Author Topic: Which country to move to if Obamacare turns bad?  (Read 4620 times)

FIREin2018?

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Which country to move to if Obamacare turns bad?
« on: May 16, 2018, 10:53:23 AM »
age 47, single, no kids, mortgage paid off.
$500k in roth/IRA/401k.
$150k in the bank.
expenses = $20k/yr

I have enough $ to FIRE this year and I want to FIRE.
the only thing holding me back is healthcare uncertainty.

Once i FIRE, i am not going back to work. (i make 6 figures but dont like my field.)

My plan for healthcare once i FIRE is Obamacare Silver plan with full subsidy.
It should be around $75/month.

If Trump messes with Obamacare such that im now paying hundreds of $$$ a month for healthcare, my plan B is to move to another country with reasonable healthcare.

Now the question is which country? WHY that country?
(I was born in the US and only speak English)
« Last Edit: May 16, 2018, 10:55:15 AM by FIREin2018? »

GuitarStv

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Re: Which country to move to if Obamacare turns bad?
« Reply #1 on: May 16, 2018, 10:59:52 AM »
Why do you believe that other countries want to take unemployed American refugees?  :P

MoseyingAlong

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Re: Which country to move to if Obamacare turns bad?
« Reply #2 on: May 16, 2018, 11:13:30 AM »
With a paid off mortgage, you must be a homeowner. How much do you spend on home maintenance per year? Including immediate repairs, reserves for major expenses and insurance?

Why not spend that much or more on your personal health?

One of the screwy things with our (the US) healthcare system is that most people treat health insurance as a health maintenance plan, like a home warranty, not as catastrophic insurance, like home insurance. One of the worst things about the ACA was effectively banning actual catastrophic plans.

ysette9

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Re: Which country to move to if Obamacare turns bad?
« Reply #3 on: May 16, 2018, 12:39:42 PM »
My personal Plan B is the UK but that is because I can get citizenship through my mother by filing out a form. You should check out the thread that has existed for past year discussing the election and healthcare. I forget the exact name of it right now; can someone help me out there? In short, I think it isn’t necessarily easy to get citizenship in other first-world countries without substantial ($1M+) assets. I share your concern, as do a lot of people, do you are doing the right thing by starting your research into backup options now.

ChpBstrd

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Re: Which country to move to if Obamacare turns bad?
« Reply #4 on: May 16, 2018, 01:23:04 PM »
I see lots of Americans talking about joining the global refugee crisis in search of democracies with benefits.

Yet this is the same country where most people don't vote and where voting participation hit a 20 year low in 2016. This is a culture where people think you're a weirdo for admitting you're an activist, donating money, or volunteering on a campaign, yet it's perfectly normal to spend 10-15 hours a week watching TV or consuming internet propaganda. It's a strange place where people routinely spend $400/month on gasoline, but if you ever admitted donating $200/year to a cause or campaign then you must be some wild-eyed radical and people aren't sure they can be friends with you.

The U.S. proves how fast the shit can go downhill if apathy and media overconsumption reaches a critical mass. Why should any other country take the risk of admitting a bunch of Americans to come over and contribute nothing to their democracy, spreading cynicism just like they did back home?

If you vote in every election, persuade others to vote, raise or donate at least $150/year, and display a yard sign or t-shirt, then you might have a decent resume' to join one of the world's vulnerable democracies that have a better-organized healthcare system than the U.S. Yet it is unclear even then why nations trying to strengthen their governance systems against an onslaught of manipulative foreign authoritarians should take on citizens who have learned to think of democracy in transactional terms rather than as a value-driven lifestyle and obligation.

Yes, there comes a time to give up on a nation where everyone has gone batshit. But nobody on this board is fleeing Syria, North Korea, or Honduras. We're talking about how to get cheaper insurance, a situation 99% of us have yet to lift a finger to improve.

Krolik

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Re: Which country to move to if Obamacare turns bad?
« Reply #5 on: May 16, 2018, 02:09:35 PM »

Jrr85

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Re: Which country to move to if Obamacare turns bad?
« Reply #6 on: May 16, 2018, 02:19:29 PM »
age 47, single, no kids, mortgage paid off.
$500k in roth/IRA/401k.
$150k in the bank.
expenses = $20k/yr

I have enough $ to FIRE this year and I want to FIRE.
the only thing holding me back is healthcare uncertainty.

Once i FIRE, i am not going back to work. (i make 6 figures but dont like my field.)

My plan for healthcare once i FIRE is Obamacare Silver plan with full subsidy.
It should be around $75/month.

If Trump messes with Obamacare such that im now paying hundreds of $$$ a month for healthcare, my plan B is to move to another country with reasonable healthcare.

Now the question is which country? WHY that country?
(I was born in the US and only speak English)

Why not move to another country now?  Work another 6 mos to a year, bank another $50k or whatever you are saving, rent or sell your house, and then go live in Thailand for 5-10 years to get your living costs even lower, and hopefully that will let your nest egg grow faster and you'll have a cushion to handle some uncertainty.

ysette9

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Re: Which country to move to if Obamacare turns bad?
« Reply #7 on: May 16, 2018, 03:04:46 PM »
Thanks for providing the links.

