[GekkePrutser]

I definitely get 3-4x less than US in the EU country where I live.

But who cares.. I like the low-pressure life here. Rents are lower than the US too. We have socialised healthcare, safe gun-free cities. That's worth a lot more than a number on a bank statement.

I hear that in the US people will lose their healthcare when they lose a job and it could cost $1000 a month (which is more than my monthly rent)! Here it's simply free. That brings a lot of peace of mind.

[rayiner]

> I hear that in the US people will lose their healthcare when they lose a job and it could cost $1000 a month (which is more than my monthly rent)! Here it's simply free. That brings a lot of peace of mind.

That's not true in most of the states where people actually live. For example where I live in Maryland: https://www.marylandhealthconnection.gov/lost-your-job-you-c...

> Yes, you have 60 days from the date of losing your job to enroll in health coverage through Maryland Health Connection. You do not have to wait for open enrollment. A special enrollment period allows you to enroll in a health plan

Eligibility for free or subsidized healthcare depends on income. Here are the income limits in Maryland: https://www.marylandhealthconnection.gov/how-to-enroll/medic.... For a family of 4, if you earn less than about $36,000 a year you qualify for Medicaid, which provides free healthcare, including prescription drugs. For a family of four, you can enroll your kids in Medicaid if your family makes under $55,000 per year.

Above that it's a sliding scale based on household income.

[dragonwriter]

> a family of 4, if you earn less than about $36,000 a year you qualify for Medicaid, which provides free healthcare, including prescription drugs.

It provides free health insurance; as Maryland Medicaid has cost-sharing requirements, it is not completely free health care. Prescription drugs, in particular, are not free for Medicaid recipients, though they are subsidized ($1-$3/prescription).

https://www.kff.org/health-reform/state-indicator/premium-an...

[rayiner]

Finland, the example used by the poster I was responding to, doesn’t have “completely free health care” either. Prescription drugs have a 50 euro deductible and 40-100% reimbursement rates depending on the situation: https://www.medaffcon.fi/en/market-access-finland/

[CommanderData]

Health insurance is not the same as universally free health care at the point of service / request for every citizen.

[rayiner]

Most countries with “universal healthcare” actually have some sort of “universal health insurance.” And it’s usually not free at the point of service. Finland for example has a user fees and co-pays at the point of service.

[jahaja]

I think it's pretty relevant to post how large these Finnish fees and co-pays are compared to the US? It comes across as pretty dishonest to omit that the fee is almost symbolic in comparison. In Sweden it's like 200SEK (~$20) per visit and it seems to be 20 euro in Finland. And both fees have a cap for people needing a lot of care.

[tptacek]

The average US insurance copay for a doctor's office visit is, wait for it, $20.

Retail health care is not where the expense insanity in the US system kicks in.

[jahaja]

What's your point? This is more or less the end of the road in Sweden and Finland with regards to fees/co-pays, there's no difference with regards to severity. Not sure why you guys are so eager to try a "it's actually pretty much the same as here" when it clearly requires an extremely superficial look.

[dragonwriter]

> I hear that in the US people will lose their healthcare when they lose a job and it could cost $1000 a month (which is more than my monthly rent)!

This is true with some caveats:

If you lose your job, you lose health insurance from the job by default. But in general you have a choice to buy the same plan you had, at the full cost (including whatever the employer used to pay), which can, yes, be $1000/mo — or significantly more.

However, you will usually also then have the option of buying a plan from your state’s healthcare exchange, which may not be as good as your employer plan, but the lowest cost options will come consistently be far less than $1K/mo. [0]

And depending on income and other factors, you may be eligible for subsidies to pay part or all of the cost of an exchange plan, or you may be eligible for public insurance via Medicaid.

[0] https://www.kff.org/health-reform/state-indicator/average-ma...

[brtkdotse]

I’m having a hard time figuring out if you’re trying to paint a rosy or a bleak picture.

[1123581321]

That comment appears to be attempting neither. The healthcare situation in the US is complex and does not fit into any simple narrative without omitting information.

[lallysingh]

If you have a family, it's more like $2500/month for healthcare.

[theshrike79]

And if you have kids, it's like grand per kid for daycare right?

The US tech sector is _perfect_ for a single male engineer, who doesn't have any health issues. You can work 16 hour days, sleep on the office sofa and earn six-seven figures before you're 30.

