I guess everyone's experience is a bit different- I have known people who run into problems after the first re-entry permit, and even more after two.

Speaking with a specialist here for my condition, we got into a discussion about difference in medical outcomes between countries- and he pulled up a detailed report which we reviewed. Seemed between UK, USA, France and Switzerland for some conditions a bit better in one, a bit better than another. We then discussed some countries that Expats routinely describe a having top health care- but the statistics and reports indicated otherwise.

Earning potential, ability to have and do more nice things. The outdoors...

Homeless and druggies in the UK too. Guns as well, just much less.

I said HERE.

i.e. where I am.

I know you do. Until August. And doesn't sound as though you're ready to make a decision so thought that might help. Jeez, it was only a suggestion.

Yep, and it's bloody awful. I had a couple of nights in a hospital a year or so after we moved, I was on a bed in the corridor along with several other people on beds in the same corridor. Hubby was referred for a colonoscopy at his PCP registration appointment, that took 7 months.

Basically, all the horror stories I've read about with the NHS (but never experienced, it's always been amazing IME), I've had here in the US. But we're paying a fortune for it.

We moved back to England in January 2017 and were very glad to be out of the US health care system. We took out private health insurance as it was a fraction of the cost of what we were paying in the USA and over the last 9 years have used it several times. We are now in our 70s and it costs less than £90 each per month with a max £500 excess/deduction. My wife has used it for cataract surgery and I’ve used it twice for surgery on my knees plus a referral to a cardiologist when I was concerned about a very slow heart rate. The paperwork here is absolutely trivial compared to what we had to go through in the USA. We can have same day video appointments with a GP who, if needed, can refer you to a specialist via a pdf letter they email to you. 5 years ago I went through this with my right knee and immediately got referred to a an orthopedic surgeon who saw me a week later and ordered an MRI. - I was able to look up several surgeons on the hospital list and choose one. He found a badly torn meniscus and I had surgery a few weeks later - this was end of 2020 with Covid still raging and surgery happened end of January. Total cost to me was £500 including all the appointments, MRI and surgery.

This year my other knee was showing similar symptoms so I went through the same process, was delighted to see that the same surgeon had not retired. Again a badly torn meniscus but this time arthritis to complicate matters, but only on the inside of the knee so 3 weeks ago I had a partial knee replacement. Again only a cost of the excess, £500, and again the invoices are extremely simple and easy to understand. Only 1 invoice so far, covering 2 consultations and MRI, goes to the insurance company then the hospital sends me one for the balance. No invoice yet for the surgery but like last time I expect they will wait until I’m signed off in 6 weeks by the surgeon and have had my 3 sessions of physio and send a single invoice to the insurer who will pay in full.

I think this is an excellent take on the subject.

I've been here pretty much continuously for 40 years now; initially in SF, then the suburbs.

If you live in a decent suburb, things don't seem much different from how they were in the 80s. It's become a lot more crowded and traffic is a challenge, and that means, pick your home and work locations very carefully (or WFH). BART is still a highly functional transit system.

I can't think of a better place to live in terms of weather; it's mild most of the year. I like to go out hiking / walking, and I can pretty much go out every day of the year. If it's raining, wait an hour and it's stopped. I go out all through December/January/February, and I just have to wear a light jacket.

The people are great. We have a VERY high immigrant population, but they are mostly well-educated Asians (Indian, Chinese, Filipinos, Vietnamese, etc) and it makes for a great community. There's also a lot of hard-working Hispanics. My Filipino partner feels very safe / at home.

I wouldn't want to live here if I didn't have a good income; that may apply here more than many other places. But - IF you are lucky enough to have a good income, a good life can be had - amazing selections of food and restaurants, and lovely scenery (hills, valleys, bays, bridges everywhere). I might be concerned about the impact of AI ... that would depend on OP's career.

Last year, my niece visited me with her family. She had visited me back in the 90s, as a young girl, and now she was visiting me with her kids, 30 years later. I was all worried, hearing the narrative that everything is much worse, and almost discouraged her from coming. In the end, they had a fantastic time, going into SF, traveling around, etc. It actually reminded me of just how lovely this area is.

The weather is great, I know of one other place with weather as good ( Medellin). Yes within a relatively short driving distance as you point out lots of pretty landscapes, and good variety of restaurants though a bit frustrating trying to find a decent Italian restaurant with authentic Italian food which I am a fan of. I certainly find greater variety and quality of restaurants in London.

