It is actually very expensive to get rid of the American citizenship and the IRS global taxation.
A German-American friend of mine now living permanently in Germany for 10 years, still has to pay America for taxes. To drop the citizenship they will have to pay a significant portion of their net worth to the IRS.
3) Normal people having any sort of income other than employment income.
In Canada, our retirement system is built upon three pillars, CPP/QPP/OAS (similar to US Social Security), RRSP (similar to US 401k), and TFSA (similar to US Roth IRA, but more inclusive, as every resident can use it regardless of income level). TFSA is arguably more important and a higher priority for retirement savings than RRSP in Canada. However, the US does not recognize TFSA as a retirement scheme. So if you are a dual American-Canadian citizen, the financial advice is not to use TFSA, as a) it won't be tax-sheltered, you will have to pay taxes to the US, and b) the paperwork required is a huge headache.
Every country has something that they don't tax and US will. Because that country does not tax the thing, there is no tax credit to offset US taxes payable and you may end up paying a lot. The thing may be a retirement savings (Canada) or capital gains (Switzerland) or a myriad of things other than employment income.
If you're living internationally wouldn't it fall under this?
>If you are a U.S. citizen or a resident alien of the United States and you live abroad, you are taxed on your worldwide income. However, you may qualify to exclude your foreign earnings from income up to an amount that is adjusted annually for inflation ($103,900 for 2018, $105,900 for 2019, and $107,600 for 2020). In addition, you can exclude or deduct certain foreign housing amounts.
#1 is a bit of a gotcha; in the case of the USA it holds tax treaties with some countries (maybe blocs like the EU?) and not with others.
If you’re earning in a country with a treaty, say the UK, you pay the local tax and any difference is paid to the US if your local tax is less than what you’d pay the fed+state if applicable.
Obviously any country/society can enact any tax rules they see fit, but if I was american living and working and paying tax abroad I would wonder what the tax difference I needed to pay is for.
I guess you could argue: military/consular protection. Yet, still feels expensive.
>If you are a U.S. citizen or a resident alien of the United States and you live abroad, you are taxed on your worldwide income. However, you may qualify to exclude your foreign earnings from income up to an amount that is adjusted annually for inflation ($103,900 for 2018, $105,900 for 2019, and $107,600 for 2020). In addition, you can exclude or deduct certain foreign housing amounts.
So if you make $X00 and in the Bahamas your income tax is $7, but in the USA your tax would have been $100, you remit $93 back to the US government. Even if you didn’t step foot in the US that year and all the income was Bahamas. Roughly.
And if you don’t like it, you make a one time payment of (I think) a third of your net worth. Which is not ideal if the only thing you own is a tangible thing like your childhood home, because now you need to sell it.
Being an American comes with a ton of benefits, and one of the costs is how mind numbingly expensive it is to leave.
Note, the conversation of whether the US should have territorial taxation roars it’s head up every few years. all of the above might change
Yes, but we have reciprocal tax agreements with many countries. In Germany he’s already paying n dollars in taxes, and that n becomes a tax credit in the US.
That’s true, but it’s fairly easy to do research beforehand to avoid this. The people generally impacted by this can afford advice from a tax attorney.
Ironically, that exit tax and the associated fees open up one of the only ways to obtain dual German citizenship as an American adult: Depending on your income, the German government may consider the cost of dropping the U.S. citizenship unreasonable, and therefore allow you to obtain German citizenship while keeping your American one.
There is little chance he has to pay any tax unless he manages to avoid paying taxes in Germany or the tax owed is lower than what you would pay in the US which again for Germany is highly unlikely.
Access to cutting edge mental health treatment, such as ketamine and estketamine for TRD, are really only available in the US. Also, if you look at the treatment, coverage, and support for ADHD it's clear the US has always been ahead of other nations.
Related:
Global Perspectives on ADHD: Social Dimensions of Diagnosis and Treatment in Sixteen Countries (2018)
WRT ADHD support, I can’t say I believe this. With our medications being on controlled substances lists, and all the (ironically incredibly ADHD unfriendly) hoops we have to jump through just to get those meds, it’s kinda hard to believe that everyone else in the world is somehow worse than that.
Per that link, it's only illegal in Russia (which is fucked up) but it's pretty close to identical to how the US handles it in every other listed country.
ADHD person here, who lived in 6 countries, including the US (the other 5 are Russia, Italy, Denmark, Spain, and Switzerland). Getting ADHD stimulant medications is way easier in the US than elsewhere.
