# free health care



## bikerboy123 (Sep 30, 2018)

Hi 
Re the recent change to who has access to free health care ie Spains version of Britains NHS, has anybody in Andalucia (Nerja/Torrox) actually registered and actually received free health care, if so how did you go about registering etc. 
Thanks


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## Alcalaina (Aug 6, 2010)

AFAIK if you are currently receiving free healthcare as a pensioner under the S1 scheme, that will continue.

If you are currently paying into the _convenio especial_, your monthly payments cease - one couple I know have received a refund - and your healthcare is now free.

Otherwise I think you just need to be a permanent resident and on the padrón - ask at your local health centre (consultario) what the procedure is for registering, as you may need to go to the INSS (social security office) to do the paperwork.

But I don't know anyone who has done this yet.


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## Mud (Oct 9, 2013)

I have only recently heard of this free health care stuff - does this apply to people who are, or will be, autonomo? and paying the monthly fee that includes health care? what does it imply for that?


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## xabiaxica (Jun 23, 2009)

iris muddy said:


> I have only recently heard of this free health care stuff - does this apply to people who are, or will be, autonomo? and paying the monthly fee that includes health care? what does it imply for that?


If you are autónomo your healthcare & pension are covered by that.


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## Mud (Oct 9, 2013)

xabiachica said:


> If you are autónomo your healthcare & pension are covered by that.


do you think it will bring a cost decrease for the autonomo payments? doesnt seem fair otherwise...


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## xabiaxica (Jun 23, 2009)

iris muddy said:


> do you think it will bring a cost decrease for the autonomo payments? doesnt seem fair otherwise...


No. Indications are that autónomo payments will increase next year.


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## Mud (Oct 9, 2013)

xabiachica said:


> No. Indications are that autónomo payments will increase next year.


(asking this as someone who is finding out about these payments only since the past week or so, might seem like silly questions: )
are the payments anything that people complain about or ask the government for more explanation about? Because a pension is a nice idea, if it suits the person paying it and does actually deliver in the end, but in spain has there been any discussion of opting in or out of that? or has there been a slice of people it has proven fruitful for yet?

or in the future, hypothetically if everyone's health care in spain is free and all you're still forced to pay into with those payments is the pension... but you leave the country... what then haha


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## kalohi (May 6, 2012)

iris muddy said:


> (asking this as someone who is finding out about these payments only since the past week or so, might seem like silly questions: )
> are the payments anything that people complain about or ask the government for more explanation about? Because a pension is a nice idea, if it suits the person paying it and does actually deliver in the end, but in spain has there been any discussion of opting in or out of that? or has there been a slice of people it has proven fruitful for yet?
> 
> or in the future, hypothetically if everyone's health care in spain is free and all you're still forced to pay into with those payments is the pension... but you leave the country... what then haha


'Free' healthcare is a misnomer. Of course it has to be financed somehow. It's the workers in Spain that pay for it, so that everyone (including children, pensioners and the unemployed) can have healthcare. People who work on contract and their employers, as well as autonomous workers, pay a big chunk of money to the government every month to cover it. This money also goes toward pensions. 

If everyone decided to opt in or out as they chose the system would collapse.


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## baldilocks (Mar 7, 2010)

iris muddy said:


> (asking this as someone who is finding out about these payments only since the past week or so, might seem like silly questions: )
> are the payments anything that people complain about or ask the government for more explanation about? Because a pension is a nice idea, if it suits the person paying it and does actually deliver in the end, but in spain has there been any discussion of opting in or out of that? or has there been a slice of people it has proven fruitful for yet?
> 
> or in the future, hypothetically if everyone's health care in spain is free and all you're still forced to pay into with those payments is the pension... but you leave the country... what then haha


Iris It would help if you completed your personal profile and state where you are and where you are from then we could pitch answers to suit your circumstances because we would know your starting point.


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## Mud (Oct 9, 2013)

kalohi said:


> 'Free' healthcare is a misnomer. Of course it has to be financed somehow. It's the workers in Spain that pay for it, so that everyone (including children, pensioners and the unemployed) can have healthcare. People who work on contract and their employers, as well as autonomous workers, pay a big chunk of money to the government every month to cover it. This money also goes toward pensions.
> 
> If everyone decided to opt in or out as they chose the system would collapse.


