Being able to do things like this is one of the things that makes me want to emigrate to the US. Healthcare is a huge showstopper though. But if it turns out that private costs more or less what I pay in taxes in Europe then maybe I'll reconsider.
If you’re on less then not likely
But remember it’s not just your bank balance. Do you really want to live in a society where your neighbour can’t afford treatment for cancer? Or where your nephew gets weekly “active shooter” drills? Where you get two weeks a year holiday if you’re lucky?
Maybe? I would like to live in a society where there's no hard ceiling on what you can achieve if you have the competency and some luck. Do you think it's easier to become a millionaire in the EU or the US? It feels like there's very little social mobility in Europe compared to the US.
[0] https://www.economist.com/graphic-detail/2018/02/14/american...
In Europe many cancer treatments are simply not paid for by social health care, because it's too expensive or experimental.
Rich people still go to private health care providers for more niche treatments, or simply for shorter waiting lists.
What you have in Europe is - long wait lists, for everyone, and fewer numbers of actual treatments (plus many things not covered by social health care, e.g. dentists)
What you have in US is - no wait lists, healthcare that's probably 2-3x as expensive, but you actually can get the best of the best treatment if you pay for it
Clearly for poorer layers of society the US system is bad. But for society as a whole I would question which system is actually better. They both have bad and good parts.
To be honest if the US actually implemented a real market system for health care, and prices would drop a bit (with the kind of stuff Mark Cuban is building), the US health system would be FAR superior than Europe, even if its not free.
You say rich, but private healthcare is a pretty normal benefit for people working in professional jobs. I'm on my third tech job and I've never not had some level of private insurance benefit.
If european healthcare was so amazing AND free, why would people do this? It makes no sense. Of course it does when you realise the cost of free healthcare, which is that it just isn't that great in terms of quality, or you have insane waiting lists, even if it is free.
There are A LOT of reasons for this. For example fentanyl probably took quite a bit off it, considering over 200,000 people are dead at this point from it.
So does the obesity crisis.
Now - I think we are probably more in agreement than not, I think there are huge issues with the US healthcare system, the entire fentanyl crises WAS created by the healthcare system, but still - I don't think the root issue, or problem to be solved is private vs public. Switching to public would just mean another set of problems.
For the record, I'm not from the US, and I mostly use private healthcare, despite there being so called free healthcare available in my country. It's just terrible. So it's almost the same as the US - rich people get healthcare, poor don't.
Asians in the US live to be 10 years older than Blacks.
https://en.m.wikipedia.org/wiki/Race_and_health_in_the_Unite...
Clearly lifespan is not solely determined by where you live.
You’d have to decide whether you agree with the methodology, but European nations feature highest in the ‘Global Social Mobility Index’ [0] while the US is 27th.
[0] https://www3.weforum.org/docs/Global_Social_Mobility_Report....
And I did look at the table. There's a difference of ~15 index points between 1st (85) and 27th (70). That still doesn't actually say much without knowing how they're calculated.
But didn’t define it.
GP pointed to a definition which shows that OP was wrong.
Then EU > US. In the EU most people have a shot at this, with free education and possibilities. In the US your chances are mostly tied to your parents' status.
> It feels like there's very little social mobility in Europe compared to the US
Maybe from middle class -> very rich. But from poor -> middle class Europe is absolutely better.
In the us they might have more money (to then spend on healrhcare etc)
Which is “better”?
If you’re below the average (income/wealth wise) and have other disadvantages you might certainly be better off in Europe. Otherwise (inherited wealth aside) US might be a better place to be depending on your personal preferences and priorities.
The transit is trash anywhere that you can actually afford to own property. The healthcare outcomes you mentioned are going to need a citation because the middle class in the US generally has OK insurance.
For happiness, that’s vague and will need a citation. Putting the entire US on a comparison with individual EU countries is dumb, but that’s how it’s sliced in https://en.wikipedia.org/wiki/World_Happiness_Report where the US is beat by many EU countries and beats others (e.g. Spain and Italy).
> Which is “better”?
Probably the one with the most immigration.
This comparison only works at birth, or maybe up to teens. We are, most likely, working professionals here. With a degree and fairly established position. Becoming a millionaire is still a monumental task. However at this baseline US is much easier.
Is your goal really “become a millionaire”? Not “have the ability to see the world” or “live in a nice house with kids an a dog”, just “have 7 figure on a spreadsheet of what I have managed to accumulate”
7 figure on a spreadsheet enables a lot.
An unregistered savings account in one of Canadian banks (just a point of reference, not sure if US has better) currently offers 4% yearly. That's 40k a year off the million. Enough to retire with kids in a LCOL country or travel year round as a nomad with a base in LCOL country.
Build a little bit more wealth and all those LCOL options turn into MCOL. E.g. northern Italy.
All while just being a working professional. It'd be unheard of in Europe to have this kind of options after just a couple years of work.
