[ArmandGrillet]

Finally. Germany combines some of the worst aspects of the US (credit ranking, complicated abortion process, private healthcare if you want decent treatments) with the worst aspects of Europe (low digitalization, high taxation, recursive federalism: within the country and within the EU).

A country like the Netherlands has its own issues (mainly housing) but doesn't have the myriad of pain points you can find in Germany like Schufa, anti-customer contract rules, or public healthcare inaccessible despite paying more than 400€/month for it as a single individual.

[ciclotrone]

I find it quite disturbing that high taxation is seen as a negative aspect of Europe. I lived in Italy, France and Germany, and I enjoyed public healthcare and education of very high standard at very affordable prices, and free in the limit that one cannot afford to pay for them.

As a relative of a person with a chronic disease I can tell you that on the one hand if we are not bankrupt it is because of public healthcare, and on the other I'm proud of contributing through my taxes so that anybody in need can have the same treatment irrespective of their economic situation.

[mk89]

Maybe nitpicking here, but healthcare is not financed with your taxes in Germany - it's financed by statutory health insurance (SHI) and private health insurance (PHI). The State "simply" sets the framework/legislation/etc. so that it doesn't get wild (like probably it is in the USA). [0]

In Italy it's the state/regions that take your taxes and pay the health system.

[0]: https://www.bundesgesundheitsministerium.de/fileadmin/Dateie...

[formerly_proven]

High taxes with no matching value behind them is undeniably a negative.

[Nextgrid]

Yes, that's my problem with high taxation, as someone who got burnt by it by virtue of living and paying taxes in the UK.

I don't mind paying my fair share of tax if it means I get good value out of it, but the state of our healthcare here means that in practice the public healthcare system is no longer fit for purpose, so we are being forced to pay for a system that doesn't work and end up having to go private (and thus pay again) when we do need timely healthcare.

I am generally in favor of fair, progressive taxation to ensure everyone has a good social safety net, but the taxation should be fair (it's no longer the case in the UK, since tax brackets haven't been adjusted for inflation) and the services paid for by those taxes should provide good value.

The danger with services funded by taxes as opposed to a private enterprise operating in a free market is that private enterprises are bound by competitive pressure - if they are delivering terrible service and stuffing their pockets with the money, you are free not to do business with them and a potential competitor (that stuffs their pockets a little less) can come along and get your business instead.

With tax-funded services, this pressure doesn't exist, so there's no incentive for politicians (and everyone else in the value chain) to deliver good service, since people generally can't opt out of taxes. This means that even if a service is currently good, there's no guarantee it will remain so since the pressure for it to remain isn't there. Thus, when you see high taxation, it's reasonable to be worried whether the service provided by those taxes is any good and whether it will remain so in the future.

[graemep]

The UK tax system (like many others) is not as fair or progressive as it is presented to be.

1. NI means that the real standard rate on earned income is substantially higher than the "income tax" rate. it is also not fair that unearned income is exempt from it. 2. Lots of purchase taxes, which are disproportionately paid by people with moderate incomes. People on low incomes spend a higher proportion in necessities which are (rightly) subject to lower levels. The more money you have (beyond a certain point) the less you spend on things subject to these taxes. 3. Too many loopholes.

> so we are being forced to pay for a system that doesn't work and end up having to go private (and thus pay again) when we do need timely healthcare.

Some of the NHS is good. NHS dentists can be very hard to find and waiting lists are long. Waiting times can be long too. Reform is prevented by the fear of a US type system and I think many people think that is the only alternative (and seem not to realise how things operate in most other developed countries).

[Nextgrid]

> seem not to realise how things operate in most other developed countries

Genuine question, what do other countries do differently? The way I see it (and described in my original comment) is that the underlying factors behind the decline of government services (no accountability, no incentive to use tax money efficiently) are common across many countries.

Some countries may get away with it for now because they're still "early", but if there is no pressure to do well it's just a matter of time before they too suffer the same fate?

[cycomanic]

I'd argue that the decline in quality of services as been a phenomenon across many western countries and to significant degree been caused by a economic idiology and a deliberate campaign with a goal of privatisation of many public goods, started in the 1980s.

Essentially funding to services are being reduced to pay for tax reductions, until at some point the quality declines significantly, which is taken as the argument that private enterprise would deliver a much better service at lower cost. Services/infrastructure are then sold and a low price and after a short while costs for services go up, but because they are now private enterprises raising prices it is "the market".

The reason why the UK is worse I believe it's due to the political system which results in essentially 2 dominant parties with very little differences.

[graemep]

Look at most continental European systems, or developed Asia - some form of government backed insurance is usual:

https://en.wikipedia.org/wiki/National_health_insurance

Singapore has an individual fund system if I understand it correctly, and that provides extremely good value for money.

One big difference is that these systems are less centralised and therefore less bureaucratic, less prone to political tinkering, and they reduce the problems of lack of accountability and incentives for efficiency.

[mint2]

Except there’s a lot of services that are unsuited to being delivered by competitive markets as it’s nearly impossible to prevent monopolization.

[Nextgrid]

Agreed, although this can be addressed by appropriate regulation. However, the ultimate issue is that the government should do its job well, and whether it's the task of adequately regulating a market vs providing the service itself, the problem that there's no pressure it to do it well still remains.

[261582335426158]

The key point to add is that (at least) 2 points must be true for this positive side of market to show:

1) There should be "forces" counterbalancing the move toward monopolies

2) It should be okay for the service to fail/die and/or it should degrade gracefully.

For example book publishing is a wonderful field that can gain from free market dynamics while prison management is a terrible field for free market dynamics.

While a dying publishing enterprise might print less books at a lower quality with deceptive marketing (and that is sorta okay) a dying prison management enterprise will squeeze every ounce of dignity/health/safety out of its wards.

Market dynamics for the economy are analogous to natural selection for evolution: both can produce wonderful things but they will require many more to die horribly.

This is not a statement against markets but I am calling for this tradeoff to be considered along with many other.

[Nextgrid]

The same factor that makes private prisons problematic also makes taxation problematic - in both cases you've got a captive market that can't opt out thus no pressure to provide a good, efficient service. In a hypothetical world where inmates could choose whether to remain in prison and which one to be in, private prisons would be competing for service quality. Actually we've got that, they're just called "hotels".

