People are FOMO flocking to Portugal

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Slacker
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Re: People are FOMO flocking to Portugal

Post by Slacker »

We were interested in potentially moving to Portugal in retirement.

We could create a long list of things we liked about Portugal, but the pros and cons versus just staying in NC convinced us that we would just stay where we are in retirement. This was after a several week long vacation in Portugal this year (we retired last year).

One of the things that stood out is real estate. We purchased our home in 2018 for under $300K and pay $1300/month for PITI. In Portugal, comparable houses were over $350K in Coimbra (much smaller, less popular area than Porto and Lisbon).

I think I'll have to go practice making my own pasteis de nata now...
Estudasses
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Re: People are FOMO flocking to Portugal

Post by Estudasses »

I wouldn't count on the current Portuguese tax climate for expats not changing in the medium to long term. The influx of tourists and more importantly property-buying foreigners to the country has pushed the Lisbon, Porto and Algarve regions waaay past what locals can afford. Something has to give in sooner or later. For now the additional tax revenue is appealing, but Portuguese governments skew much more left than in the US... Interesting times ahead for sure.
newyorker
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Re: People are FOMO flocking to Portugal

Post by newyorker »

Moving to a foreign country causes way too much stress with taxes and etc.

And i dont think any EU country can compete with america's infrastructure. They are just places for vacations.
rich126
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Re: People are FOMO flocking to Portugal

Post by rich126 »

People driving up cost of living is common, especially now. I was reading about how locals in Montana were having issues due to the state's popularity from the tv show Yellowstone. A lot of people are buying up property and housing and rent was skyrocketing for the locals. Just a reality of life. Just like a lot of housing is going up due to investors and companies buying properties/developments to rent to people. Once things start going south, things can change quickly.

I had a friend and his wife go to Portugal and they weren't that impressed. I think there are other European places I would consider in retirement before Portugal.

Years ago this older guy I was chatting with at the nightclub was telling me how he was going to move to Costa Rica and he was going to check it out soon. A few months later I ran into him and he had made the visit. He said "Geez, it is like a 3rd world country". Now I don't know how accurate that is but it was clear his expectations wasn't close to reality which I could have pointed out previously but didn't.
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Tellurius
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Re: People are FOMO flocking to Portugal

Post by Tellurius »

I’m from Cyprus. What are we doing wrong compared to Portugal, and what can we do to attract American expats?
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TomatoTomahto
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Re: People are FOMO flocking to Portugal

Post by TomatoTomahto »

newyorker wrote: Sat Jun 25, 2022 6:35 am Moving to a foreign country causes way too much stress with taxes and etc.

And i dont think any EU country can compete with america's infrastructure. They are just places for vacations.
Wow. Username checks out. If it’s a joke, perhaps a tad dry.
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fogalog
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Re: People are FOMO flocking to Portugal

Post by fogalog »

Estudasses wrote: Sat Jun 25, 2022 5:39 am I wouldn't count on the current Portuguese tax climate for expats not changing in the medium to long term. The influx of tourists and more importantly property-buying foreigners to the country has pushed the Lisbon, Porto and Algarve regions waaay past what locals can afford. Something has to give in sooner or later. For now the additional tax revenue is appealing, but Portuguese governments skew much more left than in the US... Interesting times ahead for sure.
This may come to be true but the Algarve region in particular has been home to many foreigner-owned (golf) properties for as long as I can remember. ie this is not a new phenomenon. I'd be curious to know what the actual recent uptick looks like.

I have heard talk from friends about moving to Portugal as "the place" but I moved to a foreign country where I didn't speak the language when I was younger and though I loved it, it's ...hard. I wouldn't underestimate it.
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stocknoob4111
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Re: People are FOMO flocking to Portugal

Post by stocknoob4111 »

Youtuber Vagabond Awake has some great info regarding alternatives to Portugal offering accessible residency:

Argentina, Turkey, Nicaragua, Portugal, Colombia, Peru, Chile, Panama, Ecuador, Indonesia (Bali), Phillippines, Malaysia, Thailand, Mexico

https://www.youtube.com/watch?v=bkG584qIPiM

He goes over some specifics. Turkey can be good alternative although health care is probably not on par with Portugal but COL is cheaper. Not too sure about Chile, when I went there in 2011 it was very expensive.

Question - anyone considering retiring anywhere else besides Portugal, how about the above listed countries?
clip651
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Re: People are FOMO flocking to Portugal

Post by clip651 »

stocknoob4111 wrote: Sat Jun 25, 2022 2:15 pm Youtuber Vagabond Awake has some great info regarding alternatives to Portugal offering accessible residency:

Argentina, Turkey, Nicaragua, Portugal, Colombia, Peru, Chile, Panama, Ecuador, Indonesia (Bali), Phillippines, Malaysia, Thailand, Mexico

https://www.youtube.com/watch?v=bkG584qIPiM

He goes over some specifics. Turkey can be good alternative although health care is probably not on par with Portugal but COL is cheaper. Not too sure about Chile, when I went there in 2011 it was very expensive.

Question - anyone considering retiring anywhere else besides Portugal, how about the above listed countries?
Some of those countries you list have a backlog of people trying rather desperately to immigrate to the USA, for various reasons. Accessible residency would of course be needed to retire elsewhere, but what places might you actually like enough to be content to live there? The cultures, languages spoken, climates, etc vary quite a bit among the countries on that list. Also do some thinking about long term political stability of anywhere you pick. Some of those areas are in flux, or could be in the coming decades.
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Re: People are FOMO flocking to Portugal

Post by Vanguard User »

Lisbon has similar climate to BA right?
Inframan4712
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Re: People are FOMO flocking to Portugal

Post by Inframan4712 »

newyorker wrote: Sat Jun 25, 2022 6:35 am
And i dont think any EU country can compete with america's infrastructure. They are just places for vacations.
LOL. I don’t know if you live in NYC and your opinion is skewed by the availability of public transportation, but the vast, vast majority of the US has absent, damaged, or outright dangerous infrastructure, as in bridges for example.