Here in Switzerland, for example, adult ADHD was even started to be recognized only since 2011. No immediate release formulations are legal here, only extended release. Even though Novartis, a Swiss company, is the producer of Ritalin. You can't get Ritalin in Switzerland, as it is an immediate release drug.
In Russia, _all_ stimulant drugs are banned (and ADHD usually is not even recognized as a valid diagnosis). As is you can get to prison there if you take your Ritalin with you.
I live in Ohio. ADHD meds are not that difficult to get. There’s some frustrating paperwork but that’s literally it. Any doctor can prescribe stimulant medication.
Bipolar medication on the other hand, many of my bipolar friends in Europe have difficulty getting proper medication, much less proper treatment. In the US, the only issue I had was finding a psychiatrist and therapist who was available.
The problem is cost. If I had ended up getting sent to inpatient treatment (nearly happened), the bill would have been huge.
The lady who runs "How To ADHD" on YouTube recently discussed her issues in getting a prescription after moving.
A slice of the challenges she faced:
- Few psychiatrists/doctors were willing to prescribe meds to an adult.
- You can't call to check on availability of Schedule II medications from pharmacies, you have to query in person, and many require a prescription before they'll answer.
- Insurance often requires pre-approval to pay for the meds - another hoop and another delay.
- You can only ever get one month prescription at a time (with no refills), and have to contact your doctor every month. Not too early, not too late.
Any one of these issues can be tough when you have an executive function disorder (poor short term memory, poor awareness of time, etc.), and especially if you run out of your meds and are fighting yourself just to do basic self care.
> Few psychiatrists/doctors were willing to prescribe meds to an adult.
Never had an issue with this and I have frequently switched doctors. I'd suggest finding a prescribing nurse practitioner. It's hard to find a psychiatrist without waiting six months for the first appointment.
> You can't call to check on availability of Schedule II medications from pharmacies, you have to query in person, and many require a prescription before they'll answer.
I drop three prescriptions off at a time. Or it's called in and then I call for refills. If they don't have it in stock they can probably order it.
> You can only ever get one month prescription at a time (with no refills), and have to contact your doctor every month. Not too early, not too late.
I've had five or six psychiatrists. All of them prescribe 3 months in advance after the prescription is stabilized.
Which goes to show that there is little to no consistency in how ADHD is treated in the US. Your experience doesn't match mine, which doesn't match Jessica's (the host of "How to ADHD"), which doesn't match others' from the ADHD subreddit (for example, drug tests which hasn't been brought up before).
> such as ketamine and estketamine for TRD, are really only available in the US
Go careful here. Ketamine infusion is a pretty heavy duty intervention and patients require careful monitoring while taking the infusion and for a short term afterwards.
In the UK we're looking at 1:1 nurse:patient ratios, delivered in ECT suites.
In the US the way increased access has been achieved is by dropping down the nurse:patient ratio and delivering it in wider settings. It's a more risky way to deliver the treatment.
We know that in the US there's already a problem of "doctor shopping" -- going around doctors until you find one willing to prescribe ketamine / eskatamine. This is normally associated with harmful prescribing, although it's too early to say if that's the case with these meds.
EDIT to add: There are cultural differences here. The US sees access to medication as being the same as access to treatment. The UK sees it as over-medication with at best ineffective treatment, and at worst treatment that causes harm.
> Go careful here. Ketamine infusion is a pretty heavy duty intervention and patients require careful monitoring while taking the infusion and for a short term afterwards.
I've been taking ketamine lozenges at home for 2+ years now. Ketamine is a very safe drug. It is used in pediatrics and on the WHO's list of essential medicines. It's hard to find any fatalities directly attributed ketamine in the literature.
The infusion therapy you speak of has been used to rob patients blind. Before I found a doctor that would prescribe I was on target to waste 10k a year. And that's not even considering the wasted time of appointments in the clinic.
> We know that in the US there's already a problem of "doctor shopping" -- going around doctors until you find one willing to prescribe ketamine / eskatamine. This is normally associated with harmful prescribing, although it's too early to say if that's the case with these meds.
Doctor shopping refers to going to different doctors to get more medication or to divert the prescription for profit. If one is depressed and seeks treatment from a researcher and doctor in another city or state it is not doctor shopping because of the underlying medical condition. Seeking help is not a crime.
Nevertheless, could you please post proof that there is a problem since you made that claim?
That's not really what doctor shopping means. Doctor shopping refers to going from doctor to doctor until you get a doctor who writes the medications/tests/diagnoses etc that you want. Ie. instead of accepting the judgement of one doctor, you change them until you find one that agrees with with what you want from them.
