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microtonal 2 hours ago

For instance, if you are less than 50 and on private health care through your employer than you're very likely going to have better healthcare access than anywhere in Europe and Canada.

Your healthcare insurance being dependent on your employer seems like hell though. They will always have enormous bargaining power over you and I think it also leads to chilling effect, when your health is literally dependent on your job, you will think twice to go on strike, unionize, or freely express your thought, especially when combined with at-will employment.

Secondly, I would also debate the better health care. I recently had two health scares in my direct family (one time cancer, one time another tumor) and in both cases care was quick and excellent. Of course, there is quite a lot of variance between countries. We lived in Germany for a while and I was less impressed by health care there (though it's probably still much better and definitely cheaper than the average health care in the US).

Again, that kind of thing takes 8 months or a year minimum anywhere in Europe or Canada.

Sorry, this is totally false. I checked the local established norm (49 days) and stats (generally between 30 and 150 days, depending on the hospital, which you can choose). And this doesn't depend on private insurance, because it does not exist in the county I live.

I am able to see my PCP and dentist within a week if I want. I read a statistic that in Europe and Canada you have to make those kinds of routine appointments months in advance.

I am able to see my general practitioner generally the same or next day and waiting time at the GP is typically less than 10 minutes. I can also visit my dentist the same day in the case of an emergency.

It's the same in many other European countries. I got kidney stones when we were on vacation in Denmark (I don't recommend). I visited a doctor twice, both times I called and I could immediately come to their practice and they ran tests, etc. I don't think we even got a bill for either visits. I only paid something like 10 euros at the pharmacist for a good stock of painkillers.

m4rtink 2 hours ago | parent | next [-]

Isn't employer dependent healthcare basically slavery, blackmail or both ?

vladvasiliu 39 minutes ago | parent | next [-]

This often comes up in discussions pitting the US against the EU countries.

I'm not familiar with all of them, but here in "free, socialized healthcare" France, if you don't have a "mutuelle", which seems similar to "employer-dependant healthcare" in the US, you're going to have to pay out of pocket quite a lot of money. Maybe not as much as in the US (not familiar with that country), but very much not free. Think dental, glasses, needing to spend a night in a hospital for whatever reason (even public ones!), etc. On top of your salary being much lower.

Sure, you don't need an employer to have a mutuelle, you can pay for your own. But it's usually pricier and worse coverage.

tempfile an hour ago | parent | prev [-]

Only to the extent that all waged employment is basically slavery (since healthcare is even less critical than food, water and housing).

microtonal an hour ago | parent | next [-]

Also in the US. In many other countries, you do not only initially get unemployment benefits, but also a form of basic income if the unemployment benefits expire and you haven't found a job, plus rent compensation, etc.

petcat an hour ago | parent [-]

> In many other countries, you do not only initially get unemployment benefits, but also a form of basic income if the unemployment benefits expire and you haven't found a job, plus rent compensation, etc.

It's the same everywhere in the US. Colloquially called "collecting unemployment".

robtherobber an hour ago | parent | prev [-]

[flagged]

saghm an hour ago | parent | prev | next [-]

> Your healthcare insurance being dependent on your employer seems like hell though. They will always have enormous bargaining power over you and I think it also leads to chilling effect, when your health is literally dependent on your job, you will think twice to go on strike, unionize, or freely express your thought, especially when combined with at-will employment.

As an American who's had to deal with the ramifications of employer-based health insurance first-hand, I can confirm that this strikes me as accurate. I'm lucky enough to be in a position where even being out of work for most of last year did not hurt my financial situation very much (my wife and I were actually able to buy our house during my unemployment), but even being in that fairly privileged position, due to her autoimmune condition, we've had to go through quite a lot of annoying bullshit from a lack of healthcare options due to basically being stuck with whatever my employer happens to offer.

With my previous health insurance (from a startup where there were around 10 employees during my time there), we were able to get the semiannual procedure she's been getting for years from her specialist doctor approved relatively quickly, but with the insurance from my current job, it took months earlier this year to get it approved because they kept denying it due to her condition (which is pretty rare in general, and even more rare for anyone to have it as long as she has; one of the first doctors she saw for it years ago told us "you're not going to find a support group for this online", and we've literally yet to find anything online about anyone else ever having it for as long as she has) not being on the list of pre-approved conditions. This was typical across several insurance companies for the initial request, but with this insurance company, they put us through an extremely convoluted process for appealing. First, they told her doctor that he couldn't email or fax them his letter of medical necessity and had to send it through snail mail, which even a month later they claimed they had never received. They told me I could email it to them, which I did, only for them to later claim I didn't have authorization to do that on behalf of my wife (something that never came up in the call where they told me to email it to them despite us both being there on speaker phone), and she had to fill out and email them a form authorizing me. She did that, but then after a while they still just sent us a blanket rejection for it not being on the initial list (as if there were any chance of it magically appearing on the list between when they initially denied it and when they finally processed the appeal?), and they could not provide us with any evidence that an actual doctor looked at the letter where her doctor stated definitively that he would expect her to likely experience permanent and potentially fatal organ damage with the treatment due to none of the other options having mitigated her symptoms in the past. After filing a grievance, they insisted that if her doctor filled out the information in a separate form that they had never mentioned to either him or us before, they would take it into account, so he did that, and then after a while they still rejected it with identical language to before. Finally after three months, they gave us the ability to have her doctor talk directly to an actual doctor on their end, and then it got approved within the next week. No one was able to provide any sort of coherent explanation as to why they kept putting us through such bullshit procedures that had no effect instead of letting us just do that in the first place.

