As a Type 1 diabetic, living in Italy has been good fortune. All my health care needs are met, and I pay very little for that care. Taxes are steep, but they are predictable, and I don't worry about a medical emergency bankrupting my family. Sadly, the prospect of returning to the US feels fraught with the "pre-existing conditions" provision, which has to be one of the most cynical and immoral policies in a civilized society. How odd that as someone born and raised in the US, and for 30 years a taxpayer there, I may be a medical exile from my homeland.