Once I get my bison account set up Iāll try sending from IBKR without receiving money first, and report back
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I withdrew EUR from IBKR to my bank accounts without the need of a prior deposit the other way round. Thatās including sending direct SEPA transfers from IBKR to my PT bank account.
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Iām sure you can do it, but the first time you send to a new account, there is a pop-up that says that you affirm that you are not transferring money to an account from whence you havenāt had a prior deposit. Iām 99% sure that it would work out fine, but when weāre talking about 350k, it was worth the extra step for me.
Oh, and that isnāt true when you select that you are sending to a third party - they have a separate review process for that, so easy peasy in that regard, it can just take a tiny bit longer.
Interesting? I wonder why they ask you to affirm that, and then apparently allow one to go ahead and do it anyway as if they donāt verify/enforce this requirement?
That makes me nervous?
I wouldnāt be nervous - they apparently havenāt enforced it for many people! My dial is just set to āvery cautious,ā thatās all.
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LOL, well my dial is set at āextreme paranoiaā! 
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I would be very careful on this point. Itās nice to say that Portugal has a national health care system that you are eligible for, and that it ranks well in terms of health care ratings and the like. However, the reality appears to be rather more nuanced than that.
The public health care system is, and has been, overloaded. Anyone moving there now has a devil of a time getting a health care number, by all reports, and can forget about being assigned a primary care doctor any time soon. This limits your access to health care. Prescriptions are cheap, but access to advanced tests and the like is quite throttled. Etc etc. Itās the story of seemingly most public systems at this point. And this was true pre-covid, even. Response to A+E seems to be fine; a friend of mine recently had a heart attack and said things worked just fine with no meaningful issues. However major health events come in many different forms, and given what all Iāve learned from paying attention, itās unclear to me that I would want to depend on their public health care even now - and can we really assume it will get better?
Private health care is available, and by reports quite good. However, you have to look closely at the maps to see whether itās available anywhere near you or if youāre going to be doing a lot of hiking to Porto or Lisbon for what you need. It also means leaning on private health insurance (or footing the bill yourself), though at least the private health insurance should be quite a bit cheaperā¦ assuming of course they pay. Which you want to believe but now youāre talking about a different set of rules, that you donāt know and are going to have to learn.
So, the situation is arguably better, but itās hardly a panacea and people there still die from lack of treatment for treatable conditions.
That is interesting - if I remember correctly, I think IBKR says in the SEPA setup that it has to be one of your accounts to link - it is interesting that you were able to link your lawyers account to IBKR via SEPA.
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Wow! I canāt tell you how depressing that is to hear! Is this from personal experience @jb4422 ? Are you a Golden Visa holder or resident of PT? Their healthcare system, from my reading and understanding, is highly rated and respected, or so I thought? I am a physician in the US and I can tell you our healthcare system ranks in the bottom decile among first world/Western countries in practically every category except cost,where weāre #1, both per capita, and as a % of GDP!? I assumed PTās was better, and more like the public systems in Canada and UK, both countries in which I have personal acquaintances who are physicians who indicate the level of satisfaction with the practice of medicine, in general, is significantly better than USA. Are you able to share some more specifics re: PTās healthcare system? This is one of the primary reasons we are applying for GV- the option of having access to better and more cost effective healthcare as we enter our retirement and senior years. If thatās not going to be the case we will most certainly rethink our motivation and plans.
Thanks for any input!
If I implied it is āterribleā I only meant that as it applies to the level of adequate healthcare which is accessible and available to the greatest number of people. That and the general emphasis, whether it be on preventive and primary health care, or more on large fee for service procedures, etc., that generate revenue. Itās the latter that makes it possible that the US, does in fact, and as you alluded to, have some of the most advanced medical procedures/capacities/treatments in the worldā¦if you can pay for it, or get approved for it. Capitalism spurs innovation- no argument here. There are patients in Canada who still cross the border (pre-pandemic, of course) because they can get their total hip arthroplasty or their EGD more quickly than back at home, which points out one of the drawbacks of extensive public or national healthcare systems- long waits for nonemergency treatments. Ironically my nearing Medicare age is a good thing, and from my point of view as a physician, Medicare is much easier to deal with and with lower overheads (3% vs >30%) than 3rd party payors. American has superb healthcare capacityā¦if you can pay for it.
It is typical for AML (Anti Money Laundering) - they probably store your affirmation as proof that they did their part to prevent ML - so basically CYA 
Not sure that is enough to protect them if there was really an issue though.
You probably should do some more research on the topic; what I know is second hand from research as opposed to personal experience - though āpersonal experienceā is only so useful due to sample set size. You can get a lot of info from the various FB groups from people in-country.
Portugal does lead in health care in lots of rankings. However, all such rankings have limitations based on their inputs and methods.
Letās consider Costa Rica. It ranks quite high in terms of health care. However, the reality of that high ranking is based on their relatively simple observation that if you make sure people get a once a year checkup and basic screening and get their shots and receive some other obvious stuff like basic pre-natal care, you can head off truly astounding quantities of stupidity and people stop dying for stupid fixable reasons. Indeed, one of the amazing revolutions of Costa Rican health care is the EBAIS system that puts a clinic in every podunk town and makes sure everyone gets a checkup on a regular basis even if a nurse has to drive out to them instead of them going to the clinic. Itās an astounding concept and I think the world would be a better place if it were adopted more broadly; certainly it drives Costa Ricaās life expectancy into the ceiling. But that doesnāt make Costa Rica a place where I want to turn up with a diagnosis of pancreatic cancer. Indeed, the opposite; people end up going back to the US because the local public systemās ability to cope with ComplexThingYouHave is so-so and subject to long waits, they didnāt get private insurance that would cover them to go to CIMA or Biblica Clinica because āoh we donāt need it, we can just use Caja!āā¦ but they figure out that even Memorial Sloan Kettering will take Medicare.