Yes, moving to another country is much easier if you are going there for a job to productively contribute. I have some family members who had moved to the Deep South and have researched where they could go as rétirees while despairing that their voting/campaigning/ getting involved in local politics/talking to others all seemed to fall on deaf ears of people who couldn’t see that they were supporting policies against their own and the collective interests. They found that as a retiree unless you can invest $1M it can be tough to get modern republics to open their doors to Americans. 

DreamFIRE

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Re: Which country to move to if Obamacare turns bad?
« Reply #8 on: May 16, 2018, 03:18:11 PM »
I have no interest in moving to another country.  I'm sticking it out in the U.S.  If I'm unable to rely on ACA, I'll just work OMY and pay for higher cost healthcare insurance cost.  Wait until early next year to see how things are going with the ACA.  I'm not set to FIRE until next June anyway.

For the OP, $20K/yr is pretty low.  Don't forget to include taxes and all your long term expenses.  I know you are planning to fraudulently complete the forms to get Obamacare when you don't qualify year after year as you stated in one of the various threads you started, but I think that is risky.

Reference - copy and paste full link into browser:
https://forum.mrmoneymustache.com/welcome-to-the-forum/with-$600k-cash-and-$20k-expenses-i-can-retire-now/
« Last Edit: May 16, 2018, 03:24:18 PM by DreamFIRE »

Cassie

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Re: Which country to move to if Obamacare turns bad?
« Reply #9 on: May 16, 2018, 03:50:47 PM »
Other countries can't afford to take in more people on their healthcare systems.   Some countries like Ireland if you even have enough $ to qualify to stay will not let you use their healthcare.

lbmustache

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Re: Which country to move to if Obamacare turns bad?
« Reply #10 on: May 16, 2018, 06:04:56 PM »
You could probably live in a country like India, although I am not sure what it takes to be able to reside there long-term.

English is recognized as an official language and you will find it all over major cities. QOL is a bit lower than the U.S., but you can find/get all major amenities. There is no real "healthcare system," if you have money, you can pay for the highest quality doctors (which will be very good). My dad got heart surgery for like $5k. (That's for *everything*, pre-and-post op care, testing, spending weeks in the hospital, etc.)

alsoknownasDean

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Re: Which country to move to if Obamacare turns bad?
« Reply #11 on: May 17, 2018, 07:08:19 AM »
Might just need to put in another year or two to get enough to account for any increase. If you're already nearly there a year or two wouldn't be too bad (or even down shifting to a different career for a while).

I guess there's always medical tourism if you need it.

ChpBstrd

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Re: Which country to move to if Obamacare turns bad?
« Reply #12 on: May 17, 2018, 09:45:48 AM »
It might require more than just OMY to earn enough to cover 25x of the rapidly rising cost of healthcare / insurance. We're talking about the next biggest expense after housing that is inflating at 10%+ per year. How does one budget for the cost of insurance 10 years or 20 years from now at that rate of growth?

Let's say as of now my employer provided plan would cost $13k to replace. 13k x 25 = $325k. How many years that takes to save is a factor of your circumstances. However, if the cost rises to twice that amount in a decade, you now need more like $600k, and on and on through the decades the amount required to cover healthcare escalates.

This is my point: It is no longer enough to focus on earning, investing, and frugality. Unless a whole lot of people with dreams of someday retiring raise a whole lot of hell, the status quo will be with us for decades to come and FIRE (with healthcare) will be out of reach even for millionaires.

goatmom

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Re: Which country to move to if Obamacare turns bad?
« Reply #13 on: May 17, 2018, 10:06:56 AM »
Are there any countries that actually allow you to do this?  Just curious.

Jrr85

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Re: Which country to move to if Obamacare turns bad?
« Reply #14 on: May 17, 2018, 10:11:06 AM »
It might require more than just OMY to earn enough to cover 25x of the rapidly rising cost of healthcare / insurance. We're talking about the next biggest expense after housing that is inflating at 10%+ per year. How does one budget for the cost of insurance 10 years or 20 years from now at that rate of growth?

Let's say as of now my employer provided plan would cost $13k to replace. 13k x 25 = $325k. How many years that takes to save is a factor of your circumstances. However, if the cost rises to twice that amount in a decade, you now need more like $600k, and on and on through the decades the amount required to cover healthcare escalates.

This is my point: It is no longer enough to focus on earning, investing, and frugality. Unless a whole lot of people with dreams of someday retiring raise a whole lot of hell, the status quo will be with us for decades to come and FIRE (with healthcare) will be out of reach even for millionaires.

It can't and won't inflate at 10% per year.  It can take a greater percentage of our income as we get richer, but that's not going to allow it to continue to grow much longer.  Hell, it would have already slowed down now if not for so much government money flowing into it. 

jlcnuke

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Re: Which country to move to if Obamacare turns bad?
« Reply #15 on: May 17, 2018, 11:08:07 AM »
The first question to ask is what countries would take you?  Then you can start comparing those choices..

mozar

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Re: Which country to move to if Obamacare turns bad?
« Reply #16 on: May 17, 2018, 04:02:36 PM »
You can move to an expat community in Mexico, or you could rent out a room in your house which should more than cover health insurance.  Local politics matter too. I live in a state that you could get reasonable priced health insurance before aca through the state and i expect we will still have it after the aca.

Dave1442397

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Re: Which country to move to if Obamacare turns bad?
« Reply #17 on: May 17, 2018, 04:25:06 PM »
Other countries can't afford to take in more people on their healthcare systems.   Some countries like Ireland if you even have enough $ to qualify to stay will not let you use their healthcare.

