PolyPassport recently profiled a Texan woman and her family’s journey from the US to France in search of more affordable healthcare and saner politics. They had EU passports on the basis of ancestry.
It reinforces a lot of the stereotypes we have about healthcare in Europe, particularly on pricing and access overall. Cataract surgery cost her some 300 EUR (!) and her daughter receives free prosthetics every two years.
But her story does dispel the notion that anyone, anywhere can just walk into an EU hospital and get treated—including EU citizens. That’s consistent with my own experience. I’ve lived in a few EU countries and certainly paid less for often high-quality care than in the US. But I never found it to be straightforward or necessarily leagues better than equivalent systems, say, in Asia. Like the woman in the article, I also missed speaking to providers in my native language about ailments that can’t often be conveyed with an A2 level proficiency! :)
It got me thinking about the trade-offs we face when chasing healthcare (or anything really) abroad. It’s about balancing the good with the not-so-good and making the most of our choices wherever we go.
Food for thought and a point discussion.
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It really depends on the country. “Universal healthcare” is not a one size fits all term. I used to live in Canada and I despised the healthcare system, I found it wildly inconvenient and difficult to navigate and genuinely preferred paying more for my insurance back in the states. Now I live in Taiwan and the healthcare system is so amazingly easy to navigate and incredibly affordable, I’m moving back to the U.S. soon and I already miss it lol
And it has gotten so much better in the U.S. over the last few years.🤣😂 Mass exodus of healthcare workers is burning out those who stay.
It has become a soul-less void and an aggressive pursuit of $$$$ by insurance. The service providers escalate prices in order to get a small fraction of their former reimbursements. And they are adding all kinds of services.
I had a simple yearly dental appointment. Doc cleaned my teeth, I got some xrays and he check my jaw for cancer tumors (a first for me). The claim included 8 different services that amounted to like $1,500. Insurance paid $300.
If it was a healthcare system it would be severely broken. But as an economic engine designed to generate obscene profit for a select few it is working beautifully!!👏 👏
If you want the details on who is profiting, more than ever . . .
I have T1D, and I actually pay more in Japan than I did in the US. I had great insurance in the US, though. How that breaks down is my premiums are way higher here and the doctor visits cost more. Prescriptions are slightly less.
If you compared average users in my case, it would be much more affordable in Japan.
One thing in particular about US healthcare costs is the deductible, which hits you up front, all at once.
Are you able to get the latest insulin there?
Are you on any GLP-1?
I had to Google glp-1. Didn’t know what that was. So I don’t know about that.
I am able to get the stuff I use, so I’m good, mainly fiasp cartridges. I am still using dexcom g6. The cgm and pump stuff are available by clinic you go to, which is weird.
There are usually trade offs. In my experience, it’s far easier and quicker to see a GP in australia when compared to England.
However, when it gets down to surgeries or treatments, Australia’s system is less likely to offer the newest in the market. So it can be a a bit dated in that sense.
A running theme here is that many industries are often 5 years or so behind.
That was shocking to me. In London, it is 3 weeks to see a GP, minimum. I had an urgent issue in my first week of moving to Sydney, called a GP and they said: ‘morning or afternoon appointment’. I was stunned and didn’t know they meant the same day. That being said, the ultrasound I needed took 2 weeks to get an appointment.
There’s a doctor in Madrid that all the English-speaking students and immigrants use bc he used to practice in Texas and speaks English essentially like a native, and he gets so much business from this community. I always thought there’d be a real market in popular destinations for “expat” medical services (docs practicing on the local/national system who speak native-like English). I had C1 German in Germany and now am in Spain with C1 Spanish and it was still a struggle to have medical conversations with local doctors. Sometimes it’s really nice to not have to translate every word in your head when you have a distressing medical issue.
How about an interpreter instead? That’s a big thing in US hospitals for Hispanic population
Not everyone is comfortable having a total stranger attend intimate medical appointments with them (ever been to the gynecologist while someone you don’t know interprets for you?), and interpreters usually only exist in large hospitals where there’s a significant population of minority language speakers. You’re not going to find an interpreter for standard medical appointments at small clinics or with your family doctor in small towns.
It is absurd to think one can go to another country and expect that country to reorient its language for the sole foreign person.
You made that up. The OP said nothing about expecting others to orient their linguistic approach. They simply stated that they missed the ability to express themselves and be understood as well as if they were speaking their native language.
