Introduction

Retirement migration is not only about geographical movement but also about people navigating between the policies of different states, such as those related to old age, public health insurance and residence or citizenship requirements. In countries of the Global North like the UK, Switzerland and the US, older people often rely on welfare state benefits for their economic security and their access to healthcare. In this context, the economic and health benefits that retirement migrants receive from their home countries, as well as whether they can access their state pensions and local healthcare systems in their host countries, influence their decisions about whether and where to migrate.

In this chapter, we use literature on work, retirement and health policies in later life to explore the political-economic contexts shaping the precarity of older people in the UK, Switzerland and the US. These three countries present especially interesting cases for study. On the one hand, they all contain retirement regimes and healthcare policies which assume that individuals (and their families) have the primary responsibility for security in later life. On the other hand, they provide different levels of protection to older people, both in terms of old age and retirement benefits, and ability to access healthcare.

In the following, we present an overview of the welfare state policies for later life in the three countries and indicate how they shape precarity at retirement age. We also discuss retirement migrants’ access to pensions and healthcare in their host countries: Spain, Costa Rica and Mexico.

Welfare state policies for later life in the United Kingdom, Switzerland and the United States

Retirement and health policies are key to the ageing experiences of people in the countries of the Global North (Estes and Wallace, 2010). In terms of the former, since the Great Depression in the US and the Second World War in Switzerland and the UK, authorities have enacted policies aimed at reducing poverty among older people at the national level. As we will show, healthcare policies across these nations are rather varied. The British National Health Service Act (adopted in 1946) provides free healthcare to all, regardless of age. In the US, Medicare (adopted in 1965) offers low-cost access to basic healthcare to people aged 65 and over. Switzerland has no public healthcare scheme specific to older people.

Introduction

Helen was a 76-year-old divorcee who had resided in Mexico for several months at the time of her interview. As a retired professional, she had continued to work part-time until quite recently. Yet, her present income was low, being in the range of USD 2,200 a month.

Helen had lived in the Midwest of the US for most of her life. She was divorced when her sons were teenagers; her daughter was already in college. Her ex-husband had his own business, “stocks and money in the bank, I’m sure”, and they owned two homes. However, she said that she “never pay[s] attention to things” and, as a result of that and some bad advice, received very little in her divorce settlement. She had a profession, so she did not push for alimony. She received one of their homes but no other money; the settlement stipulated that her ex-husband would pay for their sons’ medical and educational expenses. However, this last provision was not honoured due to a legal loophole. In addition, she had some major, costly medical issues to resolve. As a result, she had to sell the house quickly to pay “for them to go to school and for all their needs”. Had she been able to wait two more years, she said, she would have gotten twice as much money for her home, but she could not. What money she had left from the sale of her house she used to buy a car and put the rest (about USD 100,000) into stocks.

Before she moved to Mexico, Helen looked at her options and discussed these with one of her sons. She had thought about getting a recreational vehicle (RV) and travelling, parking it for a while in Mexico and then travelling in the US at other times:

Helen also considered living on a boat but found that just as impractical. In search of affordable and competent medical care, she had visited the general area in Mexico where she now resides.

Introduction

A recognition of precarity in the lives of older people appears in the recent move among International Living media outlets to advertise not just lifestyle and leisure but retirement migration ‘as a pathway to security in a volatile world’ (Croucher, 2022: 175). Here, marketers refer to more than financial security; they report that, after affordability, healthcare is now the most important factor that retirees consider when they think about whether and where to migrate. This concern is perhaps especially salient for older people from the US, where healthcare can be costly, who comprise the bulk of International Living media consumers (Croucher, 2022). However, as we will show, retirement migrants across the three countries we examine worry about these issues.

Often subsumed under the rubric of healthcare is the need for daily assistance that can occur in later life even among people with no immediate need of medical care. Although such support for daily living can be tied to health, it can result from changes in abilities, such as a decline in eyesight. Assistance with ADLs or IADLs differs from healthcare and is defined as separate from healthcare in such countries as the UK, where so-called ‘medical’ and ‘non-medical help’ are referred to as ‘medical care’ and ‘social care’, respectively (Simmonds, 2021). Each of these can present distinct challenges in later life.

In terms of healthcare, both writers for media outlets and personal testimonials bear witness to the accessibility and quality of care in such countries as Costa Rica, Spain and Mexico, which were ranked the first, second and fourth best countries, respectively, for healthcare by International Living (2021). The differences in costs between the home countries of our respondents and these destinations cannot be denied. However, the quality of care is also promoted as superior (Croucher, 2022). One author compares the US and Mexico as follows: ‘The primary difference … is that the care system [in Mexico] is not profit driven. Decisions for your care and wellbeing are not filtered through or guided by any profit motive. Doctors take plenty of time with you and a large number still perform house visits for patients’ (Murray, 2022: 1). That healthcare should be an important issue for older people is not surprising; however, as the previous quote suggests, at issue is not only the availability but also the quality of healthcare.