Yeah, they learned their lesson during the Celtic Tiger period, when the rest of Europe found out that Ireland had the best welfare system going at the time.

Even with 'free' healthcare, you still have to pay extra for faster/better care. Last time I talked to my (retired) parents about it, they were paying an extra 400/month for a VHI plan. My Dad's meds had also gone up from less than 50/mo to over 200/mo, so it's hard to predict costs anywhere these days.

As for Canada, my sister has had a lot of issues dealing with the healthcare system there. Tests for scary things, like suspected cancer, can take way longer than they would here in the US.

jim555

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Re: Which country to move to if Obamacare turns bad?
« Reply #18 on: May 17, 2018, 04:54:39 PM »
No county is going to be taking in people who don't intend to work.  Visas are for people with specific skills needed in that country. 

Marriage or by descent are the easiest paths to a visa/citizenship.

calimom

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Re: Which country to move to if Obamacare turns bad?
« Reply #19 on: May 17, 2018, 07:01:06 PM »
Are there any countries that actually allow you to do this?  Just curious.

This is a head scratcher for me too. It seems pretty drastic to randomly move to any country in the worldsimply to avoid paying for healthcare premiums for one person.

maizeman

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Re: Which country to move to if Obamacare turns bad?
« Reply #20 on: May 17, 2018, 08:27:09 PM »
No county is going to be taking in people who don't intend to work.  Visas are for people with specific skills needed in that country. 

Marriage or by descent are the easiest paths to a visa/citizenship.

Lots of countries have "investor" visas. This includes some members of the Schengen Area, so citizenship would ultimately let you live in most of the EU.

Many other countries (generally in south/central america or southeast asia) offer pensioner visas where you get in specifically for A) showing proof of substantial* passive income B) committing to NOT work in your host country.

*Well substantial by local standard of living comparison anyway. I think in Costa Rica you need $1,000/month in passive income.

JoJo

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Re: Which country to move to if Obamacare turns bad?
« Reply #21 on: May 17, 2018, 09:52:58 PM »
We might know a lot more a year from now, but the assumption that Obamacare subsidies for high asset non-workers will continue is not reasonable.

To quit now with such a razor thin room for error is also not reasonable.

Paul der Krake

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Re: Which country to move to if Obamacare turns bad?
« Reply #22 on: May 17, 2018, 09:59:34 PM »
If you have to ask, you're not ready to live overseas.

pecunia

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Re: Which country to move to if Obamacare turns bad?
« Reply #23 on: May 18, 2018, 06:52:18 AM »
Quote
Yes, there comes a time to give up on a nation where everyone has gone batshit. But nobody on this board is fleeing Syria, North Korea, or Honduras. We're talking about how to get cheaper insurance, a situation 99% of us have yet to lift a finger to improve.

What can we really do?  Seems like both major parties in US are bought.

This does seem like something that both makes moral and financial sense to change.  It is a matter of life and death.  Is it just too abstract for people to sit up and notice?  I think if enough people got fired up we'd see some changes.

I wonder if people just don't know.  Commercial TV won't tell you because they depend on the advertising for pills.  There's all sorts of stuff on the internet, but there is a lot of stuff in general like UFOs and ancient aliens.

Here's the thing that kind of sticks with me.  In the Spring of 2017, they tried to get rid of Obamacare.  Mr. Trump said he was going to replace it with something that was terrific.  I saw films of people protesting their politicians because if they took away health care they would die.  I saw facts and figures that millions of people would lose their heath care if they did this.  They almost did it, but John McCain came out of the hospital and voted it down.  Right wing media then said bad things about him.

So, what is recommended by the wise Mustachians to do to help fix this?  It seems kind of basic to help sick people.

Mr Mark

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Re: Which country to move to if Obamacare turns bad?
« Reply #24 on: May 18, 2018, 07:09:38 AM »
No county is going to be taking in people who don't intend to work.  Visas are for people with specific skills needed in that country. 

Marriage or by descent are the easiest paths to a visa/citizenship.

that's not true. A big stache will get you into lots of places. A nice option would be Malaysia.  Good food, decent and cheap healthcare, English speaking, and tax free.

https://en.wikipedia.org/wiki/Malaysia_My_Second_Home

ChpBstrd

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Re: Which country to move to if Obamacare turns bad?
« Reply #25 on: May 18, 2018, 08:48:36 AM »
Quote
Yes, there comes a time to give up on a nation where everyone has gone batshit. But nobody on this board is fleeing Syria, North Korea, or Honduras. We're talking about how to get cheaper insurance, a situation 99% of us have yet to lift a finger to improve.

What can we really do?  Seems like both major parties in US are bought.

This does seem like something that both makes moral and financial sense to change.  It is a matter of life and death.  Is it just too abstract for people to sit up and notice?  I think if enough people got fired up we'd see some changes.

I wonder if people just don't know.  Commercial TV won't tell you because they depend on the advertising for pills.  There's all sorts of stuff on the internet, but there is a lot of stuff in general like UFOs and ancient aliens.

