Future Expats Forum » Australia/New Zealand

Which Countries Have the Best Health Care?

FutureExpat — Fri, 29 Jan 2010 21:50:10 +0000

In the Expat Web group on LinkedIn, a member asked recently, “As an Expat, which countries do you think have the best and worst healthcare systems?”

Belgium, Spain, Switzerland, Canada, Malta and France all received positive comments. One poster said Japan’s was “the worst I ever experienced.” The US was mentioned favorably, but “only if you have good insurance. Prices are about 5 to 10 times the costs of France or Belgium.” This kind of anecdotal information is interesting, but not all that useful.

Of course to most expats and would-be expats, especially those of us who are approaching retirement age, health care is an important consideration in where we choose to live. What is its quality? Is it at least as good as what I’m used to? How expensive is it? How accessible is it? Will I have to be in a major city to have quality care available?

So what’s a concerned health care consumer to do?

There’s an interesting bubble chart on the Columbia University website, showing the average life expectancy and health care spending by country.

The US is way off by itself as the biggest spender. But our life expectancy (77 years) lags behind Japan (85), Switzerland, Australia, France, Canada, Norway, Spain, New Zealand, Austria, Korea, Portugal, UK, Luxembourg and Denmark, all of whom spend considerably less (around half!) than we do per capita.

The WHO (World Health Organization) has published a listing of medical care by country. Compiled in the year 2000, it’s a bit outdated, but might provide a good starting point. You can see it here.

A Few Considerations

First, I think it’s safe to assume that the care you’ll receive in rural areas will not be as up-to-date or comprehensive as the care you can receive in major cities. That’s true in the US just as much as anywhere else.

If living in a bustling metro area is not your taste, how fast and easy is transportation to those areas you’re considering? Use your common sense – if your dream retirement is on a remote beach or mountain-top retreat that’s an 8-hour drive over mostly dirt roads to get to the nearest city, that will be an issue in accessing quality health care. If it’s an hour or two over good roads, you’ll have significantly better access.

Are there hot spots of medical tourism in the country you’re considering? If so, you can be pretty well assured those doctors will speak English, have up-to-date training and use modern equipment. According to Business Week:

“The low cost and high quality of medical service is a big selling point for Singapore and Thailand, which have heavily promoted medical tourism in recent years. Hospital costs are as much as one-half what they would cost in the U.S.” Read the entire article here

Other popular medical tourism destinations include Panama, Mexico, Argentina, Brazil, Malaysia, South Korea, India and Israel. There are plenty of websites which discuss medical tourism, as any Google search will show.

Once you’ve narrowed down some possible destinations with health care facilities that will meet your needs, conduct your own research. When you visit the area, ask a lot of questions, find out what other expats do for health care, visit the hospitals and clinics if you can.

Ultimately, as with any other aspect of your move, you need to just do it.

End-of-Year Lists

FutureExpat — Thu, 31 Dec 2009 02:20:59 +0000

International Living’s annual Quality of Life Index. Every year, IL produces a Quality of Life index, which usually differs quite a bit from their recommendations on best places to retire. France has topped the list for several years running.

France (was #1 last year as well)
Australia (moved up from #5 in 2009)
Switzerland (down one spot)
Germany (up from the #8 spot in 2009)
New Zealand (up from #9)
Luxembourg (down from #4)
USA (down from #3)
Belgium (down from #6)
Canada (a big jump up, from #19)
Italy (down from #7)

Top Ten Retirement Havens from Live and Invest Overseas

Argentina
Belize
Chile
Croatia
Dominican Republic
France
Malaysia
Panama
Uruguay
Vietnam

Mercer’s Best Cities for 2009:

Vienna, Austria (1st)
Zurich, Switzerland (2nd)
Geneva, Switzerland (3rd )
Vancouver, Canada (tied 4th)
Auckland, New Zealand (tied 4th)

Forbes list of The World’s Most Expensive Cities to Live. According to Forbes, the 10 most expensive cities are:

Tokyo, Japan
Osaka, Japan
Moscow, Russia
Geneva, Switzerland
Hong Kong, China
Zurich, Switzerland
Copenhagen, Denmark
New York, USA
Beijing, China
Singapore

2009 Best Retirement Havens, according to International Living:

Cuenca, Ecuador
Merida, Mexico
Coronado, Panama
Punta del Este, Uruguay
Calitri, Italy

So there you have it. Some highly respected lists from 2009, and one for 2010.

Best wishes for a happy expat New Year!

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Bahrain: World’s Friendliest Country?

