Employees relocating to the U.S. face significant challenges with the medical care system. Some of the information needed is how to work within the U.S. medical system, how to find a doctor, where to go in an emergency, and how to get help for emergencies
U. S. Medical Care
Medical care in the United States in general is of high quality. Many doctors and most hospitals are independent businesses that must generate enough revenue to continue business operations. U. S. medical care also uses the high technology available for laboratory and radiological testing. Unlike many other countries, the United States does not have socialized medical care except for the elderly and the indigent. U.S. medical care is a fee-for-service business, which means that payment at the time of service.
Confusing Insurance Plans
Many employers provide group health care insurance for the employee and the employee family members. Many employers pay part of the cost for this group insurance. The employee must pay a portion of the cost of this insurance. Group health insurance plans take many forms – Indemnity, Managed Care (PPO or POS), or Health Maintenance Organization (HMO). The majority of foreign nationals moving into the U.S. (In-pats) come from countries with socialized medical care and all of these concepts and terms are unfamiliar to them. When contacting medical offices for appointments, most will encounter the question, what type insurance plan do you have? Confusion generates stress for the in-pat family and may contribute to failed assignments.
Bills from Doctors and Hospitals
One area that generates total confusion for foreigners in the U.S. medical system is billing for medical services. The hospital bill, the insurance explanation of benefits, along with co-payments and deductible totally confuse people from socialized medical systems. The terminology is new to them and the level of payment for services is confusing. To reduce stress levels the foreign national should have access to someone to help guide them through the maze of terms and paperwork for medical bills.
Emergencies in the U.S.
The in-pat should understand that for an emergency he should go to the nearest hospital where the medical staff will evaluate and treat the condition or call a specialist to care for the problem. Even knowing to call 911 for emergencies can alleviate stress for the family and especially the trailing spouse. Again, reducing these stressors improves the likelihood of a successful in-pat assignment.
Think of a situation where English is very difficult for the trailing spouse and a child has an accident at home. The parent does not know how to contact emergency assistance and the child is bleeding. Just imagine the panic of the parent. Later, when the parents are together again the family situation can explode suddenly. The trailing spouse blames the working spouse for causing the “mess”. Many stories exist about divorces caused by repeated smaller stresses and minor crises. These situations are costly to the employer in lost productivity and possibly failed assignments.
Just as due diligence reduces risks in business deals and good planning improves the chance of success for projects, so too good preparation of employees for international relocation improves the chances for a productive and successful assignment.

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In the current real estate market, the ideal of a cooperative assignment is becoming more and more popular. In such an arrangement, a middle man comes in to affect what the home seller could not himself. Very often, it is used when a middleman gets a seller to agree to a lease purchase agreement and places a tenant buyer.
If there are serious prospective buyers for a property, then the owner has no need for a Cooperative Assignment process, but if not, then such a process may offer them a tolerable alternative to continuing to lose money. The vital component for the seller is that the property has a fixed mortgage rate, as it is much more difficult to lease out property when the monthly payment is subject to change.
Once a distressed home seller is found that is willing to accept a lease option that covers the PITI (principle, interest, taxes and insurance), thereby securing the seller’s financial position, the person organizing the Cooperative Assignment then tracks down an appropriate renter that is looking to purchase a property through a lease option. The pool of candidates is much larger than those that qualify to buy the home outright, especially in the current climate where the bank’s lending standards have significantly tightened. The great thing about a lease option for the buyer is simply that they get to live in the prospective home for a number of years prior to actually buying it, a number of years in which they can improve their financial position and be prepared to purchase once the option becomes due.
For the person organizing the Cooperative Assignment, most of the fees for the service are collected from the renter/buyers. Further, if the renter/buyers need some help with the upfront fees, this can be lent at a high rate of interest by the person organizing the Cooperative Assignment. The exact mechanics of the process, the fees charged, and the profit made depends entirely on how the organizer chooses to organize the arrangements. In some cases the organizer may serve as a fee-based third party consultant, while in other cases the organizer may become a principal in the arrangement organizing the entire matter as a “Sandwich Lease Option” (where the organizer serves as the official leaser with control of the lease option and then subleases the unit to the renters). The number of ways that a Cooperative Assignment can be organized is solely limited by the organizer’s imagination and the willingness of the other principals to go along with the proposed agreement.