Here's the thing that kind of sticks with me.  In the Spring of 2017, they tried to get rid of Obamacare.  Mr. Trump said he was going to replace it with something that was terrific.  I saw films of people protesting their politicians because if they took away health care they would die.  I saw facts and figures that millions of people would lose their heath care if they did this.  They almost did it, but John McCain came out of the hospital and voted it down.  Right wing media then said bad things about him.

So, what is recommended by the wise Mustachians to do to help fix this?  It seems kind of basic to help sick people.

Are both political parties bought? I have friends who feel the ability to repeat this assumption and swear off political participation is a mark of sophistication. However, I also see lots of social media memes that seem to assure me that the entire political system is rotten, political participation is naive, and probably a system with a "strong leader" could do a better job governing than democracy. Who devotes their days to making these memes? Do they use bots to spread them? Was I targeted to receive this message? What's their agenda, anyway? Asking such questioning is a 21st century survival skill just like questioning the assumption one needs an SUV "to haul stuff" as seen on TV.

Your request for concrete steps is a good one. Here are some steps:

1) Google your state's secretary of state or elections commission. Find out the following:
     a) How to register to vote
     b) What elections are coming up (e.g. primaries, local elections, special elections)
2) Register to vote.
3) Look up the websites for each candidate and determine how their values align with yours. If the websites are vague, send the campaign your questions. You can sometimes learn the most about candidates by examining their endorsements - do these groups align with your values? Remember, you will not find a perfect match. Good enough is good enough. You might find the perfect person to vote against, though.
4) Once you have decided who to vote for (or against!) look into casting an early ballot. This saves time.
5) Let your friends know who you support and why. Campaigns sometimes spend dozens of dollars per voter to try to obtain a fraction of the influence you would have in a conversation or social media post. Does this require a bit of social courage? Yes! But actions such as this undermine the influence of money in politics. You can't be against the influence of money in politics while also not undermining it! Also, you have contributed to normalizing political activity, going against the grain in a culture that increasingly celebrates cynicism and apathy. Cynicism and apathy are why drug companies can extort people for lifesaving pills that cost a few dollars to make, yet have a six-figure price. It's why people think this awful situation is as good as it gets. Fight the big money and fight the apathy.
6) Find something you are buying that does not align with your values. E.g. Starbucks lattes, cable, faster-than-necessary internet or data plans, name-brand detergent,... even for mustachians there's always something. Donate the annual savings to candidates who support your values. Maybe it's only $15, or $50. Maybe it's thousands. Do it anyway. None of our budgets even remotely align with our values, so this should not be painful.
7) Host an "I voted" party, where the ticket for admission is an "I voted" sticker. Buy a shitload of beer. There's no need to talk politics at the party if your friends are ideologically diverse - just enjoy each other's company and normalize democracy. Again, this totally undermines money in politics and defeats those social media messages influencing people not to vote.
8) If you find a candidate who agrees with you on 70-80% of issues - holy shit, go all in. Ask if there are opportunities to volunteer. Figure out how you can raise funds, etc.
9) Learn leadership and public speaking. Find a local club of Toastmasters International, make a bunch of new less-apathetic friends, and be transformed within a year into someone who can confidently introduce a candidate at a rally, someone who can give an elevator pitch to support your values, and someone who has the potential to lead. This opens doors to many more ways to contribute and is also a good way to get a promotion at work.
10) Attend public events such as candidate forums, campaign events, debates, or city hall meetings. Ask questions in person. This nudges leaders to commit to positions or moderate positions you disagree with. Public pressure moves the needle and journalists write this stuff down.


expatartist

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Re: Which country to move to if Obamacare turns bad?
« Reply #26 on: May 18, 2018, 09:54:27 AM »
No county is going to be taking in people who don't intend to work.  Visas are for people with specific skills needed in that country. 

Marriage or by descent are the easiest paths to a visa/citizenship.

that's not true. A big stache will get you into lots of places. A nice option would be Malaysia.  Good food, decent and cheap healthcare, English speaking, and tax free.

https://en.wikipedia.org/wiki/Malaysia_My_Second_Home

+1 for Malaysia. Very hot all year round, but great cultures and quite affordable cost of living outside Kuala Lumpur. Need to keep US$50k in an interest bearing account for the visa.

Thailand has a good retirement visa program for over-50s, with about half that amount required.

Both countries have excellent and affordable healthcare, and are geared towards medical tourism - Thailand more so than Malaysia.

The Philippines has even cheaper retirement visa options.

Also, Asian cultures are IMO better socially for the aged than in the west, one is given more respect here - I'm not Asian but have been based on the continent for 15 years.

For Europe, things are a good deal more expensive and more difficult. Portugal has become popular among retirees and is growing more expensive. I'm eyeing the Greek golden visa option, my reasons for moving to Greece aren't healthcare-related though.

At the end of the day, if we choose to move to another country, it's crucial to ask Why? If you're doing it to take more than you give back to your host country, you'll probably end up disappointed.

jim555

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Re: Which country to move to if Obamacare turns bad?
« Reply #27 on: May 18, 2018, 10:37:56 AM »
No county is going to be taking in people who don't intend to work.  Visas are for people with specific skills needed in that country. 

Marriage or by descent are the easiest paths to a visa/citizenship.

that's not true. A big stache will get you into lots of places. A nice option would be Malaysia.  Good food, decent and cheap healthcare, English speaking, and tax free.

https://en.wikipedia.org/wiki/Malaysia_My_Second_Home
I was thinking along the lines of countries like Canada, UK, Australia, Germany with some form of national health.  SE Asia is also an option with the main advantage of low cost.