Ahh, Yeah that makes sense haha. Thank you!
Well, so, how is it going to be different, in reality, for workers (salaried or self employed), as similar amounts will be paid into the system to maintain and access the health care?


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## Mud (Oct 9, 2013)

baldilocks said:


> Iris It would help if you completed your personal profile and state where you are and where you are from then we could pitch answers to suit your circumstances because we would know your starting point.


Will do, thank you! Sorry, clumsily asking lots of questions currently, as have been reading so many different sources over the past few days in a rush to figure it all out


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## kaipa (Aug 3, 2013)

Bear in mindhat after Brexit thete might be different requirements for Brits. In other words plan for the worst case which would be autonomo or private health insurance. Remember also not to try and compare the systems. Spain is not so generous as UK when it comes to things like tax allowances, healthcare, benefits etc. It's standard of living is well below the UK and comes as a shock to working Brits.


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## baldilocks (Mar 7, 2010)

kaipa said:


> Bear in mindhat after Brexit thete might be different requirements for Brits. In other words plan for the worst case which would be autonomo or private health insurance. Remember also not to try and compare the systems. Spain is not so generous as UK when it comes to things like tax allowances, healthcare, benefits etc. *It's standard of living is well below the UK* and comes as a shock to working Brits.


Are you sure? *We* have a better standard of living here, than we did in UK. The cost of living here is certainly lower than in the UK even if electricity is so expensive (solution - use less.) Standard of living also includes food and we get much more fresh fruit and vegetables here and at a much lower price - OK so they might not look so perfect and pristine but we buy them for their food value not their looks.


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## Love Karma (Oct 10, 2018)

kaipa said:


> Bear in mindhat after Brexit thete might be different requirements for Brits. In other words plan for the worst case which would be autonomo or private health insurance. Remember also not to try and compare the systems. Spain is not so generous as UK when it comes to things like tax allowances, healthcare, benefits etc. *It's standard of living is well below the UK* and comes as a shock to working Brits.


Thats a sweeping statement which begs the question in what respect?


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## Overandout (Nov 10, 2012)

baldilocks said:


> Are you sure? *We* have a better standard of living here, than we did in UK. The cost of living here is certainly lower than in the UK even if electricity is so expensive (solution - use less.) Standard of living also includes food and we get much more fresh fruit and vegetables here and at a much lower price - OK so they might not look so perfect and pristine but we buy them for their food value not their looks.


Standard of living is NOT the same as cost of living.

Standard of living is (crudely) measured as GDP per capita which in Spain in 2017 was around 75% of that of the UK. So Kaipa is technically correct.


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## Alcalaina (Aug 6, 2010)

Overandout said:


> Standard of living is NOT the same as cost of living.
> 
> Standard of living is (crudely) measured as GDP per capita which in Spain in 2017 was around 75% of that of the UK. So Kaipa is technically correct.


And neither are related to wellbeing or quality of life, whose indicators include non-economic factors such as health, social and community networks as well as earnings. Spain always scores high on these.


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## Lynn R (Feb 21, 2014)

If I felt that my standard of living here in Spain was substantially below what it would be in the UK, I don't think I'd still be here. Being pensioners (although I won't get my state pension for a few years yet) we can certainly afford things we could not begin to afford in the UK on the same income.

As far as working people are concerned, they can undoubtedly earn more in the UK. But given the cost of housing, either rented or bought (home ownership in the UK is now 63%, compared to 77% in Spain), the cost of childcare, Council Tax, heating bills, etc., I cannot see that their standard of living is higher. It constantly surprises me here to find how many ordinary working families own multiple properties, have huge garages with a varied collection of vehicles, send their children to concertado schools and for after school lessons at academias, etc.


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## Isobella (Oct 16, 2014)

Lynn R said:


> If I felt that my standard of living here in Spain was substantially below what it would be in the UK, I don't think I'd still be here. Being pensioners (although I won't get my state pension for a few years yet) we can certainly afford things we could not begin to afford in the UK on the same income.
> 
> As far as working people are concerned, they can undoubtedly earn more in the UK. But given the cost of housing, either rented or bought (home ownership in the UK is now 63%, compared to 77% in Spain), the cost of childcare, Council Tax, heating bills, etc., I cannot see that their standard of living is higher. It constantly surprises me here to find how many ordinary working families own multiple properties, have huge garages with a varied collection of vehicles, send their children to concertado schools and for after school lessons at academias, etc.


