[jasonlotito]

> Yep, for-profit healthcare is a bad idea. It's the main reason our USA healthcare costs so much.

And yet it still exists in the rest of the world. But people tend to think of it only as for rich people as opposed to covering things the rest of the world ignore. I'm not saying the US is perfect, but having lived under both kinds of healthcare, cost and quality are two reasons I'm in the US.

[dgellow]

Because you wanted to pay more? Or are you saying it is cheaper in the US? If the latter, could you be more specific?

I pay the maximum possible in Germany for my health insurance and from what I understand I still pay less for healthcare than I would in the US.

[jasonlotito]

> Because you wanted to pay more?

No. Canada was 4 figures a month with a wait time of at least a year for one service.

> Or are you saying it is cheaper in the US?

It was 100% free in the US. With no wait time. For all the services needed.

> If the latter, could you be more specific?

Autism care for children.

I want to be very clear: We received more care and assistance in the two weeks prior to moving to the US than the entire time we were seeking help for our children in Canada (they are Canadian, as is my wife). Canada was at best abusive to my children.

My wife was told by a member of the medical establishment to put one of our autistic children in a home and to forget about him.

[anon291]

Are you paying for the same thing? I can see a doctor or specialist usually within a week. Less if it's urgent. I think wait times in these countries are never mentioned. Paying for a service tomorrow vs paying for one a few months from now are entirely different classes of goods.

[dlev_pika]

> I can see a doctor or specialist usually within a week

That might be true to your specific location and set up, but I have some experience and family in healthcare, both in the US and outside of it, and it is definitely not like that for much of the US.

[anon291]

That's true of any medical system? Still we can look at the data on Canadian v American health care wait times and the data tell the story.

[dlev_pika]

Possible in some cases, triaging and wait times are a thing in other places too, with the difference being that you don’t get a bill at the end. I have multiple anecdotes from people outside the US having little trouble getting primary care, or even psych care, much faster than what I’ve seen here.

When looking at comparative data, I think it’s worth breaking it down a bit by socio status, for example. In complex systems with a wide spread averages can be misleading. My impression is that we are not seeing the whole story.

[dgellow]

Depends on the urgency and the specialist, but generally yes, I can get an appointment in a week. Mental health is the only specialty where I’ve seen multiple months wait times. For a specialist you generally first go through a generalist who gives you a voucher for your insurance. But you can also go directly and pay yourself if you want to skip that step.

Even if you have slightly more wait time, the cost is still way lower. Unless you have a US employer that pays the whole insurance for you (I don’t know if that’s possible)

[anon291]

I'm not familiar with the german system... is it private or public insurance?

As for US employers paying for everything... yes it's common. It used to be that they'd just cover everything via a 'PPO' plan with minimal 'co-pays'. Usually you'd pay $5-15 for a GP, ~$50 for urgent care, and ~$100 for an ER visit.

These days, many have switched to a 'High Deductible' plan, where the insurance comes with a 'max out-of-pocket'. After you've paid that amount, then everything is fully covered, but nothing is covered until you hit the deductible.

My current company has this plan, but puts the entire 'max out of pocket' value in what's called an 'HSA' (healthcare savings account). This money grows tax free and will eventually turn into a retirement account. So, if you have no health issues, then this becomes a free income stream. If you do have health issues, then you just spend this money every year and then insurance takes over and pays for the rest. This is common in the tech world these days... not sure about other industries TBH.

[dgellow]

Germany has mandatory health insurances, with both a private and public system. By default you’re in the public system and can opt into private insurances if you have a high income (the threshold increases every year, moving more people to the public system over time).

When you have to pay a co-pay it is 5€ per prescription. You don’t pay for generalists, and do not pay for specialists if you get a recommendation from a generalist first.

There is no deductible.

Not everything is covered though, dental care often has limited coverage (only for the most basic services), so you end up paying yourself.

I never heard of a healthcare saving account, that’s an interesting and strange concept

[dqv]

> As for US employers paying for everything... yes it's common.

Hmm, I think it's better to use a percentage than a fuzzy word like "common":

https://www.kff.org/health-costs/health-policy-101-employer-...

Figure 8

12% of covered single workers and 3% for families have the employer cover their premiums in full

[gopher_space]

> I can see a doctor or specialist usually within a week.

What kind of Northern Exposure bullshit is this?

[FireBeyond]

I've lived for many years each in the UK, Australia and the US. I've worked as a healthcare provider for many years in the US.

I would dearly love to know what "costs" of healthcare you are looking at when you say the US is preferable enough to actually move to/be in/stay in the US.

Because when I can have higher end insurance from my employer, and still be out $9K for a kidney stone after insurance, I'm not seeing it. That is an outlier, for me, I'll acknowledge, but it's still nearly five digits that had to come out of my pocket after my employer paid thousands, I paid premiums, for insurance (that is insurance-in-name-only).

[jasonlotito]

> I would dearly love to know what "costs" of healthcare you are looking at when you say the US is preferable enough to actually move to/be in/stay in the US.

Autism care for children. I'm looking at $15-30k a year for a service such as speech therapy. Minimum of 6-month wait time.

US? Free. Wait time? Immediate (not hyperbole).

We routinely keep track of this. It has not improved at all.

[FireBeyond]

As someone with friends who have children with autism and complex support needs, knowing their challenges, I would say that's a great thing - but definitely varies from region to region. Finding a speech therapist for one's largely non-verbal 14 year old son has been challenging - although I'm going to a party today to celebrate his older sister's graduation from university, now a speech therapist.

[jasonlotito]

"Region to region"

Blue states > Red states 100% of the time. Though, even within those states, you have to move. But, that's not unexpected. In Canada, it didn't matter where you moved. We looked. And then I didn't even get into how horrible Quebec is specifically with regard to taking care of its children.