I wish I thought of that before: Making a decision, experience from Expats?

I also feel compelled to chip in and defend the NHS. I spent half of January in hospital and have been diagnosed with moderate to severe Crohn's disease. My treatment has been rapid, top quality and I'm on the absolute forefront of drug treatment that would have cost me thousands of dollars had I been in the US, and is completely free here. Now I couldn't move back to the US even if I wanted to, because I couldn't afford to pay for my care and I probably couldn't get insurance as it would be considered a pre-existing condition. In terms of normal doctor things, I've never had to wait more than 3 or 4 days for a GP appointment, and have gotten same day appointments when needed. For specialists, if your case is considered urgent, you get put to the front of the queue and can get an appointment quickly, within a couple of weeks or less. Yes, there is definitely a postcode lottery in that some areas have better services than others (Scotland's NHS is generally better than England and Wales), but I found that to be true in the US as well, and had all the worst health care experiences of my life in my university town in Ohio, and the best with the NHS.

Another vote in favour of the NHS here.  I've lived in the UK for just over a year, and have already seen a doctor more than I had in the last 10 years living in the US.  Not because I'm less healthy, but because I know I can afford it, so I don't have to suffer through things I would just have endured in the US.  Last night, I was having trouble with my allergies, and was considering what to do about them, when I thought "I'll just go to the doctor....yeah, I can just go to the doctor!"  It's possible that it takes longer to get non-emergent medical conditions taken care of here, but for me, that is balanced by the fact that medical treatment is so available and worry-free (ie no worries about how the h*ll you're going to pay for the treatment).  My husband has been getting treatment for sleep apnea for the last year and a half.  This has included many doctors visits, a CPAP machine, and surgery for his tonsils.  It may include surgery on his septum.  If we were in the US, we would not have been able to pursue treatment for this condition because it would have been beyond our means, so DH would just have had to accept that he'll never get a good night's sleep.  Here there is no grappling with insurance companies about whether or not something is necessary, no doctors deciding not to offer a certain treatment because the patient's insurance won't cover it....

Everyone has different experiences, of course, but FWIW, the NHS was a huge reason why I wanted to come to the UK rather than have DH go to the US, and having it has been well worth it. 

Also - I've immigrated both ways, and for what its worth... its a pain in the butt no matter what. I wouldn't make decisions based on the logistical paperwork side of things since nightmares happen going both ways, and I'm proof of that.

Also also - you'll stress yourself out like mad if you think any of this is final... coming from someone who immigrated to the uk, then immigrated to the us, and is now immigrating back to the uk.

Oh how I absolutely 100% agree with Marlespo about taking paperwork OUT of your equation!  Absolutely make your choice on where you prefer the lifestyle; where you will be more successful financially; where your support systems are; and where you believe you can be happiest.

I'm the US half of a US/UK marriage and we live in the US.  My husband moved to the US about five years ago.  We made that choice primarily because my son was still school age.  So why do I read and (sometimes) post on uk-yankee?  

Because we talk about going "home" somedays.  Because my husband has lost his job and in this current US climate, there's nothing here for him.   Because we are older (than many of the posters on uk-yankee at least) and we weigh daily the pros and cons of health care in the US.  And because we love the public transport in the UK.

We stay here because my son is now in college and we feel we shouldn't go until he's established in a career; because my parents are aged and my husband's are both long passed; and because now isn't a good time to sell our home in the US.

Someone already mentioned that one of the great things about an international relationship is that - yes - you can pick where you live.  And you can always rewind as well!

Edited to add:  You'll find loads of differing opinions on the NHS.  I'm sure you already know that people's experiences differ widely based somewhat upon the particular NHS trust in their area.  Your best source of info on NHS will be from your fiance.  He knows what the 'turnaround time' and quality of care is like in his area.

Regarding the NHS, my fiance's opinion is essentially that it has its faults and could be improved; however, he believes that it is nice to have the peace of mind that if you lose your job, or suffer some kind of other financial blow, you'll still be able to have access to healthcare and you won't have to go through the thought processes of, "Well, I feel rather sick, and I've been feeling sick for a long time and nothing OTC is working...and a doctor visit will cost X but I've also got to pay for the heating bill this month.  Hmmm.  What should I do?"

As for doctor quality, he says that NHS doctors are probably like the spectrum of doctors anywhere else.  You get some superb ones, some awful ones, and many good/fair ones.  But if you don't like the one you have, you can [usually] get another.

The closest city to him is Bristol.  I've been to a doctor's surgery in his village, and been to a hospital in Weston.  I found access to the NHS and doctor qualities there no different than around where I live (granted, I ended up in the hospital Christmas Eve and Christmas and most people were probably home celebrating).  If I moved to the UK, I suspect I would stay with him for a while until I found a job.  Once I found a job, we would likely be moving east as that's where the jobs in my profession usually are.

I think the decision is a bit difficult because we both know my job is definitely more stable and lucrative here.  However, we believe with my history of chronic medical issues, the NHS would offer me a better quality of life in regards to covered accessible medical treatment.

I have only been in the UK for a cumulative total of about a month (a week here, a week there, etc).  But from my time in the UK, I love it.  I don't know if a cumulative month is long enough for me to be able to say, "Well, I like the UK lifestyle more/less than the US lifestyle."

I shouldn't judge all the NHS on those limited experiences.

You are very sensible.

my husband was an odd's compiler for a book makers and is now currently a trading analyst for a firm in association with UEFA . You can't get this kind of job in America, where online gaming is illegal

Also i was 20 and not establish in the US. I couldn't support him and he wouldnt be able to get in on a points based system. So it was just easier for me to move to the UK.

I do love my country, but It was definitely the best decision to move to the UK because I was very closed minded living my little American life in The OC (So.California). Coming to the UK, i actually learned about foreign policy, language, culture and healthy eating in a very unbiased environment. The NHS is the best thing to ever exist and really, the only thing i miss from America is my family in California and taco bell. Ha! Oh and 24hr Ralph's...but there are 24 hr Tesco's here so boo ya!

Coming to the UK, i actually learned about foreign policy, language, culture and healthy eating in a very unbiased environment.

That's something that's also on the pro side for me.

I've always wanted to live in another country because I think it'll be a great experience to at least try out.  I would have done study abroad when I was in college, but unfortunately my majors didn't really allow for study abroad opportunities.

I'm relatively young, and personally feel that if I'm going to go for it and try something different, now's the time.  And whatever happens (I end up loving the UK and staying or hating it and moving back to the US), I'll be glad to have had the experience.