The expectation of expecting linguistic ease in a foreign country. If some one comes to the US and makes similar claims the howls of outrage on speaking English would be deafening.
I have seen a great deal of the linguistic entitlement of English speakers. My comments did not spring from a vacuum.
Hospitals in the US are literally required to provide translation services.
Yep even my tiny rural hometown has translation services. Technology is a hell of a thing!
Great post and always something I think about when I enter into conversations about (or post on topics related to) moving out of the country. Healthcare in the US has significant issues but I find the reality of the challenges to be greatly inflated by people posting on Reddit (or generally online). My career leads me to interact with injured people daily. The majority of these people make less than the median US income. Almost none of the people I interact with (<5%) express any insecurities about how they will obtain future medical care. I find it very interesting how so many people in the US expat community appear to want to pickup and move their lives primarily due to this issue.
But her story does dispel the notion that anyone, anywhere can just walk into an EU hospital and get treated—including EU citizens.
Right. Usually: even citizens who are non-residents aren’t entitled to the same service as the ones who are resident.
It’s fair the way I see it. You pay local taxes, you get access to healthcare. You don’t pay local taxes, it’s only fair that you’re expected to pay more than a resident who does. So the notion of “you can just walk in” is a bit misleading IMO.
You can’t just “walk in”. Of course exceptions are there. Some countries do let you just walk in. But I was saying overall.
Depends. There are countries that the system is not insurance based. You can have access with your “personal number” which you either get by birth or residency, so in a sense healthcare is like an unofficial right. So you always have this as a fallback plan.
I lived abroad in NE Asia in a country that has socialized medicine. I was working there, so I was on their plan. It was great. I was paying into their system obviously.
Even when I stopped working and went back to school there to get a second graduate degree, it was affordable even without being on that main system. I got the care that I needed and had access to affordable medication, including insulin.
I found healthcare in Malaysia to be really accessible and affordable. However, being on private insurance there was nerve wracking. Doctors would overprescribe medications and offer up outrageous operations for minor ailments.
Additionally, it was difficult to anticipate how different some procedures were to what I was used to. I agreed to a mole removal, which I’ve had a lot of in the US and is usually done with a tool that quickly punches out the tissue. It’s fast, minimal scarring and no stitches. In Malaysia the doctor carved the mole out with a scalpel. I ended up with a lot more scarring, antibiotics and recovery.
There were some good doctors, but I didn’t have a lot of trust in the medical system there since it felt like the doctors were working on commission for what they could push on you.
I had very cheap compulsory medical insurance several years ago when I was living in Malaysia. I was hospitalised for a few days at most. It was a private hospital with nurses outnumbering patients, excellent food, very skilled workers and the policy must have cost me less than 1,000 RMB a year
As a rule of thumb, one can only choose two of the following three attributes when selecting a service : good, fast, cheap.
For example, If it’s good and cheap, it can’t be fast.
Although the rule doesn’t apply do the US medical system, where you don’t even get one of three; instead you’re left with “bad, slow and expensive”.
This is categorically false for the US healthcare system for the vast majority of the country. There cost of US healthcare is obscenely (and unjustifiably) high but is of a very good quality and typically fast for most people.
But the cost prevents many people from experiencing good and fast service. What good is high quality, efficient care if it’s only available to those who have money? Those who aren’t part of the “vast majority” (and we’re not talking a handful of people here and there – this is tens of millions of America’s most vulnerable citizens) are excluded from quality care.
I had a baby in Germany and 2 in the U.S. and I can say without a doubt the care in the U.S. was far superior. Way more expensive but so much better.
Unfortunately that doesn’t follow the narrative that people here want to believe. I’m a strong supporter of most aspects of socialized medicine but im not going to pretend that the US system doesn’t have some (possibly many?) upsides.
Nonsense, US ranks quite well in quality of healthcare measured in survival rates for major ailments. The care is good, the system sucks.
Here in Thailand it’s more affordable, better quality, and easier.
I think I prefer my Switzerland, though it is expensive for a family. Accessibility in a major city is huge as you can often get GPs or specialists in a more than reasonable wait time. We do pay for mandatory insurance, which is expensive (and going up in 2024!) though pretty streamlined in a Phone app for our insurance and in English. Many young techies complain about the premiums every month though, and wish for cheaper health care, and I agree that it’s not prorated for poorer people which is a shame and the old retirees get a lot of benefits for their CHF. Controversial, but I think you do get better care in the US, but I don’t like the surprise billing even outlawed, somehow seems to squeak in and give you sticker shock for a visit to the hospital or doctor’s office. It is cheaper in CH, but not the utopia I think everyone wants…free quality healthcare in English.
