My husband and I both have EU citizenship through our native country. We are planning to retire there. It’s important that you know the language and have a good social net. It’s not so easy to make friends abroad and not everybody speaks English. LTC may be cheap but the medical care is not always good and you need connections to see the best doctors.
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I have friends who have applied for (and received) citizenship due to descent. One’s parents left/were Jews who left Vienna prior because of the Nazis. There was a ton of paperwork but he and his kids now have Austrian passports. The other is a Sephardic Jew and Portugal, I believe is offering citizenship to those who can document that their ancestors were kicked out in 1492 or 1496 (or just, possibly, if they are Sephardic Jews). He says it will take a couple of years.
I’d gladly apply to Portugal but my ancestors are from the wrong part of Europe and chose to leave in the late 1800s/early 1900s instead of getting killed in pogroms in Russia/Belarus/Poland/other (depending upon who owned it at any given point in time).
My wife and kids have Canadian passports, but I don’t have a sense that old age in Canada is much better than in the US (except for government-sponsored health insurance). It may be a good spot to move if a) climate change happens faster than expected; or b) the culture wars don’t abate and instead get worse.
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I think the “nicest” old age homes in the U.S. in the highest COL areas are pricier than the equivalent in other 1st world English-speaking countries. Not sure why that is so (given similar minimum wage laws) but I think that is true. Take a posh nursing home in London - compare to nursing homes in NYC, LA, Boston. London is cheaper. The same holds true for Sydney, Toronto, Vancouver.
Healthcare is “better” in the U.S. if you have money, but once you reach 75, 80, how likely is one going to go for the most expensive treatment possible rather than good palliative care?
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People are living longer now, I play bridge with people in the 90s, very healthy, still drive too, but do take care of your eyes, a lot more older people with macular degeneration.
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@nyc10023, as @DrGoogle123 suggests, good medical care has become more important at later ages. My mother passed away last month three weeks before her 98th birthday. After a severe encounter with Guillane-Barre syndrome at age 78, she embraced exercise strenuously and at age 92 could hold a plank for one minute. She was very astute intellectually and resigned board positions at a number of non-profits at age 90, not because she wasn’t capable but because she didn’t think she could handle the train ride from NJ to NY for much longer. At age 94 or 95, she moved to Memphis to be near my sister and family and lived in independent living until a few months ago. In the past year (age 97, she really began to deteriorate) and moved to assisting living two or three months before her passing and to hospice 10 days before her passing. But until 95+, she was fully cogent except for a decline in short-term memory (which accelerated over the last three years). So, good medical care at age 78 and later enabled her to live a pretty active life until age 90+.
Now, if she had had the heart problems at age 78 that she had at 95, they would have given her a pacemaker. At age 95, they felt she would not make it through the procedure.
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Questionable. People like to think that the US has the “best” healthcare and for the most extreme diseases/treatments you probably want to be an a teaching hospital in the US with lots of research in your disease.
But if you compare what are the most common diseases and how they are treated you would find many countries exceed our standards esp for preventative care. Some even offer physical therapy, mental health, homeopathic treatments and don’t limit them. I’d take health care any day in Switzerland over the US, especially now unless I had a rare cancer/disease in which case I’m going to Boston.
There are many other nations whose healthcare is outstanding. Canada isn’t bad. The UK isn’t good (long waits for things like a new hip). So it varies. And many of these nations have levels of care, so if you have the $$ you can get the best care. Some even offer 4-5 star hotel living after treatments. I’m not interested in this but some people are. So “best” is an opinion.
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Coincidentally I happened to listen to a podcast when running today that talked a lot about palliative care. On interesting but I suppose not surprising stat was that 25% of Medicare expenditures are for people in the last year of life.
For those interested in this topic, I often recommend the “Being Mortal” book (available on Amazon etc). I read it in anticipation of decline of my elderly parents, and the was really helpful to me when my mother was in Hospice care. But it also helped frame my own views to avoid extraordinary end-of-life measures, as was my mother’s preference.
Note to my friends from the “This is Us” TV show thread - the podcast and book deal mainly with physical ailments. Alzeimer’s and dementia are a trickier situation.
