Inequality is Causing Americans to Start Families in Foreign Countries

These is no shortage of people who claim the United States is the best place to do just about everything.

From growing up, going to school, working, vacationing, to retiring, there is no better locale under the sun than the good old U-S-of-A.


After all, we are the country that practically invented freedom.

We have freedom of speech, freedom of religion, freedom to pursue a public school education, freedom to vote (or not to)– all within an increasingly diverse population.

Is there anything we can’t do in the United States?

How about raising a family?

More than 66,000 Americans last year opted to have children abroad, in part due to skyrocketing healthcare and subsequent childcare costs.

Of any nation, Americans pay the most for childcare.

Two years ago, the Organization for Economic Cooperation and Development (OECD) reported American couples spend 25.6% of their income on childcare costs; single parents, 52.7%.

When it comes to public health, the most obvious inequity lies in the reality that we spend the most money on healthcare–20% of our national income–of any OECD country on the planet, yet we are not the healthiest country.

Most countries offer healthcare as a human right to all its citizens.

But of the 25 wealthiest nations, the United States is the only one that fails to do this.

Even with employer-provided insurance, most Americans pay on average $4,569 in out-of-pocket childbirth fees.

America is also the only wealthy nation without mandatory paid maternity leave.

In addition, we have longer work weeks and less paid time off than most developed countries.

The Best Countries to Raise a Family in 2020,” a recent study from family and travel researchers Asher and Lyric, looks at six categories in the world’s 35 wealthiest OECD countries: safety, happiness, cost, time, education, and health.

Of those 35 countries, the United States ranks 34th.

Mexico is last.

They are the only countries to receive an “F.”

The top five, earning “A+” ratings, are Iceland, Norway, Sweden, Finland, and Luxembourg due to low homicide rates; robust human rights standards; strong income equality; generous family leave policies for both parents; dependable government-subsidized child care and healthcare; above-average reading, science, and math scores; and a reasonable cost of living compared to average household income.

The Guardian recently spotlighted four American women who chose to start their families overseas.

Marketing professional Sarah Samoranos, 31, moved to France to pursue her Master’s degree in marketing. There she met her husband.

About her childbirth experience, she explained:

“When it came time to deliver my twins, we ended up having to go to the emergency room because something just felt off. I still had this really American fear of costs and was mentally doing the tally. Even as I’m in labor, the entire time, I’m thinking, ‘OK, they’ve given me this medicine, add it to the bill. I had an emergency C-section, add it to the bill. I needed a bag of blood, add it to the bill.’

“I also had a private room, with three square meals, a lactation consultant to teach me how to breastfeed, and someone who came in to teach us how to do the first bath…and in my head all of that was going onto the tally. When the nurses started giving diapers and formula, because my milk hadn’t come in, I told my husband, ‘no no no. Go around the corner and buy diapers and formula, I’m not paying for this.’

“When it was time to leave the hospital, I told my husband, ‘You go into the office and look at the bill.’ In my head, I was expecting to pay thousands of euros and was bracing for the impact. And then he walked in, and 30 seconds later he walked out, and I asked him, ‘OK, how much was it?” he said, ‘Darling, this is France. Get in the taxi.’”

NGO director and writer Antonia Murphy, 45, and her husband moved from San Francisco to New Zealand because of its social safety net, public school system, and subsidized childcare.

She stated:

 “In New Zealand, not only do you get 18 paid weeks of child leave, but childcare is subsidized and income tested, so when I had two little kids in daycare and I was an aspiring writer who still hadn’t published anything, my bill was less than $100 per week. And when your children are between the ages of three and five, you get 20 hours free, because research has shown that high quality childcare between the ages of 3-5 leads to one of the best outcomes. It just makes sense.”

She added:

“The clear majority of Americans don’t see that the rest of the developed world does it differently. They don’t realize they have the right to something else. There’s this idea that if you are getting assistance from the government it’s a handout, and it’s shameful or smacks of communism. But in the countries with a social welfare state, they see this as an investment in their future.”

Architecture doctoral candidate Yolanda Muñoz Lozano, 39, who re-located to Chile, attested:

 “In Chile, there’s a law that mandates six months of paid maternity leave, so I got 100% or my salary for those six months. This is great for women who are already working, but for women who are recently married in their childbearing years, it can make it really difficult to get a job. Maternity leave isn’t paid by the company–it’s paid by my own healthcare, which in Chile is more expensive for women than for men.

“After maternity leave ends, the government pays for your daycare until the baby is two years old, so you can go back to work. Once they turn two, though, you have to pay out of pocket. The university where I have a part-time job while I’m doing my PhD has very good childcare, and it’s subsidized by the government.”

 International development program director Michele Bradford, 44, said:

“I don’t understand how people function in America.”

Moving to Turkey to start a family, she explained:

“There’s this idea that everything is better in America–that healthcare is better in America. I just don’t perceive it that way. I saw going back to the states to have a baby as expensive. (I’ve had two spine surgeries at Mt Sinai Hospital in New York. The first cost me more than $100,000 and the second $93,000.)

“Women in America are also discharged almost immediately. It’s a systemic problem. And because I’m an older mom, I just didn’t see why I would go to a subpar medical system that doesn’t prioritize me and would kick me out of the hospital right away.”

While it’s true the United States is still a great country, there are myriad areas in which we could do much better.

Multiple studies confirm income inequality breeds civil unrest, substance abuse, crime, and depression.

But it doesn’t have to be that way–anywhere.

America leads every G7 nation in income inequality.

Let’s elect leaders with a vision focused on unification, not division; heath care for all, not simply those lucky enough to have employer-based coverage; childcare for all, not simply those wealthy enough to afford paying others to raise their children.

We can’t be the United States without being united.

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Ted Millar is writer and teacher. His work has been featured in myriad literary journals, including Better Than Starbucks, The Broke Bohemian, Straight Forward Poetry, Caesura, Circle Show, Cactus Heart, Third Wednesday, and The Voices Project. He is also a contributor to The Left Place blog on Substack, and Medium.