Since the birth of CBI programs, structures have been put in place to allow for maximum preservation of wealth, financial security, and freedom of travel. The recent events related to COVID-19 have made investors reconsider the selection of programs, and have shifted priorities. Access to healthcare and medical services is the factor that has gained considerable importance in the investment migration industry.

Until now, residence and citizenship programs have been designed primarily to serve optimization with regard to mobility and freedom of settlement. A residence or citizenship of a Caribbean country, for example, comes with excellent travel benefits. However, this is not of much help when borders are closed, and you require immediate medical assistance. In most cases, entering a country with closed borders is only possible if you are a citizen with the respective nationality. So, holding a Caribbean passport will allow you to travel to the respective country despite closed borders, but nowhere else. As long as you are healthy, these islands can be beautiful places to “sit-in” and wait for the health crisis to be under control and vanish. Such islands have relatively low travel rates and limited interactions with the outside world.  Compared to other countries with investment migrations programs, a shutdown, effective controlling of infections, and containment of a virus can be managed much better.

However, as soon as you require medical assistance and access to healthcare, such places can become gilded cages. The healthcare systems on the Caribbean islands, as well as in many other including European countries, are far away from being state-of-the-art. A lack of healthcare infrastructure, no self-sufficiency of medical equipment and medicine, medical practitioners that are less experienced with life-threatening conditions, and a tradition of taking advantage of medical tourism to access better treatment in countries with a further developed healthcare system. In short, if you have a serious health condition, many countries are not the optimal places to be, and you will find yourself in a rather unpleasant situation if you are unable to travel.

Even ordinary visa-free travel will no longer assist when borders are closed. Having a residence permit or citizenship in a country that can offer sufficient level of medical services access and security will allow any time, and even with closed borders, to enter the country and benefit from superior care. Alternatively, an excellent private international health insurance can assist in evacuating someone even from remote areas with closed borders in emergencies. A second alternative might be using telemedicine consultations with most experienced doctors that can help remotely through their extensive history of remote support. Remote care is much more difficult and complicated than when a doctor is physically able to examine a person and therefore requires a unique skill set.

While the world is watching and following the statistics of how countries manage to contain and eradicate new infections, it has become clear that some states have miserably failed in doing so. For decades, the USA was considered to be one of the furthest developed countries for healthcare, treatments, and medication. However, only a few weeks into the COVID-19 pandemic, the American health and medical system has come under severe strain and partially broke down. The USA is only one country amongst many others that have proven not to be able to manage this global health crisis sufficiently well. Others include the UK, Italy, Spain, or Brazil, to name a few. Medical tourists are now questioning whether the USA is still their go-to address, and so do investment migration applicants. Would you still consider the EB-5 program to be a wise choice for a safe and secure future for yourself and your kids? The latest issue of the Henley & Partners passport index has confirmed this. The program has lost tremendous ground, previously ranking 6th, now ranking 7th. Forbes’ recent report on “The 100 Safest Countries In The World For COVID-19” has rated the USA on place 58, while Switzerland is considered to be the safest.  It may suddenly appear to be a much better idea to seek residence status in, say, Switzerland, than the USA or Spain.

What has become apparent already by now is that governments need to reconsider their residence and citizenship programs to adjust to the new reality and put a more significant focus on health and access to healthcare. Attracting the most attractive investors into a country in the future will require to either develop the local healthcare system and infrastructure or by seeking alternative solutions that allow their citizens to be best taken care of as the frequency of health crises increases. Investment migration consultants on the other side will be forced to rethink how access to the best healthcare can be integrated into their services to differentiate from competitors, and also need to reconsider which programs suit best for individuals and families that not only seek security and personal mobility in normal times, but also and in particular for their health.