I'd settle for the fluff if I could somehow excise all the childish asides. I knew I'd regret clicking on a Current Affairs link. May as well read HuffPo
Politics isn't as important as people make it out to be. Perhaps people identify too much with their nationality via political leaders. With the exception of lockdowns, political outcomes rarely interfere with daily routines.
As for the ease of living abroad, once you have a source of income everything else tends to fall in place. Many countries are happy to have you if you are self sufficient. The article lists expensive options for citizenship and residency permits before concluding that expatriation is impossible.
I agree with the laments about the rise of the passport system. However the hyperbolic tone is off-putting. Likewise for the standard issue anti-capitalist tirades and slight of hand misrepresentations.
>...the loudly pro-inequality magazine The Economist.
>And despite capitalism’s promises to provide all the lifestyle choices you could ever desire, few of us have the option of trying our luck elsewhere if we want.
Most expats I've known burn out within a few years. Eventually they can't cope outside of their previous environment either socially, culturally or economically. Everything is possible for those who are driven and able to adapt. If anything, the remaining freedom within the capitalist economic system makes this possible. For those who can't adapt, contribute or support themselves, what else can be expected of a foreign country and culture?
> The article lists expensive options for citizenship and residency permits before concluding that expatriation is impossible.
I seem to recall that retiring to Mexico has been extremely popular the last decade or so. I have to agree with your point - each country is a quite different experience. If retirees can make it work then surely someone with a career can.
> once you have a source of income everything else tends to fall in place
Most people's source of income is employment. It's hard to get employment in another country if you don't already have the right to live there, especially if there's not a shortage of native workers with your skills.
Yes, most people have jobs. Those jobs are created by entrepreneurs or government. Some entrepreneurs choose to do without employees. Software development and publishing would be a niche where this model applies.
Job markets are usually protected by work permits. Arguments about protectionism can go either way. I'm not advocating either position, only making a realist's observation.
Job creators and people who have income are usually recognized as a benefit to an economy. The expectation that migrating to a foreign country (for political reasons of all things) should be made easy seems misplaced. There are ways to achieve this and live well for those who apply themselves. A little creativity that yields a modest passive income is enough to prosper on in many parts of the world.
If you think political outcomes rarely interfere with daily routines, you should realize that you are very lucky. Obamacare made a big difference to whether people could get healthcare, DACA to whether they could stay in the US, laws on reproductive freedom, right to marry who you choose, get an apartment without racial discrimination, etc. etc. etc.
Blanketly attributing outcomes to luck dismisses the agency of the individual. It is belittling. Who are you to say that I haven't experienced illegal racial discrimination?
By the way, it is much, much, much easier for an American to emigrate somewhere (few exceptions aside), than for anybody anywhere in the world to immigrate into the US. I always wonder how Americans, who generally have a strong opinion on emigration (whether pro or against), are generally not informed on how the entire process works.
The main reason Americans decide not to emigrate, is that the US is actually a fine country and a good place to live. There are a few other good places to live, like Western European countries, or maybe Japan if you can handle cultural differences, but the difference is not that much that it would be worth of getting through all the hurdles to move there. Nearly everywhere else, the quality of life is much worse.
This is incorrect. The US even in the current time has one of the most open immigration systems in the world. Which is awful, but it is nonetheless true. Try to become a citizen in Europe without having a familial claim or a ton of money. You can absolutely get a work visa (if you can arrange a job) but the chances of you becoming a full citizen is about 0.
I moved to Switzerland from Russia, and currently live here in Geneva. I also lived in other European countries. No big deal, compared to the US (where I used to live for some time, too, but couldn't get a good path to immigrate without losing my independence as a consultant). In most European countries, you can get a citizenship in 5 years, less in some cases (if you are e.g. a student in France). Switzerland is an exception, it requires 10 years now.
Living in places is not what we're discussing. Immigration is becoming a citizen of another place. Americans can move almost anywhere. Becoming a CITIZEN is an entire different kettle of fish.
I feel like this is where a lot of misunderstandings in these discussions come from--the difference between being a permanent alien and being a citizen. In the United States there's a process for people to become a full member of our society. There's also a process for being a working alien here. Two different paths that don't have to necessarily overlap.
In a number of places in Europe (I can't say how many, I've only researched the one I moved to, and know that some others are similar), you need to reside there lawfully for a number of years, in my case five, pass some basic tests of language and culture, and then you can apply for citizenship. That's really about all that's required. It's actually an almost identical process to becoming a permanent resident, which is what I'm aiming for due to no-dual-citizenship requirements.
