost for hospitalization once you have full IMSS coverage. While attending a private clinic is more akin to your experiences before moving to Mexico, if you must remain in hospital for a lengthy period of time, the cost of doing so in a clinic could be prohibitive…just like back home.

Visiting private physicians, and even biting the bullet and getting your tests done at privately owned laboratories, reasonably assures you of a familiar quality of care. Coupled with IMSS coverage, you can now be confident that you’re covered in almost all respects. In the event of a protracted hospital stay you can afford to be there for as long as necessary. The best locally available equipment will be used in your diagnosis and treatment, and you have a reasonable likelihood that attending surgeons are those who split their time between private practice and clinic work, and performing procedures in one or more large hospitals.

We maintain IMSS coverage, but rarely use it, preferring to tap our Oaxacan social networks for referrals to specialists to the extent they are required. And in any event, after having been resident in Oaxaca for a few years, those of us who are in our fifties or older have already been introduced to a broad range of specialists. As strange as it still is to be a Canadian and subscribe to the pay-as-you-play philosophy of medical care, it serves our purposes, with the IMSS safety net just in case.

Under certain circumstances you may not want to rely on even the best Oaxaca has to offer. Indeed the stream of Oaxacans traveling to Mexico City flows briskly and wide. The middle and upper classes with contacts in the nation’s capital, there quickly seek out the best in terms of physicians and state-of-the-art equipment, for diagnosis and for treatment of life-threatening diseases.

Even doctors working in Oaxaca at the IMSS and ISSSTE hospitals can make arrangements for patients to receive treatment not available here, to be attended in Mexico City or other larger centers. However, the process can be slow. We know of one case, that of a two-month-old baby with heart problems, who was finally sent to Puebla for surgery at ISSSTE, only to die before the procedure could be performed.

The solution, unless you have quality foreign coverage perhaps as part of your retirement pension plan, is to buy insurance which will pay for treatment in Mexico City, or better yet throughout the world as long as you can make your way to one of the participating top-of-the-line hospitals. In my case, I have a low annual premium, with high deductible which is waived in the event of accident. Again, it’s a failsafe mechanism in the event of, for example, a serious car accident, or cancer, stroke, heart attack, or other catastrophic ailment which would otherwise not be affordable. Oaxaca has less than the best of diagnostic equipment and treatment facilities. My plan provides for a $10,000 deductible, $2,000 annual premium, with member private hospitals in Oaxaca, Mexico City and elsewhere in the republic, and of course abroad including the US, with the Mayo Clinic in Rochester being a participant.

In summary, my medical coverage and plan for treatment is the following. We have our regular family physician, who, along with our Oaxacan friends, refers us to specialists in which we have the utmost confidence, and to whom we pay per visit. The same holds true for dental treatment. We have IMSS coverage which we reluctantly (because we don’t use it) renew on an annual basis, but believe it’s worth the price in the event we need extended hospitalization, or to have surgical procedures performed not available in private clinics. And I have my catastrophic coverage which hopefully I’ll never need to access.

Medical care and coverage can be inexpensive, and just as easily it can be costly. It’s a matter of the individual or family having a philosophy, or set of priorities, before electing to move to Oaxaca. You have to determine how you want to lead your life in terms of balancing having less disposable income as a result of medical and insurance costs, with having greater peace of mind in knowing that whatever is thrown your way will be looked after as best possible given your new life in a foreign land. If you cannot achieve a level of comfort in the resolution of these issues and decisions, then perhaps the move is not for you.

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