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Comment by ChuckNorris89 | Hacker News Reader

Same in Austria. The healthcare system is free and very good if you have something life threatening but if not, you're looking at 2 month waiting time to see a specialist and there's no way I can be living and working with a health discomfort for that long so I pay up and see a private doctor.

The current situation benefits the lower class with voting rights who have access to good healthcare without paying much taxes and the upper class can afford private anyway but if you're hard working middle class you're kinda screwed since you have to go private and pay if you want quality treatment and diagnosis in a timely manner but you're also forced to pay and subsidize the public system, which you don't use anyway, with your very high taxes.

I feel Europe is slowly migrating to a two tier healthcare system, a private and quality but expensive one for the ones who can afford it and a public underfunded one for everyone else.

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> The healthcare system is free and very good if you have something life threatening but if not, you're looking at 2 month waiting time to see a specialist and there's no way I can be living and working with a health discomfort for that long so I pay up and see a private doctor.

The private doctor is still cheaper than copays/deductibles in the US. So that seems like a weird argument to make.

>The private doctor is still cheaper than copays/deductibles in the US.

Skilled workers in the US also earn way more than their European counterparts.

And unskilled workers earn less. So what?

Not necessarily. One datapoint: Amazon pays fulfilment workers $15/hour in the US, but €11/hour (~$12) in Germany

How far does $15/hour go in some parts of the US vs €11/hour in some parts of Germany?

I imagine if you took a look at total compensation (vacation, PTO, insurance, maternity leave), stronger labor laws and other societal benefits such as cheaper college, those workers earning €11/hr would probably be able to save a lot more of it compared to their counterpart in the US.

And bonus if they get sick, they don't have to worry as much about losing their job and spiraling down into crippling debt.

> And unskilled workers earn less.

Is this actually true?

Even accounting for differences in income the cost for private doctor visits don’t make the US system cheaper.

Especially because the private doctors need to provide pricing before you go there, there is an actual market with reasonable prices.

Since someone will know before they go to a doctor what it will cost them it makes a huge difference to the US.

Emphasis on skilled. Most Americans make less, adjusted for inflation, than they did 40 years ago, they work longer hours, report more stress and are more productive (not necessarily by choice). The average American worker got shafted. Oh, and the American healthcare system costs people twice as much than average developed countries but with worse outcomes. Single-payer would save people money because of the collective negotiating leverage to push back against $100 insulin, $350 Epipens and $20 acetaminophen.

Furthermore, the US labor force participation rate never gets measured honestly or discussed because it's crazy.. there are untold millions and millions of men and women who have given up looking work. (Idle, disenfranchised people who don't have a future or families is a recipe for revolution, drug abuse and mass shootings.) Also, with automation, outsourcing and increased net population, there aren't as many good jobs as there were 40 years ago and there too many people for regular, less-skilled jobs.

Most Americans make less, adjusted for inflation, than they did 40 years ago

Only if you look at salary. If you look at total compensation, it’s grown quite a lot in the US, across income levels, adjusting for inflation.

What other components are there than salary, for the average non-tech worker?

Health insurance, life insurance, 401k match or other retirement benefits, etc.

The median income in the US has in fact been on the rise for a long time: https://en.wikipedia.org/wiki/Household_income_in_the_United...

Well, that's highly dependendent on what country in Europe you compare it to, as it can go both ways...

They also have a lot more student loans. Doctors graduate with $300k+ in student debt.

> I feel Europe is slowly migrating to a two tier healthcare system, a private and quality but expensive one for the ones who can afford it and a public underfunded one for everyone else.

Not sure if I'd agree. There are certainly fancy hospitals that look like 5* hotels but they're for routine surgery only. Top specialists are still at big hospitals because that's where the most complicated cases are treated and where the infrastructure is. You might be able to skip waiting time with private insurance but you won't see a better doctor or get better quality medical treatment. In the end, having a nicer meal and single room in your hospital don't matter that much medically.

> eel Europe is slowly migrating to a two tier healthcare system, a private and quality but expensi

can you give example of private healthcare costs?

In the UK, a 15m follow-up telephone appointment with a private consultant is ~£100-£150. An in person 30m appointment varies between £100-£300 depending on specialism and location. If they decide to prescribe something there is no extra charge. They will write to your GP with the outcome, for which there is also no extra charge.

As regards blood tests and the like, the cost depends on the type of test, but could be anywhere from £25-£300.

I do agree with the GP about a 2-tier system evolving in the EU, at least from my perspective in the UK and what I hear from colleagues around the EU; if you have something easily diagnosed and treated, the state health service is literally a life saver, even if you have to wait several months to be seen. But don't expect your doctors to be experts - your endocrinologist will likely no nothing other than diabetes etc.

Shoulder MR scan in Austria: €235 including 10% VAT

You can usually get 80% back from public healthcare insurance. You can do it all via public healthcare, but wait time is usually several weeks.

Shoulder MR scan in Romania: €115.

https://medimar.ro/tarife-rmn/

No way you're getting 80% back. More like 25%.

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