Isn't h1b the main way into the US? Hardly sounds like "one of the most open in the world". I understand you can get a job in Germany with just an A1 german level certificate
For several, if not most, of the countries in European Union, you have to reside in the country five continuous years and speak the basics of the local, official language, in order to be apply for citizenship. Given the duration of a citizenship, it doesn't sound a bad requirement.
Some countries, though, require you to have only one citizenship, which implies you will have to get rid of whatever citizenship you have. But that was not the point of your incorrect statement.
Once thing that is common in Europe is citizenship by family, and I am not aware of a country (in Europe) that allows citizenship by being born in that place. In fact, I am just aware of United States and Brazil with the latter rule, but I never investigated it further.
Jus Solid is more expansive than you think. It's most of the western hemisphere and in many European countries it is allowed if the parent(s) are in the country legally or are permanent residents.
> Try to become a citizen in Europe without having a familial claim or a ton of money. You can absolutely get a work visa (if you can arrange a job) but the chances of you becoming a full citizen is about 0.
What utter rubbish! For example, here in Sweden after 5 years of living here and nothing serious against you in your time here, you can apply for citizenship[1]. The application fee is 1500 SEK[2] (~175 USD today), hardly a "ton of money".
You have to have a permanent resident permit and to have stayed for 5 years. Unfortunately I can't find anywhere on the Swedish immigration site (in English anyway) that lays out the requirements to receive said permit.
The 'ton of money' comment were for people who wish to use pathways open to people who bring large investments into the country.
Depends on the route you took (work permit/studying/joining a family member), but if you are on work permit (and are a non-EU citizen), you can get it after 4 years of being on a work permit. (These 4 years count as part of the 5 for citizenship, so it's 4 for permanent resident + 1 more.)
I'm living in Germany, with zero previous connection to the country. Been here a couple of years on a work permit, and in another couple of years I'll be able to apply for citizenship.
I just want to point out, for an HN thread with so few comments it is unusual to see the same person posting two distinct comments that completely contradict reality [1]
Perhaps consider checking the facts before stating falsehoods?
I live in Germany. It's also very straightforward here to become a citizen. You just need to live here legally for 8 years, learn German to B1 proficiency, take a test about how our government works and pay €255.
One thing that's a big differentiator from the US system, is that the immigration system doesn't use lotteries or quotas. As long as you fulfill the requirements, as listed in the law, you get citizenship or the relevant residency permit.
Do you have a source for that? I find it very hard to believe, since the United States has by far the largest immigrant population in the world at 50,661,149.
The big thing not mentioned in the article is that there is an exit tax that Bill Clinton signed into law. Also, new banking laws make it difficult to do banking living abroad. These roadblocks are intended to keep taxpayers.
An exit tax? There is no such thing. Are you talking about the $2300 processing fee? You're paying for the paperwork and interviews. You're not going to be a citizen anymore so it seems fair to require you to pay for the time and attention of the US government to process your request.
The prong (from the link above) is $150k average trailing yearly income. And the prong only determines if you are elligible.
From there, if you are close to retirement and have your wealth in illiquid assets where a penalty for converting them to cash is steep, you are kinda fucked.
From Above link: “ IRC 877A imposes a mark-to-market regime, which generally means that all property of a covered expatriate is deemed sold for its fair market value on the day before the expatriation date. Any gain arising from the deemed sale is taken into account for the tax year of the deemed sale notwithstanding any other provisions of the Code. Any loss from the deemed sale is taken into account for the tax year of the deemed sale to the extent otherwise provided in the Code, except that the wash sale rules of IRC 1091 do not apply.
The amount that would otherwise be includible in gross income by reason of the deemed sale rule is reduced (but not to below zero) by $600,000, which amount is to be adjusted for inflation for calendar years after 2008 (the “exclusion amount”). For calendar year 2014, the exclusion amount is $680,000. For other years, refer to the Instructions for Form 8854.”
>If the Exit Tax applies to you, then you will be treated as if you have sold all of your assets on the day before you renounce your citizenship and will be taxed on your capital gains.
Should not affect most people, but if you have unrealized capital gains over ~$700k, you will be taxed as if you sold them when renouncing citizenship.
Emigration is going to be essential to avoid technological enslavement over the next few decades. I plan to move to a sovereign country with small population which has a good number of educated and well connected rich people and which has strong relationships with the elites of large (soon to be enslaved) countries. Ideally a country where the elites feel safe to have their holiday houses and send their children to school.