Last year I added my health insurance with the taxes every year, and it’s a pretty good value for a family.
For young adults without kids, at least in my experience, the premiums are lower than the max one might pay in Germany. I love how easy it is to get appointments here tbh. Germany was always a waiting game unless it was urgent. Specialists are easier to get in Switzerland. It doesn’t seem like the medical staff shortage is as high in CH compared to DE as well.
Who the hell is assuming “anyone” can just waltz in to a hospital in an EU country and “get treated”? You get a doctors appointment, diagnosis and referral for further treatment, unless you’re in an emergency, then you go to the emergency hospital. The whole premise of your post is odd.
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Americans cannot just “choose” to move to an EU country “for healthcare”. They need to qualify for a work visa. This family in your article are citizens/family of a citizen of an EU country, most Americans are not. To qualify for a work visa you have an education and work experience that would get you pretty decent health insurance in the USA too.
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Digital nomads, “retirees” and similar pay their own health insurance. Most EU countries do not even have retirement visas; they really do not want to add on elderly people to take care of.
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Many Americans find European healthcare lacking when it’s not about serious conditions but more at the discretion of the doctor. From a European point of view many find Americans over medicated and over diagnosed. When healthcare isn’t a for profit business, but considered a basic right, they tend to draw different lines. Pain medication (and its consequences) is an obvious difference between the two, so are ADHD Asia gnoses and their treatment to pick a popular example.
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“Universal Healthcare “ is just a universal shortcut most useful in American political discourse to describe a variety of healthcare and health insurance systems. Most European countries operate a mixed private/public system. For example in my country, employers have to offer access to employee healthcare, that can be either in the municipal health center, or through a private company. This is subsidised and a freelancing citizen here might wonder why it’s alright that these companies do not pay taxes in the country. Things like this draw public resources (it’s hard to find doctors to the public sector) and the system has been in crisis as long as I can remember.
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If Americans wanted to change the healthcare system for everyone, they should organise politically, rather than seek “escape” to an EU country, where people did that decades ago (public healthcare wasn’t handed down for the peasants out of kindness of our overlords, but because of fear of revolt, and the need to produce healthy workers who can work for a long time). That however would require something called solidarity.
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If you plan to move continents, do not rely on online articles, Tiktok, and viral posts about “universal healthcare”, labour rights or anything. You must read what the country and the European Union actually say on their official resources, readily available in English online. Just yesterday someone posted they had sold all their belongings to move to France en famille not quite understanding what “probation time” means. Unfortunately the host countries have no obligations to take care of an American expat family right after arrival (not even a family from another EU country, there are regulations to prevent “benefit shopping”)
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Sometimes one sees US educated nurses and even doctors wanting to work in EU countries health care. Setting aside the language requirements (c1-c2 level with medical vocabulary prioritised), nurses and doctors in a publicly funded system are paid less for equally hard work. If the countries can bargain cheaper prices for medication than the USA seems to be able, they won’t pay anything like what a registered nurse might make in a high cost of living area in the USA. Whether anyone should make the kind of money high paid Americans can, is another can of worms.
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A few comments, which are based on presumptions by me:
- She needs to be habitually resident in France to get free healthcare, even in emergencies whilst no payment is taken you must often pay the fess afterwards.
- She never paid taxes in France so it’s not good to use their healthcare system: if she moved to France in good faith then immediately had a health problem, that’s a different situation
- Honestly if this is someone’s only way to access healthcare (not about saving money alone), I have no problem with it as a human being it is the logical thing to do.
- France is not a cheap healthcare destination (on a private basis) at all
As a professional patient:
Once you have a personal number, the Norwegian system is smooth as silk, it really is brilliant. I’m getting a power chair and a chair lift soon, along with a bunch of consults and a MRI (there is an imaging facility in the mall, bloody amazing).
Prior to having a personal number, getting the healthcare I needed was a huge bitch - I had to go the ER every month for my prescriptions and docs who don’t know you hate writing scripts for fentanyl - but the system was blind to my existence, so I can’t hate.
The NHS was easily dealt with, at least for me.
TBH the USA’s system has been both the most expensive and the most fragmented, but I may have just gotten lucky with the others.