Miserable in the US: perspective needed

[nicobean]

Hi all, needing some advice on my situation.

We moved to the US nearly 4yrs ago. DH is American and wanted to move back home. We've lived in the US before kids and lasted 3 years before I wanted to move back: the area didn't suit me and I wanted to work in the NHS again (the role and responsibilites of my job are more limited in the US).

I was hopeful I could make it work this time by moving to DH's home state and doing my best to make a happy home for our 3 DC's (11, 9 & 7).  On the surface that's what we've done.  We've bought a house, have a dog, great schools the kids adore and I've got a job I enjoy where I can choose my own hours and get paid well.

However I'm not happy.  I'm chronically homesick. The main reason is anxiety: over healthcare costs for the DC and gun violence at school.  My eldest DD has an expensive life long disease which costs a lot to manage and my other 2 will need treatment in the future.  DS will also need surgery for a different issue, we've had to cancel it once already due to the co-pay.  I know if we move back we'd have to pay for NHS care and I'm fine with that.  

The climate here doesn't help either, it's brutal May to October and makes me grumpy.

Am I being selfish to consider moving everyone from their lives here?  DH is open to moving back to the UK, although I know he'd rather stay here if given the choice.
Thoughts please!

If you're going to go now is the best time re your kids. Your eldest will go into y7 (or y8) and the other two will still be at primary. They are too young to have forged life long attachments to the USA.

I agree I would do it now. I’ve been in the US for 15 years and absolutely love it here, in large part it’s because I lived in NYC and now the NYC burbs, so there are lots of Brits here, plus lots of liberal people. Not sure I would do well in somewhere like Kentucky.

I take it, in saying that the summer temperatures are brutal, that you’re somewhere like Texas or Arizona?

I think you should bear in mind that although homesick, don't let that give you a false sense of what the UK is - it's not great here, far from it and it's only getting worse.
I lived abroad for four years and came back because I missed 'home'. I really regret coming back.

It's normal to struggle with some aspects of life in another country but the answer isn't necessarily to move back especially if the rest of the family are otherwise well settled. Are you actually pining for your old life back in the UK (genuinely homesick) or are you looking for a way out of the difficult parts of living in America? Re the medical costs, how did you plan to deal with them? Did you have any idea of what the costs would be before you moved, is it costing more than you anticipated?

I do think when you know your time's up, you know and it's better to bite the bullet sooner rather than later and start figuring out your exit strategy but the grass isn't greener and all that. Pros and cons list needed!

We've definitely gone through various forms of this in our house. We now live in the US. I am a US-born dual citizen who spent most of my adult life in the UK before moving back several years ago. DW is English, currently getting her US citizenship. DD is 7; we moved when she was 3.
One thing I came to realise is that no matter where I lived, I would always miss (and possibly romanticise) parts of the other place. The closest thing to an objective truth is that they're both wealthy western countries, really quite similar in many ways, each with some pros and cons over the other. If I could Frankenstein my perfect country, for example, it would include the NHS and the American education system.
In my experience, it's also very easy to focus on the practical negatives of the place you want to leave for purely personal reasons. (Personal reasons are, of course, entirely valid.) That said, health care cost is nasty. One thing I don't get is why you'd have to pay for NHS care if you moved back. I know non-resident UK citizens now have to pay, but doesn't it just go back to normal if you've permanently moved back?
I know from my own experiences that just using cold hard facts, I could come up with an iron-clad case for choosing to live in the US ... or in the UK. In the end though, it came down more to reasons specific to us - including, simply, a gut decision on where we thought we'd be happier.

Which state are you in?

Have you checked if your DC qualifies for income exempt Medicaid? Also, if this is a life long illness which is expensive to maintain you should consider setting them up with social security so they qualify for Medicare. I say this as a parent of 2 DC with autism. We earn enough to pay for everything the DC need but the day our income drops I will be signing up for government assistance.

The summers might be "brutal" May-October. Here the winters are.

We are in the middle of a heatwave but last year winter started on. 1sr August and was 10months of the greyest most depressing cold weather

If you took out the healthcare issues and moved to a more agreeable climate and maybe cane home for a holiday every few months would everything else fall in place

Thank you for all the thoughtful and helpful replies, it's really good to have some opinions from people who know what it's like to be an expat.

Firstly the weather: I'm just not a hot weather person. I'm not even anywhere extreme like Arizona or Texas, just a hot sticky humid region. I'm sure I'd hate it even more being in the UK this year, here at least my house is air conditioned!

Kid's health: there's no way my kids would qualify for Medicaid. We have an HSA and save as much as we can, we have a high deductible plan. The aspect I hate is having to ration the kids' care myself and the constant worry about how they're going to manage in the future. We had no idea we'd have to face this level of healthcare costs although we were expecting to pay for DS' surgeries.

Unrealistic expectations: I'm sure that I'd just be exchanging one set of issues in the US with a whole lot of new ones in the UK if we moved back. It wouldn't make my kids magically well forever, it wouldn't fix DS's arm, it wouldn't make my life somehow immediately better. I guess it is back to a pro/cons list.

One new issue that's turned up this morning is that I've found my dream job advertised back in my old hospital! Time to make some actual definite decisions I think.

Thanks all again.

Is there any way you could switch from the HSA to actual insurance?

HSAs are fine for people who do not expect to incur hospital costs. They all have high deductibles. For people with predictable healthcare costs that might be high, insurance would be a better idea.