The reason why the country must have a small population is because it's not profitable for corporate interests to take control of small countries. Corporations will want to enslave countries with large productive working populations because they are more profitable to exploit. With the US, for example, you just need to corrupt one election, one legal system and you can potentially acquire 350+ million workers/slaves in one fell swoop; that's very profitable. You just need to change one single law and you can reduce the freedoms of 350 million people to squeeze additional productivity out of them... Again in one fell swoop. That's extremely profitable.
On the other hand, if you want to enslave a small country full of rich educated people, it's going to be challenging because these rich people can leverage their political connections and bribe your corporate insiders (or use their personal connections to manipulate them) to steer you off course... And then these people are not useful to enslave anyway; firstly, there are too few of them (doesn't scale), secondly, they have no skills to produce anything useful... Rich people are a liability; you want to take countries full of cattle you can milk, not parasites.
As soon as people realize what's going on, it will be too late to leave. Just like what happened in North Korea. If you want to have a decent life, you need to think like a parasite. Don't make the mistake I did early in my career thinking that anyone will try to protect your rights in the name of 'justice' - There is no justice. Human evil has no limits.
> This isn’t just a case of comfortable white people itching to do Colonialism 2.0. While there are no official statistics on the breakdown of American emigres by ethnicity, the country’s ingrained racism has made it more appealing for Black Americans to move abroad, while many Asian Americans find the job opportunities overseas better than the ones at home. Hispanic Americans are also opting out in increasing numbers for a variety of reasons.
Can someone explain to me why white people moving to another country is considered colonialism?
I really wouldn't bother. There are stronger versions of the argument that race defines everything you do, even though I disagree with them. But this publication is pretty in line with the popular view that "doing anything while white is problematic". You may be familiar with it in the context of moving house: move to a cheap neighborhood? You're gentrifying. Move to a good neighborhood? You're segregating. In both cases, you're reinforcing white supremacy.
I'm not even white, I just find the logic transparently nonsensical and am somewhere between amazed and amused that it's become so popular (and hilariously, the animus is far more targeted towards race than class).
> Can someone explain to me why white people moving to another country is considered colonialism?
The premise is that colonialism was marked by people from wealthy countries (generally Europeans) occupying and extracting wealth from poorer foreign lands. So the author is alluding that a (relatively speaking) wealthy white person looking to hop to a lower cost of living land, and be treated like a king for their wealth, is similar at face value.
That said it's really just at face value. Using your expatriated wealth to live like a king in a low cost of living country is not the same as extracting wealth, and the expats generally hold no political power either.
> Yet on some instinctual reptilian-brain level, it’s hard to shake the feeling that it’s not supposed to be like this. This doubt is sometimes sparked by reading about the lives of historical figures. When you discover that Mark Twain spent more than a decade of his life living and working abroad in places like London, Berlin, and Vienna, you might be inclined to wonder “how?”
I first had this feeling when I read in Les Mis where Valjean decides that France isn't safe anymore and that he's going to move to England, and then tells Cosette to be ready within a week.
I'm torn. Obviously sovereign societies are free to enact any rights and restrictions (within constrains of treaties they sign up to) they see fit. But I see people's freedom of movement as a natural balancing right in a globalized world were capital moves easily across borders.
In EU freedom of movement is normally only talked about as a right due to shared european values but another pragmatic view is: if you allow for such drastic unequal neighbors to be living under similar legal/economical frameworks it's only fair (and economically sound) to let people move with capital.
95 comments
[ 4.9 ms ] story [ 175 ms ] threadA German-American friend of mine now living permanently in Germany for 10 years, still has to pay America for taxes. To drop the citizenship they will have to pay a significant portion of their net worth to the IRS.
1) People who have received bad tax advice
2) The wealthy
In Canada, our retirement system is built upon three pillars, CPP/QPP/OAS (similar to US Social Security), RRSP (similar to US 401k), and TFSA (similar to US Roth IRA, but more inclusive, as every resident can use it regardless of income level). TFSA is arguably more important and a higher priority for retirement savings than RRSP in Canada. However, the US does not recognize TFSA as a retirement scheme. So if you are a dual American-Canadian citizen, the financial advice is not to use TFSA, as a) it won't be tax-sheltered, you will have to pay taxes to the US, and b) the paperwork required is a huge headache.
Every country has something that they don't tax and US will. Because that country does not tax the thing, there is no tax credit to offset US taxes payable and you may end up paying a lot. The thing may be a retirement savings (Canada) or capital gains (Switzerland) or a myriad of things other than employment income.