Portugal is attractive for many reasons mentioned upthread, and we view it as Europe’s doorstep. Just a train or low-cost carrier airplane ride anywhere in Europe.

You don’t need a car. In the US, outside of a handful of metro areas, a car is near mandatory.
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Re: People are FOMO flocking to Portugal

Post by fujiters »

Tellurius wrote: Sat Jun 25, 2022 9:16 am I’m from Cyprus. What are we doing wrong compared to Portugal, and what can we do to attract American expats?
Cyprus has a reputation for appealing to Russians wanting to protect questionably obtained money. It also ranks somewhat poorly on the corruption perceptions index. Fixing those impressions would probably go a long way in appealing to American expats.
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Tanelorn
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Re: People are FOMO flocking to Portugal

Post by Tanelorn »

afr wrote: Wed Jun 15, 2022 3:52 pm Does anyone know if the percentage of US retirees moving abroad has increased in the past few decades or is this a more recent phenomenon?
The increasing trend of US citizens giving up their citizenship for another country’s has been going on for a decade or so. The US has retaliated against this by raising exit taxes, successfully leaning on foreign banks to report to them (and as a consequence most foreign banks will refuse service to Americans), and generally making expats lives miserable. US taxes are worse than many other places (most don’t tax you on your income earned elsewhere), and especially the US expat tax returns and reporting are very onerous. All of these factors are driving people to leave, and Americans abroad to give up their citizenship. Whether those are retirees specifically or not, I’m not sure.

https://www.imidaily.com/intelligence/u ... on-update/
nigel_ht
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Re: People are FOMO flocking to Portugal

Post by nigel_ht »

Tanelorn wrote: Sun Jun 26, 2022 6:31 am
afr wrote: Wed Jun 15, 2022 3:52 pm Does anyone know if the percentage of US retirees moving abroad has increased in the past few decades or is this a more recent phenomenon?
The increasing trend of US citizens giving up their citizenship for another country’s has been going on for a decade or so. The US has retaliated against this by raising exit taxes, successfully leaning on foreign banks to report to them (and as a consequence most foreign banks will refuse service to Americans), and generally making expats lives miserable. US taxes are worse than many other places (most don’t tax you on your income earned elsewhere), and especially the US expat tax returns and reporting are very onerous. All of these factors are driving people to leave, and Americans abroad to give up their citizenship. Whether those are retirees specifically or not, I’m not sure.

https://www.imidaily.com/intelligence/u ... on-update/
6700 out of a population of 330 million and an expat population of around 9 million.

“Driving people to leave” is moderately overstating things. “Increasing trend” may be true but other than a couple bloggers (Nomad Capitalist comes to mind) talking about it for the most part it’s not that big a thing even at 10K a year which is a milestone we haven’t yet reached.
JackoC
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Re: People are FOMO flocking to Portugal

Post by JackoC »

rich126 wrote: Sat Jun 25, 2022 7:08 am People driving up cost of living is common, especially now. I was reading about how locals in Montana were having issues due to the state's popularity from the tv show Yellowstone. A lot of people are buying up property and housing and rent was skyrocketing for the locals. Just a reality of life. Just like a lot of housing is going up due to investors and companies buying properties/developments to rent to people. Once things start going south, things can change quickly.

I had a friend and his wife go to Portugal and they weren't that impressed. I think there are other European places I would consider in retirement before Portugal.

Years ago this older guy I was chatting with at the nightclub was telling me how he was going to move to Costa Rica and he was going to check it out soon. A few months later I ran into him and he had made the visit. He said "Geez, it is like a 3rd world country". Now I don't know how accurate that is but it was clear his expectations wasn't close to reality which I could have pointed out previously but didn't.
On the older guy in nightclub, we're all ignorant about many things (at least I am), there's too much knowledge to know everything, but seriously, he had to go to Costa Rica to realize it's not a rich country? :happy But I guess you would have to go to any country you were thinking of retiring to before retiring there anyway.

Costa Rica is roughly on par with Mexico economically overall. Both are members of the OECD ('a club of mostly rich countries' as The Economist adds each time they mention it) but are both among the exceptions to 'mostly'. Not criticizing either country but those two and almost all on a list in recent post are developing countries (the polite term). You're getting lower costs by retiring from a rich country to a developing country. Portugal somewhat in contrast is around the bottom economic rung of 'developed country'. I don't think any index or categorization classes it otherwise, and GDP PPP per capita ~2/3's higher than CR. Whether that's the 'sweet spot' for foreign retirement depends on the person obviously. Some Americans happily shuffle off to eg. Ecuador to retire (statistically probably mainly Ecuadorian-Americans but not always). I've liked visiting some countries like that (I mention Ecuador in part because I was welcomed warmly by people I happened to meet travelling there for business) but wouldn't dream of living there.

Even with a developed country, I would not move to one without factoring in the effort to learn the language (well) if I hadn't already. I would never live someplace permanently counting on native people to speak English to me. I have lived in foreign countries for a few months counting on that (school/work), and a few years (work) but in latter case learned the language. Master Portuguese at this point? Probably not for me.
stoptothink
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Re: People are FOMO flocking to Portugal

Post by stoptothink »

Inframan4712 wrote: Sat Jun 25, 2022 3:10 pm
newyorker wrote: Sat Jun 25, 2022 6:35 am
And i dont think any EU country can compete with america's infrastructure. They are just places for vacations.
LOL. I don’t know if you live in NYC and your opinion is skewed by the availability of public transportation, but the vast, vast majority of the US has absent, damaged, or outright dangerous infrastructure, as in bridges for example.

