We enjoy the US, especially Washington but will probably move back to the EU in ~7-8 years. Miss a lot of things from Europe though, especially the school system and public transportation.
Sure, you might get proper and very good healthcare, but what about those around you in your community?
The very non-privileged get moderately ok, free healthcare via Medicaid (along with numerous other programs for poorer people, including coverage for children, SS disability and so on). That covers the poorest/worst off quarter of the US population approximately.
It's the working poor and middle class that really get screwed with the US system. The well-off pay taxes to cover the free healthcare system that the US has. The working poor and middle class often can't afford the healthcare system, are more frequently at risk while unemployed, and their employers are less likely to provide good coverage as a benefit.
Would I get medicare/aid?
Are all people students / unemployed expected to be paying monthly premiums to get any kind of cover?
I have had healthcare in the US for a serious accident, but I had travel insurance (UK based) which likely saved me 100,000s of dollars. Fortunately they paid up without question. I'm not sure how that would have worked if I was just some regular student from the US travelling around, would I be bankrupted for life or hoping for crowdfunding? Sounds like if you have an accident in the US you need to be rich or popular (or maybe really poor).
US healthcare for the top 1/4 is far better than what public healthcare is like in most of Western Europe.
In the US if you have good healtchare you have exceptionally fast access to among the world's best healthcare services. You also have a freedom of (ab)use when it comes to utilizing healthcare services; it's a luxury you do not get in most of Europe, where service rationing and very long wait times are normal in the public healthcare sphere (also true in Canada). There are trade-offs in all of these systems.
It sucks if you're in the middle ~40% in the US. It's spectacular if you're in the top 1/4 and your health insurance is covered by your employer.
1) heterogeneous
2) subpar
3) public only
Then we’re still left with the fact that most big companies do offer private health coverage in Europe. Mostly this is for less than life threatening illnesses, psychological help and physiotherapy.
And yes in most countries some classes are purely private. I think Britain is a big exception though I've heard the NHS is also not what it used to be.
-- https://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands
Since you were replying to a comment about Holland this seemed relevant. Don't know about a general study covering all of Europe or something.
But I guess that's where the "if you're employed by a bigcorp" part comes in. You can get better service if you pay a lot, yeah that much seems a bit obvious.
Not exactly - larger organizations in the US are able to negotiate better rates with insurance companies. So it's more so that your buck goes further than it is you paying more bucks ;)
Assuming you are high up enough in the organization. Unless junior developers get the same plan and coverage as the CFO.
The bigger assumption would be that a person with a good employer plan today, had no health conditions that went under-treated as a child and are more acute in adulthood.
Someone in a UHC country may not have top-quality access to care, but it is the simple act of access to primary care itself that can have conditions diagnosed and treated early. That in turn will have a compound effect on QOL, even if you do earn the Tim Cook-level coverage plan when you're 50.
Companies are required to offer the same benefits to all employees, so yes you do get the same health insurance as the CFO.
This is one reason that companies keep pushing low-level labor jobs to contractors or falsely separate contracting companies. They want to attract software engineers with good health insurance, but avoid offering it to their janitors.
It makes it much harder to change jobs in case of difficulty and a much bigger blow to getting fired.
But if you have insurance through your work, it’s usually not that bad, it’ll probably be under a thousand.
You personally pay around that amount in "insurance", but a big part of your healthcare costs are being taken out of your general taxation. The Netherlands spends around 13-14% of its GDP. That's pretty far from 100/EUR/month per person.
I live in The Netherlands and I'd take Western European healthcare over the US's any day, but let's not sugar coat it by hiding the ball about how it's being paid for[1].
Before I moved to The Netherlands I paid 0 EUR/month in "health insurance" (a country with a true single payer system). Does that mean I wasn't actually paying anything for healthcare? No.
1. https://en.wikipedia.org/wiki/List_of_countries_by_total_hea...
https://i.imgur.com/kZlS6pC.png
The overall US healthcare cost per capita is around double the median of affluent Europe typically; higher than double vs Britain, and lower than double vs eg Switzerland or Norway.
