[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.

[tptacek]

I don't know who "you guys are"; I'm a liberal Democrat and Rayiner is not. I'm just saying that in the retail health care setting we always seem to be talking about, the cost-sharing expectations of Europe are quite comparable to those of insured people in the US. This is a problem for people whose argument about the failings of US health care condenses to "insurance isn't enough".

The US health care system has deep, systemic problems! It's just probably not the copay problem.

[rayiner]

You don’t have to speculate about this stuff. The OECD tracks out of pocket healthcare spending: https://www.oecd.org/health/health-systems/OECD-Focus-on-Out...

It’s a couple of hundred dollars a year more than Finland or Sweden, but nothing dramatic.

And the fees/co-pays are of course not the end of the road. People in Sweden and Finland pay a lot more taxes. They pay thousands of dollars more every year, even when they don’t get sick. Median after-tax disposable income, according to the OECD, is $14,000-16,000/year more in the US than Finland or Sweden.

Now, of course, Americans spend a significant part of that difference on deductibles, premiums, etc. But in most states it’s a few thousand dollars a year on average. https://www.commonwealthfund.org/publications/issue-briefs/2...