Portugal is attractive for many reasons mentioned upthread, and we view it as Europe’s doorstep. Just a train or low-cost carrier airplane ride anywhere in Europe.

You don’t need a car. In the US, outside of a handful of metro areas, a car is near mandatory.
I don't think newyorker was not necessarily referring to public transportation and road/bridges with the term "infrastructure". Probably similar to how our politicians used the term in the recent "infrastructure" bill.
Last edited by stoptothink on Sun Jun 26, 2022 7:39 am, edited 1 time in total.
tvubpwcisla
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Re: People are FOMO flocking to Portugal

Post by tvubpwcisla »

They will be back.

:mrgreen:
OpenMinded1
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Re: People are FOMO flocking to Portugal

Post by OpenMinded1 »

My wife and I have thought about moving to other countries, including Portugal, from the US in retirement, but have a long list of concerns that will probably keep us from doing it. I think most people should have the same concerns.

Will older people like us be able to learn another language to a reasonable degree of proficiency? Seems obvious that many problems would stem from an inability to speak the native language.

Healthcare in the country might be highly rated and less expensive, but what about the language barrier? How would I receive good healthcare, especially in an emergency, if neither the providers nor I speak the other’s native language very well? Will it be delayed because they have to find a translator? Are medical mistakes more likely because of problems communicating? I’ve read that about one in three speak english in Portugal. Outside the major metropolitan areas probably fewer people speak english.

Do we sell or otherwise get rid of most of our belongings here, and then buy new things in the country we move to, or do we have most of our belongings shipped to the new country? What if things don’t work out in the new country? Do we then go thru the whole process in reverse? What about pets? Sounds like a real hassle, and expensive.

We should probably spend a considerable amount of time in the country we're considering moving to before moving there as residents. I wouldn’t want to rely on what other people say about living in another country. (Florida may seem like paradise to some, but it’s a hot, humid hell to us. :D ) Can we afford to spend a considerable amount of time visiting another country? Maybe not.

Seems like there would be plenty of scammers, con artists etc. ready to “help” potential expatriates like us with our move. It might be difficult to pick the right people for assistance. How would we get legal recourse if these scammers, con artists etc. are residents of another country?

Some other major items that would take up too much time to go into in any detail: visas, passports, taxes, Medicare, pension payments as a former federal employee, and Social Security. Also, what residency status should we aim for?

I’ve never shied away from difficult tasks, but this endeavor seems almost overwhelming, and risky. What if we move to another country and then after quite a few years want to return? Seems like getting back to the US would be another overwhelming endeavor.
Last edited by OpenMinded1 on Mon Jun 27, 2022 9:06 am, edited 5 times in total.
OpenMinded1
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Re: People are FOMO flocking to Portugal

Post by OpenMinded1 »

delete
Tellurius
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Re: People are FOMO flocking to Portugal

Post by Tellurius »

fujiters wrote: Sun Jun 26, 2022 5:37 am
Tellurius wrote: Sat Jun 25, 2022 9:16 am I’m from Cyprus. What are we doing wrong compared to Portugal, and what can we do to attract American expats?
Cyprus has a reputation for appealing to Russians wanting to protect questionably obtained money. It also ranks somewhat poorly on the corruption perceptions index. Fixing those impressions would probably go a long way in appealing to American expats.
Interesting that you see it that way. It’s a developed country with lots of British expats (due to us being a former colony we are more well known there) and a population that speaks English at a very high percentage.

I’m not sure how Russians would play a role for American retirees, since we are an EU member. Maybe just the thought of Russians is bad.

Anyway, I think the days of Russian money in the EU may be over, but London’s going to be worse hit than us
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Tanelorn
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Re: People are FOMO flocking to Portugal

Post by Tanelorn »

nigel_ht wrote: Sun Jun 26, 2022 7:06 am 6700 out of a population of 330 million and an expat population of around 9 million.

“Driving people to leave” is moderately overstating things. “Increasing trend” may be true but other than a couple bloggers (Nomad Capitalist comes to mind) talking about it for the most part it’s not that big a thing even at 10K a year which is a milestone we haven’t yet reached.
Well there are only 700 US billionaires so it matters quite a lot who’s leaving. The really poor are trying to get in, while some of the really rich are trying to get out. The numbers quoted are also understated due to the government delaying people’s attempt to leave.

https://www.axios.com/2021/08/05/wealth ... itizenship
an immigration lawyer based in Orange County, tells Axios. "The bulk of the cases are individuals trying to avoid tax liability."

A lot of people who take this drastic step are tech zillionaires: Eric Schmidt, the former Alphabet CEO, has applied to become a citizen of Cyprus.

David Lesperance, an international tax lawyer based in Poland who specializes in helping people renounce U.S. citizenship, says that with coronavirus shutting down interviews for renunciation... "There are probably 20,000 or 30,000 people who want to do this, but they can’t get the appointment," Lesperance said. "There’s not a peak demand — the system’s capacity has peaked."

"It's a year-and-a-half to get an appointment at a Canadian embassy," he tells Axios. "Bern [Switzerland] alone has a backlog of over 300 cases."
nigel_ht
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Re: People are FOMO flocking to Portugal

Post by nigel_ht »

Tanelorn wrote: Sun Jun 26, 2022 11:55 am
nigel_ht wrote: Sun Jun 26, 2022 7:06 am 6700 out of a population of 330 million and an expat population of around 9 million.

