Reasons you wouldn’t move to US

[Preiu]

Dh has been offered a job in the US. The increase in salary would put us into a completely different wealth bracket but I really don’t want to move.

• fear of home invasion with guns
• school shooting - guns in general I guess
• American exceptionalism attitude annoys me
• Being away from family
• Not having Europe on doorstep

Can I ask if you have any other reasons

Gun culture.
Sexual abuse is a terribly high statistic. From research statistics vary.
Lack of history.
Too fast a pace.
Lack of free healthcare.
Obesity.
Too far from home.
General ignorance by many as to where other countries are located.

I have never been to the States. I am sure despite the above it can be a very welcoming culture to those of us in the UK.

People who voted for Donald Trump have a pathological, xenophobic hatred of Harry Potter, The Beatles, and Winnie the Pooh? Yes - we all remember that Trump rally where “Yellow Submarine” was thrown into bonfires, and Piglet was hanged in effigy. 😂

Annnnnnnnd…I’m done with the ignorance on this thread. Thanks to everyone from the UK who’s been factual, logical, and fair-minded. ❤️

Main things for me are healthcare and education being very very varied. In the USA a lot of things are better if rich and much much worse if poor. You’d need an incredible package. I don’t think you’d have much issue with guns at home, it’s more the public issue at big events, schools and supermarkets where it happens. But yeah. It terrifies me too.

Poverty and homelessness is really scary and the violent crime. You really need to be able to drive. Very cold winters and humid autumn and summer.

Trump is blatently about to get in and make things worse.

However I would consider it for a bit for a very good package! it’s also an incredible country and jf you have everything, very ‘fun’.

Oh, you're a Trumper? That explains why you misunderstood what I was saying.
Bye then.

I have lived, travelled and worked there. Still do. I’m married to an American.
Its a fantastic place to visit, well some of it is.
The healthcare though? The healthcare is an over priced mess.
As is the fact anyone off the street can go and my a military grade weapon legally, in many, many states.

@BlueskysandWind start a why the IS is great thread. Plenty of people will comment on that .

American living in Ireland here. Grew up in California

-People being superficial and pretending to be your friends when they really don't care
-Excessive materialism - buying too many things and living a lifestyle beyond one's means
-Dire support in the community for elderly people who do not have family close to them
-Inflexible approach to following the rules and black and white thinking

(I admit I have complained on this site about the boring and humdrum of living in an Irish village, but any time I have needed help, been a couple euros short at the shop even had a puncture in my tyre, strangers helped me right away).

This is so utterly, utterly shocking and a good reason for being sceptical about US healthcare.

The US is a very different country to Britain. It is not at all like America as it generally is shown in TV or movies.

Cheers Captain Obvious! Tell me, does the Pope also wear a funny hat??😅😅😅

I don't think people realise how different it is. I didn't until I went there.

Both New York and Massachusetts have Medicaid/subsidized health programmes that are far more extensive than the minimum Medicaid requirements. Look at the uninsured percentage by state. 2% in MA, 16.6% in Texas. This is what Americans mean when they talk about how different things are in different states.

I don't find Americans fake, though you do need to learn to read the difference between a polite pro forma statement like "we'll need to get together sometime" and an actual invitation. I'm on the East Coast, though, and the East Coast has a reputation for being more direct (more so than the UK even I would say).

Also I don't know whether to be gobsmacked or amused by someone who comes in and tells people what's wrong with the US but has never visited it.

It's a weird thread, isn't it? And it's not likely to help the OP convince her DH that she has rational objections to moving to the US when she tells him you can buy guns from vending machines and that there are armed homeless drug addicted mothers who are threatening cops.

I got the impression that insurance doesn't pay for much mental health care. I always hear of people only going in for 28 days.

Untrue. Under the ACA mental health conditions must be treaty in parity with physical ones. I had ongoing psychiatric help for some time - all covered. My workplace also offer an Employee Assistance resource and mental health counseling is one of a number of things offered.

Mental health is tricky. It's a very long story actually that dates back to deinstitutionalisation in the 1960s, and isn't just about payment. The system now emphasises inpatient as only a short term stabilisation measure. In fact, medicaid is barred from paying for long-term treatment in mental hospitals over a certain size because when it was established in 1965 they didn't want it to subsidise the mental hospitals that they were trying to close. It was sort of a good theory but they never built the comprehensive outpatient system that was meant to replace it (you can thank Reagan for that) and it's become clearer since then that for patients with serious mental illness you need a comprehensive wraparound strategy or they bounce in and out of treatment, sometimes becoming homeless.

