Hacker News Reader

Comment by konschubert | Hacker News Reader

Losing your health care if you quit a job is pretty dystopian.

There are lots of things wrong with Europe, but this isn't one of them .

Something Americans forget when talking about “Europe” is that it consists of different countries with different rules. Outside big ones like the UK and Germany a LOT of them also link your employment and membership in the social insurance fund.

In Estonia, for instance, your 20% social tax pays for the healthcare system. If you get laid off of course there are provisions along with your unemployment to include you, but otherwise no job = no insurance.

Regarding Estonia, this is pretty misleading. Firstly, if you get laid off and register as unemployed, you have free healthcare so long as you're actively looking for a new job (there's more nuance to this, but simplified). Secondly, people who don't have a job but are not expected to hold one are covered for free (kids, university students, military service, etc). Even if you voluntarily quit and don't want to get a new job, you're still covered for two months after the fact. In general, the only people who don't have healthcare are people who have personally opted to not have a job and not seek one either.

I specifically mentioned unemployment, and you are absolutely misleading when you say that you are covered as long as you’re looking for work. Yes, you are covered for a period of time. This time period changed during Covid.

Of course the other groups you mentioned are excluded, that’s just dumbassary.

If you voluntarily quit you are only covered in the probationary period

If you lose your job you're covered for three quarters of a year which is more than plenty to find a new job if you want one. If you voluntarily quit you're covered for two months. You can easily confirm both of these online, it's unclear why you're trying to claim otherwise.

Something Europeans forget about America is that individual states have their own healthcare plans like MA, NJ, NY, CA, etc. Others that don't default to ACA (aka ObamaCare) if you don't have health coverage. These are generally means tested insurance schemes but if you have no income then you generally have some form of free coverage.

Absolutely. I’ve been insured by Blue Cross under the South Carolina Health Insurance Program

Also not every European healthcare system is equal. For instance, here in the UK sure if you are in an accident you'll likely get help, but if you have complex health issues you can't really count on the national health service. If not for private healthcare I am not sure if I would be alive today. So you spend a fortune in taxes on a system that you can barely make use of and then you have to spend money again on private healthcare that is actually useful. It works out being more expensive than in the US. Oh and this year I had to call for an ambulance a couple of times and each time they had no ambulances available and said it's best if I take an Uber to hospital. Then at hospital 3-5 hours of waiting, while person you are with is losing their mind out of pain and you can't do anything. It's rubbish.

That’s IF your job gave you healthcare, and if it was any good, and you have to pay anyway a lot of the time. (And most jobs don’t pay for dental or healthcare)

Yep. It’s a big “if.” I took my first full time job at age 16 and I’ll be 41 in December.

During that time I’ve had over a dozen employers and only one offered health insurance. And it was so expensive that almost no one, myself included, signed up for it.

The only reason my wife works is because of the healthcare and benefits given to her by being a state employee. The money she earns is fairly insignificant relative to our other income, but the benefits make it worth it.

Private health insurance employer benefit plans exist in Europe.

Which is often supplemental insurance (akin to Medicare Advantage in the US). If you lose that your cancer or fertility treatment doesn't suddenly stop, or you won't go bankrupt due to an unexpected medical problem.

People, even in the US, often forget that the US has European style healthcare coverage it is just restricted to those above the age of 65. People over the age of 65 also make up the largest voting block, and politicians in the US often hurt younger demographics to benefit the retirees as a direct result.

It ain’t just Medicare. There’s dozens of social health benefit programs in the US, for people of varying needs.

The issue in the US isn’t a lack of social health insurance. The issue is that it’s insanely fragmented. US voters are reluctant to approve social programs unless they believe the recipient “deserves” it.

Yeah it sucks. But I guess in Europe we compensate with irrational house prices that'll pretty much keep a generation from ever owning their own home, always at the mercy of a landlord

We’re heading that direction in the US

well... I don't want to get downvoted, but it's worth reading about COBRA and the extensions offered by California, New York and other states. And of course, the ACA.

It all costs money, but it's not like you "lose your health care" the day you're laid off. Notably, COBRA is retroactive precisely to avoid gaps in coverage.

COBRA is also incredibly expensive. The few times I've been laid off, I was thankful to have been young and healthy because there was no way I could have afforded COBRA.

In my experience across three companies, COBRA just costs 102% of the total cost that was already being paid previously.

This just means that your employer was paying a lot on your behalf previously.

It just gets more expensive if you have a gap in work and have to pay for COBRA

Meh, come to Canada if you want to see really bad healthcare. It's "free" (except for all the extra tax) and it has all the characteristics you'd expect from a government administered program. (Private healthcare is illegal so there are no options, that's more the issue than the existence of public system) I get that the explicit link of employment to healthcare can be bad, just want to point out there are worse systems.

*Edit to also note Canadian healthcare has lot of insane adherents who will never admit that there is anything wrong with it.

shrug 85% of Canadians live within 100 miles of the us border. If you want to go private take a drive. I’ve lived in both countries and will take the security of the Canadian system any day.

Correct that's what people do - so our much vaunted "egalitarian" healthcare system means in practice that only those wealthy enough to go to a neighboring country and pay for healthcare out of pocket (because we don't have employer insurance for that) are able to get good healthcare, and none of the money stays in the country.

Canada has a higher life expectancy, lower infant mortality rate, and lower death rates overall than the U.S with its supposedly inferior health care system.. something is working, maybe just not the way that you would prefer.

> Meh, come to Canada if you want to see really bad healthcare.

While I'm sure it has its warts, I'm guessing your frame of reference is fairly limited if you consider the Canadian healthcare system to be "really bad". As I understand it, the Canadian system provides (with no bills to you, and regardless of your insurance status or age) for things such as:

- If you need emergency surgery in the middle of the night, and the hospital you're at can't provide it, they'll helicopter you to the nearest capable hospital -- even if that happens to be across the border in the US.

- If you're already admitted to the hospital, and need specialized surgery that can only be done in one place, they'll charter a flight, fly you over with a couple of nurses, get the surgery done, and fly you home again.

- If you have a chronic illness that requires $100,000/year specialized care for the rest of your life, that's not a problem.

- If you have treatment-resistant cancer for which the only remaining option costs $500,000, also no problem.

Reply on news.ycombinator.com