“Driving people to leave” is moderately overstating things. “Increasing trend” may be true but other than a couple bloggers (Nomad Capitalist comes to mind) talking about it for the most part it’s not that big a thing even at 10K a year which is a milestone we haven’t yet reached.
Well there are only 700 US billionaires so it matters quite a lot who’s leaving. The really poor are trying to get in, while some of the really rich are trying to get out. The numbers quoted are also understated due to the government delaying people’s attempt to leave.

https://www.axios.com/2021/08/05/wealth ... itizenship
an immigration lawyer based in Orange County, tells Axios. "The bulk of the cases are individuals trying to avoid tax liability."

A lot of people who take this drastic step are tech zillionaires: Eric Schmidt, the former Alphabet CEO, has applied to become a citizen of Cyprus.

David Lesperance, an international tax lawyer based in Poland who specializes in helping people renounce U.S. citizenship, says that with coronavirus shutting down interviews for renunciation... "There are probably 20,000 or 30,000 people who want to do this, but they can’t get the appointment," Lesperance said. "There’s not a peak demand — the system’s capacity has peaked."

"It's a year-and-a-half to get an appointment at a Canadian embassy," he tells Axios. "Bern [Switzerland] alone has a backlog of over 300 cases."
Eric Schmidt bought a 2nd passport.

If I had another 0 in my net worth I’d buy one too for the family…that’s not nearly the same as renouncing US citizenship…
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stocknoob4111
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Re: People are FOMO flocking to Portugal

Post by stocknoob4111 »

more press people promoting Portugal, I see a huge increase in these types of videos recently:


Why Retiring in Portugal Should Be at the TOP of Your List:

https://www.youtube.com/watch?v=r4asyMHcwWQ
Tribonian
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Re: People are FOMO flocking to Portugal

Post by Tribonian »

Members of my family have retired from California to Mexico for three generations and it has worked out well for all (over a dozen) of them. Only a few have better than Berlitz guidebook Spanish which is frankly embarrassing. They have received outstanding healthcare, starting with 24/7 affordable nursing as they have aged in place. All but one has made it to mid 80s and a majority into late 90s with the current crop in their 70s. That said, I don’t plan to follow their footsteps.

Outliers have retired to Ireland and found taxes onerous but healthcare outstanding. The climate is not great but the people and pubs are warm and welcoming.

I hope to follow the Marvelous Marvin Hagler model of living in a European country where I speak the language for 183 days a year or less to avoid becoming a tax resident.

Curious why people think Portugal’s Golden Visa is superior to others. Spain has an established pathway and specialized firms that seem pretty reasonable. Italy has some very affordable real estate apart from Rome but the bureaucracy can be impenetrable. Met cops at a wedding who retired to Greece and they loved it. The *only* downside they encountered was that there weren’t any good jobs for the young people. They’d experienced Greek healthcare and thought it was comparable to their Cadillac healthcare plan in the US.
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sunny_socal
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Re: People are FOMO flocking to Portugal

Post by sunny_socal »

schmitz wrote: Sun Jun 12, 2022 4:14 pm People are moving to Portugal due to FOMO?

I wouldn’t even move one state over for that
Oh I would. Fear of missing out on a normal life - that's why I moved away from California! :beer
WestCoastPhan
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Re: People are FOMO flocking to Portugal

Post by WestCoastPhan »

Valuethinker wrote: Mon Jun 13, 2022 3:33 am My friend who lives outside of Malaga mastered Spanish & is taking out citizenship. The only place she really hates in Spain is Gibraltar - for its Britishness.
[ Quote fixed by admin LadyGeek]

Gibraltar's not in Spain. :D

It's a little like your friend saying the only place in Spain she hates is Andorra.
Last edited by LadyGeek on Sun Jun 26, 2022 8:08 pm, edited 1 time in total.
Reason: Fixed quote
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Re: People are FOMO flocking to Portugal

Post by ncbill »

tvubpwcisla wrote: Sun Jun 26, 2022 7:38 am They will be back.

:mrgreen:
Sure, one expat I kept up with online came back from Mexico after a couple of decades early retired to get an organ transplant on Medicare's dime.

Once everything was stable he went back down for, IIRC, his last decade or so.
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Marmot
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Saw this article a while back

Post by Marmot »

Marty....don't go to the year 2020....Dr. Emmett Brown
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firebirdparts
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Re: People are FOMO flocking to Portugal

Post by firebirdparts »

Is Portugal about to expire or something?
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hidradenitis
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Re: People are FOMO flocking to Portugal

Post by hidradenitis »

Didn't read everything but my thoughts FWIW:

1. FOMO alone is seldom a wise reason to act, particularly when choosing where to live. It's a really big world out there.

2. As a physician I've learned that patients generally have a poor idea of what constitutes good health care. There's a tendency to confuse convenience and comfort with the provision of the right treatment for the right diagnosis based on the best available evidence.

3. For someone anticipating to move overseas, population based metrics such as life expectancy, maternal mortality, vaccination rates, etc may serve as better proxies for estimates of good health care rather than anecdotal evidence or a single encounter in an urgent care setting.

For example, many countries have little to no restriction on access to prescription medications and lower professional standards relative to the US. This is not the same as good healthcare but is much more user friendly and therefore is easier to be confused as such.

World Health Organization and OECD data can be much more helpful in understanding how various healthcare systems compare against each other.

4. A healthcare system which does a good job at population based health may be wanting for individualized treatments. The US healthcare system broadly speaking underperforms for the former but does quite well for the latter.

The country with a high life expectancy may have poor access to quality of life therapies, such as knee replacements. It's difficult if not impossible to have a system optimized for everyone.

5. I mention all of this as one who has treated several "failed retired ex-pats" who did not have realistic expectations of what to expect as the inevitable healthcare needs start to show up.

