Some proportion of diabetics I know are applying for foreign visas/passports/citizenship because they are afraid of what will happen when we, “take a shotgun to healthcare.”
I know that this fear has always been floating around the community. It’s existed for years. I haven’t done this, but how many of you have?
I spend a great deal of my life living off a passport around the world. I can’t think of anywhere in the world that I’d prefer to go over remaining at home, and regardless of the disaster that’s the current government, I wouldn’t take a foreign healthcare system over the US. I’ve lived in a number of other countries, including places with socialized medicine, and would never take that, given the choice.
The grass may appear greener, but it’s not, and good luck moving to, making a living in, finding acceptance in, and gaining citizenship in other countries.
I was born a dual national, so I have always had two passports, and at some point in my life, three. I have lived in the US, Canada, Europe, Africa, and Asia under their various healthcare systems. The US tops them all as the very best, especially awesome when Medicare kicks in.
There is a reason why millions of people from most countries around the world flock to the US when they can, versus the handful of US citizens who want to leave the US and relinquish their US passport. US citizens abandon the US for many reasons, with taxation being the primary reason, well before healthcare and politics.
I think that having a passport is a great idea, what with US citizens getting rounded up by ICE sweeps.
But I don’t see how it helps with getting healthcare. I lived and worked in Canada for a couple years in the 90’s and yes OTC insulin was cheaper there. BUT US Citizens in Canada do not get any form of automatic insurance in canada unless you’ve got insurance there like say you’ve got a job AND you’ve waited through the healthcare kick-in delays.
I think the might be afraid of the system collapsing, but I’m not 100% sure.
I think it is a good idea to have as many passports as you are entitled to. But not necessarily for reasons related to health care. I recently renewed my US passport and got a passport card at well. Even though I’m as White as anyone can be, I keep the card in my wallet at all times.
I’m surprised to have just learned that under US law, one can both multiple nationality and citizenship. I always thought that technically being a US citizen implied renouncing citizenship to all other countries and becoming a citizen of another relinquishes US citizenship. US citizens are required to use a US passport to leave or enter the US.
It applies to a native born American, it’s not clear for us immigrants. The supreme court decision was pretty much that American citizenship by birth is an inalienable right. Of course the current government (two out of three branches) want to abolish birthright citizenship which would seem to imply that no one has an inalienable right to American (i.e. US) citizenship.
The constitution is clear, though of course anything written in English is ambiguous. Search for “natural”:
[Powers of Congress] To establish a uniform Rule of Naturalization, and uniform Laws on the subject of Bankruptcies throughout the United States
[The president, Article 2] No Person except a natural born Citizen
Then, of course, the 14th; I know many Americans dispute that this is part of the constitution but the judiciary still regards it as such:
All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside.
There are no conditions on that last clause, so the power lies with Congress to change the laws with regard to naturalization or, for that matter, bankruptcy but changing them retroactively? That would be interesting.
As for passports for healthcare @mohe0001 that’s not the issue; passports are a very western idea and really don’t count for much. Citizenship is itself a very American concept.
Yeah, I could leave, but I would be leaving home. I’ve done that before (remember, I’m an immigrant) and I did it because I didn’t feel like it was my home any longer. The people no longer felt the way I did, they were out there ripping each others unseeing eyeballs out, not caring what they did so long as they got loads-a-money.
So, yeah, I get it, I surely do. But I didn’t come here because I liked the place, I came here because I thought that maybe this is a place that can be made better and that maybe I could help. I still think that’s true, this is still home and I can’t see that ever changing even if I leave it in practice.
As for the healthcare, it sucks. I live with it; the greatest improvement that has happened to my own health across the UK (extremely good healthcare), Taiwan (extremely good healthcare) or the US (yeah, whatever) is FOSS software, developed world wide, and insulin pumps and CGMs to feed them, available world wide.
The magic link is the software. It’s new, it’s subject to cost-benefit analysis in most of the worlds healthcare systems, sure I can buy it anywhere but why would I think that is good?
The number of people who can leave the US and set up elsewhere is pretty much 0, well to 4dp. Maybe out of the 300 million of us 30,000 natural born Americans plus us immigrants who don’t want to, not because this is a better place but because it is our home, until the day we die.
I believe there is a birthright citizen case on the SCOTUS docket this term. It may be a true inflection point. To me, the Constitution does not seem at all ambiguous on this point. I do not think it is obvious which way the court will rule.
Other than becoming President, no law distinguishes between natural born and naturalized citizens, even the ones where the sanction is revoking US citizenship. That doesn’t mean naturalize citizens are TREATED the same, especially these days.
If people are scared that the sh!t hits the fan when we take a shotgun to healthcare, or that insurance just gets too expensive for them to support their families, I understand that growing fear.