Not with very low salaries and even more unaffordable real estate than in the US. Yes jumping from “lower” to “middle” class seems to be generally easier in Europe but the likelihood that you’ll just get stuck there is much higher.
> In the US your chances are mostly tied to your parents' status
Inherited wealth is as if not more important in Europe. Because while yes free education etc. give you more possibilities the ceiling of how high can you go up on your own is also generally much lower.
What told you that? The median American is significantly less wealthy than the median Brit, despite similar homeowning rates and Americans having way more income. Most of Europe (plus the Anglo offshoots) have higher social mobility.
I’m not sure median wealth is a better indicator of social mobility than income.
All the other things you listed heavily depend on where you live and the company you work at?
Likewise, the same can be said of the United States. Quality of private healthcare is going to depend greatly where you are. Remote areas and smaller towns and cities are not going to have access to top-quality physicians like larger cities will have. But, top-quality physicians will have very long waiting lists. I'm currently on the waiting list for a top-national orthopedic surgeon in the Bay Area and my total appointment wait is 5 months.
Like GP said, the Internet is very misleading about this. Healthcare is OK for the middle class and that’s why there isn’t enough pressure to change it.
After that, you have the "out-of-pocket" maximum. You pay 20% of costs until you hit the "out-of-pocket" maximum, which is typically thousands of dollars per year.
Beyond that, there are actually two different deductibles and two different out-of-pocket maximums. One for in-network services, and one for out-of-network services. You can go to an in-network facility and see out-of-network providers without notice.
And even beyond that, while it has been curbed with some recent legislation, if your insurance provider decides to pay less than the provider believes they are owed, the provider can bill you independently for the remainder.
So NO, it is definitely not $2k per year for a good health insurance plan in the US. FAR from it.
How much is this monthly premium? We are talking about 50USD, 500USD, more?
You say out of pocket is in thousands per year - so I assume <10k?
I wonder what is upper bound of yearly cost for having same or better level of healthcare as in Europe.
If that's like 15k a year, than I would assume, at least for SWEs, it still makes a lot of sense to go to US - pay difference is huge. I would not be surprised that even you you would count 50k a year for medical it could still make a lot of sense to move to US if you are good - I don't hear that much about 300k, 400k or more TC per year in EU
The premiums will also vary, but probably a few hundred for most employer plans.
If you don’t know how much monthly insurance premiums are, you probably shouldn’t be arguing about the topic?
Because all of those things they mentioned are heavily dependent on the premium which they decided to omit in those hypothetical calculations
Depends on who you are, where you are, who you're employed by, the ability of your employer to negotiate a deal, the willingness of your employer to provide "Cadillac" coverage to their workforce, and how much secret data broker information the insurance cartel has specifically on you and your prior medical conditions.
The thing about healthcare in America is that everything is unregulated and completely opaque. Prices are impossible to find at time of use, impossible to negotiate, and for most customers facing a medical catastrophe they will be both "unconscious" and "out of network". If you have a serious out of network emergency that your dodgy insurance doesn't cover you could be up for anywhere between $50k and several million dollars and filing for bankruptcy the day you leave the hospital.
If I had a very serious car crash with a helicopter evacuation and a lengthy hospital stay due to a spinal injury, a million might not cover it.
I would say "heavily regulated and completely opaque".
I have had to redo my teeth due to a medical issue. My insurance paid for the medical issue. My teeth though? This year alone I've spent 13k out of pocket after maxing out my dental insurance. Next year will be the same. and the year after. And I'm paying for insurance while paying all of this.
For ACA plans, the premiums can factor in age and smoking status. That's it. Job related insurance is generally take it or leave it at a fixed price.
That's what you're worried about? A .000067% chance? You must live a life of crippling fear then, the number of things more deadly to your kids than .000067% is staggering. I assume you never let them enter a vehicle of any kind, for example.
By the way, of that 38 per year number, less than 10% happens inside a classroom [0]. The most likely location is outside in the school parking lot, a violent dispute between students, and not a "mass shooting" scenario. So if you were mostly concerned about "mass shootings", the odds of death are over 10 times less than .000067%.
[0] https://www.campussafetymagazine.com/safety/k-12-school-shoo... [1] https://usafacts.org/data/topics/people-society/education/k-...
Psychological experience of risk (fear) has a large component related to the degree to which a person has control over their exposure, combined with the worst possible (rather than typical) outcome.
So for example, statistically speaking very few black Americans will ever be assaulted by the police but no black American can feel remotely in control of whether or not this may happen to them. And the outcome may include death as a possibility.
Statistically speaking, very few women will be assaulted walking down the street (even at night) but essentially no women can feel that they have any control over whether this happens or not. And the outcome may include death as a possibility.
And so it is with school shootings: yes, statistically speaking it is a vanishingly small chance. But neither parents nor students (nor teachers) have any level of control over whether such an incident will take place in their school, and the worst case scenario is death.
When people feel they lack the agency to control whether or not a bad outcome is more or less likely in their lives, the actual statistics of the outcome tend to fade into dramatically lower significance.