Best country with no universal health care?
June 29, 2012 1:35 PM   Subscribe

In the wake of the Affordable Care Act being upheld, there have been a lot of (joking?) references to Americans threatening to move to Canada to avoid socialized health care. But now I'm curious: if someone were really determined to move from America to a country with no kind of universal health care for its citizens, what would the most attractive option be?

By attractive, I mean: reasonably safe, with a decent standard of living. It's a bonus if the culture shock coming from America isn't too huge.
posted by Alexander Hatchell to Law & Government (32 answers total) 5 users marked this as a favorite
 
The U.S is really the only developed country without universal health care. See this map for the breakdown.
posted by cushie at 1:42 PM on June 29, 2012 [14 favorites]


Note also that a lot of the countries that are shown as without universal health care on cushie's map actually have extensive government-provided health care systems, but either through inefficiency or policy have not extended that coverage universally, so the real map of places with no socialized health care would be pretty sparse.
posted by Forktine at 1:47 PM on June 29, 2012


Here is a convient list of industrialized countries without some form of universal health care:
posted by jeffamaphone at 1:47 PM on June 29, 2012 [47 favorites]


Developing countries often have a very high standard of living for expatriates, even if there may occasionally need to have increased security.

I lived in the Philippines for 6 years when I was younger, and having gone to an international school, experienced extremely little culture shock when I moved to the US. However, my neighbour also got kidnapped, so...

However, the term "developing countries" is really just an economic term, and many of these countries also have universal health care.
posted by sawdustbear at 1:48 PM on June 29, 2012


It looks like that would be India.
posted by bleep at 1:48 PM on June 29, 2012


If you can move to a foreign country in order to evade taxes, generally you don't have to worry about what the economy of the foreign country is like, because you're going to be self-supporting.

Countries like Mexico and Honduras would be a good place to move, as would any of the independent Caribbean islands (eg, none of the British or American protectorates, or members of the EU). The Philippines is also a popular choice, as is Thailand/
posted by KokuRyu at 1:50 PM on June 29, 2012 [1 favorite]


While it is generally considered to be pretty ineffective and has many other issues, India technically also has universal healthcare...
posted by sawdustbear at 1:50 PM on June 29, 2012 [3 favorites]


The U.S is really the only developed country without universal health care. See this map for the breakdown.

That map is not entirely accurate; it is missing Rwanda - yes, Rwanda - which has 91% coverage.
posted by DarlingBri at 1:51 PM on June 29, 2012


Some conservatives have brought up the example of Switzerland, which has subsidized mandated health insurance from private companies.
posted by saeculorum at 1:51 PM on June 29, 2012


South Africa?
posted by theodolite at 1:53 PM on June 29, 2012


Probably a developing nation with a sufficiently tiered society that expats can live a largely gated existence: India's one example, perhaps one of the Gulf states, or one of the smaller Caribbean island nations that does double duty as a tax haven, although most of these have limited facilities, and the rich fly to private US clinics when they get sick.
posted by holgate at 1:53 PM on June 29, 2012


From "Health Care Reform: Do Other Countries Have the Answers?," [pdf] (conclusion: no) published by the National Center on Policy Analysis (whose self-described goal is "to develop and promote private, free-market alternatives to government regulation and control, solving problems by relying on the strength of the competitive, entrepreneurial private sector"):

"The US is the only developed country in which a substantial subpopulation is nominally uninsured."
posted by Mr.Know-it-some at 1:53 PM on June 29, 2012 [1 favorite]


Here's another map from Wikipedia that breaks it down into:

Nations with some type of universal health care system.
Nations attempting to obtain universal health care.
Health care coverage provided by the United States war funding.
Nations with no universal health care.
posted by jabes at 1:54 PM on June 29, 2012


I would think Mexico would be the best option as far as being close enough to come back occasionally, relatively modern, and safe (provided you stay outside of the gang-controlled areas).

The irony of it is that most folks I know who are talking this nonsense also are pretty discriminatory towards Hispanics ("foreigners takin' our jobs!").
posted by chrisfromthelc at 1:54 PM on June 29, 2012 [1 favorite]


According to that map, Colombia doesn't have universal health care, but according to the Wikipedia page for Health Care in Colombia there is mandatory health insurance coverage.

The map also shows Belarus as not having universal coverage yet this page says "All citizens and registered residents of Belarus are entitled to a wide-ranging package of free health care benefits."

So, basically, they're going to have to move to the USA. (I think most people tweeting about moving to Canada were taking the piss anyway.)
posted by vespabelle at 1:56 PM on June 29, 2012


Some conservatives have brought up the example of Switzerland, which has subsidized mandated health insurance from private companies.

But the ACA is perhaps best viewed as a watered down version of the Swiss system. Similarly, the Singaporean compulsory savings system is still a universal system.
posted by holgate at 1:57 PM on June 29, 2012 [1 favorite]


[Answer the question - there is a huge internet where you can make your ACA rants/complaints/jokes]
posted by jessamyn at 2:04 PM on June 29, 2012


Some conservatives have brought up the example of Switzerland, which has subsidized mandated health insurance from private companies.

The ACA is in many ways based on the Swiss or Dutch systems, private provision but mandatory coverage. Most other first world countries have systems like that, or single payer / private provider, or actual state owned hospitals.