There are also many who have no resources, as with the Uk it is like comparing chalk with cheese. The main problem is that there is no safety net in Spain.


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## Mud (Oct 9, 2013)

Lynn R said:


> If I felt that my standard of living here in Spain was substantially below what it would be in the UK, I don't think I'd still be here. Being pensioners (although I won't get my state pension for a few years yet) we can certainly afford things we could not begin to afford in the UK on the same income.
> 
> As far as working people are concerned, they can undoubtedly earn more in the UK. But given the cost of housing, either rented or bought (home ownership in the UK is now 63%, compared to 77% in Spain), the cost of childcare, Council Tax, heating bills, etc., I cannot see that their standard of living is higher. It constantly surprises me here to find how many ordinary working families own multiple properties, have huge garages with a varied collection of vehicles, send their children to concertado schools and for after school lessons at academias, etc.



Hi! I'd be really curious to know what type of things you feel you can afford or do in Spain that would be less accessible in the UK.
Personally, having lived in Canada, southern france, and denmark, it's been interesting to see what different places will allow you to feel like you can or can't do. Whether it's just daily habits, what food you buy, outings, where you can live, etc... not even just relating to money, but also your time or thoughts, concerns.


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## Mud (Oct 9, 2013)

Isobella said:


> There are also many who have no resources, as with the Uk it is like comparing chalk with cheese. The main problem is that there is no safety net in Spain.


As a 20 something, I have ignorantly not put much time yet into worrying about the safety net of any given place, but I get this fear that no country's safety net will be good enough for its people... and that other places really do have none... it doesnt inspire confidence...


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## Lynn R (Feb 21, 2014)

iris muddy said:


> Hi! I'd be really curious to know what type of things you feel you can afford or do in Spain that would be less accessible in the UK.
> Personally, having lived in Canada, southern france, and denmark, it's been interesting to see what different places will allow you to feel like you can or can't do. Whether it's just daily habits, what food you buy, outings, where you can live, etc... not even just relating to money, but also your time or thoughts, concerns.


Just a few examples - we pay for private health insurance cover here, although we are registered with the Spanish public health service as well (mainly because waiting times for treatment are shorter). That would be completely unaffordable for us in the UK, not least because my husband is now over 65 and our health insurance company here does not increase premiums once existing policyholders reach that age. We can also save money each month here even before I start to receive my state pension. As we get older and start to have to think of future potential needs, the average cost of a privately run residential home place in Spain is approximately half of what it is in the UK. We now live in a penthouse apartment here in Spain where our monthly community fees are €40 per month. The average service charge for leasehold properties (flats) in the UK is now 1,836 pounds per year and 2,777 for new builds (ours is not a new build). Our IBI bill is now €445 per year whereas the Council Tax for our old 2 bedroom home in the UK is now 1,200 pounds per year. Our local Council (in common with a lot of others here) puts on lots of free leisure activities such as concerts throughout the year and provides excellent low cost sports activities (including two indoor swimming pools in the municipality whereas all but one in my former UK local authority have been closed due to budget cuts, in spite of the much higher Council Tax). For working families needing childcare, the average cost of a private nursery place is now 232 pounds per week in the UK, compared to €400-600 per month in Spain.


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## Mud (Oct 9, 2013)

Lynn R said:


> Just a few examples - we pay for private health insurance cover here, although we are registered with the Spanish public health service as well (mainly because waiting times for treatment are shorter). That would be completely unaffordable for us in the UK, not least because my husband is now over 65 and our health insurance company here does not increase premiums once existing policyholders reach that age. We can also save money each month here even before I start to receive my state pension. As we get older and start to have to think of future potential needs, the average cost of a privately run residential home place in Spain is approximately half of what it is in the UK. We now live in a penthouse apartment here in Spain where our monthly community fees are €40 per month. The average service charge for leasehold properties (flats) in the UK is now 1,836 pounds per year and 2,777 for new builds (ours is not a new build). Our IBI bill is now €445 per year whereas the Council Tax for our old 2 bedroom home in the UK is now 1,200 pounds per year. Our local Council (in common with a lot of others here) puts on lots of free leisure activities such as concerts throughout the year and provides excellent low cost sports activities (including two indoor swimming pools in the municipality whereas all but one in my former UK local authority have been closed due to budget cuts, in spite of the much higher Council Tax).