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Yes, sadly one of the things that the US is “better” at is futile care. This is a great and very famous article on the topic: How Doctors Die, by Ken Murray | DailyGood
Doctors in other countries are much more willing to say no to continuing treatment of their patients (partly because under a nationalized health care system with little risk of litigation the financial incentives are very different).
My mother (in the UK) needs a hip replacement. Before surgery there is a formal assessment of whether you will survive, with sufficiently improved quality of life, for long enough to make it worthwhile. The surgeon is entirely within his/her rights to say “no it’s not worth operating”.
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Holland is very far advanced in terms of thinking about end of life care.
I once read about how much was spent on the last month of a person’s life in the US. This was true of both my grandparents. And was painful to them and to us. Not sure if they had thought out what they wanted v. what they got they would have made the same decisions. This is why we have health care proxies in our family. IMO, decisions are best made by those who love you and know what you want v. medical professionals/hospital staff trying to prevent malpractice.
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My 79-yr old mother was recently diagnosed with a terminal illness. She lives in Canada and is receiving excellent care. There are numerous doctors involved in managing various parts of the conditions includin pain management. She receives home visits by a nurse weekly. Everything, including the medications, is covered by the government.
In my experience, Canadian doctors are not very good in diagnosing diseases that are rare. Once they identify the condition, the health care is excellent.
This said, living in Canada at any age is not easy due to the weather.
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My brother is in the process of applying for citizenship in Croatia—the paperwork is a huge hassle. He had to hire a lawyer in Croatia. It’s been two years since he started the process and it’s still continuing. Maybe this is just the bureaucracy in Croatia—I have no idea. We inherited property from my father’s family—I gave my interest to my brother. I like visiting but have no interest in living there.
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I think we have better healthcare. You might want to Google what happened to Phil Collins ex-wife, she had a surgery in Switzerland and left her permanently damaged, she could barely walked after the surgery. While I think that could happen anywhere here, but the doctors are more careful here, they could be sued is the reason why.
Actually, even common diseases with non-specific symptoms are commonly misdiagnosed (e.g. shingles can cause pain before or without causing the distinctive rash, and can be misdiagnosed in that case). It is not like Canadian or US physicians have any monopoly on that.
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You are generally right but I have direct experience with several cases of misdiagnosis (actually no diagnosis at all) in Canada when the correct diagnosis was made in a different country on the same set of symptoms.
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The second physician is more likely to be correct if they know what the first physician’s diagnosis was and that it was incorrect.
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Agree to disagree. I think that malpractice lawsuits create a medical situation where doctors do more tests and interventions than they do elsewhere. Why? They are afraid of being sued for missing something. I’ve been the recipient of excessive testing just for this purpose. I think most US citizens and residents have.
Never heard of Phil Collins’ wife case, but one person’s experience in a healthcare system does not define the countries overall system. Switzerland is very, very good. And the homeopathic treatments often work very well without intervention and naturally. Have you lived there? If not, what is the basis of your opinion ?
I think we can learn from every nation. Each place has something to learn from and does something better than the rest. The issue is the healthcare system in the US, IMO, isn’t set up for patient outcomes but avoidance of lawsuits v. patient outcomes. It has changed a lot in my lifetime and not all for the better. Though some things are net positive.
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Your wife could sponsor you for Canadian Perm. Visa. It can take as long as a year . My nephew went through this . I suspect that if you looked into it, you could make her an officer in one of your companies to expedite things.
Taxes are the thing. Renouncing US citizenship is costly.
There is no perfect system. Canada (varies by province) is great for some situations, not others.
What gets you to the front of the line there is having connections!
For an average middle class person, the care is very good in Ontario. And no worries about going bankrupt. The standard of care is different But if you have money to spend, want to consult top doctors in a short time frame, that doesn’t happen there.
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If you have lots of money, you could get care in the US. Cleveland Clinic and other large research hospitals in the US have quite a few foreign patients. Off topic for this discussion.
But I do think that the US has these large research hospital options that are a great resource for us when there is a hard to diagnose problem. I know quite a few who have found their answers when their local doctors aren’t sure how to solve.
Medicine is not an exact science and there is great difference in care here. If you are upper middle class with good insurance and the ability, your medical problems are easier. Still can be hard though.
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Same thing here, in the good old US of A. If you know a VP at a biotech co or a lab head at a major research center, that can get you in the door of specialists who are otherwise booked months out.
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