Even in the wealthy GCC states, your sponsor/employer is required to buy health coverage for you (and health care is often free for citizens).
posted by atrazine at 2:14 PM on June 29, 2012


I would think Mexico would be the best option as far as being close enough to come back occasionally, relatively modern, and safe (provided you stay outside of the gang-controlled areas).
Countries like Mexico and Honduras would be a good place to move


Mexico is working towards universal health care and already has a government-subsidized system - I hear commercials on local radio all the time about the "Popular Insurance" (note: English language stations broadcasting from Mexico, which are quite common in border areas and are required by Mexico to air government PSAs).

The pull quote: Public health care is provided to all Mexican citizens as guaranteed via Article 4 of the Constitution. Public care is either fully or partially subsidized by the federal government, depending on the person's (Spanish: derechohabiente's) employment status. All Mexican citizens are eligible for subsidized health care regardless of their work status via a system of health care facilities operating under the federal Secretariat of Health (formerly the Secretaria de Salubridad y Asistencia, or SSA) agency.
posted by LionIndex at 2:19 PM on June 29, 2012 [1 favorite]


It looks like Africa is pretty wide open, but I expect the culture shock would be immense (and stable governments are a little thin on the ground). How does Botswana strike you?

What about Belize? It's in Central America and English is the official language and it doesn't have universal health care (that I can see).
posted by It's Never Lurgi at 2:20 PM on June 29, 2012


Belize is working on National Health Insurance if it hasn't happened already.
posted by Ghostride The Whip at 2:40 PM on June 29, 2012


Well, there's always Somalia. No universal healthcare and a Libertarian paradise. A two-fer!
posted by Thorzdad at 3:08 PM on June 29, 2012 [18 favorites]


This google+ blogpost comes up near the top of news.google.com for me, almost seems too coincidental.
posted by Golden Eternity at 4:41 PM on June 29, 2012


It's certainly possible for citizens not to have healthcare coverage in Poland, Romania or Bulgaria. The UK changed its public healthcare guidance to require all EU citizens to provide proof of coverage before they were entitled to non-urgent care as visitors to the UK for exactly this reason.

I guess of those 3, Poland has by far the highest standard of living. I'm still unsure how people manage to be uninsured, though. I understand it's possible to find yourself uninsured in Germany, too.

Belarusian citizens need only provide proof of citizenship before receiving UK healthcare though.
posted by ambrosen at 4:55 PM on June 29, 2012


China. An American working for a multinational can maintain a very nice standard of living there, and it is very safe. At this point, there's a big enough expat community in the big cities to ease the cultural transition. And, hell, it's certainly the "in" country right now. Could be good for your career; make some nice connections, pick up a little of the language...
posted by mr_roboto at 5:23 PM on June 29, 2012 [1 favorite]


It's certainly possible for citizens not to have healthcare coverage in Poland, Romania or Bulgaria.


Bulgaria requires mandatory employee heath insurance through a National Health Insurance Fund. And I believe Romania does ,also.
posted by Isadorady at 5:30 PM on June 29, 2012


If you compare life expectancy with health care spending as percent of GDP you realize that the US is spending tremendous amounts and getting very little. The UK spends less than half (currently the US spends 17.3%!!!!) and has a higher life expectancy.
Somalia is an outstanding place. Very little regulation, patent protection is not enforced, no socialized health care, nice beaches...
posted by yoyo_nyc at 6:27 PM on June 29, 2012


Not sure if this qualifies, but my sister dropped her health insurance in Ireland because it was becoming too expensive and covered v little; she currently has no coverage and she is not alone as an increasing number of workers in Ireland have no health insurance coverage at all. However, if you are retired or on social assistance there is coverage and it is a lot cheaper if you do end up paying out of pocket....
posted by lesbiassparrow at 3:34 PM on June 30, 2012


she currently has no coverage and she is not alone as an increasing number of workers in Ireland have no health insurance coverage at all.

I am sorry, but... that just isn't true, or in a charitable reading, is a very odd way of looking at things. We have universal health care here. You can opt for private health insurance on top of that, and it is a benefit some employers offer, but without it it isn't like she's paying out of pocket for healthcare - she is covered with free public hospital services like everyone else is. Normally we all pay €60 for a GP visit, pay for prescriptions to a maximum of €134 per month, and pay for things like vision and hearing tests. Hospitals, diagnostic imaging, ambulance services, etc are always free.

If you are on a low income, whether you are working, on social benefit or retired, you can get a medical card which additionally entitles you to free GP visits and 50 cent prescriptions. It is not private health insurance.
posted by DarlingBri at 12:10 AM on July 1, 2012


DarlingBri, my brother was a little surprised to find he was billed the same for each night in hospital as for a GP visit (IIRC it was about €40, in 2004). He'd not been expecting that.
posted by ambrosen at 4:03 PM on July 3, 2012


Aye. It's explained here. Hospital charges are now €75 a night, capped at €750 a year whether you're in there for a broken leg or open heart surgery. There are no obstetric or neonatal charges, ever. They will always take a payment plan, there is no interest, and the reality is that our social welfare system is such that nobody is going to be bankrupted by a bill of that size.

It is by no means a perfect system but we don't have the kind of precarious uninsured middle class or medical poverty you see in the US.
posted by DarlingBri at 4:33 PM on July 3, 2012 [1 favorite]


Peru (not in any of the maps) also has a more-or-less efficient public healthcare system. Also, Peruvian prices are dwarfed by American ones.

so no republicans you can't come to Peru.
posted by Tarumba at 8:04 PM on July 10, 2012


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