Leaving the U.S. for better health care system? esp. Canada vs Portugal
October 2, 2019 5:31 PM   Subscribe

I've become interested in living abroad, particularly in permanent residency in Canada (via an investor visa or skilled worker visa) or Portugal (via their golden visa.) Is one better than the other if my concern is good public health care?

I'm an American, single, in my mid-40s, healthy, with between $1.5M to $2M in savings. I'm very healthy now, but I'm just thinking about the future. I like the idea of becoming a Canadian because it's closer to family in the U.S., but becoming a citizen of Portugal also opens up the possibility for me to live in Berlin, a city which I love. Of course, Portugal's weather is better than Canada's weather...

I have friends who have chosen to become citizens in Asia (Taiwan) and South America (Colombia) but those are secondary choices for me. I also have friends that have chosen to stay in the U.S. and rely on American options.

I'm just guessing, but I expect the best public health insurance will likely be in Scandinavia or Germany, but I think I would have a hard time getting permanent residency in those places.

Between Canada and Portugal is there a better choice? I may be able to emigrate to other countries as well, and in that case, is there one that's leagues better than the others?
posted by anonymous to Travel & Transportation (5 answers total) 9 users marked this as a favorite
 
It is better to choose Norway or Sweden, to my mind. Why do you think about permanent residency? I'm not sure that it would be a problem, by the way, nobody obliges you to take it. You may retain American citizenship and live in Scandinavia.
posted by andyvorkinson at 4:00 AM on October 3, 2019


How comfortable are you living in foreign countries? Do you have experience living and working outside of the US? Because that's going to be a significant factor.

I say this as a Canadian who lived in the US for a while and is married to an American who now lives in Canada. For both of us, the cultural shift was jarring and the source of a long-running low-grade stressors. And this was between two very culturally similar countries. I fully expect a European country with a different language and long-running cultural history that you are not part of to be much, much harder.

(As to Canadian health care: it's nice, but I can still find things to complain about. The hospitals tend to be older and less shiny! Getting a family doctor can take a while, especially if you don't live in a huge city, but there are walk-in clinics in the meantime. Drug coverage is less great than I'd like and I still benefit a lot from my employee drug plan.)
posted by suetanvil at 8:21 AM on October 3, 2019 [1 favorite]


Do you speak Portuguese? Apologies if it sounds like a silly question, but your question doesn't say and this is posted anonymously. Even if healthcare is your primary concern, you should probably move to a country where you speak the language.
posted by tobascodagama at 9:58 AM on October 3, 2019


We wrapped up our summer at sea with a month or so in Portugal and I was absolutely stunned at how much we loved it. We met a number of ex-pats there, who raved about the quality of life and cost of living. It is also convenient for travel within Europe, obviously. One couple owned a small home in Lisbon that they used to host Airbnb guests to qualify for the visa. They did describe the process as very tedious and time consuming and bureaucratic. They were very satisfied with the quality of heath care in Portugal.
posted by Lame_username at 12:05 PM on October 3, 2019 [1 favorite]


In Canada, there's a pretty wide spread in "surface quality" of healthcare - sometimes even within the same city/ regional area. I'd investigate the local hospital (and availability of specialty hospitals) in the area that you want to reside.

By surface quality I mean how clean/ new/ shiny the facilities are and how overbooked they may be.

That said, from my experience, triage is handled very well - if you need something taken care of, you'll get the treatment - if not quickly - then as expeditiously as possible, especially for life (and even quality of life) threatening conditions.

The converse is also true, though - if it isn't considered medically necessary you may be in for a very long wait. On the gripping hand, Canadian hospitals will pay for your transport and treatment if the only facility that can offer the treatment is in the US.

Some random observations: end of life care is very good, especially if you advocate/ have someone advocate on your behalf. Blood transfusions/ infusions (when appropriate) are given out like candy.

Many clinical trials span the US and Canada, and especially for life threatening or rare conditions, doctors are very open to offering participation (although it's random whether you get standard treatment or the experimental treatment).

Hospitals have a slush fund (especially specialty hospitals like Children's) - they'll treat anyone who needs treatment no matter how expensive it is; they'll try to bill you after if you don't qualify for universal coverage, and forgive it if they understand that you can't pay. Right now, there's a bit of controversy over birth tourism where the mother takes off without paying (yet their offspring retain jus soli citizenship).

Opioids tends to be harder to get - but again, if the doctor thinks you need them, you'll get them.
posted by porpoise at 4:22 PM on October 3, 2019 [2 favorites]


« Older Is my cat crying?   |   Seeking a USA made robe for a Minnesota winter Newer »
This thread is closed to new comments.