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Comment by adrianN | Hacker News Reader

"Health insurance" is not a benefit in any EU country that I know of. Are there any EU countries where health insurance is as messed up as in the US?

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In Germany, private health insurance is the norm above a certain salary level (it's not actually mandatory but when you read about it online, makes it seem so). There is a hybrid private-public insurance option below that level.

It's common for employers to subsidise the private insurance at least.

And no, it's not messed up like in the US, although it's a large expense by European standards/cheap by US standards (the insurance companies raise the rates every year, and are protected by legislation in doing so, a bit like a utility company).

Small correction: because contributions to the public health insurance fund are capped at a certain salary level (just shy of 60.000€/year), it would actually be pretty stupid to opt out of the public model just because you earn a lot. Private insurance can be attractive for people in Germany because i.e.

- their are no eligible for public insurance (only impacts a very small number of people, who are in many cases "independently wealthy", i.e. are not actually working)

- have very specific employment structures (most public school teachers benefit from having a private insurance due to certain government benefits paid to them)

- require or want certain benefits not offered by public insurance

- think that because of their special circumstance, private insurance will work out cheaper for them long-term (usually when you have the financial capacity to enter the private system at a very young and healthy age)

In France you get 'top up' insurance called a mutuelle (the state pays the first 70% - 80% of most healthcare costs - chronic conditions are paied 100% by the state). A basic mutuelle is obligatory at all jobs, but many will provide a decent one (that includes glasses, advanced dental work, hearing aids etc) as a benefit.

Basic mutuelle is not mandatory e.g. in the public sector in France.

It's mandatory in the private sector:

https://www.economie.gouv.fr/entreprises/mutuelle-entreprise...

I didn't realise that was the case for the public sector - my wife's a nurse and hers is provided.

Yes, most EU countries have free health services but health insurance is very common in both the Nordics and Southern Europe in my experience.

The Nordic countries might look similar to each other from the outside but in fact they often differ substantially.

In Norway (about 9% of the population [1]) at least it appears to be similar to the UK (about 13% or respondents to a survey[2])

So I'm not sure if that counts as very common and in Norway it is largely a perk offered by companies as part of the salary package rather than something that individuals choose for themselves.

On the other hand Denmark has about twice as many people with private health insurance [1] as Norway and about the same population.

[1] https://www.nrk.no/norge/nesten-en-halv-million-nordmenn-har...

[2] https://www.finder.com/uk/health-insurance-statistics

In the Netherlands private health insurance is obligatory but not tied to an employer, however employers can negotiate better group policy deals or compensate somehow. My last employer for example paid a bit extra for me to chose my own (was a salary line item) and my current actually pays for one directly. The basic insurance is all the same regardless of provider, but they vary on secondary benefits.

For me at least, this wouldn’t really be a deciding factor among competing job offers.

Indeed and the "group discount" or in Dutch collectiviteitskorting has been banned recently. So there is even less of a difference now.

In France you usually get a mutuelle through your company, helping to pay the extra-costs for things not reimbursed or not fully (fancy glasses, psychologist, this kind of things)

Some companies present it as a benefit, typically if using Alan

Even with socialized healthcare everyone prefers private if they can afford it.

Not really. I lived in three different european countries (France, Germany and Poland) and the switch to private was never worth the price : way more expensive for a barely better service. With public healthcare, you have the power of the numbers. Way more people are on the public side, which drives the prices down. If people are not willing to pay an astronomical price for their health, then health companies follow as long as they make decent profit.

If is offered in a lot of tech companies in Ireland, and at least some in the UK.

It isn't needed in the same way, but it makes a lot of things easier. Get seen faster, get money back from visits, etc.

Government employees in Spain have an option to use MUFACE which gives them access to private health centers. Some companies will offer private health insurance as a benefit. Most residents of Spain should have access to the public health system, exact details depend on each autonomous region.

Public health tends to have better resources, but longer wait times. Private health has shorter wait times, though these would definitely increase if more people started using it.

Relatively common in the UK for white collar workers in private companies to get private healthcare included or after paying a small pre-tax cost.

Just to clarify, health insurance is a benefit-in-kind in the UK which means you legally pay tax on it at your marginal tax rate. If you earn over about £50k you have to pay 40% of the value of the health insurance etc.

Private health insurance absolutely is

Literally every EU country has health insurance as a benefit. This is on top of the default healthcare provided by the country in question. Depending on the insurance, it can get you things such as private hospital rooms, dental plans, better eyecare, payment plans, or even extra income guarantees if you're unable to work.

> Literally every EU country has health insurance as a benefit

Well while private insurance is obviously available everywhere in some/many(?) countries employers only provide it for a very small proportion of workers.

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