6. None of this is to discourage anyone from looking at retiring overseas. I have lived overseas and am familiar with several different healthcare systems from various countries. It can be a big change for those not familiar. The more educated someone can be, the better.
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Re: People are FOMO flocking to Portugal

Post by nigel_ht »

hidradenitis wrote: Mon Jun 27, 2022 7:10 pm Didn't read everything but my thoughts FWIW:

2. As a physician I've learned that patients generally have a poor idea of what constitutes good health care. There's a tendency to confuse convenience and comfort with the provision of the right treatment for the right diagnosis based on the best available evidence.

3. For someone anticipating to move overseas, population based metrics such as life expectancy, maternal mortality, vaccination rates, etc may serve as better proxies for estimates of good health care rather than anecdotal evidence or a single encounter in an urgent care setting.

For example, many countries have little to no restriction on access to prescription medications and lower professional standards relative to the US. This is not the same as good healthcare but is much more user friendly and therefore is easier to be confused as such.

World Health Organization and OECD data can be much more helpful in understanding how various healthcare systems compare against each other.

4. A healthcare system which does a good job at population based health may be wanting for individualized treatments. The US healthcare system broadly speaking underperforms for the former but does quite well for the latter.

The country with a high life expectancy may have poor access to quality of life therapies, such as knee replacements. It's difficult if not impossible to have a system optimized for everyone.

5. I mention all of this as one who has treated several "failed retired ex-pats" who did not have realistic expectations of what to expect as the inevitable healthcare needs start to show up.
In your opinion does the existence of an established medical tourism industry indicate an adequate health care system? Is a country like Singapore or Thailand likely good?

I’ve read a couple papers and it seems that while the majority of medical tourism in Thailand is for cosmetic procedures the majority of serious ones (for UK residents) are for orthopedic and cardiothoracic procedures (more stents than cabg).

Anecdotally, my wife went to a Thai hospital with an ailing colleague and she described it as a 5 star hotel with Hopkin’s trained doctors.

Lol. I can tell you that Hopkins itself isn’t quite so posh…
hidradenitis
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Re: People are FOMO flocking to Portugal

Post by hidradenitis »

I'm not sure I have any data to comment intelligently but I would guess probably not. Medical tourism from what I have seen skews more towards cosmetic procedures and may not be as relevant to someone seeking good overall healthcare in their declining years.
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Re: People are FOMO flocking to Portugal

Post by halfnine »

hidradenitis wrote: Mon Jun 27, 2022 7:10 pm Didn't read everything but my thoughts FWIW:

1. FOMO alone is seldom a wise reason to act, particularly when choosing where to live. It's a really big world out there.

valid

2. As a physician I've learned that patients generally have a poor idea of what constitutes good health care. There's a tendency to confuse convenience and comfort with the provision of the right treatment for the right diagnosis based on the best available evidence.

And American physicians have a poor idea of what good medical treatment is available elsewhere. Even worse, since American physicians can't even tell you what it is going to cost they have no idea of what it takes to get good value treatment for your money compared to what is offered elsewhere.

3. For someone anticipating to move overseas, population based metrics such as life expectancy, maternal mortality, vaccination rates, etc may serve as better proxies for estimates of good health care rather than anecdotal evidence or a single encounter in an urgent care setting.

No it won't. Not for an individual. A better proxy is one's ability to pay for good medical care it in the country of choice. Sadly, in the USA, this is out of the reach of many.

For example, many countries have little to no restriction on access to prescription medications and lower professional standards relative to the US. This is not the same as good healthcare but is much more user friendly and therefore is easier to be confused as such.

World Health Organization and OECD data can be much more helpful in understanding how various healthcare systems compare against each other.

No, it won't. Not for an individual.

4. A healthcare system which does a good job at population based health may be wanting for individualized treatments. The US healthcare system broadly speaking underperforms for the former but does quite well for the latter.

The country with a high life expectancy may have poor access to quality of life therapies, such as knee replacements. It's difficult if not impossible to have a system optimized for everyone.

Which is why medical tourism exists and there are arbitrage opportunities available for those willing to explore them inclusive of living elsewhere.

5. I mention all of this as one who has treated several "failed retired ex-pats" who did not have realistic expectations of what to expect as the inevitable healthcare needs start to show up.

This is a failure of an individual not planning their medical needs and ability to support it with the country they have chosen as they age. This is a not a failure of medical systems abroad. A lot of expats simply return to their native home (and this is true of any expat and not just American expats) because they lack independence and need the support of family and friends; they now have access to greatly subsidized healthcare within their home country; and/or currency exchange rates / inflation have greatly exceeded their capacity to absorb the increased costs.

6. None of this is to discourage anyone from looking at retiring overseas. I have lived overseas and am familiar with several different healthcare systems from various countries. It can be a big change for those not familiar. The more educated someone can be, the better.

All valid
hidradenitis
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Re: People are FOMO flocking to Portugal

Post by hidradenitis »

I think we'll have to agree to disagree. I've lived and worked overseas in various countries for several years in both clinical and planning capacities and in my estimation have a better grasp than most of what the realities of what non-US health systems can offer. I think I've made a good attempt to try to delineate the differences between the population based and individual needs of a healthcare system. No one metric is perfect. Cheers.
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Re: People are FOMO flocking to Portugal

