I was living in Italy when I got pregnant and chose to do the private route because I was very specific about what I was looking for. I also wasn’t in their system so I had to pay for everything, including bloodwork, out of pocket. My friends in the US were shocked at how little I was paying (myself included), whereas my Italian friends were appalled that I paid anything at all. A lot comes down to perspective I guess!
Wow, yes perspective but also what you would have had to do if you were in the US instead! I feel like we (US citizens) can't compare the other way around because we grew up and only experienced the for-profit system. I'm so glad you had such a great experience there and thank you so much for sharing some of it here :)
I'm 80,have lived in France for 11 years and have nothing but praise for French health care. My family and friends still live in the States and know well the inequities and problems with US healthcare. There will always be the defenders, but I think the problems are widely enough known that there is little about the US system to defend. I didn't move to France because of the health care system here, but it's a big reason why I wouldn't return to the States.
Hi Janice, thank you so much for your comment, I know other people will find this very helpful! My sister lived in France for 20 years and is moving back this year, also in a large part due to the health care. I'm so happy to hear how well it's working for you! I think many people in the US don't understand how much better it is elsewhere because they've never experienced it and thus have nothing to compare it to.
My wife and I moved from the Dallas, TX area to The Netherlands in 2016. I, too, have no plans to return to the US for many of the same reasons you list.
Just as an FYI our healthcare coverage here is €4200 a year for both of us with an annual €385 deductible. Everything medically necessary is covered with no hassles.
Hi and thank you so much for your comment! That's so amazing to hear--both that you moved to the Netherlands (and must love it) and that your health coverage is so affordable there!!!! It really is night and day!!!!
Hi Rae, thank you so much for your comment. I'm so sorry to hear about your health and hope you can proceed when it's better or maybe even find alternative elsewhere that may work better for you!
Really enjoying this series. I want to move to Costa Rica but can't--right now--due to aging parents. It sucks that you were getting hate comments while writing this series, but I agree with you in thinking that you're doing something right if it's causing these comments. And yes, TOTALLY agree that the healthcare system is broken here. Like a lot of other things.
Thank you so much for saying that you're enjoying this series :) That makes my heart leap!
Costa Rica is a great option! I guess you "have" to be there for your parents? My parents are aging as well, but it sounds very different because I don't have to be near them. And as I always say: even if you have to wait to start your adventure, you can still be proactive and spend your time planning, researching and daydreaming!!!!
Re: the hate comments, they helped the algorithms!!! YAY!!! hahahaha
Re: the healthcare system, something needs to change!!!
Yes, have to be here. Co-caregiver of a parent with advanced dementia. My older sister and I live with them, and we trade out every week. I'm guessing I should actually at least TRY to visit CR first. Like a discovery trip or something.
Oh wow, that sounds so challenging. I'm really happy to hear you have help though (from your sister).
I didn't visit Portugal before moving here because I couldn't afford to and I love it. CR is closer though and I always say, "if you don't like where you land, you can try somewhere else!" I have a friend who is in love with Medellín and she's a full time digital nomad and has traveled much of the world. She's also a POC. If you're on FB and interested I can send you a link to her FB group. She's AMAZING and super helpful!!
My wife and I recently returned from two weeks in Italy where she developed a bad cold leading up to Christmas Day. It got to a point where I was concerned that she would need to consult with a physician in the very least for potential antibiotics. In the end she powered through without the need for medical attention, but I did do some research on what we would need to do as Americans. It really could not have been more simple, and inexpensive! I actually am kind of weirdly disappointed that we didn't get to experience the ease of it all.
Meanwhile, I returned home on January 2nd to my mom telling me how her 91 year old aunt, whom she is the caretaker for, had a medical emergency on New Year's Eve that resulted in a trip to the ER and tests for a potential blood clot in her foot. In the end it turned out to be a stress fractured heel, and because of how the orders were written by the hospital, the insurance company refused to pay for a stint in rehabilitation-something that would be essential for her to continue living on her own as a mentally sharp, independent person. Instead it was going to cost $17,000 out of pocket. For one month. Unconscionable doesn't even begin to describe it!