I wonder if the solution there would be to force politicians and everyone involved to exclusively use government-provided services - so as a condition of going into politics, you can't use private healthcare, your kids can't go to private schools, and you need to spend a day every year in a random prison and so on. Then it would mean the decision-makers got at least some incentive to make sure these services are functional and fit for purpose.

[autoexec]

> The same factor that makes private prisons problematic also makes taxation problematic - in both cases you've got a captive market that can't opt out thus no pressure to provide a good, efficient service.

What you should have are companies that offer their best prices/services to the government out of fear that they'll be passed over and those highly valuable contracts will be awarded to their competitors who do better. Governments are incentivized to select the best companies to award those contracts to because they risk being voted out if people are unhappy with the level of service they're getting for their tax dollars.

Prisoners can't kick politicians out of office when they're unhappy about the state of the prisons so that's a huge issue with prisons in general, but private prisons have another issue which is profit. Whatever it costs to keep dangerous people locked up, private prisons need all of that money plus they must extract a bunch of extra money from the public just to stuff their pockets with. If private prisons want to keep prices low to the public but also want to keep filling their pockets with money they need to provide substandard care to the people they are responsible for. A non-private prison needs only what it costs to do the job and nothing more.

[ScoobleDoodle]

Somehow in the USA these theoretical competitors that lower the profit margin and provide better service seem not to materialize. We end up with whole industries all of whose participants are funneling money to the executives and investors at the expense of customers and society. It’s such a broad issue that half of inflation is attributed to this corporate greed which is not being mitigated by the invisible hand of capitalist competition.

Without proper regulation and enforcement capitalism devolves to monopolies and oligopolies and eliminate competition and subdue market forces.

[mathgradthrow]

private enterprise is not "bound by competitive pressure". Companies only compete by virtue of the government forcing them to. Are you arguing that humans, inventors of civilization, are too stupid to figure out how to cooperate?

[Nextgrid]

I disagree that companies only compete thanks to regulation. Companies competing is the default - regulation sometimes (either as an unintended oversight or malicious intent thanks to lobbying/corruption) prevents it though.

There are many valid scenarios where competition is lacking, but generally speaking the reason it’s lacking is due to regulation/law making it impossible.

Telecoms for example is impossible because the incumbents have exclusive control of the physical infrastructure (poles/ducts under the street) or spectrum auctions where the price makes it impossible for a new entrant to enter.

Tech network effects are maintained by copyright law being abused to prevent adversarial interoperability.

[graemep]

> Companies competing is the default

If you had no regulation, they would simply form cartels or merge to create a monopoly.

[mcmcmc]

Unless you want to get into the nitty gritty of economic policy analysis and measuring market externalities, value of public goods is pretty subjective. A healthy person might not see much value in public healthcare and a single adult with no kids might not care about education. Just because you don’t value something in the same way doesn’t mean it’s not highly valued by the people who voted on and implemented the policies.

[jimcsharp]

My neighbors suck less when they're warm, full, and healthy. How do the anti tax folks get past that hurdle? I'm trying to live my most evil life here but I'm stuck on very selfishly wanting cool neighbors.

[mech422]

well - my son is out of school - but I'll still pay for good schools cuz when I retire I want a doctor that can read...

People forget, the young'uns are the ones you'll be counting on as you get older. Best to give them the best education possible, IMHO.

[mschuster91]

> High taxes with no matching value behind them

That is not the case for Germany. We have - even with all its shortcomings - a decent education system that's largely free and accessible for everyone, a decent healthcare system, a decent public transport system on local, regional and federal system, and a very decent social security network that covers unemployment, pension and elderly care.

The US in contrast has neither: parents have to pay five digits worth of money just for the birth of a child, pay through their nose for insurance, public schools are horribly underfunded, universities require six digits worth of debt, there's no high-speed rail worth the name, if you're unemployed you better have some savings, you have to take care about your 401k, and the best way if you need elderly care is to off yourself with a gun.

The only thing where the US actually is in front of Germany is allowing you to get a gun to off yourself. Here in Germany, it's almost impossible to own a gun, so people love to off themselves by jumping in front of a train, creating a huge mess for everyone else.

[greenavocado]

INOVA in Northern Virginia charges $3000 for an uncomplicated vaginal birth. They have a code which rolls up many services into that code. There are additional in-hospital expenses such as the newborn hearing test which aggregate to about $400. If you have insurance your maximum cost out of pocket for the calendar year is between 5 and 15 thousand dollars (insurance covers everything above it). If you can't pay it all at once there are charities and payment plans you can discuss with the provider. If you don't have insurance you can possibly negotiate the bill down sometimes drastically or if necessary declare Chapter 7 or 13 bankruptcy if you really can't pay the bills. Bankruptcy sounds scarier than it really is. Chapter 7 bankruptcy lasts about 3 months and Chapter 13 bankruptcy lasts about 5 years during which you pay everything above your normal average household expenses to a special account for the creditors. Medical debt is unsecured debt and can be defaulted on and purged by the court following bankruptcy proceedings. Bankruptcy is much more problematic in Europe for the individual. Americans can keep their assets in a Chapter 13 bankruptcy. Health insurance in America costs between $500-$1000 a month for an entire family.

[mikestew]

I'm sure this was meant as a "oh, it's not so bad in the U. S." type post. But I read it, and am reminded of what a suck-ass system the U. S. has. Sure, almost everything said is true. But let's reiterate:

1. One might pay up to $15K out-of-pocket for childbirth.

2. If you can't pay it, you have to go out-of-band to seek a non-standard procedure of taking care of the debt. The system is not otherwise built to handle a situation that's probably pretty common given the expenses involved.

3. If all else fails, file for bankruptcy.

All just to have a child.

What you've described is not "not so bad", but rather the plot of a bad movie from the 70s about how corporations have taken over the country and we all live in this dystopian hell where you have to give all of your assets to the corporation to be allowed to have a child. Only it's not a bad movie from the 70s, it's the U. S. healthcare system.

And I don't know what kind of low-end plan one gets for $1000/month for a whole family, but I'd bet real money that the deductible would make my eyes water.

[greenavocado]

Yes, the situation is bad.