>If you are a U.S. citizen or a resident alien of the United States and you live abroad, you are taxed on your worldwide income. However, you may qualify to exclude your foreign earnings from income up to an amount that is adjusted annually for inflation ($103,900 for 2018, $105,900 for 2019, and $107,600 for 2020). In addition, you can exclude or deduct certain foreign housing amounts.
There's a lot of exceptions. It's not a blanket "if you earn less than X you don't pay US taxes".
If you’re earning in a country with a treaty, say the UK, you pay the local tax and any difference is paid to the US if your local tax is less than what you’d pay the fed+state if applicable.
I guess you could argue: military/consular protection. Yet, still feels expensive.
https://www.irs.gov/individuals/international-taxpayers/fore...
So if you make $X00 and in the Bahamas your income tax is $7, but in the USA your tax would have been $100, you remit $93 back to the US government. Even if you didn’t step foot in the US that year and all the income was Bahamas. Roughly.
And if you don’t like it, you make a one time payment of (I think) a third of your net worth. Which is not ideal if the only thing you own is a tangible thing like your childhood home, because now you need to sell it.
Being an American comes with a ton of benefits, and one of the costs is how mind numbingly expensive it is to leave.
Note, the conversation of whether the US should have territorial taxation roars it’s head up every few years. all of the above might change
https://www.exberliner.com/features/politics/can-amis-double...
Related:
Global Perspectives on ADHD: Social Dimensions of Diagnosis and Treatment in Sixteen Countries (2018)
https://en.wikipedia.org/wiki/Methylphenidate#Legal_status
Here in Switzerland, for example, adult ADHD was even started to be recognized only since 2011. No immediate release formulations are legal here, only extended release. Even though Novartis, a Swiss company, is the producer of Ritalin. You can't get Ritalin in Switzerland, as it is an immediate release drug.
In Russia, _all_ stimulant drugs are banned (and ADHD usually is not even recognized as a valid diagnosis). As is you can get to prison there if you take your Ritalin with you.
Bipolar medication on the other hand, many of my bipolar friends in Europe have difficulty getting proper medication, much less proper treatment. In the US, the only issue I had was finding a psychiatrist and therapist who was available.
The problem is cost. If I had ended up getting sent to inpatient treatment (nearly happened), the bill would have been huge.
It's hard to have a conversation when you talk about "europe", where there are a dozen different healthcare systems.
Here in the UK treatment (including medication) is easily available to anyone who needs it.
A slice of the challenges she faced:
- Few psychiatrists/doctors were willing to prescribe meds to an adult.
- You can't call to check on availability of Schedule II medications from pharmacies, you have to query in person, and many require a prescription before they'll answer.
- Insurance often requires pre-approval to pay for the meds - another hoop and another delay.
- You can only ever get one month prescription at a time (with no refills), and have to contact your doctor every month. Not too early, not too late.
Any one of these issues can be tough when you have an executive function disorder (poor short term memory, poor awareness of time, etc.), and especially if you run out of your meds and are fighting yourself just to do basic self care.
Never had an issue with this and I have frequently switched doctors. I'd suggest finding a prescribing nurse practitioner. It's hard to find a psychiatrist without waiting six months for the first appointment.
> You can't call to check on availability of Schedule II medications from pharmacies, you have to query in person, and many require a prescription before they'll answer.
I drop three prescriptions off at a time. Or it's called in and then I call for refills. If they don't have it in stock they can probably order it.
> You can only ever get one month prescription at a time (with no refills), and have to contact your doctor every month. Not too early, not too late.
I've had five or six psychiatrists. All of them prescribe 3 months in advance after the prescription is stabilized.
Not true.
https://www.bmj.com/content/367/bmj.l7069
Go careful here. Ketamine infusion is a pretty heavy duty intervention and patients require careful monitoring while taking the infusion and for a short term afterwards.
In the UK we're looking at 1:1 nurse:patient ratios, delivered in ECT suites.
In the US the way increased access has been achieved is by dropping down the nurse:patient ratio and delivering it in wider settings. It's a more risky way to deliver the treatment.
We know that in the US there's already a problem of "doctor shopping" -- going around doctors until you find one willing to prescribe ketamine / eskatamine. This is normally associated with harmful prescribing, although it's too early to say if that's the case with these meds.
EDIT to add: There are cultural differences here. The US sees access to medication as being the same as access to treatment. The UK sees it as over-medication with at best ineffective treatment, and at worst treatment that causes harm.