Jrr85

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Re: Which country to move to if Obamacare turns bad?
« Reply #28 on: May 18, 2018, 10:46:35 AM »
Quote
Yes, there comes a time to give up on a nation where everyone has gone batshit. But nobody on this board is fleeing Syria, North Korea, or Honduras. We're talking about how to get cheaper insurance, a situation 99% of us have yet to lift a finger to improve.

What can we really do?  Seems like both major parties in US are bought.

This does seem like something that both makes moral and financial sense to change.  It is a matter of life and death.  Is it just too abstract for people to sit up and notice?  I think if enough people got fired up we'd see some changes.

I wonder if people just don't know.  Commercial TV won't tell you because they depend on the advertising for pills.  There's all sorts of stuff on the internet, but there is a lot of stuff in general like UFOs and ancient aliens.

Here's the thing that kind of sticks with me.  In the Spring of 2017, they tried to get rid of Obamacare.  Mr. Trump said he was going to replace it with something that was terrific.  I saw films of people protesting their politicians because if they took away health care they would die.  I saw facts and figures that millions of people would lose their heath care if they did this.  They almost did it, but John McCain came out of the hospital and voted it down.  Right wing media then said bad things about him.

So, what is recommended by the wise Mustachians to do to help fix this?  It seems kind of basic to help sick people.

Not that both parties aren't bought, but the problem with healthcare (and entitlements) is not the political parties, it's the voters.  Voters want all the first class healthcare they can consume and for somebody else to pay for it.  Democrats had to lie to voters to get Obamacare passed because if they had been honest that yes, universal care is going to cost more money and require more taxes, they couldn't have passed it.  Similarly, they couldn't go to nationalized care and made the trade-off in quality/availability because voters (the vast majority of whom are happy with their health care, if not the cost) wouldn't have accepted being told that they were going to lose their current coverage, but they'd still get adequate coverage at a cheaper cost.  Voters are simply unwilling to accept trade-offs, and so no politician is going to be honest about how to "fix" healthcare, which will generally either involve moving towards a nationalized system, or moving towards more of a market based system, but in either case moving away from the bastardized system we have now where the government won't allow the pricing mechanism to work, but also won't impose cost controls. 

havregryn

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Re: Which country to move to if Obamacare turns bad?
« Reply #29 on: May 18, 2018, 11:05:21 AM »
There are a lot of schemes that let you buy EU citizenship for what is not a lot of money compared to what out of pocket healthcare would cost you in the US.
Some are a bit sketchy ( you get yourself adopted by an elderly Spanish person for example)  but they're out there. If I were you I'd do that. If it was really that much of an issue the EU would  have legislated it away by now, plus I would not never judge a person for wanting to get away from a system that makes it difficult to access healthcare if you choose not to work. It should be a basic human right.
With EU citizenship you can generally live in any of the member states and many are just fine to live speaking only English.

phred

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Re: Which country to move to if Obamacare turns bad?
« Reply #30 on: May 18, 2018, 11:13:31 AM »
At age 47 you are too old -- unless you can gain resident alien status due to having two million you can deposit in one of their banks.

phred

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Re: Which country to move to if Obamacare turns bad?
« Reply #31 on: May 18, 2018, 11:16:04 AM »
Good food, decent and cheap healthcare, English speaking, and tax free.

Not entirely tax free.  You would still owe your American income tax.  Planning to give up American citizenship?  You will pay fees for that option

pecunia

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Re: Which country to move to if Obamacare turns bad?
« Reply #32 on: May 18, 2018, 12:07:24 PM »
Quote
Not that both parties aren't bought, but the problem with healthcare (and entitlements) is not the political parties, it's the voters.  Voters want all the first class healthcare they can consume and for somebody else to pay for it.  Democrats had to lie to voters to get Obamacare passed because if they had been honest that yes, universal care is going to cost more money and require more taxes, they couldn't have passed it.  Similarly, they couldn't go to nationalized care and made the trade-off in quality/availability because voters (the vast majority of whom are happy with their health care, if not the cost) wouldn't have accepted being told that they were going to lose their current coverage, but they'd still get adequate coverage at a cheaper cost.  Voters are simply unwilling to accept trade-offs, and so no politician is going to be honest about how to "fix" healthcare, which will generally either involve moving towards a nationalized system, or moving towards more of a market based system, but in either case moving away from the bastardized system we have now where the government won't allow the pricing mechanism to work, but also won't impose cost controls.

I think most voters would both understand and accept that limitations would be placed on any medical program.  I also think it would have to be phased in.  They could start a program and just call it "Basic Care" and I bet they would get millions to sign up  There would have to be a copay to prevent abuse.  I realize all people aren't like me where the mortician is practically knocking on the door before I go to the doctor.

It's just a reality that there would be limitations.  They can't do everything.  We wouldn't be able to afford our wars.

We have a market based system now and it doesn't work.  I saw a conversation on a Spanish TV show where they were saying that some things should not be left to the free market.  I couldn't help but think that attitudes are quite different elsewhere.