I don't pretend to have any first-hand experience with healthcare in other countries, but no sane system would end up with such disparate outcomes for the exact same condition for the exact same patient due to literally nothing but how much bullshit the insurance company feels like putting you though. There's literally no way for us to have stayed with the insurance company that managed to actually read the information her doctor sent them and approve it within a few days the first time because they're based in a different state that the company I was employed by happened to be based in, and my current employer has no other insurance companies as options for me to pick instead. Even without all of the potential awful things that you mention people might go through with a subpar employer, the situation actually still sucks even when you do like your employer because your insurance options are tied to them. I like my job, and other than the insurance company sucking, it works well for me, but I also can't reasonably expect them to pick up an entire new insurance option for the entire company because of the bullshit I went through, so as much as I'd love to literally never have to deal with this specific insurance company again, there's no way to do that without giving up the job as well. Realistically, that would end up causing a lot more stress and uncertainty that my wife and I don't want to go through (especially when there's no guarantee that whatever insurance we'd end up with from a new job would be any better). At least in another country, we'd have some level of consistency in trying to get her treatment approved.

999900000999 an hour ago | parent | prev | next [-]

> Your healthcare insurance being dependent on your employer seems like hell though

It absolutely is.

America is great if you make at least 150k a year and never get sick.

The moment you get sick with anything serious your employer might fire you. Labor protections in America are a bad joke. Your boss wants to fire you because your taking time off to look after a sick relative, I guess you can sue, but they’ll blame something and probably win.

Your boss lies to your face about pay and benefits, ohh well sucks to suck.

Very minor illnesses turn catastrophic. Several stories have emerged of otherwise healthy young people going without insulin and not doing so well…

https://www.snopes.com/fact-check/shane-patrick-boyle-died-a...

Even if you have insurance, ohh well…

> Parents sue over son's asthma death days after inhaler price soared without warning Cole Schmidtknecht, 22, had insurance but couldn’t afford to refill his asthma inhaler after the cost jumped from $70 to more than $500.

https://www.nbcnews.com/health/health-care/asthma-death-pres...

Half the country cheers this on. The idea of some ‘lazy’ person getting something they don’t deserve rationalizes this dystopian system.

Of course the American system ends up costing significantly more for worse outcomes.

Access to therapy is usually gate kept to those with expensive insurance plans. Medicare, if it covers it at all can easily have a 1 year wait list for therapy.

Not to mention that most people get no meaningful vacation time.

Want to quit because you’re burnt out. Even if you have savings you won’t have health insurance. You won’t be able to afford therapy without it.

Get back on the hamster wheel.

I do regret not making a better effort to leave earlier. It’s not going to get better

mlrtime 2 hours ago | parent | prev [-]

America has some of if not the best hospitals in the world. Now, that doesn't necessarily mean equal access, but those are facts not ideology.

We can argue if that is fair or not, but if you have a well paying job with good employee provided HC, America is [one of] the best places to be for medical care.

microtonal 2 hours ago | parent | next [-]

It is similar to universities, the US has some exceptional hospitals/universities and a lot of mediocre ones. Exceptional facilities are more accessible to certain groups than others. Many European countries strive for a high average, perhaps not as good as the US's best, but much better than the US average, and they are accessible to everyone [1].

My parents also lived in the US (and IIRC they were on private insurance), but no way would they want to trade European healthcare/education for the US counterpart.

At any rate, all the statistics show that the US pays ~twice as much for health care with worse outcomes for the general public.

if you have a well paying job with good employee provided HC

It's always so surprising that people from the US do not see the issue with this. Let's say, assuming that you are in tech, I hope you don't get laid off in the next round.

[1] I have to add a bunch of qualifiers here, because the EU or Europe is not a single country and some countries have private insurance, private clinics, etc.

stavros 2 hours ago | parent | prev [-]

So basically you're saying "if you can afford it, the US is one of the best places to get medical care". Well, if I can afford it, why wouldn't I just fly to the US to get that care then? I don't have to be living there.

saghm an hour ago | parent [-]

"If you can afford it" also conveniently glosses over the fact that a private insurance system means that the costs for paying out of pocket tend to be insanely high, since that an insurance company pays the hospital is basically entirely unrelated to the price that you'd get charged as an individual. Even if you're making a decent software engineering salary in the US, which would put you in a much cushier financial position than most of the country, you'd better hope that you don't ever have any major accidents or develop any uncommon medical conditions or you'll be eating into your savings at an alarmingly high rate.