It doesn't sound like you know the plight of others very well.
I also have kids and, like most people on HN, have “good” health insurance that comes with a tech job.
But get one family member that needs to see a cardiologist or neurologist every few months and you’re hitting your $6,500 deductible every April.
That is a kind of "loaded". Joe Average with a crap job, or no job, is not so lucky.
Do I understand right that this means you might have to pay up to $500 for medical problems?
That seems huge to me, it's higher than what one pays "out of their pocket" here for a childbirth for example and I don't think you can expect a regular person to spend this unexpectedly, that's about a third of the average wage (in Belgium).
I expect to pay at least $200 anytime I receive healthcare, even just for a 5 minute consultation with the doctor. Childbirth is minimum $4k to $6k, assuming vaginal and hospital stay is 2 nights. If C section and 3 nights, then add $2k to $3k. If using epidural, add $3k more. For both of our kids, we reached annual out of pocket maximum of $5k to $7k in the calendar year, for regular, non complicated vaginal births.
Deductible: What you pay before insurance company starts paying. Usually at least $2k, but varies anywhere from $0 to $10k. Could even be as high as the out of pocket maximum.
Out of pocket maximum: The maximum you pay in any calendar year for healthcare. After that, all responsibility falls on insurance company. Legal maximum for 2023 is $9,100 for individuals and $18,200 for families. Usually this is $5k per individual and $10k per family, give or take a few thousand.
The higher the deductible and out of pocket maximum, the lower the insurance premium (like any other insurance).
Insurance premiums are $400 to $1,200 per month per person from age 0 to 64, give it take a few hundred. That means for a family of 4, health insurance will be ~ $400 per month for each kid, and $500 to $900 per month for each parent. So roughly $24k to $36k per year in insurance premiums, plus out of pocket maximum is ~$10k, which means $30k to $45k per year will pay for a family’s (of 4) healthcare in a calendar year.
If receiving health insurance via employer, the employer will usually pay 70% of the insurance premiums. Sometimes more. If not receiving health insurance from employer, and you are lower income, then you can get tax credits (government subsidy). This lower income is usually $100k per year and below, the lower the income, the higher the tax credit.
Age 65+, the federal government starts paying for your hospital emergency healthcare, but you may or may not need to pay for medicines and outpatient (non hospital) healthcare depending on your income/wealth.
https://www.zorgwijzer.nl/zorgvergelijker/english
The lowest deductible on that page is ~$400.
That said, I'm shocked that the average wage in Belgium is only $1500. That sounds very low, do you not have any workers protections for wages?
Well I never lived in the Netherlands and I am not planning on doing so, so their healthcare system isn't really something I have ever had any reason to study. This system strikes me as very different from ours and the costs I see on this page are far higher than those in Belgium, France or Germany. This deductible system also does not exist in these countries.
Average wage in Belgium after tax is 19 000€ from what I can see, so about 1600€ per month, however various sources give different numbers and another number I can find gives 2250€ as median wage. The difference might be that 1600€ per month takes into account the whole population including people who aren't working while the median is calculated on the people who do have a salary, I'm not sure though.
It's not especially low either way when one doesn't have to pay "$30k to $45k per year [...] for a family’s (of 4) healthcare in a calendar year" (according to sibling comment). School and education in general is mostly free as well, which also helps I guess. A family of four in reasonably good health should expect to spend a few hundred euros per year on healthcare here.
He had to visit a hospital recently, while he never disclosed to me what his medical condition was, at the end he mentioned that his hospital bill was almost $1500... "Only to find out I'm also allergic to penicillin" and that "if I would have taken an ambulance it would have doubled the bill"