One thing I'm sure about is that things are bad in the NHS right now and not getting better, certainly compared to 4 years ago. I am a total home body and love living in the UK, would never live anywhere else if I could choose, but things are very odd here since the Brexit vote, a combination of political paralysis and over excitement. I really would not move back for a couple of years until it's clear how Brexit settles down. I'm not someone who thinks it will be a disaster but a lot of things will change over time imo.

Could you get better insurance? It sounds like you don't have great benefits in yours or your DH's job. We moved here so DH could sell his soul to work for a large multinational and he gets great health insurance through that job. Our co-pays and deductibles are low. We are close to one of the most famous hospitals / universities in the world so that is also a factor to think about. Yes, US healthcare can be tricky to navigate but if you do have good insurance, you get access to world experts and cutting edge treatments. Unlike the NHS, where treatment is limited by NICE guidelines.

In general, I think the NHS is great and much more humane than the US system but the upside of the US system is that you have more choice and access to experts - as long as you have the insurance to facilitate that of course.

Regarding schools, the gun violence issue is very scary to me too. I still haven't found a way to fully deal with that. One option that many expats I know go for is private schooling where there is better security and violent kids can be excluded more easily. I don't necessarily approve of that choice but it is an option some go for. Religious / parochial schools are more selective and are not as expensive as fully private schools. Our local Catholic school is private and the fees are about $6k per year.

If you are desperately unhappy, however, you might be better off to plan your move back now before the kids get any older.

I have observed that the public schools have far better security than private around here. Violent kids can be excluded from private schools easier, but there is little or nothing to stop them coming back, armed.

Public schools where I am come equipped with a host of intervention specialists - pastoral care is great. There is also a 'school within a school' where kids with emotional or other disorders can be sent to outside specialist providers at the expense of the District.

RC high schools where I am run to about $14k per year.

Agree that Brexit is unpredictable - I know people making plans to move to Ireland.

I wish I had more advice for you, but I just wanted to say that I understand. I live in the US too, and I hate it most of the time. I also worry about healthcare and gun violence, although my circumstances are different. People often say I would be mad to move back - but they don't know the realities of living here.
I would say you are definitely not selfish to consider moving back to the UK. It would be selfish to move your whole family against their will, but to consider it and talk it over with them - not selfish. Good luck

Op
Given your child’s health, wasn’t this issue a critical consideration as to whether or not you move?

nicobean Feel free to PM me on the Medicaid income exemption rules. New Jersey is very generous and I have a sneaky feeling the state you live in isn't a blue state with good care for its people.

Others might think New Jersey is the armpit of America but they really do a good job of looking after their people. I couldn't live in most other states. Guns in schools isn't an issue. Very few people carry or keep a gun in their home. Would moving to a more progressive part of America help you?

Private schools are a fine choice for many people, but I'd caution against thinking they're particularly safer. They're typically not bound by as many regulations, meaning there often aren't rigorous protocols in place.
If it seems like most horrific things you hear about happen in public schools, it's worth remembering that that's largely because that's where the vast majority of all US education happens. I believe 87 percent of all US students attend public schools.
Having said all that, I'd gently push back on the notion that gun violence is something to worry about on a daily basis. I'm firmly anti-gun - donate to several organizations, consider it one of the main criteria by which to judge politicians. But while it's enraging that it has to be a problem or issue at all, when you look at gun violence in US schools in terms of actual percentages - in terms of whether or not your child, on this day, is likely to be threatened by a gun - it's really not a worry. I view gun control as a political and moral issue, but it's not something I think about when I drop off DD in the morning.

Sorry, reading back over that last comment, I hope I'm not coming off as unduly harsh. I don't mean to say "gun violence is a stupid thing to worry about" or anything like that. More that it's important to consider the difference between something that (rightly) receives massive attention when it happens v something that's a daily practical concern for most people.

Thanks again everyone, all these viewpoints are really helpful.

As far our state I realise now I'm making it sound like we're destitute, but actually we're very middle class in a very nice middle class area in one of the blue-est states. Knowing that I'm very privileged makes me feel even more ridiculous that I am feeling like this.

I've spent my entire career in acute hospitals in the UK and US. Our city is famous for it's hospitals so there's no lack of expertise here. However some knowledge is not always helpful as I know all the worst possible outcomes of the disease my kids have. I tend to leap ahead and worry how they're going to manage at college or when they have to fund their own drugs and equipment.

The point about trying to improve our health insurance is an excellent one. DH is hoping to get a new job soon which would mean new insurance so fingers crossed we can get a better plan. My job is benefit free, that's why it's paid well and flexible.

Thanks all for listening.

Just thinking aloud, is it worth you getting a good benefits package through the hospital you work in? Also, here in the NYC area places like NYU and Columbia offer amazing benefits including healthcare. You might earn a little less but with both of these universities tuition for your DC is fully paid for. That's a $500k benefit if you have 2DC.

Do you know how the NHS would treat your DC? As in, although the upfront cost wouldn't be there, would the treatment be as good as the care you can access in the US? (My Frankenstein country includes the best US hospitals but without having to pay for them at the point of access - I know that's not possible, but hey o)

@nicobean I'm sorry you seem to have a difficult decision to make. Would the treatment in the UK be as good as it is in the US? You said that you would have to pay for treatment if you came back to the UK but you wouldn't. As long as you are coming back and establishing residency rather than just visiting treatment will be free for you.