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Re: Which country to move to if Obamacare turns bad?
« Reply #33 on: May 18, 2018, 03:06:09 PM »
Quote
Not that both parties aren't bought, but the problem with healthcare (and entitlements) is not the political parties, it's the voters.  Voters want all the first class healthcare they can consume and for somebody else to pay for it.  Democrats had to lie to voters to get Obamacare passed because if they had been honest that yes, universal care is going to cost more money and require more taxes, they couldn't have passed it.  Similarly, they couldn't go to nationalized care and made the trade-off in quality/availability because voters (the vast majority of whom are happy with their health care, if not the cost) wouldn't have accepted being told that they were going to lose their current coverage, but they'd still get adequate coverage at a cheaper cost.  Voters are simply unwilling to accept trade-offs, and so no politician is going to be honest about how to "fix" healthcare, which will generally either involve moving towards a nationalized system, or moving towards more of a market based system, but in either case moving away from the bastardized system we have now where the government won't allow the pricing mechanism to work, but also won't impose cost controls.

I think most voters would both understand and accept that limitations would be placed on any medical program.  I also think it would have to be phased in.  They could start a program and just call it "Basic Care" and I bet they would get millions to sign up  There would have to be a copay to prevent abuse.  I realize all people aren't like me where the mortician is practically knocking on the door before I go to the doctor.

It's just a reality that there would be limitations.  They can't do everything.  We wouldn't be able to afford our wars.

We have a market based system now and it doesn't work.  I saw a conversation on a Spanish TV show where they were saying that some things should not be left to the free market.  I couldn't help but think that attitudes are quite different elsewhere.
  Government pays for almost 2/3's of health care.  Private insurance (largely tax advantaged employer plans and now subsidized individual plans) covers another ~20%, with somewhere in the neighborhood of 10% actually being paid for by the actual recipient.  Not to mention that the government puts a stranglehold on the supply of doctors.  That is "market based" in the sense that there is a market, but it bears no relationship to what people mean when they say market based, where a pricing mechanism is used to both allocate goods and services and to inform decisions impacting supply and demand.  You can have a lot of intervention and still have a more or less functioning free market; but you have to allow for some possibility of a pricing mechanism to reasonably call it free market.

In the one area where we more or less let a free market operate in healthcare, which is cosmetic procedures, inflation has been lower than CPI.  We're not ever going to allow general healthcare to operate like that (and for emergency services, we couldn't), but we don't have to have such a stupid system that there is no functioning pricing mechanism. 

affordablehousing

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Re: Which country to move to if Obamacare turns bad?
« Reply #34 on: May 18, 2018, 03:14:40 PM »
New Zealand would be a great choice but I think the minimum buy-in for citizenship and free healthcare there is $2.5MM invested in the New Zealand market. But you get good weather, English speakers, free healthcare, liberal politics, hobbits, and a low likelihood nuclear target. That would be my choice. If you sell your house how much more $$ can you raise?

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Re: Which country to move to if Obamacare turns bad?
« Reply #35 on: May 18, 2018, 04:19:40 PM »
New Zealand would be a great choice but I think the minimum buy-in for citizenship and free healthcare there is $2.5MM invested in the New Zealand market. But you get good weather, English speakers, free healthcare, liberal politics, hobbits, and a low likelihood nuclear target. That would be my choice. If you sell your house how much more $$ can you raise?

Fascinating. Just researched this quickly, and it appears to be just under $2.5M. If my family wasn't all reasonably close by (a 2ish hour flight), I would definitely consider this.

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Re: Which country to move to if Obamacare turns bad?
« Reply #36 on: May 18, 2018, 05:39:16 PM »
Quote
In the one area where we more or less let a free market operate in healthcare, which is cosmetic procedures, inflation has been lower than CPI.

I guess there is some difference from cosmetic surgery which in most cases is voluntary and other medicine which will keep you from dying. 

Maybe the Spaniards were right simply because the power of choice is largely removed from much medicine.  It can be kind of looked at like a protection racket.  "Hey Bud - If you want to live I guess you give up the house or its the box in the ground."



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Re: Which country to move to if Obamacare turns bad?
« Reply #37 on: May 19, 2018, 02:42:52 AM »
OP are you willing to work? Or are you wanting to change to another line of work? Is your background in something practical or at all high demand? NZ and Aus have jobs for skills in high demand, my husband was easily hired to work as a water engineer in Aus but he was younger (~40) at the time. The jobs can lead to permanent residency.

If you're interested in starting a business, Germany and the Netherlands both have great and affordable options for starting up a business for US citizens. I believe there's virtually no age restriction. You can get EU residency in 5 years and a NL passport in 5 and German in 8. However the NL and many other EU countries have a wealth tax, something to beware of if having tax residency there. Makes for a great option if you're a retiree with a pension who doesn't own a home; not so great if you have assets.

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Re: Which country to move to if Obamacare turns bad?
« Reply #38 on: May 19, 2018, 07:31:12 AM »
OP are you willing to work? Or are you wanting to change to another line of work?

This OP likes to hit and run with the threads he starts.  But he did mention in bold letters in the OP, "Once i FIRE, i am not going back to work. "

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Re: Which country to move to if Obamacare turns bad?
« Reply #39 on: May 19, 2018, 10:18:23 AM »
When I first read the post his wording was not as absolute as it is now, more ambiguous, not bolded.

There are a number of good visas available for people who want to start a business.