I've been taking ketamine lozenges at home for 2+ years now. Ketamine is a very safe drug. It is used in pediatrics and on the WHO's list of essential medicines. It's hard to find any fatalities directly attributed ketamine in the literature.
The infusion therapy you speak of has been used to rob patients blind. Before I found a doctor that would prescribe I was on target to waste 10k a year. And that's not even considering the wasted time of appointments in the clinic.
> We know that in the US there's already a problem of "doctor shopping" -- going around doctors until you find one willing to prescribe ketamine / eskatamine. This is normally associated with harmful prescribing, although it's too early to say if that's the case with these meds.
Doctor shopping refers to going to different doctors to get more medication or to divert the prescription for profit. If one is depressed and seeks treatment from a researcher and doctor in another city or state it is not doctor shopping because of the underlying medical condition. Seeking help is not a crime.
Nevertheless, could you please post proof that there is a problem since you made that claim?
https://smmry.com/https://www.currentaffairs.org/2020/11/you...
Copy on IPFS
https://ipfs.io/ipfs/QmQVWdzhXU52yLRNCMLFrX3sgYAjnVUhpFnJ5U7...
As for the ease of living abroad, once you have a source of income everything else tends to fall in place. Many countries are happy to have you if you are self sufficient. The article lists expensive options for citizenship and residency permits before concluding that expatriation is impossible.
I agree with the laments about the rise of the passport system. However the hyperbolic tone is off-putting. Likewise for the standard issue anti-capitalist tirades and slight of hand misrepresentations.
>...the loudly pro-inequality magazine The Economist.
>And despite capitalism’s promises to provide all the lifestyle choices you could ever desire, few of us have the option of trying our luck elsewhere if we want.
Most expats I've known burn out within a few years. Eventually they can't cope outside of their previous environment either socially, culturally or economically. Everything is possible for those who are driven and able to adapt. If anything, the remaining freedom within the capitalist economic system makes this possible. For those who can't adapt, contribute or support themselves, what else can be expected of a foreign country and culture?
I seem to recall that retiring to Mexico has been extremely popular the last decade or so. I have to agree with your point - each country is a quite different experience. If retirees can make it work then surely someone with a career can.
I used to agree with your first sentence but Government never gives attained powers back. The lockdowns represent a crossing of the Rubicon.
Most people's source of income is employment. It's hard to get employment in another country if you don't already have the right to live there, especially if there's not a shortage of native workers with your skills.
Job markets are usually protected by work permits. Arguments about protectionism can go either way. I'm not advocating either position, only making a realist's observation.
Job creators and people who have income are usually recognized as a benefit to an economy. The expectation that migrating to a foreign country (for political reasons of all things) should be made easy seems misplaced. There are ways to achieve this and live well for those who apply themselves. A little creativity that yields a modest passive income is enough to prosper on in many parts of the world.
As long as you're white. And male. And straight. And cis. And wealthy.
The main reason Americans decide not to emigrate, is that the US is actually a fine country and a good place to live. There are a few other good places to live, like Western European countries, or maybe Japan if you can handle cultural differences, but the difference is not that much that it would be worth of getting through all the hurdles to move there. Nearly everywhere else, the quality of life is much worse.
I feel like this is where a lot of misunderstandings in these discussions come from--the difference between being a permanent alien and being a citizen. In the United States there's a process for people to become a full member of our society. There's also a process for being a working alien here. Two different paths that don't have to necessarily overlap.
Some countries, though, require you to have only one citizenship, which implies you will have to get rid of whatever citizenship you have. But that was not the point of your incorrect statement.
Once thing that is common in Europe is citizenship by family, and I am not aware of a country (in Europe) that allows citizenship by being born in that place. In fact, I am just aware of United States and Brazil with the latter rule, but I never investigated it further.
Citizenship based on where you're born: https://en.m.wikipedia.org/wiki/Jus_soli
Jus Solid is more expansive than you think. It's most of the western hemisphere and in many European countries it is allowed if the parent(s) are in the country legally or are permanent residents.
Most of the New World is jus soli, while some European countries now accept jus soli under certain circumstances.
What utter rubbish! For example, here in Sweden after 5 years of living here and nothing serious against you in your time here, you can apply for citizenship[1]. The application fee is 1500 SEK[2] (~175 USD today), hardly a "ton of money".
1: https://www.migrationsverket.se/English/Private-individuals/... 2: https://www.migrationsverket.se/English/Private-individuals/...
The 'ton of money' comment were for people who wish to use pathways open to people who bring large investments into the country.
https://www.migrationsverket.se/English/Private-individuals/... (Ctrl+f "Permanent residence permit")
That's hardly "zero."