FutureExpat — Wed, 09 Dec 2009 00:40:04 +0000

According to Forbes.com, Bahrain scored the top spot in HSBC’s recent survey of 3,100 expats. They admit this might be a fluke — only 31 responses came in from Bahrain, compared to 450 from the UK, for example. But it’s an interesting list, nonetheless. Canada moved down from its No. 1 spot last year to No. 2, followed by Australia, Thailand, Malaysia, South Africa, Hong Kong, Singapore, Spain, and in the No. 10 spot, the US.

Read the article here, and see the scored list of countries here.

A Town Like Alice: Expat Book Review

FutureExpat — Fri, 16 Oct 2009 01:42:22 +0000

A Town Like Alice by Nevil Shute is multi-layered expat novel, which was made into a TV mini-series in 1981. It has been one of my favorites for a long time, not only because of the expat themes, but because it also features a strong female protagonist who overcomes some truly daunting obstacles. Author Nevil Shute is interesting in his own right. A prolific author, with over 20 novels to his credit, Nevil Shute Norway was by profession an aeronautic engineer and pilot. Shute became an expat himself. He was born in 1916 in London, and emigrated with his wife and daughters to Australia in 1950 following World War II. His books strongly reflect his love of airplanes and flying, and his adopted country. He died in Melbourne, Australia in 1960.

London, After World War II

The book is divided into three distinct sections: London just after World War II, Malaya during the War, and subsequently in Malaya and Australia. When we first meet her, Jean Padgett is a young woman, living by herself in London after the end of World War II. She receives a letter from solicitor Noel Strachan who informs her that her uncle Douglas Macfadden has died, and that if she can prove she is his niece she may be entitled to part of his estate. Jean meets with Mr. Strachan and discovers that Mr. Macfadden, whom she barely remembers, was reasonably well off and has left her his entire fortune. However, being a confirmed bachelor and not trusting a woman’s ability to handle her own financial affairs, Jean’s legacy is to be held in trust for her by Mr. Strachan and his partner until she reaches the age of 35.

During the War

Jean shares her history with Mr. Strachan over the next several months. He learns that she lived as a young child in Malaya (modern-day Malaysia), where her father worked in the rubber industry. Jean and her brother Donald learned to speak Malay, and their mother encouraged them to continue using the language even after they went to England to attend school. After finishing school, Donald got a job in Malaya, and Jean went to live there as well in 1939, working as a shorthand typist. War had broken out, but the family felt Jean would be safer in Malaya than in England.

However, Malaya was taken over by the Japanese. Jean’s evacuation to Singapore was slowed down when she detoured to help a family with three young children, and she was captured by the Japanese along with others who had not made it out in time. The men and older boys were removed to a prisoner of war camp, but there were no accommodations for female prisoners or children. Instead, the Japanese Captain ordered them to march, under guard, to Kuala Lumpur, from whence they would be transported to new prison camps being built in Singapore.

There was no prison camp for women, in Singapore or anywhere else, and the group was marched from one end of Malaya to the other. After months of forced marches, near starvation and lack of medical attention, and during which two-thirds of the original number died, they found a safe haven in a small village. Their Japanese guard had fallen ill and died, and Jean persuaded the headman of the village to let them stay and help with the rice planting in exchange for food and shelter. They stayed there for three years, until the war ended.

At one point during their travels, the women and children had come across several Australian prisoners who were driving trucks for the Japanese. The men felt sorry for the women, and obtained some food and medicine for them. One of the men also stole several chickens for the women, and when the theft was discovered, he was punished so severely that he died while the women were forced to watch.

After the war, Jean returned to England, went to work for Pack & Levy, a firm that made high-end shoes and handbags, and tried to forget her war experiences. Her brother Donald had died while a prisoner of the Japanese, and their mother had also died.

After the Legacy

Jean leaves her job and goes to Malaya to dig a well as a way of thanking the village that sheltered her during the final three years of the war. While chatting with the well diggers, Jean discovers that Joe Harman, the Australian prisoner who had stolen the chickens for them, had survived his ordeal and recovered after months in the hospital. She decides to travel on to Australia to see for herself how he is doing.