Oh wow, just wow, there are no words! I'm soooo sorry to hear this about your aunt but very glad to hear your wife is okay!!! My sister has a heart attack last year and the hospital tried to saddle her with $200k in fees but she fought them and fought them and fought them. She asked for proof of everything. They were charging for things they never did, just adding a bunch of made up stuff to the bill. She would call and say, "they never did this procedure, show me the proof". She fought them for six months and in the end they dropped it. I'm sure your aunt doesn't have that kind of patience but maybe someone can advocate for her? Again, I'm so sorry to hear this, they are sharks. :(
I had knee replacement surgery in Mexico last year for $7000 and my surgeon made 2 house calls to check on me afterward and never charged me. I had an outstanding experience - better (overall care, my comfort, genuine sympathy, and excellent facilities) than when I had my gallbladder out in Washington, DC. I knew the US health care system was broken, but that experience brought it home.
Hi, and thank you so much for your comment! Wow, that's amazing and I'm so glad to hear how well your surgery was there! And I love how empathetic they were!
I noticed a huge difference in empathy between the public hospital here in Portugal vs the private hospital. In the public hospital they rolled their eyes at me and refused to give me any pain meds as I sat screaming in pain for six hours with one finger sticking up backwards and the other twisted around. But when I finally did get help and surgery, in a private hospital, it was a great experience.
Terrific post, Kimberley, and some excellent insights.
As a non-US citizen, I've often heard horror stories about American 'healthcare' but your examples provide even greater perspective. I was appalled by the stories you've shared, and send you my condolences on the loss of your dear friend.
When I was younger, I coveted an American Green Card (but never got one). Subsequently, I travelled to the US many times, always with health/medical cover - although I wonder now if it would ever have been enough! - but have no plans to visit again. I can only vote with my feet and my tourist dollar. It is not only the healthcare system that is broken in America.
Please keep on with your brave and thoughtful series. I've learned a lot - and have been given a lot to think about - through your writing, and enjoy the honesty, authority and the social proof of your content.
Hi Jan! I'm copying what I wrote on your restack :) thank you soooo much for your kind words about my writing and series and your readership Jan! It seems that health insurance in the US is mostly for emergency coverage and I still get it too whenever I return for a visit. It may not cover “everything” if something catastrophic were to happen but at least it would cover something! I have one friend who was in debt to her hospital bills for five years because she insisted on working extra to earn more to pay off the $200,000 bill!!! And she was barely treated for this. So many stories, not all, but many of them devestating.
And you’re absolutely right, there are a lot of things broken in the US and sadly more will break in the next 4 years. It’s insane to hear the facts about how the economy is better now than before, how employment is at its highest, etc. and to know that everything everyone has worked for will be gone soon. Not to keep getting political but… yes I agree and I think the “American Dream” that everyone’s been “sold” is dead :(
Wow. Yep, this is the main, and really only, reason we left the US. After Hubby's back was broken in a car wreck, his insurance company tried to kill him. It took years of litigation, and finally, a Senator's involvement, to keep them from succeeding. We remained in the US until I could retire with a minimum pension (I retired on disability due to cancer complications), and then we got out. I told Hubby that I would dedicate the remainder of my life to getting him out of the US. We are also in Portugal. We get great healthcare - he gets the pain meds he needs to be functional, and I get the meds I need post-cancer.
I had the best insurance in the USA possible—state employee. And yet, when I had strep throat, they couldn’t see me. My temperature spiked, and I just showed up at the clinic, and said, I can pass out on your floor and you can get an ambulance, or you can get me a throat swab and some antibiotics. Your choice. They saw me, reluctantly, until they saw how high my fever was. Murmured apologies, swab, antibiotics.
I couldn’t believe that even being fully insured I was having to put up with this. I don’t blame you at all for moving. I am in the UK permanently now and being able to use the NHS, for all its problems, gives me great peace. I’ve been very happy with my doctor.
As someone with a pre-existing condition who's about to move back to the US with his wife because of work-related reasons, I'm terrified. Lol. $1,500 per month for health insurance is CRAZYYYYY.
I was living in Italy when I got pregnant and chose to do the private route because I was very specific about what I was looking for. I also wasn’t in their system so I had to pay for everything, including bloodwork, out of pocket. My friends in the US were shocked at how little I was paying (myself included), whereas my Italian friends were appalled that I paid anything at all. A lot comes down to perspective I guess!