Anyway, comparing earning 175k USD to 162.37k EUR:

Germany, married with 2 children, Stay At Home Mom Scenario, Tax Category 3, Berlin Region:

Solidarity + Salary Tax is EUR 40.428,00 Pension Insurance: 8.314,20 € Unemployment Insurance: 1.162,20 € Care Insurance: 900,45 €

Total: 50.805 € = $54,706 before health insurance

Virginia, USA, same scenario as above, incl. 2 child tax credit of $4000, four state exemptions: FICA + Federal + State Tax - Child Care Credit: $44,162-$4,000 = $40,162 before health insurance

Germany costs $14,544 a year more for a family with two kids before health insurance. To be fair though, the differences are lesser for most Germans, as almost no common jobs pay over 120k EUR gross.

[Ringz]

> INOVA in Northern Virginia charges $3000 for an uncomplicated vaginal birth. They have a code which rolls up many services into that code. There are additional in-hospital expenses such as the newborn hearing test which aggregate to about $400.

Free of charge in Germany

> If you have insurance your maximum cost out of pocket for the calendar year is between 5 and 15 thousand dollars (insurance covers everything above it).

In Germany, insurance covers everything over 0€. It depends on the insurance whether you have to pay extra for individual treatments (treatment methods without, or with disputed scientific evidence) or not. Rarely more than 100€. If expenses for illnesses exceed a certain amount in a year (about 3000€), it can be deducted from taxes.

> Health insurance in America costs between $500-$1000 a month for an entire family.

In Germany, it depends on your income how much the insurance costs for the entire family. 500-1000€ is also possible in Germany. But without all the extra expenses, negotiations with doctors, clinic, insurer, and bankruptcies...

[burnerthrow008]

> In Germany, insurance covers everything over 0€. [...] If expenses for illnesses exceed a certain amount in a year (about 3000€), it can be deducted from taxes

But how can you have anything to deduct if insurance covers everything over $0?

[Beijinger]

"In Germany, insurance covers everything over 0€. "

Yes. But you wait >6 months to see a specialist. And Germany has not the same level of health care than the US. Sorry to break the news to you.

[staringback]

> Free of charge in Germany

Paid solely by taxes instead of some taxes and some out of pocket

[albert180]

If Access to Health Care in the US is so great, why is infant mortality worse than in Cuba and they score dead last in every Health or Life Expectancy Metric among the G7?

[jandrewrogers]

None of these are primarily medical outcomes. Life expectancy, for example, is skewed by an anomalously high rate of fatal injuries when people are young, which has nothing to do with healthcare quality. For better or worse, trauma medicine in the US is arguably the best in the world because serious injuries are so prevalent.

There is also the practical matter that the US is a continent-sized country and regional effects matter. Some US States have life expectancy on par with the best European countries despite the anomalously high fatal injury rates among young people.

[greenavocado]

In case you haven't noticed, the demographics of America have changed a little bit since 1990.

We also have a small problem with fentanyl.

[staringback]

Have you seen the health of an average American?

[skeeter2020]

It's a little more subtle than this, and of course subtlety is doesn't play well these days, but the US stats vary greatly across geography and ethnic lines. Cuba isn't a great comparison, beyond the shock of "they're worse than a bunch of commies!"

[jjav]

> (insurance covers everything above it)

Be aware that this is not true!

What insurance-speak calls max out of pocket is not what a normal person thinks max out of pocket means.

If you have a year of high medical bills you can easily pay much more out of your real pocket than your so-called "max out of pocket" in the insurance paperwork.

That is because the insurance company only credits what they feel like it towards their accounting of max out of pocket, not what you actually paid.

I don't have an insurance bill handy here to quote numbers but in their monthly or quarterly statements you can find what you have to pay and what they credit against your tally of yearly out of pocket. The latter is often less than the former.

> Health insurance in America costs between $500-$1000 a month for an entire family.

You're off by a lot. About $3500/mo here in CA for my family. Employers usually pay a good portion of that (but it varies) but if you go unemployed on COBRA, it's all out of pocket.

[dkekenflxlf]

500-1000 USD per month for a WHOLE family is fucking cheap!?

In Germany, i'm paying more than 1150€ per month as single (and im not privately insured but publicly)

[pflenker]

1) I doubt that you pay as much. I pay less than half of that and have a comfortable salary. Did you include the "Arbeitgeberanteil" (which is not part of what you are paying)? 2) You can't easily extrapolate that number to a whole family. Kids are usually insured for free if the higher-earning parent is not privately insured.

[Scharkenberg]

1150? That's literally impossible. The current maximum is about 1050. See "2024 Höchstbeitrag GKV inkl. Pflegeversicherung (ohne Kinder)".

[rusticpenn]

I think the upper limit is 800€

[wyre]

No one should have to declare bankruptcy for birthing a child. To suggest it is obscene.

[lupire]

Why do I pay $25K/yr for my family? Is yours high deductible?

[greenavocado]

6,000 dollar deductible per person with total 15,000 dollar out of pocket maximum for the family. My current health plan is better because my company found a partner that aggregates many smaller companies to get better rates from insurers. Before this I was uninsured and would call many different providers to negotiate the best cash price for various procedures such as wrist MRI with contrast. I got cash quotes ranging from $850 to $3500 and got exactly what I needed from a local provider for $850. I called up several providers in Canada and they offered similar cash prices (on the low end) so it wasn't worth the 8 hour drive each way.

[mschuster91]

> INOVA in Northern Virginia charges $3000 for an uncomplicated vaginal birth.

In Germany all of that is being covered by the government insurance scheme. The only thing you have to pay is stuff like a private room for postnatal recovery time [1]. Oh and you get a very long time paid post birth to recover and bond with your child. No such nonsense as giving birth and having to work the next day like it's common in the US.

> If you have insurance your maximum cost out of pocket for the calendar year is between 5 and 15 thousand dollars (insurance covers everything above it).

We don't have that at all, insurance covers everything, you never even see a bill or have to deal with stuff like "in network". The only thing is a 5-10€ co-pay per prescription (utter nonsense if you ask me, it was introduced as a "cost control" measure to prevent people from... diverting medication? idk, it's ridiculous but small enough that it's harmless).

> Bankruptcy is much more problematic in Europe for the individual. Americans can keep their assets in a Chapter 13 bankruptcy.

Agreed on that one. It's also a huge contributing factor into why Americans have it easier to start up side hustles.

> Health insurance in America costs between $500-$1000 a month for an entire family.