So you have to look a little harder at what youāre concerned about and how well the local system can handle that. Again, letās consider Costa Rica, since Iāve spent some time on the matter. Letās imagine you get your leg cut off and need a prosthetic. Thereās one, count them one, western-trained prosthetist in the country. There are some others, locally-trained. They probably do a yeoman job and get it done for most people. Are you going to get a prosthetic you can do yoga with? Errr, prolly not. Are you ok with that?
If you pay for private health insurance, itās generally accepted that Portugal has good health care; there are no meaningful waits at the private hospitals and the like. However some types of care are only available in the public system so there are dependencies. Private health insurance is generally considered quite inexpensive. However the private institutions tend to be in Porto or Lisbon or the Algarve. I can find basically nothing between Lisbon and Faro, nothing inland (Evora maybe?), and something of a gap between Torres Vedras and Coimbra/Figueira da Foz. This makes sense of course; private institutions need clients with money and there isnāt much of that inland. Note that this is just my own research and rather incomplete. But it is biasing my view of where I might want to live.
This isnāt to say the public system is horrid. In truth I do not know, other than the known stats of the wait times for various treatments/services. It could be fine. My Portuguese friend has been through A+E twice now in the last couple years and has been fine. The fact that all prescriptions go through the public system is a major win for a lot of people as it keeps all those costs down on the floor. And having A+E in the public system means that car crashes and heart attacks are not fast-tracks to penury. All major wins. However, Portugal is just as subject to the flaws of a public healthcare system as any other.
Health care almost anywhere else in the world is going to be more cost effective than the US. But bad / good are relative. As a professional consumer of health care services, I tend to think that -if- you have the money and/or the good health insurance policy and need The Best, the US is still amongst the best in the world if not the absolute best, depending on specialty, and your ability to be your own advocate. The trick of course is having that health insurance policy; sadly only a limited number of us (and our senators) have access to such policies, and they are blisteringly expensive to the employer, meaning fewer and fewer can access them. This in and of itself drives down our health care outcome rankings. It of course also presumes you have access to a Weill Cornell or Cleveland Clinic or Mayo in a reasonably handy fashion.
I donāt mean to bash on Portugal or drive you off. Itās just not so black and white as āPortugalās health care is betterā and thatās all that I mean to head off. Itās like saying GV is just āput money in here, passport out the other sideā - true at some level, but it aināt that simple.
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Appreciate your thoughts, Jeff. Your extensive analysis is what I wish I had done more of 6 months ago.
Thanks for your post. Sorry if my shorthand comment sounded as if I thought Portuguese public health care is a panacea. It is not. But it is a far cry better than the US in some ways. Every healthcare consumer needs to do their homework to find what will work for them.
I work in medical diagnostics and have in therapeutics as well. I have worked in 30+ countries and seen most western and many eastern systems in practice. In my experience, there is no panacea. All systems have issues. And I am not suggesting that Portugalās is even the best. But for a savvy consumer, having a public option (and a more affordable private option) adds to the toolbox. For me, I do not like having the US health system as my only option. Medical tourism is always option but is transactional in nature. That may change with improving telehealth platforms that have progress rapidly during the pandemic.
Your friend who was treated for a heart attack with no really issues is no small thing. Lifetime cost to treat and care for a non-severe heart attack can run into 7 figures in the US.
And Iād be cautious about proclaiming the USās superiority in health care. Specialties-yes, we do very well if the specialty in interest also happens to be very highly paid. Have a chronic wound? Youāre not in such luck. Reimbursement is low and treatment is mediocre at best, despite that a diabetic ulcer is more deadly to almost all cancers. US is middle of the pack on most outcomes measures. And itās dead last by a huge margin on cost-for-outcome measures. If we could get just as efficient on cost as the 2nd most expensive country (Switzerland) we could take the savings and plug the entire social security gap.
Healthcare and healthcare economics is a complicated, and fascinating, topic. Too nuanced for a chat board. But it would be great to continue to connect with others over these issues. Thanks again for your post.
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This has been interesting. Thanks to the others who have written. And yes itās an interesting topic.
Somehow it seems really weāre all on the same page. The US has some of the best care, and yet is willing to throw large sections of its population under the bus; like much else, itās a land of extremes - medicare (with its flaws) for the older, medicaid for the really poor if you happen to live in the right state, gold-plated healthcare for the wealthy, and nothing but high bills and frustration for the people in the middle, with widely varying outcomes across the spectrum and crazy costs. Portugal has its flaws, but any public option is certainly better than no public option, the average outcomes are still probably better than average outcomes in the US, the private sector provides something of a bypass for those willing to pay for it, and the cost of the private sector is still blissfully lower than the US.
In truth Iām just kind of nervous about the whole thing. While the US system has flaws, I at least understand it and am used to it. Portugal is a whole new mixed bag about which I know little. Itās a topic of research at the moment.
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Curtis, I have a first-hand (and first-āother body partsā) experience with the public āhealthcareā system in one of the countries you mentioned. I may seem ācheaperā than the US system, but I would never ever recommend it to anyone. I am lucky enough to have a private medical insurance on top of the ānationalā one, which at least ākind ofā works, in a sense that I can at least get to see a doctor in a reasonable timeframe.
But generally I try to avoid it if I can and usually prefer travelling to another country for any tests or treatment more complex than paracetamol.
From what I know, the same approach is practiced by other people who care about themselves and who can afford it. For example, my former boss travelled a few times to Cuba (of all places) for treatmentā¦
So Iād say āratingsā are one thing, but reality on the ground is quite another.
That said, I have not yet touched the PT system besides a few mandatory Covid tests.
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