Jean and Joe are reunited, after a few twists and turns, and fall in love. Jean never does return to England but marries Joe. After learning how girls from the small Outback town near the cattle ranch that Joe manages leave home and move to cities thousands of miles away because there is no work for them, Jean starts a business employing a few young women to make fancy alligator shoes and handbags like those she became familiar with while living and working for Pack & Levy in London. This starts a snowball effect: instead of leaving for the cities, the girls who work for Jean stay in town, get married, and start families. They leave their jobs, and more girls come to work for Jean, which attracts more stockriders and other male workers to the town. Jean opens up an ice cream shop to give them someplace to spend their money. The shop employs a few more girls, attracting more men to the area, and giving Jean ideas for more businesses. The town is gradually transformed from a dusty Outback hole to a vibrant little community, with plenty of entertainment for the young families. The initial source of all this growth is Jean’s inheritance, doled out to her in small pieces by Mr. Strachan according to the terms of his trusteeship. Ironically, the Macfadden family money was earned by a grandfather, who worked in one of the “gold towns” of the Australian outback, towns which had boomed during the country’s gold rush, and then gone bust.

Postscript

Fascinating to me is the fact that the middle portion of the story is based on a true circumstance, and the author explains in a note at the end that he expects to be “accused of falsifying history.” In fact, he states, the forced march of the women happened in Sumatra in 1942, not in Malaya. According to Shute:

“A party of about eighty dutch women and children were collected in the vicinity of Padang. The local Japanese commander was reluctant to assume responsibility for thse women and, to solve his problem, marched them out of his area; so began a trek all round Sumatra which lasted for two and a half years. At the end of this vast journey less than thirty of them were still alive.”

“In 1949 I stayed with Mr. and Mrs. J. G. Geysel-Vonck … Mrs. Geysel had been a member of that party. … In the years that followed Mrs. Geysel marched over twelve hundred miles carrying her baby, in circumstances similar to those which I have described. She emerged from this fantastic ordea undaunted, and with her son fit and well.

“I do not think that I have ever before turned to real life for an incident in one of my novels. If I have done so now it is because I have been unable to rsist the appeal of this true story, and because I want to pay what tribute is within my power to the most gallant lady I have ever met.”

Buy from Amazon.com A Town Like Alice

Happy Labor Day! Here Are a Few Expat Blogs to Enjoy

FutureExpat — Fri, 04 Sep 2009 08:00:58 +0000

I thought I’d post a list of some well known and not-so-well known personal expat blogs to enjoy over the long Labor Day (in the US anyway) weekend. In no particular order. . .

Bleeding Espresso, by an American who moved from Pennsylvania to her ancestors’ village in Italy.
Chris Winchester, who moved very recently from the UK to New Zealand, and who promised to write a guest post here but hasn’t gotten around to it yet. (Wink!)
Mid-Atlantic English, subtitled “How I Learned to Stop Worrying and Love the Host Culture.
Jim & Carole’s Mexico Adventure. A former community organizer and his wife moved to Ajicic, Mexico and photo-blog about it.
Cuenca, Ecuador, New Life in Retirement. A CPA and an acupuncturist retire to Cuenca. I especially like his commentary about their multi-year process of deciding where to retire, and then implementing their plan!
I’ll try to post more links to expat blogs once a month or so. I find them fascinating, and hope you do too.

If you have a favorite blog you’d like to recommend, contact me or click the Comment link below to pass along the information.

Doing Business Abroad

FutureExpat — Tue, 11 Aug 2009 08:00:53 +0000

If your overseas move will include doing business, the World Bank has just published a list that might help you narrow your search. According to their annual Doing Business report, the countries most favorable to starting a small- to medium-sized business are:

Singapore
New Zealand
United States
Hong Kong
Denmark
United Kingdom
Ireland
Canada
Australia
Norway

Obviously, ease of starting a business is not the only criterion for choosing where in the world to live, but if you have years of your working life ahead of you, it’s something to consider. With the exception of Singapore, all the other countries on the list are in Europe and North America.

World’s Best 20 Cities

FutureExpat — Tue, 19 May 2009 03:11:24 +0000

Vienna State Opera

Forbes Magazine has published a list of the top 20 cities in the world to live in. Europe took the most honors, with three of little Switzerland’s cities (Zurich, Geneva and Bern) in the Top 20 and Vienna, Austria at the top of the list. There were two from Australia (Melbourne and Sydney) and two from New Zealand (Auckland and Wellington). Canada was represented by three provincial capitals, Ottawa, Toronto and Vancouver. The USA, Central and South America, Asia and Africa were conspicuous by their absense. Read the whole article.

The study was conducted by Mercer, and you can read their version here.

What Kind of Expat Are You?

FutureExpat — Mon, 11 May 2009 23:36:39 +0000

What kinds of people leave hearth and home for life in another country?

Here are a few categories I’ve come up with. I’m sure that many expats fit into more than one. I know I do! Let me know if you have a category I’ve missed.