Assuming I were the sole earner and my wife would be a SAHM with an arbitrary number of children, I'd (at a gross wage of 52k/y) pay 340€ a month to health insurance and my employer another 340€, so in total (including a per-insurance surcharge of, in my case, .5%) my healthcare costs are capped at about 700€ - for all of us.

On top of that we'd get, like all parents in Germany, "Kindergeld" of 250€/month per childpaid by the government to assist in child rearing.

Pretty awesome if you ask me. I honestly don't know how y'all survive.

[1] https://www.eltern.de/kosten-geburt

[burnerthrow008]

> In Germany all of that is being covered by the government insurance scheme.

Ok, but you agree, don't you, that $3000 is quite different from "parents have to pay five digits worth of money just for the birth of a child"? That is off by an order of magnitude.

> No such nonsense as giving birth and having to work the next day like it's common in the US.

I think you should stop consuming so much media from Russia Today :) Or maybe re-consider the trustworthiness of wherever you read that.

The fact is that, at the federal level, Americans may take 12 weeks (unpaid) time off work after giving birth under the FMLA, and it is prohibited to retaliate against an employee for taking that time.

Additionally, the majority of Americans live in states which mandate paid time off after giving birth, (usually 8 to 12 weeks) plus additional unpaid time. California, to use the most populous state as an example, mandates 8 weeks of paid time, plus 28 weeks unpaid. New York, on the opposite side of the country, goes even farther by mandating 12 weeks paid time.

Part of the reason you may be confused is that this is not always explicitly named as "maternity time". It is often called as "disability leave", and nearly all disability statutes include recovery from pregnancy as a disability.

Unless you are maybe trying to argue that Europeans are legally prohibited to work the day after giving birth, you are way off base here.

[Beijinger]

"a decent education system that's largely free and accessible for everyone"

I give your Universities a 2-3 (On a scale 1 Top, 5 fail). High schools are getting worse and worse due to the immigrants. So you would want to send your kid to a school without many immigrants, mainly due to language barriers.

"a decent healthcare system" Again, I give you a 2-3. More and more people are sucking services, fewer people pay in. Hey, alone 1 Million Ukrainians are insured, while less than 25% have a job. How long do you wait to see a specialist? >6 months!

"a decent public transport system on local, regional and federal system" Again grade 2-3. You have a functioning public transport system. But ask Switzerland what they think about it. Or look at China if you want to learn something about bullet trains.

"and a very decent social security network that covers unemployment, pension and elderly care."

Is on the brink of collapse. Pensions are great. For state employees. The rest gets retirement benefits. They are compared to the EU very low.

I don't have health insurance by the way. Germany has to take care of so many immigrants. Nothing left for me. And try to compete with them to find an apartment. The government pays for them. And the government is never late with payments, hence landlords prefer this.

[Scharkenberg]

Can you cite your sources?

This literally sounds like regurgitated shit from far-right politicians rather than thought-out analysis based on real statistics. In fact I would go so far as to suspect astroturfing.

[Beijinger]

Yes sure. For German articles please use google translate.

1. a) 0 Universities among the top 10: https://www.timeshighereducation.com/student/best-universiti... (In most other rankings, German universities rank much worse)

b) sinking high school performance: https://www.oecd.org/publication/pisa-2022-results/country-n... The collapse coincides with the arrival of refugees under Merkel....

c) Many immigrants in school. Hint: You can't teach math or chemistry if the majority of the kids don't speak German https://www.spiegel.de/spiegel/integration-an-manchen-schule...

2. a) Currently don't find a better article. Biggest problem compared to China. Germany has the same tracks for bullet trains, local trains and freight trains. Often the bullet trains run a 120 or 160 km/h https://www.businessinsider.de/tech/warum-es-ultraschnelle-z...

b) Switzerland complaining that German late trains destroying their time tables: https://www.focus.de/finanzen/news/schweizer-experte-droht-d...

3.)

a) Waiting for several months (around 6, based on own experience) to see a specialist: https://www.sr.de/sr/sr3/themen/panorama/saarland_warten_auf...

b) Retirement, as percentage of former income, EU comparison: https://www.merkur.de/leben/geld/deutschland-rente-vergleich...

Forgot the last point:

4. Examples https://www.bw24.de/baden-wuerttemberg/neid-debatte-vermiete... https://www.deutschlandfunk.de/fluechtlinge-dubiose-geschaef...

And personal experience from friends of mine who are landlords.

[mk89]

On a scale 1-5, 2 and 3 are exactly the same as or better than "decent". Otherwise the previous poster would have said "they are perfect (=1)".

You're being a bit unfair, to be honest.

[Beijinger]

I did not say it is third world.

[Nimitz14]

Switzerland does everything better than Germany with far less taxes.

And since we're trading anecdotes I've found US Healthcare to be the best compared to the 3 european countries I've lived in before.

[mschuster91]

> Switzerland does everything better than Germany with far less taxes.

They have the advantage that the country is so small. Us Germans however have to deal with the fact that we have the 5th largest country of Europe of which a lot of is settled and has to be supported by the entire population.

And in any case, Swiss taxes aren't that much lower than Germany's either - average tax load in the country is ~29% [1], Germany is at 33.9% [2]. Switzerland's total load may be even higher because the German figure includes social security payments, Statista for Switzerland is only taxes.

[1] https://de.statista.com/statistik/daten/studie/1176146/umfra...

[2] https://www.bpb.de/kurz-knapp/zahlen-und-fakten/soziale-situ...

[Nimitz14]

You know Switzerland is all hilly or mountainy right? Building infrastructure is inherently much harder and more expensive and yet Switzerland does a much better job of it. Switzerland is also actually more diverse with it having 3 distinct languages. The federalization via cantons is smart and works well.

I'm certain your two sources are not measuring the same thing. Swiss taxes are much lower. Median income in Germany is 43k which results in a tax rate of 34% in bawu. Median income in Switzerland is 78k, that in Zürich gives a tax rate of roughly 12% (!!!). Of course in Switzerland all health insurance is private so you end up having to pay more but this does not increase with more income!

Anyways the idea that the tax burden is the same is completely laughable.

[skeeter2020]

your second point strikes at the crux: On the whole, the US sucks. At the top margin, it's the best in the world.

[jandrewrogers]

The US actually has a good pension system relative to other developed countries. Retirement plans like 401k, IRA, etc are in addition to the pension system, they don't replace it, and are frequently superior to their European counterparts both in scope and flexibility.

There is plenty to complain about but pensions and retirement is one area that the US does comparatively well.

[skeeter2020]

My initial reaction is - then why is the US leading in so many areas, if based on your chracterization it's such a laggard? I'd argue it has the best in all categories, it's just not close to even distributed. "Decent" is completely inadequate for education, healthcare and transportation. These are far too important for " good enough, usually" solutions.

[breather]

Ah that's where the much higher quality of life kicks in.

[alexwhb]

Agreed. Additionally taxation in our modern Fiat currencies is a farce, since the central banks can literally take as much buying power as they want from you. Taxation is literally just an illusion to make you feel like you are directly paying for government services.The real taxation is inflation.

[dkural]

There is no capital gains tax - Germany has less progressive taxation than the United States! VAT in general is a regressive tax, that many EU countries inordinately rely on. A US-citizen has to pay taxes no matter where they reside, but the wealthier citizens of EU countries can easily evade taxes by domiciling themselves in various tax havens around the EU. Germany does a very poor job collecting taxes from the highest earners.

[kmlx]

> I find it quite disturbing that high taxation is seen as a negative aspect of Europe.

after receiving the same services for no or minimal tax i also find it very disturbing that people still think high taxation is necessary.

[0xFF0123]

Where?

[mk89]

In general, if you don't pay taxes, in the listed countries you still can get treatment. It was probably a provocation - I guess?

[kmlx]

hong kong. super low taxes, great public services.

singapore. low-ish taxes, excellent public services.

there are others.

[RHSeeger]

> I find it quite disturbing that high taxation is seen as a negative aspect of Europe.

High tax rates and, in fact, ANY taxes area a negative. However, that negative is (hopefully) offset by the positives that the things those taxes go to pay for provide.

[throw10920]

> I find it quite disturbing

Typical emotional manipulation...

> that high taxation is seen as a negative aspect of Europe. I lived in Italy, France and Germany, and I enjoyed public healthcare and education of very high standard at very affordable prices, and free in the limit that one cannot afford to pay for them.

...coupled with an utterly illogical (and factually incorrect[1]) non-argument.

You can have these things without high taxation, if the system that implements them is efficient. It's not.

[1] https://news.ycombinator.com/item?id=39402957

[Beijinger]

" I'm proud of contributing through my taxes so that anybody in need can have the same treatment irrespective of their economic situation."

It is a big world my friend. And if millions come to use these services but don't pay in, the services get thinner and thinner. 1 Million Ukrainians came to German. Less than 25% have a job. The rest is financed by the taxpayer. Money, Rent, Health insurance...

Edit:

It reminds me of a Third Reich joke. An old woman goes into a map shop and looks at a globe.

She asks the sales person: What is this big blue land on the globe?

The sales person says: This is the USA.

Old lady: And this huge Red area, what is this?

The sales person says: This is the Soviet Union.

Old lady: And this tiny brown spot, what is this?

The sales person says: This is our Third Reich.

Old lady: Does the Fuehrer know this?

-----------

I hope you get what I am trying to say.

[mousetree]

As a German who pays a lot in taxes each year, I’m more than happy for those taxes to support our Ukrainian friends who are refugees during this terrible situation

[lastdong]

It's important to remember that Ukrainian individuals in Germany make up just 1.2% of the population, the majority of whom are war refugees.

And while 0.9% can be treated just as a number, each one of these individuals has a unique story and deserves our empathy and understanding.

[0] https://www.osw.waw.pl/en/publikacje/analyses/2023-08-25/ukr...).

[illiac786]

The one I have seen are all young women and kids. They will cause not even a fraction of the health care costs a 70 or 80 year old German generates. I can't find this stat but basically it's exponential, one generates more health care costs in the last ten years of its life than during its entire previous life, on average.

[vizzier]

Adding a source to this claim as it is very valid [0]. I cannot find a good overview of the overall demographics of the ukranian refugees other than it is mostly women and children due to the borders being closed to outgoing men. Employment rates will rise as people integrate.

[0] https://www.oecd.org/health/Expenditure-by-disease-age-and-g...

[Beijinger]

In Germany, 75% of Ukrainians don't work. In other EU countries, nearly 80% work. It is a question of the system and incentives.

[illiac786]

Source? This is interesting.

[mk89]

> They will cause not even a fraction of the health care costs a 70 or 80 year old German generates. I can't find this stat but basically it's exponential, one generates more health care costs in the last ten years of its life than during its entire previous life, on average.

I really don't wanna get into this populist debate, which is really annoying lately as it seems to be our biggest issue in the world, but ... the 70-80 years old people (probably) worked in the country, they contributed to their own country, and should be treated with some respect or decency and not just as a cost.

[iforgotpassword]

They enjoyed the golden years after WW2 where the economy was booming, decent pension starting at reasonable age, nobody cared about the environment, people lived like there's no tomorrow.

Now the coming generations can deal with the fallout.

[mk89]

It's a bit unfair what you said and probably you know it - next generations can blame so many things on us today... it's just like history or life works.

[fabian2k]

That's an overly negative and hyperbolic view. Nothing is entirely wrong here, but you're painting every single point in the most negative way possible.

You can certainly argue about how good the healthcare system is in the end, but it isn't categorically inaccessible. And if you pay 400 EUR/month you're earning enough money and can choose the private health system if you prefer that.

The credit ranking also works in very different ways than in the US, so I wouldn't compare them directly. I'm not sure what you mean by anti-consumer contract rules.

[panki27]

While choosing to be in the private system is an option, it only "makes sense" if you make at least 70k€ a year, so definitly not for everyone.

The issue is not getting in - but getting back out before you retire and don't have enough available income to pay the rates anymore.

[fabian2k]

If you pay ~400 EUR for the public healthcare you make 70k or more.

The cost for public healthcare is scaled by income, and is limited around 400 EUR. It's a bit higher now, but I would suspect that the OP is not necessarily talking about the most current values here and is hitting the older limit and therefore earning more than the "Beitragsbemessungsgrenze".

[miroljub]

The limit is ~900 € per month, not ~400 €. People frequently forget the employer matching, which at the end comes from your pocket, since it's mandatory.

Also Freelancers and self-employed need to pay full contribution of 900 €, not "just" a half.

