Importance of Securing World-Class Health and Wellness Through Citizenship By Investment

A growing number of investors are acquiring second residencies or citizenships with healthcare access as a primary consideration. Programs in Italy, Greece, Portugal and Turkey each provide access to national health systems and private care at costs well below US equivalents.

Health Tourism and Thermal Medicine in Italy

Tuscany has thermal springs that have been used for therapeutic purposes for centuries. The water, locally called "Aqua Santa," is used to treat gastroenteric conditions, liver disease, arthrosis and vasculopathy. One Tuscan center has added a medical facility staffed by 14 physicians and a rehabilitation gym alongside its thermal operations. The facility runs programs for detox, post-cancer rehabilitation, post-surgical recovery and chronic pain conditions including fibromyalgia. The thermal water stimulates peripheral microcirculation and promotes muscle relaxation, which can reduce pharmaceutical dependency.

Italian Golden Visa holders can access these facilities without visa restrictions or time constraints. A tourist visa limits the duration of treatment; a residency permit does not.

The American Anomaly: High Cost for Average Outcomes

The US spends nearly twice the per capita average on healthcare among wealthy nations. The OECD confirms this repeatedly. The high spending does not produce correspondingly better outcomes in life expectancy or chronic disease management.

The cost structure is driven by for-profit providers, pharmaceutical pricing, private insurance intermediaries and administrative overhead. Even insured Americans face high deductibles and co-pays. The Commonwealth Fund has reported that nearly a quarter of insured Americans are underinsured.

In countries with strong public healthcare systems, private providers operate in a regulated environment where the public option constrains pricing. The SIP Health Cost Index 2025 ranks the US as the most expensive private healthcare market, with average annual international private medical insurance costing $17,969.

Global Healthcare Arbitrage

Private healthcare cost exposure is now a factor in residency and citizenship planning. The SIP Health Cost Index 2025 benchmarks private healthcare costs for mobile individuals across 50 countries. The data shows large cost differences that affect the long-term affordability of any given destination.

For families with global mobility, a second residence or citizenship is increasingly part of healthcare cost management.

Portugal, Italy, Greece Golden Visa

These three programs provide residency permits with access to national health services. Each has low minimum stay requirements, Schengen area access and a path to citizenship.

Conclusion

Healthcare costs vary dramatically by jurisdiction. The US is an outlier in spending relative to outcomes. Golden Visa programs in Portugal, Greece and Italy provide access to healthcare systems where costs are lower and regulated. For investors already considering a second residency, healthcare access is a practical benefit that compounds over time.