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.