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Re: Which country to move to if Obamacare turns bad?
« Reply #40 on: May 21, 2018, 11:33:55 AM »
New Zealand would be a great choice but I think the minimum buy-in for citizenship and free healthcare there is $2.5MM invested in the New Zealand market. But you get good weather, English speakers, free healthcare, liberal politics, hobbits, and a low likelihood nuclear target. That would be my choice. If you sell your house how much more $$ can you raise?

If you're looking for English-speaking countries, Ireland and the UK also offer investor visas that offer a path to citizenship with no work requirement. The amounts are higher than the OP plans to FIRE with though. Ireland requires a 2 million net worth, with the required investment either being 1 million in a local business (not publicly traded stocks) or 2 million in Irish REITs. A 500k charitable donation is also accepted in lieu of an investment. The UK requires a 2 million investment, which can be invested in UK-based publicly traded securities.

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Re: Which country to move to if Obamacare turns bad?
« Reply #41 on: May 21, 2018, 12:19:36 PM »
In most countries, you don't need citizenship to get affordable healthcare.  You can easily stay somewhere for months with a tourist or retiree visa and then move on to the next country.  That's pretty much my plan if Obamacare gets scrapped.  It's sort of my plan anyway because I want to travel and visit a lot of different countries.

I've been researching this and in many places, you don't need health insurance because the bills you will be charged for healthcare are simply affordable anyway.  GoCurryCracker has some details about this on his blog if I recall.  I'm thinking about Mexico, Colombia, Ecuador, Thailand, Malaysia, Viet Nam.

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Re: Which country to move to if Obamacare turns bad?
« Reply #42 on: May 21, 2018, 01:55:58 PM »
I see lots of Americans talking about joining the global refugee crisis in search of democracies with benefits.

Yet this is the same country where most people don't vote and where voting participation hit a 20 year low in 2016. This is a culture where people think you're a weirdo for admitting you're an activist, donating money, or volunteering on a campaign, yet it's perfectly normal to spend 10-15 hours a week watching TV or consuming internet propaganda. It's a strange place where people routinely spend $400/month on gasoline, but if you ever admitted donating $200/year to a cause or campaign then you must be some wild-eyed radical and people aren't sure they can be friends with you.

The U.S. proves how fast the shit can go downhill if apathy and media overconsumption reaches a critical mass. Why should any other country take the risk of admitting a bunch of Americans to come over and contribute nothing to their democracy, spreading cynicism just like they did back home?

If you vote in every election, persuade others to vote, raise or donate at least $150/year, and display a yard sign or t-shirt, then you might have a decent resume' to join one of the world's vulnerable democracies that have a better-organized healthcare system than the U.S. Yet it is unclear even then why nations trying to strengthen their governance systems against an onslaught of manipulative foreign authoritarians should take on citizens who have learned to think of democracy in transactional terms rather than as a value-driven lifestyle and obligation.

Yes, there comes a time to give up on a nation where everyone has gone batshit. But nobody on this board is fleeing Syria, North Korea, or Honduras. We're talking about how to get cheaper insurance, a situation 99% of us have yet to lift a finger to improve.

Fucking brilliant

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Re: Which country to move to if Obamacare turns bad?
« Reply #43 on: May 21, 2018, 02:27:38 PM »
Quote
In the one area where we more or less let a free market operate in healthcare, which is cosmetic procedures, inflation has been lower than CPI.

I guess there is some difference from cosmetic surgery which in most cases is voluntary and other medicine which will keep you from dying. 
 
Maybe the Spaniards were right simply because the power of choice is largely removed from much medicine.  It can be kind of looked at like a protection racket.  "Hey Bud - If you want to live I guess you give up the house or its the box in the ground."

There are differences, but the doc's in cosmetic fields make a comparable amount to those doctors in other fields.  And most healthcare isn't of the you're going to die if you don't get this care immediately variety.  You'd have to have some regulation around pricing, particularly transparency and non-discrimination, to make sure health care providers don't charge more based on the perceived desperation of the patient.  But it'd be hard to do worse than we are doing now.

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Re: Which country to move to if Obamacare turns bad?
« Reply #44 on: May 21, 2018, 02:53:55 PM »
Thanks for the info in this thread.  DW and I are probably ~6-8 years away from FIRE, aged 41 and 37, with a 3 yo.  We're planning to try relocating to Canada in the next couple of years, with the intention of working there for a while, then retiring early.  Healthcare is part of our motive (though not the largest part).

It was interesting to learn about some of the other options.  Personally, I like SE Asia (I lived in Taiwan for a number of years, and traveled around a fair bit) but my wife is more interested in a place where our daughter could feel at home (ie wouldn't always be identifiable as an expat).  We'll see!

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Re: Which country to move to if Obamacare turns bad?
« Reply #45 on: May 21, 2018, 06:19:35 PM »
In most countries, you don't need citizenship to get affordable healthcare.  You can easily stay somewhere for months with a tourist or retiree visa and then move on to the next country.  That's pretty much my plan if Obamacare gets scrapped.  It's sort of my plan anyway because I want to travel and visit a lot of different countries.

I've been researching this and in many places, you don't need health insurance because the bills you will be charged for healthcare are simply affordable anyway.  GoCurryCracker has some details about this on his blog if I recall.  I'm thinking about Mexico, Colombia, Ecuador, Thailand, Malaysia, Viet Nam.