It’s a moot point for me, because I’m gonna stay and fight this fight. Check this out - I think the doctors understand the problem. If they can be rallied, maybe we can get an edge on fixing this mess.
This is good engagement by the doctors on LI…
They write things I don’t understand in response, though…
I think they are trying to say that we are totally screwed. A lot of people hold that opinion - a surprising number of people feel that way.
I think I’ve heard the, “I’ll leave the country” statement before, sometime around the second Bush. I suspect it’s a general response that few people follow up.
The people who will really be affected by the current changes either already have another country to go to or simply cannot afford to leave. I have little sympathy with people who pack up their bags and go, even though that is what I did to the UK; it’s not an answer it’s an admission of defeat. Speaking here as someone who was given the opportunity and really did do it.
I disagree with almost everything you say but, like you, I’m not defeated yet.
I don’t really feel that I have the freedom or the capability to the leave the state, let alone the country. 
I’ll try to hold ground here. I’m drowning, but if I go down, it’s gonna be here.,
Look what popped up…
The doctors understand what I wrote. They get it. This is a significant response from them.
We have a lot of whistleblowers coming forward across industry.
I’m seeing constructive movement. Simultaneously, nothing is happening. It’s a really weird moment in time.
Yeah, the article is from Minnesota so is likely to be somewhat biased; Medtronic are an Irish company but until 2015 they were a Minnesota company 
I don’t know but I can guess who got upset.
Yeah, well; the words say one thing on the front page but give a graph that says something completely different then, I assume, they go and say the opposite thing on the inside where their Minneapolis readers won’t notice.
Who knows; Medtronic’s last low was October 30, 2023 at $68/share. My wife bought at 81 in August then 79 in September and has stuck since; now a healthy profit for us. The stock market lemmings always head for the cliff so go in the opposite direction.
I kinda trust the Star Tribune, up to a point, but they have to sell their paper so what is on the first page is marketing and what is on page A5 is reporting, maybe.
Nevertheless I started to skim the full article:
and I’m not convinced. Looks like clown hoopla for the benefit of their bespoke audience (I only skimmed it so I may revise that opinion).
I have the greatest respect for Tyco, not as an investor (I leave that to my wife) but as a user; make cheap ■■■■ that works and they are not based in China. They are no longer called “Tyco”, they left that name to the two other companies they split off in 2007. Maybe Medtronic did not understand what they were merging with but more likely, entirely IMO, they couldn’t get their head around the principle of manufacturing really cheap ■■■■.
We shall see; Medtronic are really not on the line ATM but unless they get their corporate head around the idea that what they need to do is cheap ■■■■, with added software, they will be. Like everyone else.
One good thing for me; I’ve used Tyco products all my life and I only just realised how ubiquitous they are.
What do you think “activist investor” means?
I saw something similar when people started striking on UHG. They called them “angel or activist shareholders,” before their board and shareholders moved against the company. They might have been Catholics. I think there were some Catholic organizations invested that really took the side of patients. But I had never seen a company turn on itself from the inside before.
I’m in deep ■■■■ in this town, John. But I’m having the time of my life and regret nothing. These are interesting things happening that I have never seen happen before. I didn’t know that the machinery could operate this way. People are reacting to the widespread discontent of patients and medical providers in all sorts of creative new ways. It’s fascinating to me.
It means someone who thinks the company is being run badly and buys a sufficient interest to cause changes in the board. In this case the investor is “Elliott Investment Management”. I asked my wife and she immediately recognised the name, “Oh that guy, he goes in and causes trouble in the board, they’re lazy they just live off the money that’s coming in.” (Or something approximately like that.)
It’s about money and potential; the investor believes the company can do better, takes an interest and gets changes made. Apparently there are two new directors with “MedTech” experience on the board now and renewed vigour. This pundit seems to agree:
For people who don’t want to read all the financial stuff the stuff about “exiting the diabetes market” is this link:
(That’s the same pundit.) Note that the second article is from May, before the Elliott investment happened, apparently in August but I’m guessing it could have happened earlier. They apparently didn’t need to do a SEC disclosure which is required for investments of >5% or >$100million, or maybe they did and the SEC hasn’t processed it yet; I think it would be a quarterly disclosure.
Medtronic’s market cap is $123billion, so the SEC limit is hit at an investment of just 0.08%, apparently (unless I misread the rules). The weird thing is that Blackrock recorded an investment of 6.9% in March, yep, that’s $8.5bn at todays share price. Blackrock seems to have a reputation for being the opposite of Elliott; a passive investor that is happy with the management as is.
Thanks, John. Helpful intel.
Yeah, that split happened somewhat recently - looks like May.
At UHG, the stockholders sues their own company over Witty. I didn’t know that could happen. It was fascinating to watch. The stock price went into the toilet until Buffet jumped in.