A lot of US healthcare is covered entirely or partially by employers. If you're a software developer making near or over six figures, it's very common that your healthcare costs are covered by your employer.
What you're talking about when you say "100" for Holland is subsidization by way of taxation for covering healthcare costs. When you say it's free in Spain, you're talking about subsidization by taxation. Around 1/4 of the US population also gets "free" healthcare (ie the higher income brackets are paying higher taxes to cover those people).
US healthcare is artificially very expensive, for numerous reasons. The employer provided system can also make unemployment quite risky, definitely. There is no free lunch however, someone is paying for the healthcare in France, Switzerland, Germany, the Netherlands, and so on. Whether it's $7k (Germany), $8k (Switzerland), or $11k (US) per person, it's a lot of money.
Norway? Really. Health care costs here in Norway are capped at about 350 USD per year. If you pay more than that you get a card that exempts you from paying for things like GP visits, X-rays, MRIs, prescriptions, etc. Anything you did pay in excess of that you get refunded in the next tax settlement.
You are confusing "individual out of pocket extra costs" with "total costs".
Norway's annual per capita expenditures on healthcare are about 71883 krone (about $7,000 USD). Only the United States and Switzerland are higher.
Source: https://www.ssb.no/en/nasjonalregnskap-og-konjunkturer/stati...
In the US, your employer will buy you health insurance, which covers some but not all of your healthcare costs.
If you don't need much medical care, your costs in the US will be small or nothing, essentially the same as in Europe, probably with much more expensive and luxurious service.
But if you do need extensive care, then even when a good insurance policy, you may be facing substantial costs.
A friend who moved to New York with a big tech company told me (lightly paraphrased to anonymise):
> I’ve had a surgery, a ton of dental work, and a new child. It’s cost me tens of thousands of dollars, but the experience has been consistently better than in the UK.
If that child had been ill and needed special care when it was born, that could have been hundreds of thousands. Whereas in Europe the cost is still zero, or only a little more.
There's also the issue that the insurance is tied to your job, and it's extremely hard to get decent insurance directly from an insurer. I'm not sure if this is still true in the Obamacare era, but I've read of extremely rich people being unable to get decent insurance.
I know all the self-employed and entrepreneurs in the Netherlands do this, they all have "BV"s and "Holdings" so they pay less income tax.
How do people cope that are on minimum wage?
Only if you also include the public pension and unemployment insurance deductions (both of which are also percentage based and capped) you'll max out at about 1050 Euros.
Then again, the Netherlands reportedly (https://longreads.cbs.nl/european-scale-2019/car-ownership/) has 48 per 100, which would be higher than the highest USA state, while I think most people are aware of the difference in car mentality between the two countries so something doesn't add up here. I'm not sure what I'm missing.
https://www.theatlantic.com/international/archive/2012/08/it...
> The U.S. is ranked 25th in world by number of passenger cars per person...The Carnegie paper explains that car ownership rates are closely tied to the size of the middle class.
Depending on how you count there are between 4 and 9 mass transit lines alongside a fairly extensive bus network and commuter rail system.
Granted, if you live in the suburbs you’ll need a car for most activities.
- medical staff demanding to know if I'm Polish or Ukrainian in the middle of a big medical procedure where I am already in tears and in pain
- easier to get things done at banks and other admin places if you call the customer service number and speak (good) Swedish
- first thing that anyone asks in any social interaction is "Where are you from and what are you doing in Sweden?" Might not be malicious, but it's starting to grate on my nerves. Where I am really from is probably the least interesting thing about me.
And by the way, I am originally from another Nordic country and look Western European. I can only imagine what it's like for someone who looks different.
As in, some of those accents are treated better, some worse
The exception is melting pot cities like London and NYC - where you are likely not interacting with the native population at all.
If you don't have kids that need a school or daycare (or have the luck to live in one of the few areas with good public schools), that alone may be a 5 digit difference.
It's probably pretty comparable, as academic salaries in the US are significantly higher than anywhere else, except perhaps Switzerland.