[yurishimo]

But this also depends almost entirely on where you live. €100k in the almost any city in Netherlands, France, or Germany is a great income that can support a family with one earner. $250k might only put you in "solidly" middle class if you have to live in SF or NYC. The difference is that the $250k salaries are 99% of the time only widely available in these extreme HCOL cities.

Healthcare for a family of 4 in some parts of the US is absolutely fucking bananas compared to most of Europe. I've seen monthly premiums of $2k+ after the employers part, not to mention the deductible!

[euroderf]

Efficiencies from health care competition are illusory when you properly scope it to include paperwork hassles, time hassles, and pressure on provides to skimp.

[CogitoCogito]

There basically is no healthcare competition in the US at all regardless of any qualifiers. You often don’t even know how much a procedure will cost you. That fact alone means there is no price competition. Even if in the past there were hospital competition (assuming you’re in the position where you have the time to shop around), hospitals are merging regionally to take care of that.

The US healthcare system is incredibly expensive and ineffective. Americans often like to come up explanations for this status quo but the fact is the system is trash when compared internationally.

[geraldwhen]

This is patently false. 250k+ is readily available in cheaper cities. You just have to work at BigCoSoulStompers.