Health Thoughts from Abroad

Technology, pah! A slight problem with my WordPress payments, combined with being on holiday, has prevented me from posting for a week or two. Has anything been happening while I’ve been away?

I was “across the pond” in America, on my annual jaunt to the land milk and honey, which seems to be suffering from a souring of the former and a lack of the latter. It’s good to go away, but it’s always nice to come back too, even if it’s to a Britain that is undergoing a transformation that America might be going through itself soon. Melanie Phillips in The Times is clearly thinking along those lines, and she wrote an excellent Opinion column on the American interest in Brexit this week. Clearly she moves in different circles to that which I do while on holiday – it appears she was fielding questions about geopolitics while I was only regularly responding to the query “Would you like a large fries with that sir?”

Much as I enjoy holidaying in America, I can categorically state I will never retire there, or anywhere else abroad. I doubt I’ll even spend the winter months in any of the P(I)GS (Portugal, Greece, Spain – I’m omitting Ireland as beyond consideration.) I never fancied living in France, and Germany isn’t for me either. If I was heading anywhere for the winter, it would be the Southern States of the good ole US of A, providing President Trump will still let me in. I daydream of happily being a British Snowbird in Miami, and often find that in my mind I’m going to Carolina. Just as long as I don’t get ill – or get shot – while I’m out there. It sometimes feels there’s an equal chance of both.

The thought of falling ill in America must be quite terrifying as you must surely wonder whether or not your insurance policy will cover whatever it is that ails you? Your health is something that you find yourself thinking about a lot more as you head into the retirement years. Fortunately we didn’t have to avail ourselves of any medical services while we were in America, but a friend of ours who suffers from epilepsy made the mistake of forgetting some of her prescription pills on a recent trip to Florida. To cut a long story short, she finally managed to obtain a week’s supply – seven single tablets – for which she was charged $700. Her shock at the cost was only matched by the American medical staff when she told them “But I get these free in Britain!”

This month we’ve heard of two couples we know who “retired abroad” but have decided to return to Britain. I haven’t yet had the chance to talk to them to discover why they’re coming back, but I’m quite interested in finding out. It could be for the NHS, it could be that they’re concerned about us “Brexiting”, it could be that they’re finding Britain offers good value for money these days on a number of fronts, from pension tax breaks to the price of consumer goods. Whatever the reason(s) I suspect that the thought of healthcare might be one of the factors taken into consideration.

I don’t know of anyone who’s successfully emigrated to the US, possibly because it’s actually quite hard to get in there but, as you grow older, the thought of what healthcare you might eventually need to access starts to loom larger in your plans. In America, that just has to be a big worry.

It seems I’ll be reliant on the NHS as a pensioner. For almost thirty years, the various companies I worked for paid into a variety of private health schemes which, as an employee, I was able to access. Fortunately I seldom had to, but that facility literally stopped the same day that I stopped employment. My track record of good health and “my” long history of contributions into private healthcare will count for nothing if I choose to seek out another private policy.

It’s the NHS for me then, just as it is (and will be) for millions and millions and millions of others. But what’s the alternative? Or rather, what alternative do I have that doesn’t cost a mint and acknowledges the money I’ve already paid into the private system and the lack of claims I’ve made on that system so far? When it comes to health in retirement, it seems to me that the private sector is playing in a game where it’s “Heads they win, tails they don’t lose”. Meanwhile the majority of us, who are undoubtedly going to need the NHS at some point in our retirement years, are left reliant on a system that can hardly find a coin to play.

8 thoughts on “Health Thoughts from Abroad

  1. ‘Or rather, what alternative do I have that doesn’t cost a mint and acknowledges the money I’ve already paid into the private system and the lack of claims I’ve made on that system so far?’

    I am a Brit living in the US, where I have a health insurance policy with a high deductible/ excess; this makes for low monthly premiums as I’m paying the first some thousands out of pocket each calendar year. It’s basically catastrophe insurance, while I pay myself for the odd kiddie ear infection doctor visit.

    It combines with a Health Savings Account, into which I can save $6.5k annually tax free, invested in cash/ funds of my choice. I can use this money for medical costs and still pay no tax on withdrawals or, once 65+, can spend it on anything and pay the tax on the way out – it’s like an amped-up pension.

    It essentially solves what you’ve described above – if you stay healthy throughout early/ mid life, you have your own spending pot for the more expensive later years.

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      • True enough… and unless you enjoy that mood of impotent despair, don’t read the book I’ve just finished, ‘Being Mortal’ by Atul Gawande, which is all about how as a society we’re doing end of life care all wrong…

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  2. Health insurance certainly is a problem when you live abroad. We’re in the US right now and my wife got shocked with a $7000+ bill (after insurance pays their part!) for some urgent dental care. The same procedure in Japan is apparently billed $1000, so she is now considering flying to Japan (her motherland) to get the treatment there. That’s how bad health coverage is in the US

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    • I once flew to the US with a newly filled root canal in cold sweat terror over something going wrong with it in the States and no dental cover in my insurance policy. I didn’t fancy nipping to Mexico for treatment, as I have read of Americans doing…..

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  3. May I have a small rant about relying on the NHS. As someone nearly at FIRE I had a glimpse into the future courtesy of my late mother, and did not like what I saw. NHS treatment fine, but what about the B******’s you voted for on your local council. Any money in the bank and your local council will charge you £185 a week for a nice lady to spend 8.36 minutes wiping your backside and pouring milk on your cornflakes, and if things get worse its £42000 plus for an average care home at today’s rates, which rather blows your safe withdrawl rate out of the water! Also bearing in mind when it gets to this stage rather than working out p/e ratio’s and yield curves you are quite happy on planet zog as long as they are spoon feeding you tomato soup and sing along a max is on continuous loop ! so who is left minding the money ? if you are not very careful its the B****’s at the council. No one seems to build this into FI planning. Ok so don’t blow it all on the lambo, but there may well be a case for spending the inheritance by the time planet zog starts to rise in the east.

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  4. What exactly health service wise do you think you will not get with the NHS? Pretty much all emergency and intensive care work is done by the NHS, most oncology and most of the elective stuff like hip replacements. What services do you think you will require which the NHS will not provide?

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