There is some irony in this story. For many of the Americans who choose to leave the United States, the reason is identical to that given by newcomers to our shores: a better quality of life. Americans can be rightly proud of their economic and political might, but the United States is among the top ten most expensive countries to live in in the world, and the recent spike in the Consumer Price Index has made things, particularly healthcare, energy, shelter, and food, notably more costly.
Quality of life is a complex thing, made up of more than dollars and cents. Americans give all kinds of reasons for emigrating: concerns about the costs and quality of healthcare, public safety, and the general ugliness of our political divide top many lists.
A recent survey conducted by West Health and Gallup found that 46 million Americans cannot afford non-elective healthcare. According to the Centers for Disease Control, every year, millions of Americans travel internationally for medical care. The CDC lists dental care, cosmetic surgery, fertility treatments, organ transplants, and cancer care as the most common procedures.
There is a fascinating website run by an outfit called Medical Tourism that provides some price comparisons on major surgical procedures. For example, a heart bypass operation costs $123,000 in the U.S. but only $7,000 in India. A knee replacement here at home is $35,000 but just $8,000 in Columbia. A facelift in America is $11,000 but it’s a bargain at $2,813 in Thailand.
The United States is the runaway world champion of gun violence among high-income countries with ten million or more population. The numbers are staggering: In 2021, there were 4.52 firearm homicides per 100,000 people in the U.S. That number for Portugal was 0.19, and for South Korea, 0.01.
America’s gun-owning tradition goes back to well before our founding and is enshrined in the Second Amendment to our Constitution. According to thetrace.org, 494 million firearms have been produced for the U.S. market since 1899. It’s little wonder that our rate of death by firearms is seven times higher than Canada’s and 340 times higher than the U.K.’s
Although three out of four Americans say they feel safe walking the streets at night, America is a relatively violent country. U.S. crime rates for the “big three” crimes of homicide, rape, and robbery are several times higher than the averages for European countries, according to the Bureau of Justice Statistics.
The L.A. Times recently reported that the Pew Research Center surveyed people from 17 countries, including Europe, Asia, and North America, and found that Americans were the most likely to agree that American society is split along political, racial, and ethnic lines. More than half of Americans say their fellow citizens can’t agree on basic facts. Some folks simply want to live in what they believe is a kinder, gentler nation.
Why Not to Leave
One reason Americans generally don’t relocate overseas is high taxes, despite all the grumbling one hears on the subject. It is true that some correlation exists between the migration of Americans from state to state, but there is really no escaping the burden of federal taxes on American citizens.
Nine of the top ten states that saw the largest gains in population in 2019 and 2020 were states with either low or zero state income tax. Half the states that lost tax filing population in that period had above-average tax rates. We can’t know if taxation was the proximate cause of those population shifts, but it seems reasonable to assume it had some weight in the decision mix.
The U.S. has what is known as a worldwide tax system for its citizens, and all U.S. citizens are required to file a tax return every year regardless of their residence. According to the IRS website, “You generally are required to file income tax returns, estate tax returns, and gift tax returns and pay estimated tax in the same way as those residing in the United States.”
Generally, you can expect to receive a credit for taxes paid to other countries. For example, if you earn money working in Australia, you would report the earnings and deduct the amount of tax collected by Australia using the foreign tax credit.
The only way to escape American taxes is to renounce your U.S. citizenship. One imagines that few Americans would be willing to cut ties with our country solely over taxes, but some expats do. In 2020, 6,705 renounced their U.S. citizenship, and the top reason given was the burden of filing U.S. taxes.
Americans’ concerns get to the core of what it is—or perhaps what it was—to be an American. A recent poll from the Wall Street Journal/NORC found that only 36% of respondents believed the American dream still held true. The poll defined the “dream” as “if you work hard, you’ll get ahead.”
Inflation, in the form of high student loan debt, high rents, high interest rates, and high healthcare, energy, and food costs, are just naturally going to lead to some pessimism. Add to that the crime, violence, and snarling political and social disagreements and you get some people dreaming of greener and more pacific pastures in other countries.
So, where are Americans going? Many stay right here in North America; 40% choose Mexico, Canada, or Central America. About one quarter choose Europe, 14% each to Asia/Pacific and the Middle East, and 3% each to Central/South Asia and Africa. U.S. expats live in more than 160 countries.
About one million Americans now live in Mexico, where the cost of living is about 30% of the United States. The warmer weather and slower pace of life are appealing to many. Mexico makes it particularly easy for Americans to emigrate there.
Portugal is another country that welcomes immigrants. The natural beauty, warm sunshine, and low cost of living, combined with easy access to the rest of Europe, make Portugal an attractive option. Portugal also has something called a “golden visa,” a painless pathway to citizenship in five years through ownership of real estate. Malta, floating in the Mediterranean south of Sicily, has similarly attractive features and relatively easy immigration policies.
Every country has its own rules, and there will always be obstacles, like learning a new language and accessing health care. And of course there is the reality that friends and family will be far away. But, the cost of living in the United States is high, and for folks with a fixed pension or real uncertainty about retirement security, emigration could be an attractive option.
