Ah that does make a difference then. But another re-entry permit maybe? If you're still undecided it would buy you some more time.

Best of luck to you.

These questions are legitimate, but seem unlikely to help you make decisions. Here are some others you might consider:

Can your OH actually get the healthcare he thinks he can? Post-covid, there is a nationwide doctor shortage. As in, we moved interstate a year and a half ago and have only just managed to get PCPs. This is with good insurance -- there just aren't enough doctors. You are going to have to make some calls to research this one, the insurance company websites say everyone is accepting new patients and they most certainly are not. Having a kid puts the stakes of this one through the roof IMO. It's not like you will be able to pop back to your old state to keep seeing your old doc (which is what we were reduced to).

How will your support network compare here? Will you go from support of family/friends to something comparable or not? I know plenty of people who manage having kids with no local support network (it's par for the course in academia), but it is a very different kind of existence on the absolute daily level. Also, I think the childcare shortage may be as bad as the doctor one in some places. A colleague had to hire a nanny because they simply had no other options. She picked up the 4am shift stocking shelves at Target to pay for it! (This is a well-educated person in a decent job, but nannies are expensive!)

How willing/able are you to stick your head in the sand and ignore the news? It is basically a survival skill at this point. Engaging with the news cycle drives people to distraction/exhaustion/despair. If it is already doing that from afar, will you be able to compartmentalize if you come here?

So basically I would advocate for digging into some practical questions.

Ditto. We moved here mid 2023, finally had our first registration appointments with a PCP 2 years later. And then had to wait 6 months for a mammogram after that. Healthcare here is shockingly bad.

I would never leave my child 'for a bit' for the sake of immigration! Child has a green card, so not relevant.

I really wish we would not make sweeping generalizations from our own personal experience. I'm sorry that you had that experience but I would say the exact opposite. My wife has had life threatening episodes and received the most excellent care; if we had still been back in West London she would not have survived. The fact is that, just as anywhere in the world, there are parts of the USA that are idyllic, safe with little or no crime, with good public schools, good health systems, even sane local politics and there are other parts that I would avoid at all costs. That's life!

Reasons why not?

Re read my post: we all have greencards and valid reentry permits.

I doubt we'd get a third one tbh. Also another 2-3 years of indecision is not going to help.

I was obviously not talking about countries at war.

I'm truly shocked at this CO. I know you live just outside of a major metropolitan area on the east coast and I'm here in a little city in Mississippi. When I call for a mammogram down here, I am scheduled within 10 days of the date of my call. The same when I lived in Westchester County, NY 25 miles from Midtown NYC. My husband died last month in a hospital here in sleepy MS and he received excellent care while he lingered before death claimed him. But then I'm just an old crusty woman of many years so what the heck do I know but what I have experienced. My daughter lives in lower NYS and she and her family have excellent doctors and medical care. Of course, I'm not at all familiar with the healthcare in Europe except for what my Tante Selma received in Germany and it according to her was excellent, so I can only judge what I have experienced. I have experienced healthcare in Canada and it was terrible and I had to come back to the US to get the proper care. We've never had a PCP healthcare policy but an HMO and could go to any physician of our choosing who was accepting patients. But as I said, these have been my experiences in both a large metropolitan area and a sleepy southern town.

I live in Cleveland (Eastern suburbs). We have the world famous Cleveland Clinic here. Good doctors but waits for appointments and shortage of primary care doctors. Wait for mammograms are usually 3 - 4 months.

Interesting -- I hear about friends in the UK waiting months for appointments (in fact it has made my OH swear he would never live there!), but here in CT I get instant attention for medical needs. Perhaps it's because I'm already on the roster, as it were, but I get a notice that it's time for my annual mammogram, call in, and get an appointment right on the twelve-month mark that my insurance requires. When I had my hearing checked recently and the doctor wanted to be sure that the problem didn't have deeper roots, I was booked for the brain scan he requested the very next day. Same thing when I had a vision problem: my eye doctor arranged for me to see the retina specialist the next day. So again, we see that it's impossible to generalize.

This is why I think OP needs to look into specifics wherever it is they are looking to live. See about PCPs and whatever specialist(s) they need. It could be totally fine, but definitely seems worth a few phone calls!

Our main problem was not having PCPs, since everything we needed required a referral (even on a PPO). The waiting lists were quoted as 8 months when we arrived, but wound up being more than 12. And we were lucky: apparently they are now closed

Education quality is one issue. Safety as children get older. The behavior of parents at sporting marches and lack of discipline in schools and by parents.

We lived in an area supposedly with "top" schools by American standards- parents would pay a lot of money to get into that school district. I was not impressed about academics of the school, and the safety issues. Very ideological education.Where I worked was near the school ,and at lunch students would go to local convenience store at petrol station so I saw often the behavior of the students- with upper and middle class students getting severely bullied. I do not know how prevalent the anti-vaccine crowd is in California, though this might be a concern.

San Francisco used to be a wonderful city, now with the homelessness, crime, traffic and so forth it certainly has gone downhill in recent decades. While last two years reports of improved crime statistics, long term trends are worse.

Cost of living another factor, so even with higher salaries in tech sector, rent and other costs eats up much of the higher salary compared to other states.

Yes in the tech sector there can be great opportunities, however for a family I do not see that making up for the negatives,

Of course there are other factors- such as if one have a wider family around, or of course where in particular in America or UK one lives.

I have lived in Bay Area three times in my life, so my views perhaps a bid jaded since I remember what it used to be like.

My experience is in general there are delays with NHS, but at least in my case more serious issues are seen to in somewhat reasonable time period- however I pay 150 per month for private insurance to get immediate appointments or surgery if I need just in case. One issue I had treatment for in America and the UK main difference was specialist in UK took more time to explain and discuss condition.