On 14 July 2022, International Living, a well-known company promoting international retirement migration,1 posted to its website the testimony of John, an American retiree living in Costa Rica. John explains why he and his partner retired abroad:

John describes the better quality of his new life in Costa Rica:

Introduction

Scholarship over the last 40 years has explored the contexts in which retirement migration unfolds, how these have changed over time and the diversity in retirement migrants’ motivations and experiences. We depict increasing precarity as a social fact resulting from neoliberalism and austerity trends in the Global North (Phillipson, 2021), one that results in anxiety about the future (Lain et al, 2019, 2021; Grenier et al, 2021). To some extent, such precarity has been related to ageism, whether in terms of discrimination in the labour market or welfare state policies (see Phillipson, 2021). Often overlooked, however, is that ageism (and the specific impacts it has on precarity) also influences older people's plans and experiences, including those of international retirement migration. In this chapter, we discuss the importance of examining how ageism influences precarity and the experiences of retirement migrants. We point to global inequalities borne of colonialism, wherein accumulation was centred in countries of the Global North, many of which occupied, dominated and exploited the people and natural resources of countries in the Global South. In the present era of unequal global relations, the ‘unequal accrual of privileges and rewards from a global system of production and accumulation’ (Hayes, 2018a: 11) undergird retirement migrants’ statuses and options, as well as shape their interactions with local populations. We end the chapter with a description of our study, which took place in Spain, Costa Rica and Mexico, and of our sample, which was composed of Swiss, British and US retirement migrants.

Retirement migration: what do we know?

Retirement migration has drawn attention from scholars in North America since the early 1980s, as it has become a more frequent practice (Calzada and Gavanas, 2018). Some early studies focused on seasonal migration to the US Sunbelt – that is, the movement of North American retirees (US and Canadian citizens) to the warmer regions of the US for the winter. Longino and Biggar (1981) conducted some of the first research on seasonal and permanent North American retirement migrants’ social ties and interactions in the US Sunbelt. They showed that the retirees who migrated permanently to these areas fostered the integration of those who came only for a couple of months every year and that, together, the two groups constructed communities.

Introduction

Joseph and Margaret, both aged 63, are an American married couple of 34 years. They retired early and have lived in Mexico for the past four years. Margaret worked as a high-school teacher and principal; Joseph worked in a managerial capacity for a non-profit organisation. Both had grown up on the West Coast and by the ocean, and had hoped to stay there. However, despite their professional backgrounds and middle-class status, by their late 50s, they began to see that the cost of living in their city ruled out a decent life there. They still had a mortgage to pay on their house, and they described themselves as living paycheque to paycheque. Moving to Mexico allowed them to live debt-free and still be by the ocean, as well as close enough to family (their son, siblings and a mother) that they could visit.

Part of what they enjoyed about Mexico was the way that they were treated by the local populations. As Joseph said:

He contrasted what he perceived as respect for older people in Mexico with what he saw in the US. Reflecting an awareness of inequalities, Margaret expanded on this feeling of inclusion as ‘just people’, juxtaposing this to the feelings of invisibility that older women face in the US:

Introduction

Sherry (age 70) and her husband Gregory (age 71) have lived in Mexico for a few years. They have been married for 30 years; each had been married once previously. Sherry has two children from her previous marriage; she and Gregory did not have any children together. Sherry is close to her daughter, who is moving for a new job that will also make it easier for her to see her mother in Mexico, and she will see her more often. Sherry is less close to her son, though they speak about once a month; she says that he will never visit. She is not close to her step-grandchildren, all of whom are grown.

When Gregory retired, Sherry was still employed and could work remotely if need be. If she could afford it, she would have preferred to move back to a city where she had once lived on the East Coast of the US, but that was too expensive. They looked at some places in Mexico, spending a couple of months in each, and did the same in some cities in the US. Eventually, they rented a place in Mexico, with the thought of staying for two years to see whether it facilitated being close enough to their daughter and son-in-law. They decided that it would work for them, both for family and for health reasons. Both Sherry and Greg had multiple chronic health issues. They maintained their healthcare providers in the US and held open the possibility that, as they aged, they would establish relationships with healthcare practitioners in Mexico.

The combination of their ability to see her daughter and son-in-law, access to desired healthcare, and economic considerations swayed them towards Mexico. As they were fairly well off, their economic reasoning bore more explanation:

Introduction

Commenting upon precarity in later life, Fine (2021: 175) remarked recently: ‘Risk among those of advanced age is not a matter of choice. Nor can it be reduced, it is argued, to an outcome of lifestyle options of individuals. It is instead produced by the sociocultural, economic and political environment, requiring political actions to address issues concerning inequality.’ This book has sought to understand better how international retirement migration interacts with precarity in later life, and in doing so, it ultimately dovetails with Fine's observation. We built our study based on two observations. The first is that retirement migration is a growing phenomenon, one that scholars have often attributed to: (1) the increased buying power and resultant consumption among older people in countries of the Global North; (2) the globalisation of communications; and (3) the global leisure, healthcare and housing markets targeting older citizens of richer countries. Based on this, scholars have tended to view retirement migration as differing from the migration of younger people, in that it does not result from the search for better work conditions. Instead, retirees benefit from their pensions; they therefore diverge from younger people because they can use their economic power to relocate abroad and improve their lifestyles, particularly by consuming leisure and adventure. To do so, they move to poorer countries, either in the Global South or in European countries with lower costs of living, where they exploit the human, economic and natural resources of the host countries. In so doing, they also reproduce postcolonial power relations and structures (see, for example, Benson, 2013, 2015; Hayes, 2018a, 2018b). Based on these observations, many scholars depict retirement migration as a practice mostly performed by privileged older people who use their power for leisure purposes.

Second, other researchers argue that precarity increasingly shapes older people's lives in Global North countries, despite existing welfare state policies aimed at providing social protection to them. Drawing on the works of such scholars as Lain et al (2019, 2021) and Grenier et al (2021), we emphasised that such precarity can be economic, social or linked to needs for healthcare or assistance with daily life, and that these result from major transformations in the welfare state, the labour market and the household within a broader global context.