Spotty health insurance coverage has been the deciding factor for some expats. Anna Inglis, a 38-year-old freelance photo producer based in Brooklyn, said she had decided last month to return home to New Zealand in part because she did not have health coverage through her job.
The American system of private health insurance, with varying coverage and sometimes high premiums, deductibles or co-payments, is a stark contrast to the public systems in places like New Zealand, Australia and Britain, where government-subsidized access to doctors and many services is universal.
Some expats say their health insurance options in the United States are so poor that they have instead used travel insurance as their primary coverage. Others, like Ms. Inglis, have only the most basic level of health coverage in New York, but back home, that is not a consideration.
“I feel reassured by the New Zealand political system,” she said. “Hopefully, the system can cope better than the New York system is currently.”
This intuition to flee the United States, and its health care system, during a pandemic may be a good one.
“The U.S. has been a leader in so many other areas, but when it comes to the health care system, it is behind,” said Adam Kamradt-Scott, a global health security expert at the Center for International Security Studies at the University of Sydney.
Professor Kamradt-Scott said that as pressure mounted on the American system, it was possible that citizens would be prioritized over foreigners. Some hospitals in the United States, especially in New York, are “literally so overwhelmed that people are only presenting when they are very, very sick.”