[jstanley]

> Google tells me that the most common reason for hospitalization in the US is childbirth. Thankfully, here in San Francisco, that would only set me back $15,000

Surely this is not true?

Does having kids just bankrupt ordinary people in the US or what?

I'm not asking about exceptional cases, like what is the normal way of dealing with having to pay $15,000 just to have a baby climb out of your body, when I'm assuming most people don't have that much money?

[nelsonic]

There's a reason for the saying: "The Rich get Richer and the Poor get Children". Perversely having children is a "luxury" many people simply cannot afford.

The happiness a "bundle of joy" should bring to the family is often replaced by additional stress of having to work a "better paying" (but often soul-destroying) job to be able to afford the bigger house, school/education, extra curricular activities like sports/music/ballet and eventually college tuition.

Conrad Bastable's well-researched post could easily have concluded that having kids "too early" will bankrupt a family.

The solution/answer is affordable housing. Housing is the single biggest "expense" for all people/families. Which is why it's the problem I want to tackle personally: https://github.com/dwyl/home

The fact that merely giving birth to a child in SF is $15k is mind-boggling. The "Government" needs to fix that or risk population decline catastrophe which will have many knock-on effects!

SF should follow the model from Finland where young parents/mothers are given cash incentives and all FREE healthcare: https://www.kela.fi/web/en/families

[berberous]

Apologies if this unsolicited advice comes off as rude, but consider easing up on the italicizing and "quoting" of random words. It makes your writing style hard to read and waters down the effect when you do each once per paragraph.

[nelsonic]

@berberous, it's good advice and welcome feedback. Thank you.

I just tend to write the way I talk and using punctuation, speech marks and italics/bold is the only way I can think of to convey intonation/meaning. I will try harder to avoid the excessive use of emphasis, as you say it detracts from the writing/reading.

PG almost never uses any sort of emphasis in his essays: http://paulgraham.com/articles.html so I'm going to wean myself off it.

I am genuinely grateful for the feedback. =)

[SmallDeadGuy]

I completely agree. To me, 9 formatting changes in a single sentence, e.g. in the second sentence of that GitHub repo readme, is incredibly excessive. While the comment you replied to isn't nearly as extreme, it still has a similar issue of too many formatting changes per paragraph.

[expertentipp]

> The fact that merely giving birth to a child in SF is $15k is mind-boggling. The "Government" needs to fix that or risk population decline catastrophe which will have many knock-on effects!

The fertility and associated problems of local population can be completely ignored by the government of country like US - country with low population density, predictable steady population growth, and always a large group of people around the world willing to immigrate into the country. If not you, it's going to be someone else.

[chrisco255]

Assuming you don't have healthcare insurance, which 90% of Americans do, it would set you back around $3000, according to: https://www.parents.com/pregnancy/considering-baby/financing...

[gambiting]

But if I understand it correctly, for some unfathomable reason American health insurance policies usually have a deductible on them - so even if you are insured, you could still be paying few thousand dollars out of your pocket, no? That's insane.

[gwright]

There are lots of problems with the American health system, but the concept of a deductible for insurance isn't one of them. Insurance without deductible is really a pre-payment plan for "normal" expenses (along with its administrative overhead) wedded to a true insurance plan.

Half (or more of) the battle in these public policy discussions is coming to an agreement on terms.

[vinay427]

Lots of insurance plans in other industries have deductibles in other countries, and the US certainly isn't unique in this respect. For example, deductibles are the norm in health insurance plans in Switzerland, which has a system not all that different from that in the US.

[snovv_crash]

In Switzerland the deductible is annual, not per visit. Once you hit that cap, everything is free (except voluntary cosmetic stuff).

Thus, insurance actually acts like insurance, like car insurance or fire insurance, there to catch you in a bad situation, not to give you discounts on your day-to-day expenses.

[s3nnyy]

It's not like this in the US?

In Switzerland there is a deductible for adults but everything connected to pregnancy and child-birth is deductible-free. Also, kids below 18 yrs old have mandatory insurance that is has no deductible, thus treatments for them are free.

[snovv_crash]

In the US the deductible is different depending on the treatment required. Defeats the purpose of insurance in my opinion.

[JauntTrooper]

My wife's C-section delivery in the Bay Area cost ~$2,100 out of pocket. We had very good insurance.

[chrisco255]

Bay Area is arguably the most expensive place in the country, so it's not indicative of U.S. as a whole.

[pc86]

It's much easier to have an intelligent and reasonable conversation about something if you avoid the editorializing and hyperbole by calling everything you may disagree with "unfathomable" and "insane."

[dagw]

it would set you back around $3000

That's an average. The problem is the huge variance. Also just because you have heath insurance doesn't necessarily mean your insurance will pick up the tab.

[jandrese]

There are health plans that don't cover a childbirth?

[sailfast]

Because of the affordable care act, no (thankfully, as pregnancy was a pre-existing condition) but your insurance may not cover a doctor or hospital which could (even accidentally) add up to thousands of dollars. Ask who people are when they walk into your room, and whether their treatment is covered depending on your insurance.

[sailfast]

Not sure why this got downvoted - pre-existing conditions are covered by law but that doesn’t mean the procedure at that hospital is covered at the same level as an in-network shop.

I’ve been charged out of network at an in-network hospital because the physician didn’t identify themselves or their network. If they’re not your primary doc it might be worth asking for someone who is covered to save you hundreds or thousands of dollars.

[jstanley]

So is that the normal case? The median birth results in the parents paying $3000? That still seems absurd.

Do most people just decide to do it at home and take the risk?

[dagw]

People save up for having a kid the way they save up for anything else expensive. Also most hospitals are 'kind' enough to allow you to set up a payment plan so you can pay it off over a few years.

[chrisco255]

No, normal case is your or your husband's insurance pays for it

Deductibles can vary wildly depending on someone's insurance plan. However, there are a myriad of financing options, charities, etc if for some reason you can't afford that.

[lotsofpulp]

https://www.parents.com/pregnancy/considering-baby/financing...

https://www.bloomberg.com/news/features/2018-06-26/sky-high-...

I would estimate the vast majority of people in the US need to budget at least $5k for a baby, if everything goes right. It would be better to have $10k cash though depending on prenatal visits, c section possibility, and multitude of other costs that can arise.

[gutnor]

Does healthcare insurance pay for that in the US ? In the EU, this is considered a personal life-choice procedure and very rarely handled by insurances - like cosmetic surgery. (being the EU though, you can get it for free using public healthcare)

[maeln]

It's not the case in most EU country I visited. In France, giving birth is 100% free, even if you have to go to a private clinic/hospital.

[gutnor]

There may be a confusion here, I'm referring at Private Healthcare and not Public Healthcare run by a private company.

Spain sometimes subcontract public healthcare to private hospital. However from a patient point of view, you are still treated as a public healthcare patient (i.e. you pay through your tax and the government has a specific financial agreement with the company running the hospital).

Otherwise I'm confused by France model. What's the business model of a Private Hospital is they receive no money neither from the Government nor insurances nor their patient ?

[etiennemarcel]

The French system is hybrid. There's public and private health insurance, and public and private hospitals.

For everyday care the public health insurance reimburses 70% and the private health insurance the remainder.

For more serious procedures (such as a baby delivery) the public health insurance reimburses 100% of the fees. The prices are fixed by law, the practitioner can charge more (if it's a private hospital) but then the private health insurance will have to pay the difference.

The public health insurance is paid through taxes (I think something like 5 to 10% of the salary?) and the private health insurance is between 50 to 100e depending on your family and coverage (glasses, teeth, etc.)

[jstanley]

I'm only familiar with the UK, but the NHS absolutely deals with births for "free".

[stevekemp]

We paid €200-300 in Finland, to receive a private room for mother, father, and baby for a few days post-birth.

I think we'd have been given a shared room for free, but at the time it seemed like a good choice to make.

[dagw]

Sure, but if you for some reason don't want to give birth at an NHS hospital then your health insurance probably won't cover the costs of a private hospital.

[hef19898]

In which country? I don't know of any. Except for added services like a private room and stuff like that are more comfort oriented than medical.

[gutnor]

The UK and Spain have a private health sector with Clinics, GP, ... To access those you either need to pay cash or have a private health insurance.

Both the UK and Spain have also a public health sector, with Clinics, GP, ... that is accessible for free.

In the UK and Spain, very few private health insurances covers Birth or Emergency Care: for those you are supposed to go to the public service or pay cash in a private clinic.

Other countries like Belgium have health insurances that give you the kind of extra comfort you mention. But they cost something like 5 EUR a month vs the 100 EUR in Spain and the UK.

[maxxxxx]

On average yes but if there are complications or the hospital does some billing shenanigans it may cost you much more and there is almost no way to protect yourself from that other than just having a lot of money.

[blihp]

Our medical costs are so out of control it's not funny. Many years ago (i.e. last century) you'd go to the doctor and either they'd treat you on the spot or possibly prescribe something for most common ailments. And if that didn't work, you'd go back and then they'd run some tests and/or send you to a specialist. Today you go to your doctor, who most likely refers you to a specialist, who orders tests from a lab (of course each step racks up costs)... then maybe you get your prescription. Didn't work? Rinse and repeat with a more specialized specialist. Part of it is CYA to protect from liability, part of it is just the health care industry growing out of control.

[Joeri]

Maybe the problem is insurance networks. This incentivizes doctors and hospitals to play by the rules of high-revenue / high-payout insurance providers, whose revenues are high because of those rules.

[lotsofpulp]

Not really, since people would switch to other health insurance providers who have lower premiums. The problem was not forcing everyone into the same insurance market.

Letting all the healthy white collar office people stick with their employer chosen health insurance means the leftovers are the poor and unhealthy which many insurance companies can’t handle the losses from since there is no health population to balance it out, so you have places that have no health insurance competition.

Even then, the people that make the most money in healthcare are the providers (doctors) and by a significant multiple, so increasing their supply would be necessary to bringing costs down.

[vishnugupta]

Continuing that sentence...

> ...unless of course we needed a C-section, in which case it’ll be a casual $30,000.

In India, we got c-section done in a luxurious hospital in a suite ward for slightly over $1K. About 80% of that was covered by insurance. Even if it wasn't that kind of money is a typical middle class family in India can easily afford. Note that I'm talking about top of the line hospital so the median cost for a c-section is somewhere around $500.

I guess what I'm trying to say is that I'm really blown away by that kind of cost difference. In a developed country shouldn't health be more affordable? No wonder medical tourism is on the rise in India.

[JetSetWilly]

In the UK a C-section costs an average of 2219USD to the NHS,

This cost disparity is not one of developed world vs undeveloped, it is one of an insane health care system vs a rational one.

[elhudy]

In the UK, nurses are also hardly paid living wages [1]. Particularly in high cost of living areas like London. About USD15/HR for an experienced band 5 nurse.

[1]https://www.rcn.org.uk/employment-and-pay/nhs-pay-scales-201...

[feistypharit]

If it's not the birth itself, it doesn't stop there. No protected time off, expensive, subpar childcare options, long work hours if you want to advance your career. One way or another, you are punished for having kids.

Unless you're really rich. It's now more of a status symbol amongst the rich. "Oh you have 5 kids? Two nannies, a cook too. That's the life!".

[codingdave]

It doesn't bankrupt us, but it does cost money. Not really the childbirth itself... that is a one time cost, and it varies greatly with 15K being the high end. But food, housing, education, clothing, and everything else you provide kids, not the least of which is health care.... it all adds up. To about a quarter of a million over time, if you believe the analysts.

So with 3 kids, I'm likely $750K down on my wealth. As a tech worker, that is not bankrupt. But if I were living closer to poverty? Then the problem is less about my personal wealth and more about where I choose to cut corners when raising the kids.

[Digory]

It's patchwork. They can't turn you away in an emergency, and Medicaid covers expenses for the poor. An uninsured family member recently had their unexpectedly complicated delivery written off entirely under the hospital's charity guidelines.

But I recall reading a vivid passage about ten years ago, talking about the difference between rich and poor maternity wards: the wailing.

Anesthesia is an elective expense in childbirth, not always covered by Medicaid.

[sbinthree]

My wife and I had a child in Canada with about as extreme a complication as you can get (transferred to Level 3 ICU for the sake of mother and baby). We calculated that it would have cost at least $200k in the US in direct costs, let alone things we couldn't quite get a price for (medication, the hourly rate of the over 20 medical professionals in the room during delivery, etc.). Would have ruined us for sure if out of pocket.

[verisimilitude]

That is correct. To corroborate: my health insurance contract states I must pay $13,600 towards my medical expenses (this is AFTER premiums) per year, before they will begin paying on my behalf.

[maxxxxx]

That's an extreme deductible. How much are your premiums?

[verisimilitude]

I just got next year's fees: premiums are $911.86 per month for family of three. More than the principal and interest on my house...

[cowsandmilk]

Health insurance will cover much of it, but more importantly Northern California is overpriced for medical procedures. Boston is $5,000 less and has equally good hospitals. And St. Louis is down at $6,000 and has really good hospitals as well.

I had a friend who got an appendectomy at Stanford that was paid for by Google (she was on business travel, works in the London office) and the price was obscene, far above what should ever be charged, literally 10x what other hospitals charge. That place is crazy.

[lotsofpulp]

It’s not overpriced if there is no monopoly. No one is stopping other providers from moving to Northern California and stealing business by offering lower prices. If people want to live in a place with great weather, outdoors, food, and career opportunities, then they have to compete for it because lots of other people do too, and hence they have to compete to purchase things like homes and service from healthcare providers.

[mikeash]

Nothing is stopping them, other than people not shopping medical procedures based on price, partly due to a complete lack of price transparency.

Maybe you could move in and set up a maternity ward and advertise it as “only $10,000!” And then people will ask what the competition charges and you won’t be able to answer. They won’t be able to answer.

[lotsofpulp]

I would hope it’s common knowledge nowadays, at least amongst the educated, that you should call your insurance or check their website for in network providers. I can call mine and find out how much certain procedures or codes cost, and if it’s not an exact amount, they can usually give a pretty good estimate.

Also, I would expect any service to cost 50% more in the Bay Area.

[VLM]

You'd do all that complicated paperwork while semi-unconscious with pain before an emergency appendectomy?

[nybble41]

No, you do all the complicated paperwork before the emergency, so you already know exactly what to do when things go wrong.

How well things go during an emergency depends on how much effort you put into preparing ahead of time. Nothing new or strange about that.

[lotsofpulp]

I was referring to planned procedures such as giving birth.

[mikeash]

Hospital stays are a whole different thing from more routine procedures. A lot of the costs are directly billed by the doctor and bypass the hospital, and hospitals don’t know what their own costs will be.

If you have insurance that covers this, it’s simple. You don’t even need to call anyone. You’ll pay your deductible.

If you want to compete on price, you’ll either need to charge substantially less than people’s dedictibles in order to make a noticeable difference, aim your price competition at insurance companies (who pay vastly lower prices already), or target the not-exactly-lucrative uninsured population.

[iends]

You'll have to go back to the doctor and ask for a list of the exact ICD-10 codes that they are going to use and bill the insurance company for.

[noonespecial]

You are quite wrong about that.

https://en.m.wikipedia.org/wiki/Certificate_of_need

[jstanley]

> A number of factors spurred states to require CONs in the health care industry. Chief among these was the concern that the construction of excess hospital capacity would cause competitors in an over-saturated field to cover the costs of a diluted patient pool by over-charging, or by convincing patients to accept hospitalization unnecessarily.

That is an incredible misunderstanding of supply-and-demand. Just, wow.

[lotsofpulp]

Wow! Did not know about that. So many barriers to free market...

[vechagup]

Most insurance plans that allow access to providers in a broad network without a referral (these are often dubbed "PPO" or "high deductible" plans) have an annual out of pocket maximum that the insured will be required to pay before the insurance covers all remaining expenses. E.g., the maximum for "family" coverage on my plan is $5400.

It's commonly said that having a baby will result in costs that exceed your out of pocket max, so you can think of the out of pocket max as the real cost to a family on one of these for the medical services from prenatal care through the birth. Caveat: Your accumulation towards this maximum will typically reset to 0 at the beginning of the calendar year, so try to finish your pregnancy before 12/31.

[patrickg_zill]

Even with a good health care package, a friend paid $10 thousand dollars (his maximum deductible) for the first year of one of his children, due to infant allergies.

[kasey_junk]

That is not what most people consider a 'good' health care package. That would be considered a 'high deductible' plan.

When people talk about 'good' health care plans in the US they tend to think of traditional low deductible PPO. Those tend to have family deductibles in the $500-1k range.

Though the employee premium differences might add up to more than 10K in the face of a 'good' health care plan so its largely not relevant to the argument about health care costs in a nation vs nation way (though you'd want to include tax burden for health insurance in that case).

[nradov]

There's no real correlation between the "goodness" of an insurance plan and its deductible. In the end all that really matters is the quality of care you receive and how much you have to pay for it.

Many employers offer high deductible plans but also contribute into the employee's HSA which can be used to pay deductibles. In theory that incentivizes the employee to shop around and get the best possible deal on care.

[kasey_junk]

Agreed but in this anecdote what do you think would happen in that case? I’d guess the person would complain about the deductible even though in real terms it might be cheaper than premiums on a low deductible plan.

[megaman8]

It's worth noting, the birth rate here in CA has been reducing for the last 30 years and recently has reached a 100 year low. It's currently lower than it was during the great depression.

[georgeecollins]

Having a child is really expensive if you don't have health insurance. You can negotiate that cost in advance, but I don't know if people really do that very often.

[InclinedPlane]

Absolutely true, having kids bankrupts plenty of people in the US, especially if there is a medical issue with the child.

[TomMarius]

It costs around the same in Europe if you don't have insurance. I'm pretty sure it's the same in the USA - this is the rate that would be charged to your insurance company. Rates are way lower for uninsured people if you ask them and tell them that you're not insured (I got a bill lowered 10 times when I broke my hand); and of course most people have some kind of insurance.

To the people downvoting: please read properly. If you move your place of residence outside your country, you're no longer insured, and that's what I'm talking about - I specifically said "if you don't have insurance".

[ludoo]

Actually in Italy you don't pay a dime, unless you want to. The level of care you get varies by region, but is generally pretty good, especially for regular, mass events like birth.

[BeniBoy]

Same in France. Standard care is free, extra can be taken care of by your private insurance.

[gambiting]

That's absolutely not true. If it is, name an EU country where that is the case. If you are a citizen of an EU country, you are entitled to use the healthcare system in that country(and any other EU state), purely by virtue of being a citizen.

The only case that would maybe trigger a payment would be if you were a visitor to EU and had a baby - but most likely no hospital would bill you as hospitals are just not equipped for billing, they don't have the staff or the equipment to do such weird things as issue bills for treatment to people. I know at least several non-EU people who had treatment in EU and no one ever asked them for any insurance info to bill them, unless it's something major and very very expensive there's just no point, it would most likely cost the hospital more to figure out how much and how to bill you in the first place.

[dagw]

as hospitals are just not equipped for billing

In Sweden every visit to a doctor or hospital is billed, as is every night spend at the hospital, so they are definitely equipped to handle it.

[TomMarius]

That is absolutely not true. I am a citizen of the Czech Republic and if I stop being insured, e.g. because of changing my place of permanent residence, I'm not entitled to anything.

[gambiting]

Then Czech Republic must be an exception in the EU - pretty much every other country that I lived in worked on the simple principle of "you are a citizen/resident = you are entitled to care". Even if you didn't make any payments ever(due to lack of a job, or being homeless or disabled for example) you would still be 100% covered.

[expertentipp]

Not the case for Poland either. If one is not employed and not registered as unemployed (authorities are doing all they can to keep the official unemployment statistics low), one has to proactively subscribe to "voluntary health insurance". In case one doesn't - pronto! one has no healthcare insurance. Of course, the constitution guarantees the healthcare, free-universal-healthcare blah blah - good luck suing everyone or anyone while being in such life situation.

Slightly different, but also extreme, case - Germany. There, one always is insured, only for the months one doesn't pay a debt is accumulating (you thought healthcare can incur debt only in US?). It's quite difficult to get out of German healthcare insurance actually, even while being EU citizen and moving out of Germany.

In fact, for a EU citizen who takes advantage of free movement of workers and relocates often between EU countries, one can fall pretty badly on its face healthcare insurance-wise.

[hef19898]

Really? As long as you are properly employed in any EU country you should also be covered in that country. There are some issues regarding cross-border, meaning a German is working in Spain and needs medical attention in Germany that would be invoiced to the Spanish insurance.

In Germany free-lancers face issue, they need to get their insurance somewhere. But thay have to get, there is no such thing as uninsured German resident.

[TomMarius]

It is not an exception, it's almost the same at least in Slovakia, Poland, Hungary and Austria. It is not true that you'd be always covered - you'd be covered only if you're registered in the system and entitled to be a part of it (by the virtue of being a resident); if you have your residence outside the EU, you're entitled to nothing; if you have your place of residence in other EU country, you're entitled only to treatment of immediately life threating issues - you still need travel insurance to travel to other EU countries if you want e.g. dentist covered, also you can't injure yourself doing sports and such, that would not be covered at all by the basic insurance.

It's true that you'd be covered even if you never paid but you have to be entitled to be a part of the system - and thus you're insured. Also the money for treatment will be later demanded from you, on top of insurance payments and interest (personal experience); of course there are options for the socially less able (the government pays insurance for them, that's why it might seem free) but as a software engineer, no it's not true.

If you read my comment properly you'd know that I'm talking about uninsured people.

[ahje]

EU citizens are able to move to another EU country are eligible for the same benefits as locals as long as they are working and paying taxes there and for X time after that (I can't remember the exact number).

In the Nordic countries that's extended quite a bit for citizens of other Nordic countries (even if the other country isn't in the EU), and I wouldn't be surprised if there are other groups of countries in the EU with their own similar agreements.

None of the above says anything about the level of welfare the individual EU countries have, however. If an EU member has a below-average welfare system then you might end up with nothing simply because you don't meet the requirements for receiving benefits.

[NiekvdMaas]

Incorrect. For example in The Netherlands it is mandatory to be insured. If you refuse to pay insurance, not only will you have to pay 100% of healthcare costs, you'll also be fined.

[gambiting]

Yes, except that if you are not in a position to pay(make below X/year, are disabled, homeless etc etc) you don't pay anything. You have to have insurance, but depending on the circumstances you might not have to pay for it.

[icebraining]

Are you sure you replied to the correct person?

[icebraining]

In Portugal we have fees even in the public system, supposedly to reduce frivolous use. That said, they are usually under 10€, and large swaths of the population - including pregnant people - are exempt, so yeah, having a baby is free.

[pjc50]

I think it would have helped if you specified Czech rather than "Europe", because it's a big place and it looks like many of the smaller countries have this kind of non-public system. The rules appear to be complicated: https://www.kancelarzp.cz/en/links-info-en/health-insurance-...

It sounds like there's a hole for people to fall in: if you're a Czech national, but not resident nor employed in Czech Republic, but in the country anyway, and you don't have private insurance, then you have a problem.

(It looks like if you're a resident proper in another EU country with resident-based healthcare, such as the UK, then that would work for EHIC purposes if you visited Czech Republic.)

[TomMarius]

There are rules that are EU-wide - because they're set by an EU regulation. If you're a resident in any EU country, you get the blue card. That makes you entitled to whatever (this is depending on the country and not set by the regulation) in your country of residence and basic care of life threatening issues in the rest of EU, Czech Republic included; however if you injure yourself doing e.g. sports in other EU country, that's not covered! That's why travel insurance still exists, otherwise it'd be pointless.

My comment was talking about uninsured people, so mostly non-EU residents and people that didn't pay and weren't entitled for coverage by their government - the way it works is that your governments pays the insurance for you if you can't, but will not if you can; there is an exception - Germany, where everyone is covered through taxes.

[hef19898]

I'm no expert on the gritty details of the German system (who would have thought health care could be that complicated, right?) but as German resident I have some insights. Everybody who knows better, please correct me.

In Germany everybody who is employed in way that pays social insurance is also health insured, you cannot opt out of it. In that system, in addition to taxes, social security and unemployment insurance, you pay a certain percentage of your gross salary to get health insurance. This percentage varies by your choosen provider. Your employer is paying the same amount (more or less, not sure if the employer amount is fixed). You can opt out of the public system above a certain salary and pick private insurance, prices vary greatly.

Unemployed people are insured by the state, I guess using taxes or social security or unemployement budgets, I have no idea. You have to be registered as unemployed to be covered. If you do not register you have the choice of being insured with a family member (public health care) or voluntarily (private or via the public system). You are obliged to be insured oine way or the other.

Exceptions are soldiers (some kind of in-service system with cost reimbursement, don't ask for the details), public servants (something similar in a lot of cases, again, please don't insist on details), certain professions (doctors, pharmacists, artists,lawyers) with their own insurance solutions. You are screwed as a afreelancer, your only solution is a private insurance that can get quite expensiver.

TL/Dr: You are always insured one way or the other. It is not paid for by taxes.

[TomMarius]

Yes I got that part wrong. Sorry I misunderstood the text I read on the topic, you're right. My original comment was talking about people that are not insured (and not obliged to e.g. due to not being residents). My point is that healthcare always costs something, and the sum is very similar to the cost in the US once you get them to give you a discount for uninsured people - but of course there is better social security for entitled people (most of residents) in the EU.

[hef19898]

Last time I checked, the US was among the most expensive countries regarding health care. But I don't have a source at the moment.

And sure, health care ia costing money, nobody is argueing that. What Europe figured out is that a solidaric system, one where people with less individual costs are covering for those with higher costs, are the optimal solution from a national perspective. It still pizzles me how that can actually be a issue in any developed democracy.

And again, all legal residents are eligible for health care in EU countries. A good thing if you ask me.

[dirktheman]

It's free in The Netherlands. Well, not technically free but it's covered by the universal healthcare so it won't cost you a dime. (FYI the basic healthcare plans all cover the same regardless of insurance company. It covers nearly everything that you could go bankrupt on. There are extra packages that cover additional care like physical therapy or dentist costs. A basic plan is around EUR 90,- per month with a deductible of EUR 385,- per annum, but there's no deductible for MD visits and, yes, childbirth/neonatal care).

[NiekvdMaas]

Note that medicines count towards your deductible, as well as any more serious investigation by the GP (x-rays, blood tests, etc).

[raarts]

Virtually all of Europe has either publicly sponsored and regulated universal health care or publicly provided universal healthcare.[1]

So if an EU citizen moves to another EU country, there's no problem.

An average hospital in The Netherlands (#1 in quality in Europe [2], but #6 in costs) charges the insurance company between €607 (natural birth) and €4450 (c-section).

[1] https://en.wikipedia.org/wiki/List_of_countries_with_univers...

[2] https://en.wikipedia.org/wiki/Healthcare_in_Europe#European_...

[sergiosgc]

No. Prenatal care, childbirth and postnatal care are entirely free in Portugal and in most European countries I know of. In Portugal it's both free and either best or second best in world ranking.

[jvannistelrooy]

Do you have a source? I did a quick google for the Netherlands, but couldn't find any information about the real costs (without insurance).

[TomMarius]

I do, the Czech laws regarding health insurance - and pricing will be sent on request to the hospital.

[nik736]

Can you elaborate? In Germany at least this is not true at all.

[TomMarius]

In Europe there are countries where you can not be a part of the public system in some cases, such as changing your permanent residence outside the country.

[gambiting]

Well, ok, I see what you're getting at - but unless you moved to outside of EU, you are still fully covered by the country where your new permanent residence is. If you moved out of Czech Republic to Spain for example, just get an EHIC card from Spain and you can get treatment wherever you go in EU, including Czech Republic.

[TomMarius]

Yes, but I was talking about the case when you're not insured. Btw the treatment you're entitled to in other EU countries (outside the issuer country of your insurance card) is limited (but of course childbirth is covered) and you need travel insurance (it's cheap in EU, around 2 euro per day), especially if you're doing sports as any injury done during sports is not covered at all outside your country.

[bryanrasmussen]

In Denmark it costs 0, also since we're raising the next generation of payers into the tax system we get paid money quarterly (about $700 [guesstimate] for the first couple years decreasing over time, our 9 year old gets a governmental stipend of $200 per quarter [another guesstimate])

I guess what I'm trying to say as someone who lived a lot of years in the U.S - why the hell they gotta screw you so hard there?

on edit: of course I should also specify that Denmark is pretty capitalistic, so you pay for your kindergarten once you enroll the kids in there and that will cost more per month then you are getting in stipend.

[falcolas]

> why the hell they gotta screw you so hard there?

The same reason most things happens: Lots of short term profit, no matter the long term cost.

[kasey_junk]

You (or one of your countrymen) pay for it with taxes, that isn't the same as it costing $0.

Now, it likely a) does cost a lot less in Denmark than in the States in real terms and b) paying for it with taxes might absolutely make the most operational sense. But it isn't free.

[cronz]

Haha, what? Childbirth costs 0 € in a public hospital

[CaptainZapp]

Well, yes. That's true for most European countries (unless you go private).

https://www.babycenter.com/101_what-birth-costs-around-the-w...

[dagw]

Technically in Sweden it costs ~10€ pr. night.

[TomMarius]

It doesn't. Not everywhere and every time. See my other reply.

[cronz]

Well of course if you are not a EU resident you don't get free childbirth. This is a country not a resort hotel.

[TomMarius]

Yes exactly - I specifically said "if you don't have insurance". I really don't see your point, you're saying the same thing I do.

[3D13158219]

No idea why you believe this. I've had babies in two European countries and didn't pay a thing for either of them.

[TomMarius]

I believe it because the law and EU regulation explicitly states it.