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Comment by chimeracoder | Hacker News Reader

> If you're talking about Silicon Valley or New York, taxes won't be that different.

I live in New York City. My taxes (as a percentage of my income) are substantially lower than they would be if I worked the same job in London, Berlin, Paris, Stockholm, Amsterdam, or any of the European cities that are considered to be "tech hubs".

> But it's still insurance (co-pays, premiums, only covered at these clinics etc)

...so? That's the case in most of Europe too, with the UK being the main exception. Most European companies use some form of private insurance or have out-of-pocket expenditures.

As far as I'm concerned, none of those "problems" exist. I have no monthly premiums to pay, most copays are $0 or close to it, and I don't think twice about finding in-network providers. It's much easier for me to book a specialist if I need to than it would be in any of those other cities.

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> I live in New York City. My taxes (as a percentage of my income) are substantially lower than they would be if I worked the same job in London, Berlin, Paris, Stockholm, Amsterdam, or any of the European cities that are considered to be "tech hubs

Got any numbers on this? I was under the impression that effective tax rate is pretty much the same (if not lower, depending on your income) in London vs New York [0]. Could be wrong.

[0]http://www.hopesandfears.com/hopes/city/city_index/168817-ta...

>>> As far as I'm concerned, none of those "problems" exist. I have no monthly premiums to pay, most copays are $0 or close to it, and I don't think twice about finding in-network providers.

Right, so it works like universal healthcare... Great. You forgot to mention your deductible. Is that 0 true? Is it 0 to most people?

> That's the case in most of Europe too, with the UK being the main exception. Most European companies use some form of private insurance or have out-of-pocket expenditures.

Except private insurance in Europe is basically subsidised by government programs, which is why they are so much cheaper than in the US. Also, co-pays may exit, but do deductibles? I'm not aware of that.

> It's much easier for me to book a specialist if I need to than it would be in any of those other cities

Sure. You can also just get extra private insurance in those countries too.

> Got any numbers on this? I was under the impression that effective tax rate is pretty much the same (if not lower, depending on your income) in London vs New York

I have no idea how they're calculating those numbers in that link. They're all dead wrong.

> Except private insurance in Europe is basically subsidised by government programs, which is why they are so much cheaper than in the US. Also, co-pays may exit, but do deductibles? I'm not aware of that.

Once again, none of this is relevant, because at the end, it all works out to the same level of coverage, except with dramatically higher levels of disposable income for people in the US compared to those other cities.

It literally doesn't matter how heavily the government subsidizes it, because it still doesn't make up for the dramatically lower salaries.

The deductible usually is in the range of $200-$500. Doctor vists are a $25 flat fee, drugs are similar, etc. If you get cancer or something huge, maybe you'll pay $2000-5000/yr out of pocket?

All those numbers are pretty small compared to your compensation. You can just throw it in a bank or brokerage account after working for a month and will cover your medical deductible expenses for a very long time.

> The deductible usually is in the range of $200-$500. Doctor vists are a $25 flat fee, drugs are similar, etc. If you get cancer or something huge, maybe you'll pay $2000-5000/yr out of pocket?

Exactly. The maximum you can pay out of pocket is capped at $7,350 for individuals and $14,700 for families. That's the absolute maximum, and the insurance plans for almost any tech job (which is what we're talking about in this thread) are going to have caps that are a lot less than that.

$14,700 isn't a small amount of money for a family, but it's a lot less than the after-tax difference between salaries in New York and London/Berlin/Munich/Paris/Amsterdam/etc. for these jobs. Even if you're a single-income household, you still come out way ahead.

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