Longevity
One American's health costs in Malta vs. the U.S., by the numbers
By John Hyland, . Life and Health Today.
Mariska Breland has multiple sclerosis, a history of breast cancer, and half a liver. In the United States, that medical history made her an actuarial problem. When her husband left federal employment and the couple faced buying coverage on the insurance exchange, the cheapest mid-level plan they could find for both of them in New York ran to roughly $30,000 for 2026, including copays and deductibles. That figure came after marketplace premiums had already risen an average of 26 percent for 2026, and United Healthcare was requesting a 52 percent increase for New York for 2027, according to Breland's account in STAT News.
She had an exit that most Americans do not: a European Union passport inherited from her mother. She and her husband moved to Malta.
What she pays now, and what it covers
In Malta, Breland pays 38 euros a week, which she describes as roughly $2,300 a year, into the national social security system. That contribution, she writes, covers hospital stays, emergency helicopter rescue, and her medications, including the multiple sclerosis drug that carries an $80,000 annual list price in the United States. There is no prior authorization process and no requirement to try a cheaper drug before accessing a more expensive one.
For speed and convenience, she uses Malta's private tier alongside the public one. A same-day general practitioner visit at a pharmacy costs 15 to 20 euros in cash. A specialist runs 70 euros. An ultrasound, if wanted quickly, costs 120 euros and, in her account, was read by the performing physician at the appointment rather than sent to a radiologist later.
For an oncology follow-up, she saw a physician she identifies as Dr. Brincat, who she says ran the oncology department at Mater Dei Hospital for 17 years. The appointment came two weeks after she called.
The comparison she draws
Breland cites a 2025 survey by the American Medical Association finding that U.S. physicians average 40 prior authorization requests per week, with their practices spending 13 hours a week managing them. Forty percent of doctors, the survey found, employ staff specifically to handle insurance companies, and about three-quarters of physicians reported that denials had increased over the previous five years.
Her Malta general practitioner, she writes, uses a laptop running what she describes as a vaguely Y2K version of Windows and corrects lab forms with white-out tape. Her American doctors included department heads at Georgetown University and Johns Hopkins, and a plastic surgeon who had chaired the national board that certifies plastic surgeons. She is not arguing the clinical quality is equivalent. She is arguing the administrative friction is not.
She also notes that Malta's health system spends roughly a quarter of what the United States spends per person, yet Malta's average life expectancy runs about five years longer. She attributes that gap to the system rather than lifestyle, pointing out that Malta has the highest adult obesity rate in the European Union.
What this account does and does not establish
This is a first-person essay, not a clinical study or a comparative health systems analysis. Breland's experience is shaped by her specific conditions, her EU citizenship, her husband's income, and the particular structure of Malta's two-tier system. She signals that the public tier is where her experience becomes more complicated, but her piece does not detail the waiting times or access constraints on that side.
The cost figures she cites for U.S. premiums are consistent with publicly reported trends. Medical care services prices in the United States were up 2.5 percent year on year as of September 2026, according to the U.S. Bureau of Labor Statistics, meaning the underlying cost of care continued to rise through that period.
What her account cannot show is whether her clinical outcomes in Malta will match what she received in the United States, or how the system would perform for someone without her specific combination of conditions, income, and legal status. She is explicit that the EU passport is an inheritance, not a replicable strategy: "Most Americans with a condition like mine don't have an escape hatch to the European Union," she writes in STAT News.
Anyone weighing their own insurance options for 2027, with open enrollment running November 1 to December 15 according to Breland's account, is dealing with variables specific to their health history, state of residence, and coverage needs. That calculation belongs with a benefits advisor or clinician who knows the details.
Source: https://www.statnews.com/2026/11/04/moving-to-europe-free-health-care-differences/?utm_campaign=rss
Life & Health Today provides information for educational purposes only, not medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional.