[Eridrus]

> the social services provided (universal healthcare, etc).

I think the individual value of most social services is pretty low to people in this demographic (recent graduates taking software jobs in the US).

Sure, universal healthcare is great, but US companies also provide health insurance.

[estebank]

That demographic you're referring to is no less likely to be involved in traffic accidents that can send you to the closest available hospital. In the US that means an ambulance bill and very likely a hospital bill that your insurance might not cover, and the high possibility of chronic pain that's not necessarily covered by your health insurance. And that's even before having to deal with lawyers in order to obtain compensation back from the driver's insurance company in order to repay the out of pocket expenses. (The system, at least in California is set up in such a way that the car insurance has to pay 3X the costs to divide in thirds for 1) your lawyer, 2) your insurance provider and 3) yourself.)

[rconti]

Give me a break. Healthcare in the US is a joke, but if you're on an engineer's salary and benefits plan, you're probably paying nothing for any of these things.

Protip: "treble damages" is not a thing California invented in order to pay legal fees

[estebank]

> if you're on an engineer's salary and benefits plan, you're probably paying nothing for any of these things.

My wife was hit by a driver while cycling. She was taken to an in-network hospital as it happened to be the closest one. A 10 block ride on an ambulance yielded bill for a few thousand dollars. On the day of the event, the only out of pocket expense was <100 USD, but since then we've incurred several thousand dollars in expenses to treat the consequences of that event.

You're right that as somebody with an engineer's salary who's been diligent in making sure we had savings for unforeseen events, we've been able to pay all of the required fees as they came, but that doesn't mean it shouldn't be taken into account when talking about compensation across different countries, or that being young and healthy precludes needing health care.

> "treble damages" is not a thing California invented in order to pay legal fees

I prefaced with "at least in California" because it's the place where I've had to find this out. I'm more familiar with systems in other countries.

All lawyers that we had to contact (which was already a shocking thing to do for me) had the same payment structure and explained it the same way: there would be a settlement, to be divided equally by HC provider, lawyer's fees and victim. I mentioned this because I can assure you that most people that don't know the American system would be surprised about it.

[rconti]

I could tell you had a specific story, as you alluded to the details in your original comment, but again, these are the exceptions rather than the norm. I get it; my wife was in a car accident that sent her to the hospital for a week, almost exactly a year ago. I've gotten the $200k 'denied' explanation of benefits paperwork from the insurance company (and no doubt the total bill ran over $500k), I've been threatened with collections over a $3500 ambulance bill and had to sign up for the payment plan while I spend all the free time i can muster faxing paperwork to and fro with various insurance companies. It sucks, it's inefficient, and it's simply setting money and productivity on fire.. but ultimately, there's a chain of responsibility. It's the at-fault party's responsibility, whether you have to chase after their car insurance company or your own health insurance company.. eventually it can and should be covered if you're at a good job, but good god it's a nightmare to actually deal with.

In the end, though, I don't consider health insurance to be a cost an in-demand professional would factory into a decision to move from Canada to the US.

[CydeWeys]

Yes, but most companies in this space provide some sort of healthcare, which covers a lot of that, and accidents are a small percentage of total healthcare outlays anyway. Much more healthcare spending goes to older people, for a much broader array of more common conditions than "got into a bad car accident".

Health insurance is much more expensive at 55 than at 25.

[estebank]

Younger people do have fewer needs to treat chronic illnesses. That doesn't mean that healthcare can never be a significant financial burden regardless.

- I've met people that have had terminal cancer in their very early 30s (didn't leave a giant bill to their state as this happened in the UK)

- I've had a friend that needed an ambulance for his pregnant wife from an airport (>10K USD in out of pocket expenses)

- I've been stabbed in an attempted robbery (again, no expense as this was in Argentina)

- Young people with chronic illnesses exist

[CydeWeys]

I think it's pretty clear from context that I was talking about average medical expenses by age, for which older people do pay much, much more.

Also, $10K is a low figure for medical expenses compared to how much one can spend. End of life care for the elderly can easily run into the hundreds of thousands of dollars per year. My grandfather has been in and out of the hospital a lot this year with a broken hip, complications thereof, and fairly advanced dementia, and his covered medical expenses have been astronomical. He gets full-time care every waking moment, 7 days a week -- so that's several full-time salaries on top of medical expenses. $10K doesn't even begin to scratch the surface of how much it can cost to treat someone.

[estebank]

I believe that the disagreement we're having is born of what I'm possibly failing to do, which is getting the point across that talking about averages when the distribution is not anywhere close to normal is not useful and can be disastrous. If the average cost is maybe a few hundred dollars a month, but you have a low probability of having to pay several thousand dollars in an unlikely event, different people with different thresholds for risk will make different decisions. I'm just trying to make explicit to foreigners some things that are implicit to Americans so that they can make decide for themselves if it is worth it. I've clearly decided it was worth it, given I'm in the US now, but there's plenty I learned only once I was here that I would have appreciated knowing beforehands.

As an aside, the 10K figure was just he ambulance ride. I'm supplying that as a lower bound for the cost on an accident, which people in other countries would not believe.