I'm currently in Italy myself, and my father was visiting me and got a nasty case of pneumonia on the way over. Here in italy care is (mostly) free,as is his hospital stay here in genova. While it may be not to the full American standard, his care has been great, and the staff wonderful.
I'm glad to be in a system here where Healthcare is good, and affordable, and that with this episode my father is not bankrupted or in considerable debt because of it, especially as an elderly patient. La dolce vita.
Germany requires immigrants to have private health insurance until they are granted permanent residence/citizenship. That insurance can have restrictions on pre-existing conditions and/or be prohibitively expensive.
If you are already an EU citizen the rules can often be quite different than as a US passport holder.
I am not a global expert in immigration law though and I'm now going to research Italy. ;-)
Thank you!
This is not true! I'm in Germany since 2012 and still don't have permanent residence permit, but have public health insurance from day one.
I think you're conflating a few different terms and perhaps not fully understanding what is meant by public and private insurance in Germany?
If you can manage the visa issue then you can get excellent care at a tiny fraction of what you pay in the US. Over the years I have had surgery, been hospitalized for an illness, had a fair amount of dental work, and had thorough medical exams annually. It's not just the low cost. The service and hospitality is unlike what I ever experienced in the US.
> Thailand. They don't give permanent residency here anyway.
While the process is difficult and there are caps on how many people can receive it each year, people can and do obtain permanent residence in Thailand. I know a number of people with PR, they're all businesspeople who have been here for many years.
> start[ing] a business (expensive and designed to fleece foreigners, beware).
The Thai Board of Investment provides a number of attractive incentives, including a 5 year income tax holiday(!), to foreigners starting a technology business who are willing to commit to modest capital and hiring requirements. Doing business in Thailand is difficult in other ways (limited technical talent, limited and poor English skills, high compliance burden), but I wouldn't characterize BOI as a scheme to fleece foreigners at all. If you are incorporating without a BOI promotion then things are much less attractive, but most software businesses with an intent to hire a few employees will qualify pretty easily.
> you can get excellent care at a tiny fraction of what you pay in the US
True but with caveats. When it comes to affordable, good health care, "better than the US" is not a meaningful standard. The US is a shameful failure in this regard. That said, the cost and quality of health care in Thailand are pretty good--aside from a good private system, Thais and foreigners on long-term visas get free universal health care at government hospitals(!), some of which are pretty good. But it should be noted that private insurance in Thailand carries a number of limitations, such as maximum lifetime payouts and long lists of conditions which aren't covered. In short, the Thai system serves medical tourists very well, but if you're looking for lifelong, comprehensive coverage, things get complicated.
My personal opinion is that Thailand is trying in this area, but currently isn't the best place for most tech businesses to incorporate unless they want access to the Thai market. The main reason for this is the limited talent pool. For some businesses, BOI incentives and the low cost of operating here may make up for this. Either way, Thailand is still a pretty amazing lifestyle destination, and for freelancers/remote companies/very small biz level there are a few options to stay here long-term (Iglu, Elite visa, etc.).
That's interesting. What type of long-term visas qualify foreigners for universal health care?
Some of the government hospitals are good as you said. I had foot surgery at Siriraj Hostpital, Thailand's oldest and biggest government hospital. While the facilities are old and tired-looking the care was excellent and the doctor was outstanding, this guy https://sites.google.com/site/ankleclinic/aboutus. But I went during their "special clinic hours" which is the same facilities but different hours than when the universal health care patients are treated. Unlike the regular hours, during special clinic hours you have to actually pay for services.
They assign you to a particular hospital when you enter the program, and you're entitled to free care at this hospital, if you need a procedure they can't perform, they'll refer you to another government hospital which will also be free. Waiting periods sometimes are long, so it's a good idea to have private insurance as well. Foreigners in Bangkok at the moment all seem to be getting assigned to a hospital in Phrakanong which has a pretty good reputation. You can change your assignment later, I've heard the Police General Hospital on Rama I is very good.
I've heard it's also possible to remain in the program after your employment ends if you pay a small monthly fee (maybe $15).
There is also a Thai equivalent of the USA's social security program, though the payouts are very modest.
Overall it is a good system, you just have to be aware of the limitations of Thai insurance in catastrophic cases (probably I will switch to an expensive expat health insurance plan in the next year or two because of this).
This was the most pronounced in South Korea, because it is so advanced technologically but somehow still has that SEA feel of wanton medical incompetence. It catches you by surprise more.
Massive doses of antibiotics no matter what, IVs for no good reason, X-ray to check for head lice (!!)... fun stuff.
I heard medical care in Singapore and HK can be excellent though. Interesting to hear you've had such a good experience in Thailand, it was the opposite for us (GP, dental, surgical -- you name it, it sucked, even in ?top? places like the Bangkok Hospital). Where did you go?
I've had dental work at Bumrungrad, Bangkok Hospital and more recently been going to a small dental clinic near my home. Besides regular checkups and cleanings I had a redo of a root canal that was done in the US and went bad after moving to Thailand, got a new crown, and had some old fillings replaced - excellent care in all cases and particularly the dental clinic has the latest and greatest dental tech.
I have also been getting annual medical exams since moving here 15 years ago, at Bumrungrad, Phayathai, St Mary's Korat, and Bangkok Hospital (Korat and Pak Chong branches). They have always been routine and efficient. The weak spot is the consultation with the GP after all your results are in - some of them a pretty dopey and I would guess it is those guys that are going to be a bad experience if you see one of them for an ailment.
Those are all anecdotes, of course. YMMV.
The system here is a safe haven in other means as well. As a citizen, you are qualified for equal treatment and costs to those in your hometown in other EU countries as well. You can be abroad for up to a year and any medical emergency within the EU would be covered by the state. It's almost backward but I feel like my peers don't want to travel as much when they are young, partly because they know the medical systems in other parts of the world can screw them up.
Cost of living is VERY HIGH though compared to income and even in absolute terms (about the only cheap thing is healthcare :) though if you earn 70k / year you're set unless you want to live in an U.S.-sized house and drive an U.S. sized car) and bureaucracy is very bad.
Immigration systems are currently collapsed because of the flood of Venezuelan refugees, and thousands of Cubans and Dominicans are coming too, so you might have to wait 18 months for the government ID that gives you access to healthcare.