I'm living in Germany, with zero previous connection to the country. Been here a couple of years on a work permit, and in another couple of years I'll be able to apply for citizenship.
That seems very very far from zero.
Perhaps consider checking the facts before stating falsehoods?
[1] https://news.ycombinator.com/item?id=25069948
One thing that's a big differentiator from the US system, is that the immigration system doesn't use lotteries or quotas. As long as you fulfill the requirements, as listed in the law, you get citizenship or the relevant residency permit.
https://en.wikipedia.org/wiki/List_of_sovereign_states_and_d...
From there, if you are close to retirement and have your wealth in illiquid assets where a penalty for converting them to cash is steep, you are kinda fucked.
From Above link: “ IRC 877A imposes a mark-to-market regime, which generally means that all property of a covered expatriate is deemed sold for its fair market value on the day before the expatriation date. Any gain arising from the deemed sale is taken into account for the tax year of the deemed sale notwithstanding any other provisions of the Code. Any loss from the deemed sale is taken into account for the tax year of the deemed sale to the extent otherwise provided in the Code, except that the wash sale rules of IRC 1091 do not apply.
The amount that would otherwise be includible in gross income by reason of the deemed sale rule is reduced (but not to below zero) by $600,000, which amount is to be adjusted for inflation for calendar years after 2008 (the “exclusion amount”). For calendar year 2014, the exclusion amount is $680,000. For other years, refer to the Instructions for Form 8854.”
https://1040abroad.com/faq/renouncing-u-s-citizenship/#:~:te...
https://www.irs.gov/individuals/international-taxpayers/expa...
Should not affect most people, but if you have unrealized capital gains over ~$700k, you will be taxed as if you sold them when renouncing citizenship.
The reason why the country must have a small population is because it's not profitable for corporate interests to take control of small countries. Corporations will want to enslave countries with large productive working populations because they are more profitable to exploit. With the US, for example, you just need to corrupt one election, one legal system and you can potentially acquire 350+ million workers/slaves in one fell swoop; that's very profitable. You just need to change one single law and you can reduce the freedoms of 350 million people to squeeze additional productivity out of them... Again in one fell swoop. That's extremely profitable.
On the other hand, if you want to enslave a small country full of rich educated people, it's going to be challenging because these rich people can leverage their political connections and bribe your corporate insiders (or use their personal connections to manipulate them) to steer you off course... And then these people are not useful to enslave anyway; firstly, there are too few of them (doesn't scale), secondly, they have no skills to produce anything useful... Rich people are a liability; you want to take countries full of cattle you can milk, not parasites.
As soon as people realize what's going on, it will be too late to leave. Just like what happened in North Korea. If you want to have a decent life, you need to think like a parasite. Don't make the mistake I did early in my career thinking that anyone will try to protect your rights in the name of 'justice' - There is no justice. Human evil has no limits.
> This isn’t just a case of comfortable white people itching to do Colonialism 2.0. While there are no official statistics on the breakdown of American emigres by ethnicity, the country’s ingrained racism has made it more appealing for Black Americans to move abroad, while many Asian Americans find the job opportunities overseas better than the ones at home. Hispanic Americans are also opting out in increasing numbers for a variety of reasons.
Can someone explain to me why white people moving to another country is considered colonialism?
I'm not even white, I just find the logic transparently nonsensical and am somewhere between amazed and amused that it's become so popular (and hilariously, the animus is far more targeted towards race than class).
blacklist = banned
whitelist = blacklist
The premise is that colonialism was marked by people from wealthy countries (generally Europeans) occupying and extracting wealth from poorer foreign lands. So the author is alluding that a (relatively speaking) wealthy white person looking to hop to a lower cost of living land, and be treated like a king for their wealth, is similar at face value.
That said it's really just at face value. Using your expatriated wealth to live like a king in a low cost of living country is not the same as extracting wealth, and the expats generally hold no political power either.
I first had this feeling when I read in Les Mis where Valjean decides that France isn't safe anymore and that he's going to move to England, and then tells Cosette to be ready within a week.
In EU freedom of movement is normally only talked about as a right due to shared european values but another pragmatic view is: if you allow for such drastic unequal neighbors to be living under similar legal/economical frameworks it's only fair (and economically sound) to let people move with capital.
Because of that I'm wondering why the cover photo is from Bruges, Belgium, more specifically:
https://www.google.com/maps/@51.2091441,3.2241047,3a,90y,334...