Costs of property are insane, and this drives up all the other costs. It is quite disheartening what has happened to San Francisco, let alone Oakland and parts of San Jose. Education whether public or private schools certainly much lower standards than decades ago. Some very weird views on parenting and bringing up children, While more a problem in the cities, crime overall and safety issues certainly worse off than decades ago. I worked in San Francisco and then Menlo Park - in front of office I worked at in San Francisco now a cesspool of homeless encampment at most times.

I lived in Bay Area three times in my life, first time as a child for period of time- we kept the house in same neighborhood which I moved back to third time, so I saw the changes over time in the same neighborhood.My opinion is not a place to bring up a family.

The few times I have been back a few times for business only confirms for me we made right move to leave the Bay Area. One aspect was the traffic.; and we then spent time in Pacific Northwest and had a much better overall quality of life.

Those are valid points about life in the US. But for me they are all cancelled out by all the negatives ... it's true that the natural beauty of the US is stunning, just in California alone the variety of snow, mountains, beaches, deserts etc is amazing.

Homeless and druggies in the UK, yes but not on the scale it is in US cities. Gun crime is very, very low compared to US - come on!

OH has his eyes on Orange County area ... so we wouldn't be going back to SF if we did make the move to California.

I've spent almost all my time in Northern California, and it was always fashionable to poo-poo Orange County as 'sprawling suburbia', and the home of 'Disneyland'. But a couple of years ago, I had reason to visit Laguna Woods, Laguna Hills, Laguna Beach, San Clemente - all REALLY nice places! I doubt I could ever afford Laguna Beach/San Clemente, but the inland areas were really nice - clean, safe, rolling hills, etc. I even contacted a realtor and 'made some inquiries' ... . I concluded it was about the same price as the area I live in now. I never took it any further, since I'm getting too old to relocate, but I decided it was certainly a good place to live. I distinctly remember driving through Laguna Woods / Aliso Viejo and loving the setting! We also loved the ocean-front towns; still funky despite the gentrification. We had a fantastic dinner in the town of 'Orange', then the best tacos ever in Newport Beach, and a great meal by the pier in San Clemente.

Now I want to go back!

Regarding the political situation; I feel that the current US administration is just as bad whether you live in Europe or the US. The current admin is wreaking havoc in Europe and I'm not sure I'd feel any safer in Germany or Poland. Daily life here hasn't changed for the vast majority of people (yes, it sucks to be brown and undocumented).

Did you say where you are living these days - what country? I didn't see it in the posts I read.

Regarding healthcare - the one caution I would offer is that if you don't have a PCP, it may take a while to get one. For my partner and I, we can get in to see our doctors within a few days, but if you are 'new', apparently there are waiting lists to sign on with PCPs. At least in some areas. Last year, my partner needed serious retina surgery. We saw the specialist almost immediately, and they wanted to schedule her the next week for surgery! We had trips planned and had to stall them!

If you are given to living or hanging about in the poorer parts of the big cities then, sure, you are going to see the less happy side of life. Someone with a healthy income can avoid most of those scenarios, unless they are partial to bumping white powders or living on the wilder side of life.

Gun crime is an issue but if someone were going to live in daily fear of something then I'd say that should be about getting into a serious car accident - the driving standards here are abysmal and the occurrence of road incidents far exceeds that of violent gun crime. Just last week I saw a car piled into the central median of the local two lane interstate while the attending police officer gave the driver an old school sobriety test, in the middle of the 'fast' lane.

The current political situation is, for some of us, far from ideal but I'm stuck in a deep red Deep South state where the politics has been right of sensible for a long time and I can't see that changing any time soon, regardless of any president's ideological leanings. Add to that Trump's most recent detrimental meddlings globally and, if I were the type to worry about stuff beyond my control, I'd be wary of guaranteeing the safety of visiting any major city, festival or sporting event anywhere at the moment.

I hope that whatever decision is reached that it is one you can both be happy with.

San Francisco is still a wonderful city. Violent crime, for example, has been trending downwards for a long time now and is at its lowest level since... the late1950's. I am really struggling to think of many places in the US I would want to live in at the moment in preference to SF. Either right-wing politics or climate rule out most of the country for me.

Someone else was asking why nobody has left since the start of Trump's second term. Anecdotal, of course, but I know several people who've moved back in the last year. Well, to Ireland and France to be precise. I would likely have joined them but for family ties here now. And I am convinced I wouldn't choose to move here at present, given the ongoing political shit show and the likelihood of far more damage being done to the country over the next three years.