Adriana E. Ramírez: What makes an ‘expat’ vs. an ‘immigrant’?

My friend S, a forensic nurse that helps children who have been sexually trafficked, was let go from her job after the nonprofit she works with lost their federal funding. She’s now considering moving to Guatemala to work for an NGO.

My friend M, who worked abroad for USAID, is trying to figure out how to stay in Europe for health insurance reasons. A friend from college has vowed to move to Vietnam and never return here.

What is the difference between an expatriate and an immigrant? Both leave their homelands. Both settle abroad. Both often work without authorization. But “expat” signals privilege of wealth or education. An immigrant is seen as poor, in need of help.

These differences are semantic. The truth is that both are people who have been pushed to seek a better life elsewhere, whether they were in danger or they wanted a higher quality of life. And until we know how to talk about immigration with all the nuance and empathy it requires, we’ll be debating apples against oranges without acknowledging they’re all fruit.

Take Malte Zeeck, the founder and co-CEO of InterNations, the world’s largest expat network, who believes that for expats “living abroad is rather a lifestyle choice than borne out of economic necessity or dire circumstances in their home country such as oppression or persecution.”

Maybe it’s worth considering how many immigrants come here because of a “lifestyle choice” (there are more middle class people without legal status here than we realize). It’s also worth considering how many Americans move abroad in order to escape our health system. There are 100 million Americans with medical debt, and there’s a reason more are looking for answers elsewhere.

When Americans take on the risks associated with illegal immigration, they usually do so for financial reasons — approximately 300,000 are undocumented. And the top financial reason is medical debt.

Got a ticket for my destination

Years ago, when my good friend Lizz turned 40, she invited my husband and me to her party in San Miguel de Allende in Mexico. My husband didn’t speak Spanish then, but she reassured him, “there are so many Americans in San Miguel.”

She was right. We went to visit a friend of hers, a retired American painter, who kept a studio near the center of town. That evening, we went out to a bar owned by another American expat friend of hers.

As my husband and I walked back to our hotel later that night, giddy after dancing, adventure and good conversation, we debated the benefits of one day retiring South of the Border.

We wouldn’t be alone. There are anywhere between 1.1 and 1.5 million Americans living in Mexico. And according to the Mexican government, about 200,000 expats are living there illegally — undocumented, if you will. We had met several at the bar in San Miguel.

Locals call them “dry backs,” or “little dry ones.” Private clinics have sprung up to cater to American medical needs.

Where my thought’s escapin’

People leave their countries for many reasons. In my 15 years living on the U.S.-Mexico border, I met people from around the world who left their homes due to political intimidation, violence, threats from cartels and, of course, for the opportunity to make a better living.

Most of the people who chose to leave for financial reasons did so because their families were starving, or they were working nonstop without building up any savings. Some toiled for hundreds of hours a month only to make the equivalent of what a nice evening meal costs in Pittsburgh.

“Everyone wants to come to the U.S. for financial opportunities,” an immigration lawyer I spoke to said. “Everyone wants to work hard. Everyone wants a chance to live a better life. That’s not enough to grant asylum — that’s not enough of a reason to get to stay.”

But finances, and medical debt, are the number-one reason driving Americans to live abroad, legally and illegally. Or as my friend Hugo put it, “I don’t know a single Mexican who has gone bankrupt for health costs. And maybe Americans want that too.”

Homeward bound

“I can live off my social security check here — like really well. Housekeeper, cook, nice condo, the whole nine yards,” my father’s friend Mark, a retired mechanic from Dallas living in Colombia, told me. “The trick is to earn in dollars and spend in pesos.”

Mark left the U.S. because he could no longer afford necessary medical treatments. He moved to the Colombian Caribbean coast about six years ago and is in good health these days. “My biggest cost [in Colombia] is health insurance, which is less than $200 a month. There is no way I could live like this at home.”

When I asked Mark how legal his stay in Colombia was, he demurred. “I make it work, everything else is details.” He later admitted to overstaying his tourist visa — a deportable offense.

Mark is one of the 15,000 Americans living in Colombia illegally. I asked if he was ever afraid of being sent back to the U.S.

“Why would I be deported?,” he replied. “I’m not committing any crimes. I live a good life here.”

Adriana E. Ramírez’s previous column was “Book bans here and abroad reveal the power of words.”