Post by halfnine »

hidradenitis wrote: Tue Jun 28, 2022 8:57 am I think we'll have to agree to disagree. I've lived and worked overseas in various countries for several years in both clinical and planning capacities and in my estimation have a better grasp than most of what the realities of what non-US health systems can offer. I think I've made a good attempt to try to delineate the differences between the population based and individual needs of a healthcare system. No one metric is perfect. Cheers.
I've lived in multiple countries across four continents over the last 15 years and continue to do so through today. Enough time abroad so that in addition to having a foothold in the US, I also can get essentially free medical treatment in two other countries; and quality, cheap medical treatment in a thrid country based on citizenships and residency without much legwork. So, I think I have a pretty good idea of what medical treatments are available (not necessarily what is available or affordable to a local within a healthcare system). So, yes, we will have to agree to disagree. At the end of the day healthcare is individual and country wide metrics are of little interest. What matters is what medical treatment one can get in the specific locale (not necessarily country) where one lives.
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Re: People are FOMO flocking to Portugal

Post by Vogatrice »

I am currently finishing year 2 of expatriating to Italy and intend to stay for the long haul. Having said that, FOMO is the worst reason I can think of to make a similar move. OpenMinded1 listed a lot of possible hurdles to moving overseas. Yup, those are all valid in my experience. The reason to leap those hurdles has to be personal. You have to want the life you are moving to, and be willing to learn how to jump the hurdles and enjoy the process of that learning, or you will slink home telling horrible stories about "the Italian bureaucracy". Or the Portuguese bureaucracy, or how horrible the locals are, or whatever excuse you can find to explain your failure to integrate.

Sounds harsh, but in fact it is not easy to change your country of residence and a lifetime of cultural cues. Sure, Italian food is great, but you can't get dinner until 7:30 or 8:00. The climate is fantastic after Midwestern winters, but you have to learn to close your shutters against that Mediterranean sun. Your doctor is not going to offer you a smorgasbord of all-you-can-eat specialists and screening tests. The U.S. government will make your life a living hell of forms and filings. Not everyone is going to invite you to join their family feasts underneath the olive trees and grape vines.

But I am here because I want to be. I have learned the language. I persist in asking questions until I understand how to get the health care I need (and it's been excellent quality, but it's not what I want, it's what I need.) I miss my friends and am working hard on making new ones. The geo-arbitrage on my cost of living has been everything I hoped. The food is indeed terrific.

In short, don't do this because "everyone else" is doing it. If you want to do it, do your own research on how to be successful, identify your own motivations, and go for it. Just don't overpay for it in a place that "everyone" is flocking to, and be ready for the long haul on integration into the local life.
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Re: People are FOMO flocking to Portugal

Post by hidradenitis »

halfnine wrote: Tue Jun 28, 2022 12:00 pm At the end of the day healthcare is individual and country wide metrics are of little interest. What matters is what medical treatment one can get in the specific locale (not necessarily country) where one lives.
It sounds like your experience thus far has been positive and I hope it continues to be so. I think an example may serve to illustrate the point I'm trying to make.

Let's take the case of the average 65+ American retiree. A good place to start is to have a reasonable understanding of the health issues such an individual may be expected to encounter during the time that they are living as an expat retiree overseas.

The CDC publishes the top 10 causes of death by age cohort and this could serve as a proxy for understanding what the future may entail for our retiree. Using the most recent available data, we could expect that our 65+ American is at highest risk of death from cardiovascular disease, followed by cancer. (This ignores the fact that underlying risk may change as a result of the move overseas, but let's take this as the baseline for the sake of the example.):

Image

This then begs the question: How does a particular healthcare system perform in regards to the care of cardiovascular disease given that our retiree is more likely to die from this than from any other single condition? One particular aspect of acute cardiovascular care is that outcomes may be more dependent on the healthcare system as a whole than one's ability to navigate the healthcare system.

In other words, a wealthy individual living in a low-income country may be forced to rely on the availability and competence of the local ambulance service and ability of the regional hospital to perform percutaneous angioplasty. This is because the best outcomes are highly correlated to the care received within the first 90 minutes, and an individual may not have the luxury of seeking or receiving platinum care within that time frame. So robustness of the healthcare system as a whole may in fact be highly relevant to the individual case.

When I worked in Kenya, I learned that Nairobi has excellent options for acute cardiac care. I also learned that getting a patient experiencing acute myocardial infarction to Nairobi from Nakuru within that 90 minute window can a challenge for anybody, including for the well heeled and/or well prepared.

This graph depicts 30-day survival rates following an acute myocardial infarction for various OECD countries (taken from https://www.oecd-ilibrary.org/sites/0cf ... cf23378-en):

Image

A retiree choosing to retire between Latvia and Norway would be well served to ask which factors might account for the discrepancies between the two healthcare systems, and how these factors might impact their own health.

Population-based metrics are certainly not determinative for any single individual. We may spend a lifetime fretting about cardiovascular disease only to die, as Thurgood Marshall put it, at the age of 110 being shot by a jealous spouse. But in the absence of having a crystal ball, I think the information such databases offer should prompt thoughtful questions about what one can expect from the healthcare infrastructure in which one lives.

Reorienting to the OP (for fear of hijacking the thread), I guess my thoughts are that housing costs and visa requirements are only a part of the picture when trying to decide if Portugal is right for you. Good luck with whatever you decide.
Last edited by hidradenitis on Wed Jun 29, 2022 12:18 am, edited 1 time in total.
Sleepless
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Re: People are FOMO flocking to Portugal

Post by Sleepless »

SteadyOne wrote: Sun Jun 12, 2022 7:09 pm How many people will REALLY move overseas for good and stay?
9 million Americans. That's the official estimate. https://travel.state.gov/content/dam/tr ... r-2020.pdf
Still only 3%. Bound to grow.
[Political comment removed by moderator oldcomputerguy]
Perhaps Americans are in some sort of denial but the US is doing very poorly compared to other Western countries on all quality-of-life indicators.
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halfnine
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Re: People are FOMO flocking to Portugal

Post by halfnine »

Sleepless wrote: Tue Jun 28, 2022 11:59 pm
SteadyOne wrote: Sun Jun 12, 2022 7:09 pm How many people will REALLY move overseas for good and stay?
9 million Americans. That's the official estimate. https://travel.state.gov/content/dam/tr ... r-2020.pdf
Still only 3%. Bound to grow.
[Political comment removed by moderator oldcomputerguy]
Perhaps Americans are in some sort of denial but the US is doing very poorly compared to other Western countries on all quality-of-life indicators.
Other countries have their flaws as well and In the large scheme the USA is still a great place to live. So there is nothing inherent about the USA itself for Americans to be in denial about. What Americans tend to be in denial about is there are quite a few other great places to live out there. And depending on what one values these places might be superior at an individual level.
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Re: People are FOMO flocking to Portugal

Post by HanSolo »

Slacker wrote: Fri Jun 24, 2022 3:51 pm One of the things that stood out is real estate. We purchased our home in 2018 for under $300K and pay $1300/month for PITI. In Portugal, comparable houses were over $350K in Coimbra (much smaller, less popular area than Porto and Lisbon).
That's a bit steep. I have a fear of getting overcharged (FOGO). I assume I'm not alone... but somehow, I doubt we'll see articles like "People are FOGO avoiding Portugal".
hidradenitis wrote: Mon Jun 27, 2022 7:10 pm World Health Organization and OECD data can be much more helpful in understanding how various healthcare systems compare against each other.
This article compared 11 high-income countries (Portugal not included): Mirror, Mirror 2021: Reflecting Poorly

It says: "The United States ranks last overall, despite spending far more of its gross domestic product on health care." Results were based on "Commonwealth Fund international surveys conducted in each country and administrative data from the Organisation for Economic Co-operation and Development and the World Health Organization".

Other rankings including more countries available from Wikipedia (citing OECD data) and World Population Review.
nigel_ht wrote: Mon Jun 13, 2022 7:46 am Post covid my desire to move abroad has greatly diminished…many countries left their retiree residents high and dry.

The MM2H program is a great example of where changing politics deliberately lock out many folks from returning home and with new requirements will kick many out. If you purchased a home there you’re pretty screwed.
I saw articles about that in the early part of the pandemic, that people who thought they lived in Malaysia were prevented from going to their own home there, due to not being treated as residents per lockdown policies. That's a pretty serious "gotcha" and I think there needs to be a review of which countries caused that problem for foreign retirees and which did not.
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nigel_ht
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Re: People are FOMO flocking to Portugal

Post by nigel_ht »

HanSolo wrote: Wed Jun 29, 2022 2:19 am
nigel_ht wrote: Mon Jun 13, 2022 7:46 am Post covid my desire to move abroad has greatly diminished…many countries left their retiree residents high and dry.

The MM2H program is a great example of where changing politics deliberately lock out many folks from returning home and with new requirements will kick many out. If you purchased a home there you’re pretty screwed.
I saw articles about that in the early part of the pandemic, that people who thought they lived in Malaysia were prevented from going to their own home there, due to not being treated as residents per lockdown policies. That's a pretty serious "gotcha" and I think there needs to be a review of which countries caused that problem for foreign retirees and which did not.
Yah, MM2H was on my list of things to investigate but it seems like they don’t want me and I’m okay with that.

I suspect they don’t actually care that much about American retirees but the large number of Chinese that were using that for their kids education than for retirement.

Seems like 4-6 months somewhere and move during the go-go years should work with most tourist visas.

Then spend a couple months in the US during nice weather whenever that is for home base and leave again.

With good medical evac and staying in the bigger cities medical should be okay. Mostly we’re looking at places where there are expats and a decent amount of English spoken…Singapore, George’s Town, Malta…places that used to belong to the British Empire I guess…
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Re: People are FOMO flocking to Portugal

Post by Tanelorn »

HanSolo wrote: Wed Jun 29, 2022 2:19 am This article compared 11 high-income countries (Portugal not included): Mirror, Mirror 2021: Reflecting Poorly

It says: "The United States ranks last overall, despite spending far more of its gross domestic product on health care." Results were based on "Commonwealth Fund international surveys conducted in each country and administrative data from the Organisation for Economic Co-operation and Development and the World Health Organization".
I would strongly caution against taking anything away from Commonwealth Fund’s highly political rankings. They managed to get the US listed dead last in 4/5 major categories. It is much more a statement of their political goals and that the US isn’t in line with them. They’re big on “equity” and cost and “access”, and stuff that’s basically wishing for universal free medical care. The US has the best medical care money can buy in many areas, but that doesn’t count for them if it’s not free and easy for everyone. You can tell their biases from their recommendations-
top-performing countries rely on four features to attain better and more equitable health outcomes:

- They provide for universal coverage and remove cost barriers so people can get care when they need it and in a manner that works for them.

- They invest in primary care systems to ensure that high-value services are equitably available locally in all communities to all people, reducing the risk of discrimination and unequal treatment.

- They reduce the administrative burdens on patients and clinicians that cost them time and effort and can discourage access to care, especially for marginalized groups.

- They invest in social services that increase equitable access to nutrition, education, child care, community safety, housing, transportation, and worker benefits that lead to a healthier population and fewer avoidable demands on health care.
Various biases in similar healthcare surveys I’ve seen include differential infant mortality metrics (US tries to save much more premature babies and counts them as dying from a much earlier age than as a miscarriage) and life expectancy (which largely has to do with cultural and lifestyle choices, rather than failures of the medical system). Take from this what you will, but neither of these “failings” of the US are likely to be relevant to an individual adult.