[cycomanic]

No the employers contribution doesn't come out of your pocket. The employers contribution comes out of the employers pocket and is the cost of doing business. That's like arguing the rent for the office space or even the warehouse or servers come out of your salary. Your salary is essentially a function of supply and demand and not a function of cost. I mean, if external costs would influence salary we'd see remote workers earn more than on site ones, because employers save on office rent. In reality it's more likely to be that remote workers have a lower salary.

[miroljub]

Frog the company perspective, your cost is what they have to pay to get you. That's where the supply & demand gets decided. Everything that reduces your net compensation from that amount comes effectively from your pocket.

Company "contributions" are just a government conspiracy to gaslight you into thinking you pay less taxes & contributions than you actually pay.

[lupusreal]

If you're paying 400 EUR for public healthcare, shouldn't you receive good healthcare for that? Why is private healthcare even in the discussion? Why does the public option suck?

[mns]

Even if you get in, it's scummy. Once you get to a certain age, the payments are crazy. Not to mention people "selling it", like a colleague of mine got scammed into going private, he had some eye issues a couple of years before, and when the issue came back, the insurance refused to pay because it was an existing condition, making his treatment unaffordable and having to literally quit, leave the country for a while and come back just to get back to public.

[tietjens]

Hello from Germany. No lies detected. Don’t forget about a working culture where process always ranks above results, and leaders commonly lack confidence to make pragmatic decisions.

[odiroot]

> Don’t forget about a working culture where process always ranks above results,

And where tenure ranks above skills or experience. Especially if unions are involved.

[anovikov]

Well, this working culture makes result slow and expensive, and as a result, in many cases uncompetitive, but it does a good job of avoiding fuckups and while slow and expensive, things usually get done predictably, on time and on budget. Which probably makes it better than American reckless "fake it till you make it" approach in most of the complex projects.

[tietjens]

I am familiar with this response but I can’t take it seriously. The country is looking at something like -0.4% growth this year. “On time and on budget” really? Like the Berlin airport? Like the digitalization budget that hasn’t been spent? There is no spirit of pragmatism here. Only a fear of not following the rules.

[freshbob]

No, it absolutely does not. It might have in the past, when industry was booming in Germany and setup costs were huge and mistakes were very, very expensive. However, they've pretty much lost the race when it comes to software and digitalization, where setup cost is pretty much non-existent, mistakes are inexpensive (fail early, fail fast), and ROI are generally multiples of 100%.

[anovikov]

I had an experience with a German client in a software project. It freaked the hell out of me with slowness of decisionmaking, long contract every point of which as it turned out, was material, in a nutshell it was a 50/50 coding vs lawyer job and took 5x the time same thing would take with an American client. It also made me next to no profit.

But, unlike a lot of things we write for Americans, that one turned out to be actually workable, usable in their (rather large) product, and runs happily to this day almost 5 years later. I count it as a success and attribute it mainly to this boring, overly conservative and procedure-ridden work process.

But yes, i agree, that for software projects, virtues of this approach are more limited than in "hard" engineering, and probably do not outweigh downsides in many cases.

[chrisandchris]

I think scope, budget and time is a triangle. You have to choose 2 of it, and 1 is always lost. There's almost never a on-budget, on-time and on-scope project.

[sofixa]

> Europe (low digitalization, high taxation, recursive federalism: within the country and within the EU).

A decent chunk of those are exclusive to Germany, or at least far from the norm in the EU or Europe in general. For instance digitalisation varies wildly between countries, but Germany is definitely one of the most embarrassingly behind countries. Taxation also varies (e.g. Bulgaria and Estonia have flat income taxes). Federalism isn't a thing in most European countries too.

[jonp888]

I'm a bit surprised you would consider the credit system the same as the US. It doesn't have the bonkers bit of the US system where you have to take great care to be in a small amount of debt even if you don't need to be, in order to "prove" your creditworthiness so that you can be in a lot of debt later.

[bombcar]

Being in debt to build credit is mostly a fairy tale told by the companies - just having an open line of credit is all you need to provide account age. You don’t need to use it or carry a balance (you may need to use it periodically to keep it open but that can be charge/pay off immediately).

[kevin_thibedeau]

It's starting to creep into public services. You couldn't even get easy access to Covid stimulus funds without a credit card. Debit cards were rejected despite providing the same level of ID verification.

[devmor]

At what point did you need to use a credit card to receive your economic stimulus payment? I simply confirmed my most recent tax year information when I claimed mine.

[usr1106]

German "public" healthcare is much more accessible and has much better coverage than its Finnish counterpart.

Despite Finland reapeatedly making headlines (including on HN) about being a Nordic welfare state.

Germans are typically complaining from a high level.

Source: Members of the wider family living in both countries. Some over 80 and needing a lot of healthcare services.

(I hear general practioners can be a problem in poorer areas in the East. My experiences are from a prosperous area in the West.)

[graemep]

> Germans are typically complaining from a high level.

Do Germans share the British tendency to think everything is better in the rest of the world?

As an immigrant (as a child, admittedly) and someone who has lived and worked elsewhere and, more importantly, does not completely share this aspect of the culture, I find British pessimism and self-flagellation really, really annoying.

[carstenhag]

Germans unfortunately like to complain a lot. Many things are better elsewhere, is claimed. Except for many other countries nearby. And the weirdos from UK leaving EU. And the weirdos from US with Trump. And we have it so bad, so bad. Sometimes I hate my fellow Germans.

[graemep]

Nice to know its not just us!

[oarfish]

A finnish colleague once told me that the Finns just don't go to the doctor unless something falls off. Any accuracy to that?

[usr1106]

Yes, especially for Finnish men in the countryside that's a sterotype with quite some truth behind it.

Edit: And that results in a dangerous combination: First waiting too long and then getting the answser "no free appointments". And if you insist the next one is in 3 or 6 months. Many Finns do not insist.

[robert_foss]

This is entirely correct. Having lived both in North America and Sweden this is a very accurate description.

[meroes]

400€ for medical, dental, and optical combined you mean. And less for students. And you conveniently leave out their 4 week minimum vacation time/year. (my sis and her BIL just moved from there, and help people move there).

Digitalization is really behind yes, and homeownership is even more expensive than the US. But rent is almost half the US and groceries are cheaper. And instead of subsidizing full sized pickup trucks and EVs, you get Audis, VWs, etc for cheaper.

