My son is an expat. The country he is working will not give him a passport, but next year he receives a residency card. Once that happens I seriously doubt he will return to the USA. Right now he is protected from USA income tax so he sees no reason to give up passport. He already receives free medical care plus he purchases private insurance. Unless it is an emergency or a bad cold or flu, he uses private insurance. Not a bad system we should dump Bozocare for something similar.
I’m becoming familiar with the medical options outside the USA. After the SCOTUS ruled we are serfs and can be compelled to buy whatever the govt says I figured I would ultimately look for my medical care outside the USA.