Wow, yes perspective but also what you would have had to do if you were in the US instead! I feel like we (US citizens) can't compare the other way around because we grew up and only experienced the for-profit system. I'm so glad you had such a great experience there and thank you so much for sharing some of it here :)
I'm 80,have lived in France for 11 years and have nothing but praise for French health care. My family and friends still live in the States and know well the inequities and problems with US healthcare. There will always be the defenders, but I think the problems are widely enough known that there is little about the US system to defend. I didn't move to France because of the health care system here, but it's a big reason why I wouldn't return to the States.
Hi Janice, thank you so much for your comment, I know other people will find this very helpful! My sister lived in France for 20 years and is moving back this year, also in a large part due to the health care. I'm so happy to hear how well it's working for you! I think many people in the US don't understand how much better it is elsewhere because they've never experienced it and thus have nothing to compare it to.
My wife and I moved from the Dallas, TX area to The Netherlands in 2016. I, too, have no plans to return to the US for many of the same reasons you list.
Just as an FYI our healthcare coverage here is €4200 a year for both of us with an annual €385 deductible. Everything medically necessary is covered with no hassles.
Hi and thank you so much for your comment! That's so amazing to hear--both that you moved to the Netherlands (and must love it) and that your health coverage is so affordable there!!!! It really is night and day!!!!
Very interested in this but afraid my health is already too compromised. I am looking forward to your future posts!
Hi Rae, thank you so much for your comment. I'm so sorry to hear about your health and hope you can proceed when it's better or maybe even find alternative elsewhere that may work better for you!
This was such an interesting comparison of various healthcare systems around the world. Thank you for taking the time to break that all down for us!
You're so welcome! It seemed important, I'm so glad you found it helpful :)
Really enjoying this series. I want to move to Costa Rica but can't--right now--due to aging parents. It sucks that you were getting hate comments while writing this series, but I agree with you in thinking that you're doing something right if it's causing these comments. And yes, TOTALLY agree that the healthcare system is broken here. Like a lot of other things.
Thank you so much for saying that you're enjoying this series :) That makes my heart leap!
Costa Rica is a great option! I guess you "have" to be there for your parents? My parents are aging as well, but it sounds very different because I don't have to be near them. And as I always say: even if you have to wait to start your adventure, you can still be proactive and spend your time planning, researching and daydreaming!!!!
Re: the hate comments, they helped the algorithms!!! YAY!!! hahahaha
Re: the healthcare system, something needs to change!!!
Yes, have to be here. Co-caregiver of a parent with advanced dementia. My older sister and I live with them, and we trade out every week. I'm guessing I should actually at least TRY to visit CR first. Like a discovery trip or something.
Oh wow, that sounds so challenging. I'm really happy to hear you have help though (from your sister).
I didn't visit Portugal before moving here because I couldn't afford to and I love it. CR is closer though and I always say, "if you don't like where you land, you can try somewhere else!" I have a friend who is in love with Medellín and she's a full time digital nomad and has traveled much of the world. She's also a POC. If you're on FB and interested I can send you a link to her FB group. She's AMAZING and super helpful!!
My wife and I recently returned from two weeks in Italy where she developed a bad cold leading up to Christmas Day. It got to a point where I was concerned that she would need to consult with a physician in the very least for potential antibiotics. In the end she powered through without the need for medical attention, but I did do some research on what we would need to do as Americans. It really could not have been more simple, and inexpensive! I actually am kind of weirdly disappointed that we didn't get to experience the ease of it all.
Meanwhile, I returned home on January 2nd to my mom telling me how her 91 year old aunt, whom she is the caretaker for, had a medical emergency on New Year's Eve that resulted in a trip to the ER and tests for a potential blood clot in her foot. In the end it turned out to be a stress fractured heel, and because of how the orders were written by the hospital, the insurance company refused to pay for a stint in rehabilitation-something that would be essential for her to continue living on her own as a mentally sharp, independent person. Instead it was going to cost $17,000 out of pocket. For one month. Unconscionable doesn't even begin to describe it!
Oh wow, just wow, there are no words! I'm soooo sorry to hear this about your aunt but very glad to hear your wife is okay!!! My sister has a heart attack last year and the hospital tried to saddle her with $200k in fees but she fought them and fought them and fought them. She asked for proof of everything. They were charging for things they never did, just adding a bunch of made up stuff to the bill. She would call and say, "they never did this procedure, show me the proof". She fought them for six months and in the end they dropped it. I'm sure your aunt doesn't have that kind of patience but maybe someone can advocate for her? Again, I'm so sorry to hear this, they are sharks. :(
I just arrived in Tijuana from LA for dental work.
Hi Manon! That's great!! I have several friends who went to Mexico for dental work and had good experiences!!!
I had knee replacement surgery in Mexico last year for $7000 and my surgeon made 2 house calls to check on me afterward and never charged me. I had an outstanding experience - better (overall care, my comfort, genuine sympathy, and excellent facilities) than when I had my gallbladder out in Washington, DC. I knew the US health care system was broken, but that experience brought it home.
Hi, and thank you so much for your comment! Wow, that's amazing and I'm so glad to hear how well your surgery was there! And I love how empathetic they were!
I noticed a huge difference in empathy between the public hospital here in Portugal vs the private hospital. In the public hospital they rolled their eyes at me and refused to give me any pain meds as I sat screaming in pain for six hours with one finger sticking up backwards and the other twisted around. But when I finally did get help and surgery, in a private hospital, it was a great experience.
Thank you sooooo much for sharing your story!!!
Terrific post, Kimberley, and some excellent insights.
As a non-US citizen, I've often heard horror stories about American 'healthcare' but your examples provide even greater perspective. I was appalled by the stories you've shared, and send you my condolences on the loss of your dear friend.
When I was younger, I coveted an American Green Card (but never got one). Subsequently, I travelled to the US many times, always with health/medical cover - although I wonder now if it would ever have been enough! - but have no plans to visit again. I can only vote with my feet and my tourist dollar. It is not only the healthcare system that is broken in America.
Please keep on with your brave and thoughtful series. I've learned a lot - and have been given a lot to think about - through your writing, and enjoy the honesty, authority and the social proof of your content.
Jan
Hi Jan! I'm copying what I wrote on your restack :) thank you soooo much for your kind words about my writing and series and your readership Jan! It seems that health insurance in the US is mostly for emergency coverage and I still get it too whenever I return for a visit. It may not cover “everything” if something catastrophic were to happen but at least it would cover something! I have one friend who was in debt to her hospital bills for five years because she insisted on working extra to earn more to pay off the $200,000 bill!!! And she was barely treated for this. So many stories, not all, but many of them devestating.
And you’re absolutely right, there are a lot of things broken in the US and sadly more will break in the next 4 years. It’s insane to hear the facts about how the economy is better now than before, how employment is at its highest, etc. and to know that everything everyone has worked for will be gone soon. Not to keep getting political but… yes I agree and I think the “American Dream” that everyone’s been “sold” is dead :(
Wow. Yep, this is the main, and really only, reason we left the US. After Hubby's back was broken in a car wreck, his insurance company tried to kill him. It took years of litigation, and finally, a Senator's involvement, to keep them from succeeding. We remained in the US until I could retire with a minimum pension (I retired on disability due to cancer complications), and then we got out. I told Hubby that I would dedicate the remainder of my life to getting him out of the US. We are also in Portugal. We get great healthcare - he gets the pain meds he needs to be functional, and I get the meds I need post-cancer.
Hi Elaine, I responded to this on your note!!! (as you've seen) :)
I had the best insurance in the USA possible—state employee. And yet, when I had strep throat, they couldn’t see me. My temperature spiked, and I just showed up at the clinic, and said, I can pass out on your floor and you can get an ambulance, or you can get me a throat swab and some antibiotics. Your choice. They saw me, reluctantly, until they saw how high my fever was. Murmured apologies, swab, antibiotics.
I couldn’t believe that even being fully insured I was having to put up with this. I don’t blame you at all for moving. I am in the UK permanently now and being able to use the NHS, for all its problems, gives me great peace. I’ve been very happy with my doctor.
As someone with a pre-existing condition who's about to move back to the US with his wife because of work-related reasons, I'm terrified. Lol. $1,500 per month for health insurance is CRAZYYYYY.