Dear Liza, 

I am considering the drastic step of fleeing the country as a healthcare refugee. I have a medical condition that requires expensive medications, frequent doctor’s visits, and regular blood work, which costs me considerably more than my monthly rent. I live alone, and I am penniless and constantly stressed about money. I work full-time, but if I want to keep this medical condition in check, I desperately need to cut back on my hours.

I met someone online, a longtime friend of trusted friends who lives in a European country that still has national healthcare. He has been romancing me now for five months; I went to visit him, and the sparks flew. I am very much in love with him, but I recognize that it’s early days yet for this relationship.

We have discussed me moving there sooner rather than later—as in, as soon as I can find someone to take over my lease. He has offered to marry me so that I can have access to free medical care, and tells me daily that he wants us to build a life together. I’m very much inclined to say yes. Is this a crazy, ridiculous plan? Too much of a gamble? Paying my bills every month just isn’t happening, to the point that I can’t always get the medications I need to keep working. Should I take the risk?
—Sick in Love

Dear Sick,

What a romantic story! Who can resist a plot twist in which our protagonist finds love and democratic socialism? And just when you need free healthcare more than ever! With all my heart, I want to tell you to start packing your bags and planning the wedding.

But first, get a lawyer.

That sounds crushingly pragmatic, I know. But European immigration laws concerning spouses are complex and inhospitable. I can imagine why. In my 20s, I spent one evening with a ridiculously handsome Danish man I’d never met before, and the chemistry was explosive. I thought, “I should move to Copenhagen and have a baby now—think of all those social benefits!” This is no doubt exactly the sort of disillusioned yet idealistic Yankee reasoning that EU governments hope to deter.

Immigration laws concerning spouses are different in each European Union country. You can’t just move there and begin enjoying your healthcare tomorrow; while many European countries do require hospitals to treat anyone who shows up, getting the routine care you need, as well as the right to work legally, will be trickier. Some countries require the sponsoring spouse (in this case, your beloved) to meet income requirements. Others might require that you have a health check; your preexisting health problems could inspire nitpicky objections to your application. Mistakes long forgotten could be used against you—even parking tickets.

If the laws and processes of your sweetheart’s home country prove prohibitively strict, ask your lawyer about the Surinder Singh route, which allows non-European spouses to get EU immigration rights by temporarily living and working elsewhere in the EU, usually for at least three months.

You should also consider, says former UK immigration adviser Lara Sharp, that “if he decides to break up with you, you’re fucked.” When a non-EU person marries an EU person and takes up residence in an EU country, her “status in that country is dependent, in relation, wholly and completely tied” to the whim of her spouse, says Sharp. In the event of a breakup, you could lose your access to healthcare and might not even be able to work or remain in the country.

It’s also worth considering that generous government benefits like healthcare are under attack by neoliberal and conservative forces in many European countries. Even if love lasts, social democracy might not.

Sharp says you’d be better off marrying a Canadian, as Canada is more welcoming to foreign-born spouses than the EU. Americans tend to find Europeans hot—too many Godard films?—but perhaps it’s time we changed our romantic preference to Canadian. (Is there a place to check that on OkCupid?)

I’ve been a bit of a downer here, Sick. But I do think you should go for it. Americans do marry Europeans, and emigrate, all the time. But—as with most matters of socialism and of the heart—it won’t be simple.

* * *

Dear Liza,

When I was 25, I inherited a bunch of stocks in companies with abhorrent environmental and human-rights records—i.e., Coca-Cola, Caterpillar. Instead of selling everything, I chose to work for lefty causes, volunteer my time, and donate to progressive charities. My personal MO of giving back has landed me, at 45, in a morass of exhaustion, feeling like I have a codependent relationship with the world—everyone else’s problems are far more important than my own. I don’t know how to find balance and self-esteem under the weight of my uneasy relationship with wealth and the giver identity I’ve created around it. Help!
—Poor Little Rich Girl

Dear Rich Girl,

You’re not wrong to feel that billions of people have it worse than you. But please stop torturing yourself.

“What stands out most is that the writer suggests that she made a moral compromise for which she has felt guilt or shame ever since,” says Dr. Anthony Charuvastra, a psychiatrist with a practice on Manhattan’s Park Avenue. He explains that your donating and volunteering is a form of ego defense called “undoing.” You should forgive yourself for—or at least accept—the decision you made, as a young adult, not to sell the stocks. Says Dr. Charuvastra, “She gave in to her libidinal impulse to hang on to wealth—you could call it greed—even though it conflicted with her other beliefs about virtuous behavior. She has paid for her initial inability to stand up to her libido/id with a lifetime of apparent self-sacrifice that has left her feeling morally and mentally exhausted.” Ego defenses are the moral equivalent of carbon offsets: Consider the husband who takes on extra household chores to counteract his guilt over a secret affair; he probably still feels guilty.

“What’s neurotic,” says Dr. Charuvastra, “is that she is not applying her intellect to this problem.” That’s the project now: to think seriously about your money and what you want to do with it.

I wouldn’t recommend giving it all away; that makes no sense in a society so lacking in safety nets. But a financial adviser could help you figure out what you need in order to live comfortably for the rest of your life, anticipating all the worst-case health, aging, and employment scenarios for you and your loved ones. Subtract that dollar amount from your current net worth. If there is in fact a difference, give that away—perhaps to organizations or people fighting inequality. Make that your last gift, and move on.

Or you could sell the stocks and invest in businesses developing renewable energy like solar and wind. You could also wait until you’re inspired to fund a project of your own—a left-wing environmental think tank or perhaps an artists’ colony.

Whatever gifts you choose to make, you also need the respect and satisfaction that comes with a freely chosen career. What do you find most rewarding? Writing? Art? Or do you aspire to a profession for which you lack the training, like library science or philosophy? You can fund the kind of transition that is, for most people, almost impossible in midlife.

I don’t want you to abdicate your admirable social responsibility, Rich Girl. But it’s time for you to live with less guilt and more joy.

Have a question? Ask Liza here.