But as someone who's definitely not 30 any more, with a family and health issues there is no way I'm even considering moving to the US.

I could easily triple or quadruple my take-home pay, but I'd be taking all the safeties off my, and my family's, life. Not a fan.

[rayiner]

> And if you have kids, it's like grand per kid for daycare right?

It depends on your income. Here in Maryland, families of four making up to $70,000/year are eligible for childcare subsidies.

These numbers come from high income people who try to imagine what it would be like to be low income but don’t actually know about all of the programs the US, especially blue coastal states and the Midwest, have for people under a certain income level.

For higher income people like engineers, their employees will pay for their healthcare. Things like daycare can be a stretch, but you only pay that for a few years before the kids are eligible for free per-school. Say you have 2 kids and they need $1,500/month daycare for four years. (That’s more than I pay in Maryland which is a high cost state.) That works out to about $3,600 per year over a career. Two people working will absolutely make that much more in take home pay the US than in Europe.

[theshrike79]

On the other hand, in Finland the cost is around 200-250€ a month per child and the cost goes down with each child currently enrolled.

From ages 0-5 you need to pay for childcare, pre-school starts at 6 and that's free. Pre-school isn't 8 hours a day though, so you need to pay around 100€ to supplement it with childcare.

After that it's school, high-school and university, all free again. High-school & university require you to buy the books though, which do have a cost, but nothing like the US schoolbook prices from what I've gathered. It's hundreds of euros per term if you buy new.

[rayiner]

School is free here too. Most people don’t go to college in either Finland or the US. (It’s slightly higher in the US.) But the average person who does go to college graduates with about $30,000 in debt. Which they will make up for given higher salary and lower taxes in the US within a few years. The median post-tax disposable income is $15,000 per year higher in the US than Finland.

[rayiner]

It depends on how much money you make. Here in Maryland, for a family of four making $70,000 per year, the premium is under $300/month for a high deductible plan, and under $500 for a low deductible plan. Even a family making $100,000 receives federal subsidies: a low-deductible plan is under $800/month, and a high-deductible plan is under $450/month.

We implemented a sweeping healthcare reform a decade ago now. You can't just pretend that never happened.

[GekkePrutser]

Wow, this is literally more than I make after tax :( And I have a senior IT job at a multinational.

But I suppose wages take this into account. High rent prices, healthcare etc. Otherwise people wouldn't be able to live off their wage.

[lallysingh]

Note: almost all of this would be paid by my employer on my behalf. I'd be on the hook for ~$350/month

[freeone3000]

Programmers can. Most people cannot.

[rayiner]

Most people can’t live on their wages? What do they do? You realize that over 90% of US citizens have health insurance right?

[freeone3000]

Go into debt, mostly.

Going off the 2019 numbers, so pre-pandemic: 10% of Americans have a negative net worth. 30% of americans are on means-tested benefits: Medicaid, foodstamps, TANF, WIC, welfare, or section 8. An additional 20% on top of that, or more than 50% of Americans, receive federal subsidies, so do not fully pay for their own insurance.

Even for those who qualify as "with insurance", for the above specification, do not possess insurance nearly to the scale that is implied in the above quote of $2500 per month. Of the 86% insured (the number rose from 10% in 2018 to 13.7% in 2019), 20% are on individual plans with a deductible over $5000.

Fewer than 40% of Americans actually have healthcare insurance of the quality implied above -- which makes sense, because $2500 a month is actually a reasonable figure, and that exceeds wages for 40% of Americans. Reminder that 30% of Americans live at or below the poverty line, and receive government assistance for basic needs of food and shelter.

[tptacek]

10% of Americans have negative net worth, but something like 8% of Germans have negative net worth, and Germany is a much smaller and more homogenous country. Is 10% a crazy high number? And look at Sweden's number. Is Sweden a basket case?

[xyzzyz]

Fewer than 40% of Americans actually have healthcare insurance of the quality implied above

If you are free to set metric arbitrarily, you can always ensure that majority of Americans do not meet it. For example, fewer than 40% of Americans drive cars that are younger than 5 years old. Does it mean that driving is out of reach for most Americans? Clearly, it's not.

More concretely, despite that "fewer than 40%" have healthcare coverage of the sort you arbitrarily chosen, it turns out that 70% of Americans rate their healthcare coverage as either excellent or good ( https://news.gallup.com/poll/245195/americans-rate-healthcar... ), and this figure has been stable for last 20 years.