Because I hadn’t done any research, I arrived a few days before the start of Ramadan. We had to wait through closed offices and holiday observances; but, we were finally able to get married about three weeks later. So many people ask me, “How did you manage to get married in another country?” It was a challenge, but this experience is what helped shape my perspective about life overseas; take it all in stride.

I have lived all over the world; Turkey, Belgium, Bosnia, Israel, and now Mexico. I am thoroughly enjoying myself. However, I believe that in order to take full advantage of your expat life you have to relax a bit and understand that you don’t have the same amount of control as you do in your home country. I have had many opportunities to work myself into fits of frenzy; however, my outlook on this uncommon life has saved me.

What Do You Mean, I Can’t Buy Groceries Here?

I can remember standing in the checkout line at a grocery store in Belgium. I had a basket full of groceries and was at least 7 months pregnant. I handed the cashier my credit card and my passport and began bagging my groceries. However, I was alerted to the fact that there was some sort of problem with my identification. The cashier explained that my middle name was not on my credit card as it appeared on my passport and therefore, I couldn’t pay for my basket full of groceries. I tried to explain to her that it was just my middle name and didn’t have to be on my credit card, but my explanation was not sufficient. I speak enough French to get through my daily life; but, I can’t go head to head in a verbal battle with a native French speaker.

So, here I was holding up the check-out line in Carrefour and getting angrier by the minute. Had I been in the states, I would have demanded to speak to the manager, asked for the number to corporate headquarters and called them while I sat in the car. In this case, however, I pushed my basket to the front of the store, bought a hot waffle on my way out, and went back later with my husband and his credit card.

These sorts of experiences will happen, especially when you first arrive in a new country. If you don’t fluently speak the language, you will encounter them much more often. But they will give you opportunities to laugh later on. They are simply part of the adventure. There is no sense in getting upset and angry. Take it all in stride.

I could tell you stories about rogue taxi drivers, hostile sports fans, ridiculous apartment deficiencies, and the worst McDonald’s on Earth. Of course, when you are standing face to face with a cashier and can’t buy your groceries, it can be disheartening. If you have to demand that a taxi driver take you back home because he doesn’t know where he is going (and you don’t really either), it can be a bit overwhelming. But when you stick it out and get past these little bumps in the road, the journey is a blast.

Brandi N. Grays is the owner of Eleven Twenty-Three Creative Group, a small business marketing firm. She blogs about starting and growing your small business. She will be launching her own blog dedicated to expat moms in the spring of 2010. You can reach Brandi at brandingrays@1123creativegroup.com.

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.

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

Top Ten Retirement Havens from Live and Invest Overseas

1. Argentina
2. Belize
3. Chile
4. Croatia
5. Dominican Republic
6. France
7. Malaysia
8. Panama
9. Uruguay
10. Vietnam

Mercer’s Best Cities for 2009:

1. Vienna, Austria (1st)
2. Zurich, Switzerland (2nd)
3. Geneva, Switzerland (3rd )
4. Vancouver, Canada (tied 4th)
5. 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:

1. Tokyo, Japan
2. Osaka, Japan
3. Moscow, Russia
4. Geneva, Switzerland
5. Hong Kong, China
6. Zurich, Switzerland
7. Copenhagen, Denmark
8. New York, USA
9. Beijing, China
10. Singapore

2009 Best Retirement Havens, according to International Living:

1. Cuenca, Ecuador
2. Merida, Mexico
3. Coronado, Panama
4. Punta del Este, Uruguay
5. 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!

From Other Expat-Related Blogs

• How Green Is Your Move? from the Global Coach Center.
  

  “I packed out this week and once again, just as it happened during several other pack outs, I watched the movers use a lot of paper, carton, plastic, bubble wrap and tape. Now, of course, I want all for my things to make their way safely and in one piece across the ocean. But sometimes the amount of packing materials that’s being used for any one move is just staggering.”

  Read the complete post

• Festivals Around the World this July from Easy Expat.
  

  “Summer’s begun and so have the parties. Check out some of the most popular festivals and events from around the world this July.”

  Read the complete post

• A Career Coach’s World Without Borders at CNNmoney Small Business, a story on expat career coach Megan Fitzgerald.
  

  “In a rented conference room near Emperor Hadrian’s tomb, career coach Megan Fitzgerald greets two regular clients. Though all three are American expatriates, there’s a good deal of Mediterranean-style cheek kissing. Then it’s down to business on this bright February morning.”

  Read the Complete Post

• The flip side of expatriation — Repatriation at the Expat Exchange.
  

  “. . .what about the adults that move away and have to come back and fit in? What happens when you leave everything you know and are accustomed to only to be thrown back to the wolves two years later?”

  Read the Complete Post

If you enjoyed this brief roundup of what other expats are saying, let me know and we’ll do it more often! Just click the link below to leave a comment.