Healthcare while traveling works for acute situations, but will not be an option for chronic illness, the devastation of cancer, or MedEvac situations. A retiree visa can gain you residency in a place but little else.

Something not mentioned yet on this thread - when you're ill, having supportive friends and family around is really important. This deep support network isn't something you can create easily when in a foreign country. Friendships tend to be transitory among expats since we move so much, and can often be relatively superficial. It takes time to build a good life with trusting friendships.

ETA: Treatment for common killers of the western world like cancer and heart disease is *still* not cheap even in countries like Thailand.
« Last Edit: May 21, 2018, 06:25:54 PM by expatartist »

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Re: Which country to move to if Obamacare turns bad?
« Reply #46 on: May 21, 2018, 07:14:07 PM »

Healthcare while traveling works for acute situations, but will not be an option for chronic illness, the devastation of cancer, or MedEvac situations. A retiree visa can gain you residency in a place but little else.

Something not mentioned yet on this thread - when you're ill, having supportive friends and family around is really important. This deep support network isn't something you can create easily when in a foreign country. Friendships tend to be transitory among expats since we move so much, and can often be relatively superficial. It takes time to build a good life with trusting friendships.

ETA: Treatment for common killers of the western world like cancer and heart disease is *still* not cheap even in countries like Thailand.

It can also be extremely difficult to advocate for yourself in a foreign medical system, and that is one of the most critical aspects of getting effective healthcare for serious or chronic issues.

Im Canadian, so I know very little about American healthcare, but what did people do before ACA? Was there a different system in place? Or has this always been a major retirement concern in the US before ACA?

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Re: Which country to move to if Obamacare turns bad?
« Reply #47 on: May 21, 2018, 10:14:14 PM »
Im Canadian, so I know very little about American healthcare, but what did people do before ACA? Was there a different system in place? Or has this always been a major retirement concern in the US before ACA?

I think the following is mostly right.  If not I'm sure someone will be along to correct me.

Before the ACA, I think people were either on Medicare, Medicaid, VA, insurance through their job or school, a private insurance plan (either individual or group), or went uninsured.  For uninsured people, there were sometimes government or private sliding-scale clinics that provided some forms of basic care.  Also, there was a law passed that emergency rooms had to treat and stabilize anyone without regard to ability to pay or insurance coverage.

Individual plans before the ACA could have lifetime maximums for coverage, could write pre-existing condition clauses (so if you already had sought treatment for a hernia, they wouldn't cover a hernia surgery for you once you got coverage), could vary in what they covered (for example, they could exclude coverage for pregnancies or addiction treatment), could charge you more based on your health, could charge women more than men, and could charge you more if you were older.

Pre-ACA, potential FIREes I know were concerned about getting affordable coverage.  Some elected to go on COBRA, which is a law that allowed someone to stay on the group policy through their employer for 18 months after leaving the company but paying the full premium instead of having the employer subsidize them.  Others joined groups like IEEE and got on group insurance plans that way.  Some considered going back to college and getting covered through the university.  Some were old enough to go on Medicare, or had VA coverage.  Some bought individual catastrophic plans.  Some bought high-deductible comprehensive plans.

Post-ACA, the main thing that seems to have changed is that ACA policies are available now and are subsidized by the federal government on a sliding scale based on income.  ACA policies have minimum essential requirements (MER) which is a list of about 15 things that all policies must cover.  I think even policies that are not sold on the ACA exchanges now have to cover those things, as well as meet all the other ACA requirements:  men and women are charged the same, and there is a maximum ratio (3:1 or 5:1, I can't recall) which limits how much more an insurer can charge older people compared to younger people.  I think there are no more lifetime maximum coverage limits.

When the ACA first came about, FIREes I knew were very excited and viewed the ACA as the missing piece that would enable people to FIRE without as much concern about healthcare costs.  Worry about this aspect of FIRE seemed to drop for a few years.

Now people seem to be worried again about the ACA and what changes may be made to the law or what the next iteration of US healthcare will look like.

I would say that the level of concern overall now is higher than it was before, although that's pretty subjective and I'm not sure why that would be.  I think it is simply that there is now a government program that people hope and plan to rely on that might not be there or might look different in the future.  So whereas FIREes before assumed they had to do it themselves, FIREes now hope the government will help and if the government decides to help less, then that feels like something is being taken away.

Personally, I thought about this before I chose to FIRE two years ago, and I somewhat casually decided that the ACA would be around for at least a few years and whatever came after that I could probably find something that would work for me.  My logic is that I'm a pretty typical American, and so whatever we come up with next will have to work for most people, so it is likely to work for me as well.

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Re: Which country to move to if Obamacare turns bad?
« Reply #48 on: May 22, 2018, 04:14:06 AM »
^thanks for the explanation! Much appreciated.

pecunia

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Re: Which country to move to if Obamacare turns bad?
« Reply #49 on: May 22, 2018, 06:15:28 AM »
Secondcor521:

Quote
Others joined groups like IEEE and got on group insurance plans that way.

This is good information.  What other organizations will provide health (not life) insurance?  Could this be an option rather than moving abroad?  I've received mail from organizations I belong to but they are only peddling life or car insurance.

I also know people who have retired a few years early who find a part time job.  They use the money from the part time job to pay their health care premiums.  They could possibly still be reduced through Obamacare, I don't know.

Perhaps either of these could be considered alternatives to leaving the USA.