As others have said, what matters for your personal decision is individual to you. You already know if you can afford medical care, good insurance, or whatever in the US system and you can compare that to wherever else you’re considering. Wealthy tax exiles face very different considerations than those looking to retire early on a limited budget elsewhere based on lower costs.
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Re: People are FOMO flocking to Portugal

Post by kramer »

I happened to see a graphic the other day about net movement of dollar millionaires among countries. Sorry I don't have a link, and I think it might have applied to 2020 and 2021. Anyway, as a percentage of population, Portugal had one of the highest per capita net millionaire gains in the world (ranked in the top 10). But the absolute numbers are still small, something like 1500 net millionaires moved into Portugal.
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Re: People are FOMO flocking to Portugal

Post by sixtyforty »

Tanelorn wrote: Sun Jun 26, 2022 6:31 am
afr wrote: Wed Jun 15, 2022 3:52 pm Does anyone know if the percentage of US retirees moving abroad has increased in the past few decades or is this a more recent phenomenon?
The increasing trend of US citizens giving up their citizenship for another country’s has been going on for a decade or so. The US has retaliated against this by raising exit taxes, successfully leaning on foreign banks to report to them (and as a consequence most foreign banks will refuse service to Americans), and generally making expats lives miserable. US taxes are worse than many other places (most don’t tax you on your income earned elsewhere), and especially the US expat tax returns and reporting are very onerous. All of these factors are driving people to leave, and Americans abroad to give up their citizenship. Whether those are retirees specifically or not, I’m not sure.

https://www.imidaily.com/intelligence/u ... on-update/
Why would anyone have to "give up" their US Citizenship? I know in Italy you can have dual citizenship, not having to give up anything.
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Re: People are FOMO flocking to Portugal

Post by Tanelorn »

sixtyforty wrote: Wed Jun 29, 2022 7:26 am Why would anyone have to "give up" their US Citizenship? I know in Italy you can have dual citizenship, not having to give up anything.
To avoid US income and estate taxes, and all the paperwork around those. It’s especially bad for expats with foreign accounts. Nearly all countries don’t tax you on assets / gains / income from things earned abroad, so you can invest in a tax haven offshore and pay nothing.
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Re: People are FOMO flocking to Portugal

Post by halfnine »

Tanelorn wrote: Wed Jun 29, 2022 7:27 am
sixtyforty wrote: Wed Jun 29, 2022 7:26 am Why would anyone have to "give up" their US Citizenship? I know in Italy you can have dual citizenship, not having to give up anything.
To avoid US income and estate taxes, and all the paperwork around those. It’s especially bad for expats with foreign accounts. Nearly all countries don’t tax you on assets / gains / income from things earned abroad, so you can invest in a tax haven offshore and pay nothing.
Actually, most countries tax your foreign gains/income if you are a resident of the country as can be seen here. For those countries that do tax there are some caveats, of course. In some instances individuals might be able to defer or eliminate taxation but this is typically only allowed for a few years and often if the money from abroad also isn't brought into the country.
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Re: People are FOMO flocking to Portugal

Post by Sleepless »

halfnine wrote: Wed Jun 29, 2022 7:58 am
Tanelorn wrote: Wed Jun 29, 2022 7:27 am
sixtyforty wrote: Wed Jun 29, 2022 7:26 am Why would anyone have to "give up" their US Citizenship? I know in Italy you can have dual citizenship, not having to give up anything.
To avoid US income and estate taxes, and all the paperwork around those. It’s especially bad for expats with foreign accounts. Nearly all countries don’t tax you on assets / gains / income from things earned abroad, so you can invest in a tax haven offshore and pay nothing.
Actually, most countries tax your foreign gains/income if you are a resident of the country as can be seen here. For those countries that do tax there are some caveats, of course. In some instances individuals might be able to defer or eliminate taxation but this is typically only allowed for a few years and often if the money from abroad also isn't brought into the country.
Most countries don't tax non-resident citizens. The US belongs to a very small club of countries that do. It's a PITA.
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Re: People are FOMO flocking to Portugal

Post by EddyB »

nigel_ht wrote: Sun Jun 12, 2022 7:11 pm
koryg75 wrote: Sun Jun 12, 2022 6:57 pm As someone living in an area that I 100% don’t want to retire in, I can empathize. But I’m at least 7-8 years away, so I’ve settled on the mindset that a lot can change in that timeframe. These areas in Portugal could become insanely crowded and less appealing, or not. That goes for many “hot” areas right now. Not much we can do about it. I suppose you could start making a list of areas similar to the hot markets in Portugal. The one thing I for sure wouldn't do is buy something just because of FOMO.
I dunno…I was looking at Bozeman a decade ago and I think I’ve missed the window. I should have bought a cheap lot or something back then.

There is no way to “save enough” if billionaires start buying stuff.
There’s something to be said for buying if you can and you have a strong expectation that you’ll want to be in a particular spot.
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Re: People are FOMO flocking to Portugal

Post by EddyB »

Tanelorn wrote: Wed Jun 29, 2022 6:25 am Take from this what you will, but neither of these “failings” of the US are likely to be relevant to an individual adult.
We must have different definitions of “relevant.”
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Re: People are FOMO flocking to Portugal

Post by nigel_ht »

EddyB wrote: Wed Jun 29, 2022 8:35 am
Tanelorn wrote: Wed Jun 29, 2022 6:25 am Take from this what you will, but neither of these “failings” of the US are likely to be relevant to an individual adult.
We must have different definitions of “relevant.”
Well, I eat like an American and had an American style heart attack but that was a personal decision. :)

Smarter folks with healthier lifestyles probably won’t suffer as much from stereotypical American health problems…

I dunno which country has better health care if you are rich.

I’m not rich but my insurance lets me go to Hopkins so I dunno how much better I can do elsewhere for any procedure that’s been approved for use in the US…
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