The ACA requires mental health parity, but the system for valuing services and determining payment is flawed, so providers are not always paid enough -- doubly so for patients on Medicaid, which the sickest are. And there's a perennial shortage of providers, especially in rural areas. Because you cannot force doctors and therapists to participate in insurance, some providers, especially in large urban areas, do not accept it and you have to pay out of pocket; depending on your coverage you might get reimbursed in part.

However, given the horror stories I am hearing about mental health care on the NHS these days, especially CAMHS and autism services, I am not sure that I would choose either the UK or US for mental health care if I had an option.

I will say that the US is generally very good at provision for younger children, particularly children with autism and developmental disabilities. Many states have medicaid programmes that cover children with disabilities independently of their parents' income (meaning all treatment and therapy is free). All states have an Early Intervention birth-to-three programme that provides services in people's homes (speech, physio, OT, special instruction as needed) and special education preschool services. 2 of my 3 are autistic and have been seen at one of the best children's hospitals in the country and the care has been superb. I paid out of pocket once for a specialized evaluation (neuropsychological assessment) but that was to bypass a wait list and I got part of the fee back. The only thing that wouldn't have been covered is if I wanted a psychoeducational evaluation as that isn't considered medical. (Usually the school does this, but sometimes parents get it done privately for various reasons, usually because the school fights them about doing it.)

Care for adolescents with serious mental health issues is harder; there's some evidence that too many inpatient beds have been cut for them.

I would not say all my experiences with the US health system were wonderful and I wouldn't defend its structure (despite working in it!) but I will say that both the health and special education systems have been excellent for us.

Guns and shootings in the US? What are you talking about, rare as hens teeth, totally irrational, never happens. Fake news. (Wonders if Republicans will think again now...)

You'd think they'd consider their lack of gun controls again, but for many that will mean thinking about about how they can have even more weapons, because of course the route to safety is more, and deadlier, guns.

I can almost hear it now, "The reason Trump and others got shot is because there weren't enough armed people there".

Were you in hospital longer than 28 days then?

Yep. But apparently this isn’t a problem…

That's good to hear.

And yes, the mental health system here has been badly cut back unfortunately.

My question was based on US programmes (documentaries, reality shows etc) and people are seriously mentally unwell that they need to 'check in' somewhere and they only ever go for 28 days when they obviously need much longer which made me wonder if it was to do with insurance. It seems the same with rehab.

My experience with being seriously unwell in the UK was I'd stayed an inpatient for as long as I needed.

Healthcare costs in old age.
Everything else I could work around.

Thank you for the wheelie bin answers, I think it was the same clip I saw, as if it was a new invention.

@candyisdandybutliquorisquicker

Re the healthcare comparison. You can't really compare the NHS to US private system. If you have insurance you can self refer here. You can also get a private room as standard (there are downsides to that though) and order from the bar if you want.

I can't remember when I last had a letter from the NHS, I usually get a text message.

If your parents are getting letters that's because they have asked to be contacted that way.

There's no fixed rule about 28 days. The parity law makes a fixed rule illegal. But there are points at which they will question a continued stay and require a medical justification. Now, they will do this if you are in hospital for a physical condition too. The UK has fairly rapid stays (if you want long hospital stays go to Germany) but there's immense pressure from several points in the system to keep hospital stays short and American stays are particularly quick -- I've known hysterectomies and mastectomies done as outpatient surgeries for example. The specific length 28 days often refers to inpatient substance abuse rehab programmes rather than, say, inpatient treatment for psychosis or attempted suicide. I know of cases both where there was extremely rapid discharge for something like that (less than a week) and ones where the hospital was able to make a case for a much longer stay, over a month, sometimes two. As a very general rule, dedicated psychiatric hospitals are better at doing this than inpatient units in general hospitals.

Hospital costs in old age are a totally different matter. You get Medicare, which is imperfect (you'd want to buy a supplemental medigap policy) but it's guaranteed and even Medigap is guaranteed issue if you buy it when you first enroll in Medicare. The problem is the same as the UK, social care costs. (Medicaid will cover this after you exhaust your resources, but the problem with that is easily grasped.)

Mostly the same as you tbh. I wouldn’t be so bothered about not having Europe so close as South America and Canada look fab to explore. Plus, there are so many amazing looking American states that I reckon you could have years worth of holidays without even leaving the country. I’m actually not surprised that so many Americans don’t have passports!