[discopicante]

Now compare median income of Germany vs US. Economic opportunity is fading away in Germany. Also, pretty much all cars - especially Audis, VWs, etc are (20-30%) more expensive in Germany vs US.

[moi2388]

True, but in the Netherlands it’s the government itself which sells all of your data, literally everything from your house, it’s price, location, blueprints, satellite images, what you paid for it, previous owners, your car, and even your government ID number if you are registered as a company, just to many a couple.

And yes, you obviously have to pay to get your own data.

[WarOnPrivacy]

> or public healthcare inaccessible despite paying more than 400€/month for it as a single individual.

This is super close to my early 2010's ACA experiences. Even when a poor earner could scrape up enough to buy a plan, the deductible made it unusable.

Policy pricing was exorbitant for $12k/yr earners but dropped enough for 22k/yr that a few plans were buyable. The challenge was coming up with another $somethingthousand to cover the deductible.

There was a sharp drop-off in plan pricing at 32k/yr and some mid-grade plans were in reach. IIRC deductibles were lower on those plans and they may have been usable (or nearly so).

What struck then. Of the news orgs cheering/damning the ACA, zero of them ever covered how pricing dropped as income rose. I assume that's because pricing was only ever disclosed to folks who completed the lengthy signup process - and news folks found it too daunting to experiment with.

[fabian2k]

There are no real deductibles in German public healthcare, though some areas are excluded almost entirely like glasses and certain dental work. The cost is also scaled to income, the 400 EUR (which is only 50% of the cost, the other 50% pays the employer) here are what you pay when you earn ~70k EUR per year and are essentially the maximum for public health care. So it is much cheaper if you earn less money.

One of the main current criticisms of the system is that it can be very difficult to get appointments with specialists compared to people with private health insurance.

[dkekenflxlf]

Bro, du solltest mal deine Gehaltsabrechnung prüfen - mit dem Gehalt bist du bei knapp 1000€

[fabian2k]

I used the values from the original post, which is only the employee part and not the employer part. I also assumed that they're not using current but slightly older values here. I also didn't include the PPV, if you include that and count the employer part you end up at 1000 EUR.

[interactivecode]

Healthcare is kinda shit in The Netherlands. Long waiting lists even for simple things. Never actually prescribing medication but instead over prescribing paracetamol. Only being able to get a set amount for appointments regardless of actual need.

Sure if you’re in a car crash and urgently need care they will help you without going bankrupt but anything less urgent good luck getting an appointment this week / month / year

[notaustinpowers]

Does The Netherlands not have Urgent Care facilities like the US? I feel like those for of facilities could handle the issues of a lack of access for simple or menial things. I had to get a cyst lanced a few weeks ago and I just walked into an Urgent Care by my house and was in and out in about an hour with no appointment. I think it was about $180 since I didn't have insurance.

[anonzzzies]

I am dutch and have lived in quite a few countries in the eu and se asia: I would prefer to never have to deal with NL healthcare services again compared to other countries. And I have been (unfortunately) been in hospitals, a lot. Since the 90s NL is striving to become little USA policy wise and this is still getting worse. It’s a shit show.

[karpour]

This, not nearly as bad in the US, but a mess of private insurances.

[njarboe]

A mess of private insurances, partial payment by the government of private insurance based on income, and then full (or almost full) government payment based on veteran status, income, and age. It's more complicated than this of course.

[miken123]

> A country like the Netherlands has its own issues (mainly housing) but doesn't have the myriad of pain points you can find in Germany like Schufa

In the Netherlands we have BKR, which is less all-encompassing than SCHUFA, but also needed to be fined before giving proper right to access under the GDPR: https://edpb.europa.eu/news/national-news/2020/national-cred...

[oytis]

Is Netherlands healthcare better? From what I've heard from people having lived in both countries, German healthcare is more accessible. E.g. in Netherlands you can't see a specialist doctor unless you convinced your GP you absolutely have to - which can be hard at times.

[jacquesm]

I'm 58 and not exactly in the best of health. I've had to rely on healthcare in NL quite a few times over the last 20 years or so and all of those were serious cases. I have nothing to complain about, but that's n=1. To increment that n a bit: I know lots of people here and almost all of them have had some health issues over the years and the vast majority of those have been dealt with in a serious and reasonably effective manner.

Where NL is utterly ineffective is when it comes to vague symptoms. Until it is perfectly clear what is wrong you're going to be seriously frustrated because the diagnostic machinery isn't really all that effective, when in other countries they'd spend a fortune to find out what's wrong with you in NL unless it's 100% clear you're going to have a hard time getting the care that you need.

I blame Calvijn, NL seems to have a misplaced sense of reduced expression of emotion resulting in an expectation to tough things out rather than to deal with them and for some reason doctors seem to see complaints without a direct relatable cause as an attack of hysterics rather than as something to investigate. If you come from a different background you're going to find this a very difficult thing to deal with.

[formerly_proven]

> the diagnostic machinery isn't really all that effective, when in other countries they'd spend a fortune to find out what's wrong with you in NL unless it's 100% clear you're going to have a hard time getting the care that you need.

What other countries are those?

[maeil]

Ironically the US seems to be best, or at least the "least bad" at this (if you can afford it); it's the only positive thing I can see about US healthcare.

[Unfrozen0688]

>when in other countries they'd spend a fortune to find out what's wrong with you in NL unless it's 100% clear you're going to have a hard time getting the care that you need.

Sweden here, I hear the same things. I have had good experiences with health care here as my problems have been "normal" and straight forward.

But what other countries? Really, name one.

Same with computers.

You want to fix a straight forward problem or a vague one?

[javajosh]

>low digitalization

Given that everyone uses IBAN, and it works great, I strongly disagree.

>private healthcare if you want decent treatments

Your mileage may vary, but I was very impressed with the speed and ease of acquiring healthcare under a public plan. The lack of paperwork for seeing a new doctor is astonishing. The lack of copays, SOBs, and all that is like a breath of fresh air, and is worth copying in the US. Heck I once saw a doctor for something and simply gave my card, and saw the doctor in the next hour, and she decided I needed an ultrasound...and did the ultrasound in 5 minutes herself. In the US, this would have been a multi-week ordeal with multiple rounds of paperwork and visits to different offices.

My wife also had a C-section at a Berlin hospital and the care was competent and 100% covered by our public insurance. In the US couples requiring a C-section can expect $20k+ of debt.

