From a reader: Most of the retirees living in the Philippines are Filipino-Americans. Most of the rest are married to Filipinos. We are not complaining about paying up-front for medical care, we have been doing that for years (although direct billing would be nice). What we are complaining about is the difficulty filing claims and meeting often unknown requirements. This results in lowered reimbursements and or denied claims. The new demonstration program limits us in or choice of hospitals and doctors. We must use the one hospital in the demonstration area and the doctors associated with that hospital. No matter if there is a better hospital close to where we live. Like you, we chose to live outside the U.S. for personal reasons. How would you react if you were required to use a hospital, for instance, on the opposite side of Tokyo from where you live? We are only asking for equal treatment.