It sounds like you definitely made the right decision in moving!  getting more for what you put in, it seems.


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## Lynn R (Feb 21, 2014)

iris muddy said:


> It sounds like you definitely made the right decision in moving!  getting more for what you put in, it seems.


Pensioners, and younger people on low incomes, get assistance with various things in the UK which would not be available to them here in Spain. However, we ourselves would not be eligible for any of those in the UK (apart from a free bus pass and free prescriptions although we don't pay much for prescriptions and my husband gets half price travel) so I tend to base my comparisons on having to pay full price for things because that's what we'd have to do.


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## kaipa (Aug 3, 2013)

What I meant was the cost of living probably. If you have to work here the cost of living is definitely lower than UK. I earn about 800 to 900 Euros a month and effectively work between 30 to 35 hours a week. Yes my flat was cheap compared to UK but I still have to rely on savings to get me through the year. At first I thought Spain was cheap but once you actually start using euros and stop thinking of pounds it's very different. For me a euro has about the same mental value as £2. Plus the allowances are very small compared to UK. No child benefit or working tax credits here. If you live off any kind of UK income then I'm sure Spain seems quite cheap even with the weakness of the pound however if you are going to come here to work brace yourself for a poor salary, limited rights and long hours split over a 12 hour day. If you are lucky enough not to need the work then just bend the picture so it fits the frame


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## Megsmum (Sep 9, 2012)

As in most things, everything said on this forum is very subjective and very much personal experience. We live on far less than any on here however we also have sacrificed much and that’s the quid pro quo of the decision. 

I’m of the opinion and have been since we decided to come. Base everything on like for like then there are no nasty surprises [ I’m referring to pound v euro here] and Always have a good contingency fund.

Working families, young people and those of us older self sufficient and those on good pensions will all have a different lifestyle and a different set of risks

I’m usually loathe to say we live on this amount as it all relative. We live off grid so no bills as such. We own our own house with a hectare of land there is no way we could afford that in the UK. We also own a 4x4, because of where we live and that’s like having a heavy electricity bill We don’t have holidays, but due to deaths births and marriages we , well I return to the UK more than we calculated for. Our life here is not really, for us, about the monetary savings, it’s the simple fact that we could aged 55 leave the UK and 50 hour working week and retire here on a pension and savings, so from that aspect Spain is cheaper than the UK but once living here everything else is subjective 

Having read your other posts you seem to have lived in various places so I’m sure you are well used to adapting to a new country


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## Overandout (Nov 10, 2012)

People think that the prices of goods and services are the biggest factor in cost of living comparisons, but as has been stated, although "things" here may be cheaper to buy, people earn less, so it generally evens out. For me, the only thing which stands out as being more accessible than in the UK is eating out (I mean a quality meal, not BK or McD).
But the big difference for me is the lower cost of "compliance". As an example, I have a flat which I couldn't sell due to negative equity, so I rent it out. It is so easy! We asked the mortgaging bank if they would agree and they said sure, no problem. We asked our insurers if they would agree, they said sure, no problem. We went to the town hall to see if we needed to change anything in the flat, make electrical tests, fire resistant furniture or anything like that, no, nothing needed (although we did put in smoke detectors and a fire blanket for peace of mind). In the UK we would have had to change to a "buy to rent" mortgage, got special insurance, had the electrical appliances checked and certified, changed all the furniture to fire resistant grade upholstery... it would have been economically much more challenging.
Now I am not saying that one system is better or worse than the other, but it certainly is easier (cheaper) to comply with the rules for this kind of thing in Spain.