[jamesmunns]

Low digitalization isn't just payment - it's also needing to fill in paper forms, or making in-person visits to government and business offices.

I've been living in Germany for about a decade, and it is still behind in many of these items from when I left the US, and having a friend that recently moved from Germany to NL, he was blown away at how convenient and just not-hostile so many day to day interactions with governments and businesses were.

Like - big picture, I'm very happy in Germany, but certain things are still very archaic and sometimes needlessly so.

[shellfishgene]

I agree, just look at the recent (well, decade-long?) attempt to digitalize the car registration process, which can only be called a total desaster.

[Bayart]

My impression coming from France, which I never thought of as particularly progressive on the technological front, is that Germany is full of odd, idiosyncratic archaisms.

[ffsm8]

> public healthcare inaccessible despite paying more than 400€/month for it as a single individual.

That's a pretty new thing though (been getting worse for the last 10 yrs). And the person responsible for the legislature that caused this change is the current health minister.

Also... 400€? It's a percentage of your salary. And you're omitting that the employer pays the same amount, so you're effectively paying 800€ at the very least.

[asymmetric]

> Also... 400€? It's a percentage of your salary. And you're omitting that the employer pays the same amount, so you're effectively paying 800€ at the very least.

Not everybody is employed.

[Aerroon]

If you're not employed then aren't you expected to pay both halves yourself?

[fabian2k]

It is paid by the social security system in that case. If you're self-employed then you will have to pay both parts yourself.

[Aerroon]

Ah, that's nicer than here. In my EU country you just don't get healthcare if it's not paid. Funnily enough you can't just go and pay it either, it has to come through something like a job.

[generic92034]

> And the person responsible for the legislature that caused this change is the current health minister.

Could you please explain that a bit more?

[ffsm8]

He revamped pretty much evey monetary incentive a few years ago, which directly caused the "gold rush" privatization of hospitals etc, making a lot of treatments uneconomical. There has been a lot of coverage about it over the years - both by official channels and independent YouTubers and journalists, I'm not going to do it justice by summarizing it in a comment here.

A somewhat recent German video (2yrs old) is "Pflege katastrophe - exposed". But ARTE , DW and ZDF all have reported on it at this point

The controversy about diabetis patients getting amputations over simple treatments is a pretty well known symptom of this revamp, as operations get a very high payout

[carlosjobim]

> you're effectively paying 800€ at the very least.

That makes it worse! Not better.

[jonp888]

It's a collective payment system whereby everyone receives the same treatment, but high earners subsidize low earners, students and pensioners. Whether that is a good idea or not is of course a matter of debate, but it doesn't make sense to compare the benefits with the cost because they are not linked.

If you are a really high earner you can opt out and pay a private risk-based premium instead.

[carlosjobim]

The original commenter was complaining that he was paying €400 per month and not getting adequate service for what he is paying. Somebody else mentions that he's actually paying €800 per month (and not getting adequate service). That makes it even worse, and I'm surprised if somebody can not understand that.

[bombcar]

But as a higher earner he’s paying 800€ so that someone poorer can pay 100€ and not get adequate service. ;)

As an American I choose to ignore this and pretend that everywhere else has perfect healthcare and government.

[chmod775]

From that amount I can tell they're at or near the maximum amount you can pay (a software dev salary will usually get you there). It currently tops out at 421,76 Euro and doesn't increase any further from there.

Many people at that income bracket opt for private insurance, because it will be cheaper and provide you better care.

[blackmoon42]

Cheaper, when you are young and single. Get a family and pay for every member. Get older and see your rates increasing. Also the rates won't drop if you're a pensioner.

You need to know your future, as it's more or less a decision for life.

[Unfrozen0688]

low digitalization, high taxation

Sweden is highly digitalized, we pay on our phones, pay taxes on our phones, do government stuff on phone or webbrowser. No stores do cash anymore (also a negative)

High taxes is a positive if used right

[miroljub]

Sweden is a low tax land compared to Germany. In the past, it was known for high taxes, but one could argue that this progress came together with the tax reduction in the last decades.

[albert180]

That's utter bullshit. Your quality of care in the hospital is exactly the same as with public health insurance. Also sometimes private insurance is even worse when it comes to addiction and psychological treatments

[hocuspocus]

You're treated the same in big hospitals but when I was in Berlin, private vs public meant I could get an appointment at a dermatologist tomorrow instead of in two months.

[tietjens]

This is not true. Private insurance means better care in hospitals in Germany. Better access to appointments, choice of head/experienced doctors, even can mean better rooms.

[albert180]

You know, I'm a med student, so I have a bit more experience :) The Head/Experienced Doctor is still letting the Learning Doctor doing everything and pops in only for the visit. Also the "standard" Patients get also checked by a Oberarzt regularly. The difference is miniscule. The Rooms are sometimes nicer I agree, but the care you get is still 100% the same. The Hospital also doesn't get extra money for the treatment besides the Fee for the "Chefarzt" and the nicer room. Otherwise they'll only get the same DRG payout as for a "public patient"

[Trollmann]

No, it means you may potentially have all of those but there is no guarantee. Neither is there a guarantee that a publicly insured person wouldn't receive the same treatment. E.g. if there aren't any free "better/worse" rooms what are they supposed to do? Many of these are nowadays covered by employers as a benefit or for cheap (~5€) out of pocket if you want.

Private insurance matters most for specialists that don't (aren't allowed to) have (or want) a public insurance license.

[ArmandGrillet]

Just open Doctolib and tell me it's the same when looking for any kind of doctor. The difference in waiting time is 3 months, bare minimum.

[Ringz]

I just opened Doctolib and did a test with a dermatologist. The difference between private insurance was 23.5.2024 and public insurance 5.6.2024. That makes 13 days and not "3 months bare minimum".

https://0x0.st/HnBZ.png https://0x0.st/HnBN.png

[albert180]

Also if your primary doctor determines that you need an urgent appointment, they can give you a priority code, which gives you a quick appointment, since those visits are paid on top of the regular budget for the specialist

[mk89]

> private healthcare if you want decent treatments > public healthcare inaccessible

What do you mean? I am not sure what you mean by decent treatments.

> Schufa

There is some change happening there, especially now that the EU Justice Court ruled against credit scoring institutions (they break GDPR, etc.). Very slowly, as usual, but it might happen. (Also the current governement is planning changes.)