Yes. I'm American but was born in a small country in Eastern Europe. I was planning on moving back during the pandemic, however I was presented with some job prospects I couldn't reject and my move was delayed. But I do plan on retiring in my hometown within two years. There is universal healthcare which sucks for the most part, but private insurance is extremely cheap (compared to the US) and I could retire more than comfortably with my current nw. And by 'retire' I don't mean stop working, I mean I'm going to work on whatever I want.
And to your original point about healthcare, it is the absolute single reason for why I did not take any sabbaticals or long term leave even while burned out, for my insomnia during layoff seasons and generally for my job related stress.
Makes me curious how much marketplace costs vary per state?
In any case, as another person pointed out, the ACA plans also provide very high premium credits for low income households, covering up to ~80% of the costs (from what I've seen). But this also varies by state, I think.
Platforms like Gusto, etc. make it so even small businesses can offer benefits and insurance like bigger companies do.
I went though various big and small employers plans, several states' exchanges, and none were nearly as good as doing the legwork to get benefits setup for my own company. Now I choose.
The minimum payroll is defined by the minimum wage in your local area, keep in mind you can also choose how many hours you work.
Is Gusto for stuff like that? Single member LLCs?
I disagree, I think it's there job to help you reduce your taxes, if they're able to do so legally. I'd look for accountants who think so too.
One step further, being your own doctor when ever possible is even better. Bring out the rusty knife for surgery, a club for anesthesia etc. most surgeries are not rocket science.
Trust me, you want modern medicine, the kind that comes from factories and hospitals. Not what you can cook up in your backyard.
Modern medicine is truly magical, don't let anyone tell you otherwise. We just need to make sure it doesn't bankrupt us to get it.
Assuming that you have done your homework and that you are right. ( a lot of especially young people think that things are magical now, while IMO some things have regressed) .
>We just need to make sure it doesn't bankrupt us to get it.
Why shouldn't a motivated/intelligent layman try and get hold of those devices and learn them? Yes things can go wrong, but what _real_ suggestions you have for people to get procedures done, safely AND reasonably priced?
"Why shouldn't a motivated/intelligent layman try and get hold of those devices and learn them?"
Why don you buy a typewriter and write Shakespeare?
You really just assume that you, untrained and unexperienced would be better than a trained professional? You would really cut open your partner or child, cut out a section of their bowels, sew them back together, and know all the right drugs to give and have the half million dollar anesthesia machine? Do you have the MRI machine you need to diagnose this?
It's the same reason we don't just let anyone work on airliners.
Someone who thinks they can do this is dangerous, and borderline psychopath. I'd encourage them to watch one live surgury first. Saying you can fo something like this without even seeing it once is why this shows too much unfounded confidence. Yikes.
Can tell right away that you aren't too bright. It's attitude like that that gives rise to guilds.
Are you a barbarian from the middle ages?
Last time I went to the ER, the wait was 10h for kidney stones. Thankfully I passed out for 4h in the waiting room from the pain and the stones passed by the time I saw a doctor, so all they did was send me home.
My family doctor died 10 years ago and I'm still on a list.
Sometimes there are information gaps between their capacity and the provincial bureaucracy.
COVID was a big one; lot of doctors decided to just retire at once. But primary care physicians are facing issues of the workforce aging out. I think about 18,000 of the 48,000 primary care physicians are set to retire by 2030, but we only add in about 1600 new primary care physicians a year. So by we'll be down by 8400 primary care physicians by 2030 and then however many years it takes to back fill to 2024 levels.
Meanwhile Canada's increased it's population from 37 million in 2019 to 41 million in 2024, with projections of us hitting around 43 to 44 million by 2030.
Most of it stems from the fact that lot of doctors don't want to be primary care physicians. The hours aren't terrible but the pay is low good compared to their specialist care counterparts, and they have far more administrative overhead then any other specialty. And often the work is miserable and thankless. I can't remember who said it but IIRC family doctors have the highest burn out rate out of all physicians.
This is all third hand information so take it for what it's worth, and I'm assuming that I've got an overly simplified view of the issue. Someone in the medical field could probably answer better then me.
I remember contrasting that with my US experience at the same time, where a 10 minute consult with a doctor cost 600USD. I had a really obvious ear infection, just needed some antibiotics, but he must have seen me as a cash-cow and ordered a ton of unrelated blood tests that were pointless since I was flying out the next day. I walked away feeling like I'd been scammed.
(In Australia a doctor's visit is under 30USD, blood tests don't cost much either)
Your brother was very lucky, or this is fake.
Of course, as with most things, government in South Africa is basically jealous of private medical insurance here and is trying to destroy it because public healthcare is a failure here. We really need to add a third item to this list: Nothing in life is certain, except for death, taxes and the government fucking up everything it touches.
I decided to learn from their experiences and GTFO while I could. I miss my family and friends dearly, but it’s a massive relief (and privilege) to be able to get the care I need and not worry about whether the cost is going to bankrupt me.
It’s not all smooth sailing, though. The immigration agency here (AIMA) currently has 300,000 cases in the queue. It’s so difficult to get an appointment that people are making hundreds of calls per day, standing in queues for hours only to not be seen, and filing lawsuits.
Most people here make about €1200/mo and there’s a severe housing crisis that I have contributed to with my presence. The influx of people like me with vastly higher purchasing power is creating resentment: the far-right party quadrupled (5% -> 20%) their seats in parliament by running against immigration.
Having said that, I do love it here. I’ve been considering blogging about my experience since there’s a dearth of clear-eyed information from real people who moved to Portugal and aren’t selling something.
Anyhow, I’m happy to share more info and resources with anyone who wants to learn more. Please feel free to reach out - my contact info is in my profile.
I have Portuguese friends who relocated to the US (for the salary, rest assured they own homes there to go back to). They're saying there are waits and quality issues.
It’s a breath of fresh air. I’ve had to wait a week or two here and there for exams and tests, sure. My preferred hospital system has a great app where I can book doctor appointments (€15) and see results as soon as they’re available. The system knows what my copay is and I pay it on my way home. That’s the end of it; there are no inscrutable bills in the mail months later for hundreds or thousands.
Here’s an example: due to family history, my doctor recommended an MRI. When she saw my horrified face she told me not to worry. I booked it, got a text from my insurance company a few days later with the approval, and had the exam a week after that. The results were available in the app soon after, including the raw images (not that I have the training to interpret them).
My copay for the MRI was €50. I pay €80/mo for the best insurance available. I’ve never had a claim denial and have never interacted with my insurance company.
Also, for those who require plans similar to the one previously provided, COBRA (18 months) is decent -- expensive but presumably less expensive than "equivalent" in the marketplace if we're talking about a good corporate plan.
Just that COBRA costs quite a lot.
In my state the health insurance marketplace only has 'bronze' plans that are in-network only (with mediocre options) and high deductibles, it costs 6-800 for individual and close to 1500-2k for a family.
The United States has rigged the employment market to forever keep you dependent on a corporate employer until retirement. Now these same companies are taking away remote work, forcing people close to expensive and increasingly annoying cities like New York City, where the median one bedroom is one million to buy.
So, for giving your time to a company, your reward is never being able to be fully independent without huge risk. Healthcare is the Company Store Voucher of the modern era.
Has anyone else considered leaving the United States long before retirement age?