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Originally published July 5, 2014 at 8:03 PM | Page modified July 6, 2014 at 9:45 AM

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So, you say you want to retire in Canada

Canada’s more liberal social and economic policies, including cradle-to-grave health care from the government, remain appealing. So, too, is the draw of a country with spectacular landscapes and, in some places, more affordable real estate.

/ The New York Times

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It’s a nearby country where most natives speak English and there are few major cultural differences from the United States. Yet the number of Americans choosing to head north to retire in Canada has remained low — reaching a high of 1,675 in 2008 (for immigrants older than 49), then dipping to 1,060 in 2011, and rising again in 2013 to an estimated 1,565.

Recent changes to immigration law have dimmed Canada’s appeal somewhat, certainly to wealthy would-be residents, once eligible to immigrate if they had a net worth of $1.6 million and could offer an $800,000 interest-free, five-year loan to the federal government. That program, which attracted some people with money but little commitment to Canadian life, was dropped in February, and 50,000 applications are to be returned, some to potential immigrants who have been waiting more than four years.

But for some Americans, Canada’s more liberal social and economic policies, including cradle-to-grave health care from the government, remain deeply appealing. So, too, is the draw of a country with spectacular landscapes and, in some places, more affordable real estate.

“I have a garden! I have a tractor!” said Dr. David Bannon, president of the Medical Society of Prince Edward Island. For him, life in Canada’s smallest province — with 140,000 inhabitants, an island so small it shares an area code with the province of Nova Scotia — is heaven. He moved to Canada in 1992 after growing up in Los Angeles, studying in Chicago and practicing medicine in Fargo, N.D., and Key West, Fla.

Wooed north by his wife, who is originally from Prince Edward Island, Bannon said: “I’m happier here than I’ve ever been. I’ve done so much better here financially.” When he left Florida, his malpractice insurance cost $50,000 annually. On Prince Edward Island, thanks to a provincial government subsidy, his annual cost of $8,000 is reduced to just $1,000 a year.

As a general surgeon still in practice, Bannon knows Canada’s medical system firsthand. The major differences between the U.S. and Canada are less medical than cultural, he said, evident in Canadian patients’ tolerance for wait times and moderated expectations of their health-care providers.

“Canadian systems work because they’ve been regionalized in order to cut costs,” Bannon said. An American regional hospital will offer a broader menu of services, and “you’ll get those services here, but you’ll have to travel to a larger city for them.” These include MRIs, CT scans and other complex and expensive tests.

Some areas also have very few family physicians able to take on new patients.

Katrina Brogdon, a Texas-born elementary-school principal in Whitehorse, a city in Canada’s Yukon Territory, has experience with that, with two children active in athletics.

Faced with an eight-month wait for an MRI and a two-hour flight to Edmonton or Vancouver to get it, Brogdon and her daughter, a competitive swimmer, flew to Vancouver on their own. Brogdon paid $1,000 from her own pocket for quick access to an MRI, while their provincial health plan reimbursed them for the airfare, since the specialist was unavailable locally. Her daughter, suffering from shoulder pain, didn’t want to wait any longer for a diagnosis and treatment plan.

“We had no physician for three years,” said Elisabeth Burrow, an American who moved back and forth between the U.S. and Canada for her education and career, and now runs a food company in Fergus, Ontario, about 90 minutes from Toronto. Like Brogdon, she and her husband used their hospital’s emergency room or traveled to Toronto for care.

“The Canadian system isn’t 100 percent foolproof,” she said. “There are waiting lines for some procedures, but they’re trying to address it.”

Born in New Haven, Conn., where her father was a professor of medicine at Yale, Burrow now lives on a 97-acre farm, producing and selling pecans, walnuts and hazelnuts.

“I can’t see moving from here,” she said. “It’s safe. I don’t lock my door. Canadians are very gracious. They say their please and thank-yous. They’re more than willing to help you.”

Burrow also highly values Canada’s less divided political culture. “I couldn’t go back to the U.S. now. I just couldn’t,” she said.

Americans who are not yet Canadian residents but hope to retire there should start planning at least two to four years in advance, said David Aujla, an immigration lawyer in Victoria, B.C.

Since 2008, the Progressive Conservative party has changed the way potential immigrants are selected, restricting the list of eligible skilled occupations to only about 30; previously most professional, technical and management occupations were acceptable, Aujla said.

Potential residents can get health coverage within three months of obtaining a work permit or permanent status. They do not have to be citizens to receive it.

To obtain a work permit, Aujla advises his older clients to attend a Canadian college or university on a student visa and obtain a degree, after which they will be given a three-year permit.

“You’re already acclimated. You’ve got a network,” he said.

And Canadian universities are often more affordable: Graduate tuition for international students at the public University of Toronto, ranked highly in an annual survey by Maclean’s magazine, is between $16,886 and $48,293 Canadian dollars a year, depending on the degree.

In January, Canada’s currency hit its lowest value — 89.7 cents to the U.S. dollar — since April 2007, reducing the cost further for Americans.

It is also possible for Americans to obtain work permits in 60 professional job categories found in the North American Free Trade Agreement. This avenue gives expedited and easy entry for those potential immigrants who have a signed employment agreement with a Canadian employer.

“If you are highly skilled, age doesn’t matter at all,” said Aujla, “but it’s middle management that the government is very tough in screening.”

Alternatively, if you can prove that you have a viable business, you can apply to the government of whichever province you’ve chosen to live in. If your application is approved, it then goes to the federal government, an interview process that takes about two years, Aujla said. “There’s no age limit for business owners.”

The third category under which immigration is possible is “self-employed,” reserved for farmers, athletes and artists. “The key is to show you’ve been viable and can produce income,” which can be as low as $40,000 to $60,000 a year.

But applicants must also prove, according to the requirements of Citizenship and Immigration Canada, the country’s immigration department, that they intend to make “a significant contribution to the cultural or athletic life of Canada.” Someone hoping to teach piano in Toronto, the country’s largest city, might have less success winning government approval than someone willing to move to a small town in British Columbia, for example.

Canadians also face higher taxes, some of which pay for the health-care system available to everyone. “We pay them willingly, not gladly,” says Joseph Green, 79, a retired American who taught for years at Toronto’s York University and now lives in downtown Toronto.

Daniel Earle, 75, who was born in Rhode Island, educated at Michigan State, Harvard and Louisiana State University, and worked for 37 years as a professor of landscape architecture at LSU, now calls Yarmouth, Nova Scotia, his home.

He bought 8 acres and an 1860 house there for $11,000 and acquired the right to move to Canada through his Canadian wife, who had to sponsor him financially for 10 years to ensure that he could not become a burden on the system by claiming welfare benefits. He has his own income, but that sponsorship requirement has since been increased to 20 years for new immigrants.

Life in Yarmouth, a town of 7,000, is not much different from “small town USA,” he said. “It was an easy transition.” He and his wife are avid sea kayakers and boaters, and their home faces a river. Earle has faced a few medical issues and recently had cataracts removed after a six-month wait for his appointment.

“If you have a critical problem, like a heart attack or brain aneurysm, you’re seen right away. I’m delighted with the care here. I don’t have to worry at all.”

He does pay a premium for his choice, in the form of $12,000 Canadian dollars in taxes to the Canadian government in addition to his taxes in the U.S. “It’s a huge chunk,” he said, “but if I were living in the U.S., I’d still have some other costs. It doesn’t bother me.”

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