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## Lynn R (Feb 21, 2014)

kaipa said:


> What I meant was the cost of living probably. If you have to work here the cost of living is definitely lower than UK. I earn about 800 to 900 Euros a month and effectively work between 30 to 35 hours a week. Yes my flat was cheap compared to UK but I still have to rely on savings to get me through the year. At first I thought Spain was cheap but once you actually start using euros and stop thinking of pounds it's very different. For me a euro has about the same mental value as £2. Plus the allowances are very small compared to UK. No child benefit or working tax credits here. If you live off any kind of UK income then I'm sure Spain seems quite cheap even with the weakness of the pound however if you are going to come here to work brace yourself for a poor salary, limited rights and long hours split over a 12 hour day. If you are lucky enough not to need the work then just bend the picture so it fits the frame


Don't you think it is rather telling that in spite of the much higher salaries in the UK, working families HAVE to claim extra help like tax credits and child benefit in order to survive? That says a lot about the cost of living and therefore the standard of living families are able to afford. You are right, there are no working tax credits here, but there are additional tax allowances for parents (someone with two children has additional personal allowances of €5,100 per year and for a third child another €4,000 per year and the fourth and any subsequent children another €4,500 per child per year) which don't exist in the UK. Someone with the income you quote of €900 per month should not pay any income tax in Spain due to the low income allowance, and from next year people earning up to €14k per year will be exempt from IRPF and those with income below €18k will pay less. At today's exchange rate €14k is almost exactly the same as the new UK personal tax allowance of 12.5k pounds from next April will be.

If a Spaniard said they earned €900 per month they'd probably neglect to mention that that normally means 14 payments of €900 per year, not 12.


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## kaipa (Aug 3, 2013)

I appreciate your comments Lynn. However my own experience here in Spain is that life is a lot tougher as a working person than in UK. The drought of jobs has been a godsend to employers as they can exploit there employees fears easily. As a Language teacher in the UK I earned a reasonable salary and felt well protected by the law and well treated by my employer. Here I have to accept that only part of my real salary is declared and that my SS payments are less than they should be etc. Should I complain my boss will simply find another person to do my job. It is not really his fault as that is the norm.All in all it is not a great situation but one you just accept and get on with


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## Lynn R (Feb 21, 2014)

kaipa said:


> All in all it is not a great situation but one you just accept and get on with


But what I don't understand is, why? If you really believe that your standard of living is so much worse here, your conditions of employment are much worse (and I would certainly never have moved here had I had to work), you've said you are not happy with the education your son is receiving, etc., why do you stay? It's not a prison, you could move back to the UK and earn so much more, etc. tomorrow. You really don't sound very happy and life is too short to live it somewhere you are miserable, if you have the means to change it.


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## kaipa (Aug 3, 2013)

My son lives here with his mum and he is too young to be separated from both parents so like many people my choices are limited. If itvwasnt for this I wold have returned to UK.Spain is great place to retire to but is difficult for young working people. Hence the reason so many young Spanish have moved away from Spain. If you are retired and have the security of a pension and your children are grown up then I dare say Spain is a good place to live. If you come needing to work and support a family it is hard. If you dont speak Spanish it is harder as you remain isolated culturally and will struggle maybe without the support of friends and family


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## Lynn R (Feb 21, 2014)

kaipa said:


> Spain is great place to retire to but is difficult for young working people. Hence the reason so many young Spanish have moved away from Spain.


I've just met one in the supermarket (someone we know, not a chance meeting), who moved away from Spain and got a job in London - but has moved back, for a job at a local swimming pool where he works from 1.00 pm to 9.00 pm each day. He's not the only one we know who tried it but didn't stay the course.

Your description of your situation explains a lot. Life is never happy when you are forced by circumstances to stay somewhere you would rather not be, and it colours everything - unfortunately.


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## Overandout (Nov 10, 2012)

Lynn R said:


> But what I don't understand is, why? If you really believe that your standard of living is so much worse here, your conditions of employment are much worse (and I would certainly never have moved here had I had to work), you've said you are not happy with the education your son is receiving, etc., why do you stay? It's not a prison, you could move back to the UK and earn so much more, etc. tomorrow. You really don't sound very happy and life is too short to live it somewhere you are miserable, if you have the means to change it.


My situation is quite different to Kaipa's, but I think this question applies to me also.

I could easily be earning more money in the UK, with better employment conditions, better redundancy protection, company car etc. but there is more to life than work.

I would flip your question around Lynn: who in their right mind would stay in the UK just because the employment conditions are better, when almost every other part of life is better here?


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## kaipa (Aug 3, 2013)

I see your point overandout but I really think that it depends on what stage of life you are at. It is nice to think that money isn't everything but as happiness studies show if you don't have enough money to effectively participate in the opportunities your society promotes it is very difficult to move to other aspects of happiness. The problem is , I think, some young people are seduced into thinking that they should prioritise other thing over money without realising that such a credo works for those that probably regard £ 15,000 as a small amount of money and easy to obtain but no for others where this might mean working 7 day weeks at minimum wage levels.


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## Lynn R (Feb 21, 2014)

Overandout said:


> My situation is quite different to Kaipa's, but I think this question applies to me also.
> 
> I could easily be earning more money in the UK, with better employment conditions, better redundancy protection, company car etc. but there is more to life than work.
> 
> I would flip your question around Lynn: who in their right mind would stay in the UK just because the employment conditions are better, when almost every other part of life is better here?


Well, obviously you chose to come back here after your time in Thailand, so life can't be that much of a struggle for a young working family in your experience.

I was pretty certain I wouldn't have been able to get a comparable job here to the one I had in the UK (having spent many years in management in public administration, and having very little knowledge of the language before we moved here) and didn't fancy trying to make it here by working in a bar, cleaning holiday villas or suchlike, so I judged it more prudent to stick it out in the UK until such time as I wouldn't have to!


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## Overandout (Nov 10, 2012)

kaipa said:


> I see your point overandout but I really think that it depends on what stage of life you are at. It is nice to think that money isn't everything but as happiness studies show if you don't have enough money to effectively participate in the opportunities your society promotes it is very difficult to move to other aspects of happiness. The problem is , I think, some young people are seduced into thinking that they should prioritise other thing over money without realising that such a credo works for those that probably regard Â£ 15,000 as a small amount of money and easy to obtain but no for others where this might mean working 7 day weeks at minimum wage levels.


Yes, I don't dispute what you are saying. Luckily(?) for me, I spent a relatively short time earning very little (my first job in Spain paid 600€ / month) so I know what it is like, all be it not long-term.


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## Overandout (Nov 10, 2012)

Lynn R said:


> Well, obviously you chose to come back here after your time in Thailand, so life can't be that much of a struggle for a young working family in your experience.
> 
> I was pretty certain I wouldn't have been able to get a comparable job here to the one I had in the UK (having spent many years in management in public administration, and having very little knowledge of the language before we moved here) and didn't fancy trying to make it here by working in a bar, cleaning holiday villas or suchlike, so I judged it more prudent to stick it out in the UK until such time as I wouldn't have to!


Why were you so certain? I gambled all I had in the UK to come to Spain and start my career from square one. New country, new language etc. It was tough, and although I will never have exactly the same security and benefits in the UK, I do feel that I have reached as high a level as could have reasonably expected.

By the way, my Thailand "expatriation" was just that, my company sent me and kept my work contract in Spain open for my return, so the choice to return was pretty much predetermined, but yes, I am glad I came back to Spain.


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## Lynn R (Feb 21, 2014)

Overandout said:


> Why were you so certain? I gambled all I had in the UK to come to Spain and start my career from square one. New country, new language etc. It was tough, and although I will never have exactly the same security and benefits in the UK, I do feel that I have reached as high a level as could have reasonably expected.
> 
> By the way, my Thailand "expatriation" was just that, my company sent me and kept my work contract in Spain open for my return, so the choice to return was pretty much predetermined, but yes, I am glad I came back to Spain.


I was older than you when we started thinking about moving (late 40s) and knowing the system of oposiciones in Spain for jobs in the public sector, plus having to learn the language practically from scratch, I didn't think my experience and skills would be much in demand here. You seem to have done brilliantly, and I admire that, I really do.


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## Overandout (Nov 10, 2012)

Lynn R said:


> I was older than you when we started thinking about moving (late 40s) and knowing the system of oposiciones in Spain for jobs in the public sector, plus having to learn the language practically from scratch, I didn't think my experience and skills would be much in demand here. You seem to have done brilliantly, and I admire that, I really do.


Thanks. Sadly though, I would never recommend that anyone do what I did. It could have so easily gone so badly wrong...

And I agree with your reasonings, working in the public sector is Spain as a foreigner must be one of the most tricky of objectives to achieve, although I did once meet someone who had achieved something far more admirable than I, an English Policia Nacional (although he was of course nationalised as a Spaniard), that must have been really tough.
I think location is also a big factor. In Madrid there are more opportunities than on the coasts.

Anyway, this has naff all to do with free health care!!


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