I worked for outsourcers before as well doing support type jobs. Bad pay, ever increasing performance pressure, no benefits (no sick pay or health insurance), so if you got sick you were shit out of luck and healthcare was prohibitively expensive. Private insurance was available of course but these were all angle shooting companies in the affordable range that are barely better than having no insurance at all. The gap to the 3rd world is quickly closing in a lot of places these days unfortunately. (and not in a good way)
What does "socialised medicine" mean? Many European countries have mandatory health insurance premiums on top of normal taxation (for example: Netherlands, Switzerland).
The original poster says claims Ireland doesn't and whilst I'd assume they know more than I do, http://www.hse.ie/eng/services/Find_a_Service/eligibility.ht... makes it sound substantially free or heavily subsidised ("comprehensive, government funded public healthcare system").
The link I posted said that's for roughly 30% of people, to receive completely free care, so yes, it's fairly low. Skimming further than that page suggested the remainder was still heavily subsidized. Most European countries I've experienced do not have 100% free healthcare for all.
Germany doesn't, for example. You have private ensurance companies and you have to chose one. When things go bad, you bet the insurance company won't be on your side. It's all ok if you have a good job (IT or otherwise) that pays for the best, but for poorer people it sucks.
> Germany doesn't, for example. You have private ensurance companies and you have to chose one.
What? No. In Germany you have public health insurance and private health insurance.
Private is only an option if you make over ~55,000€ or are self employed. Of course there are many private insurance companies happy to sell you insurance. They're in it to make money. Just be prepared for the premiums to increase as you get older.
Public health insurance [0] is available from several different providers, all which basically offer the same thing: you get sick and go the doctor, you are treated without charge.
> When things go bad, you bet the insurance company won't be on your side.
I have never been seriously ill, but for all the minor things (flu, infection) I just went to the doctor and gave them my health card.
I do know people who have been seriously I'll, requiring hospitalisation, and I haven't heard many complaints from them. They're still alive, and not financially ruined or suing the Krakenkasse.
So how exactly will they not be "on your side" ?
The public health system in Germany, and other European countries from what my friends say, is not the most luxurious or expedient, but you get the care you need and without paying extravagant amounts as one would in America.
I know people in America on ACA who pay thousands per year and still have a deductable of thousands. Sure, I pay ~4,000€ to the Krakenkasse through the mandatory salary deductions each year, but I have no deductable for care.
As a young and healthy person it doesn't cost the German government that much each year to keep me alive, but this money goes toward keeping other people healthy and alive. I consider that a worthwhile goal (though I do strongly want them to ban tobacco advertising).
I don't mind Japan's system. You pay monthly to the government (about 10% of your income for a married couple with a child) then the government pays 70% of your medical bill out of that, no questions asked.
The short answer is no. The long answer is your bill is based on your salary from the previous year e.g. Jan 2017 bill will be based on Jan 2016 income, which is not nice if you don't have a job anymore. The good part is extensions are easy to get. Other than that it is free for poor people.
I don't want to dox myself, but you can probably guess which western European country doesn't. Healthcare isn't US level expensive there where you'll go bankrupt with any minor issue but still prohibitively expensive if you don't make much and break your arm for example, so it's somewhat essential.
A colleague of mine got diagnosed with a serious heart condition, was away for a month or so without sick pay, got fired as a result and went bankrupt from medical bills.
> I don't want to dox myself, but you can probably guess which western European country doesn't.
Maybe this is supposed to be an easy question, but as an American, I have no idea which western European country doesn't have socialized medicine, and Wikipedia is not helping me out.
From the description I assumed it was one of the more Eastern European countries like Romania. I've never looked at Ireland like that. I assumed they had the same setup as most of western EU countries.
[Born and raised Irish, left at the first opportunity ]
Ireland is a weird (and sometimes nightmarish) mix of European and American culture. For some reason we decided that some of the dumbest ideas of the US simply had to be implemented, at great cost to the average citizen.
In Canada, specifically BC if you fail to pay monthly medical premiums you have no health insurance either they sell your account to collections and you have to pay cash for any doctor visit. Since private health is not available you're screwed and have to either leave the province to get health insurance again or continue paying cash.
There's always loopholes in socialized medicine usually only affecting the poor.
I keep hearing that you will 'go bankrupt' with every minor health issue in the US. Do you actually live in the US? Have you used US healthcare?
I pay for my own health insurance (because I own my own company) and while not cheap, it's affordable. I think I pay around $250 US/month. I get regular checkups included (most prescriptions cost me $10 or less) and I had a colonoscopy last year and it cost me less that $50.
If I had major surgery, I would be out a couple of grand. While it does have problems, it's nowhere near as bad as many would like you to think.
Aside from the deductible, most insurance plans in the US cover only a percentage of costs. 80 or 90 percent is common. For a single, simple, surgery it's bearable. Something like cancer, with ct scans, chemo, radiation, surgery with a 1 week hospital stay, etc...can bankrupt you.
"Something like cancer, with ct scans, chemo, radiation, surgery with a 1 week hospital stay, etc...can bankrupt you."
Again, I will have to disagree. Do you have any actual experience with this or are you going to just give me more talking points....
My wife's sister went through stage 2 breast cancer over the past 2 years and she had her own insurance plan as well. After 4 major surgeries and 1 year of chemo, her total expenses are $10K.
You can negotiate with hospitals and they almost always have payment plans with 0 interest for a few years. She negotiate it down to $5K, which is pretty reasonable, considering the amount of time she spent in the hospital.
My Aunt lives in Canada and she had thyroid cancer a couple of years ago. Because it wasn't considered 'life threatening', she had to go before a health board to determine when she should actually receive surgery.
They determined that she could have surgery in 2 years. This was unacceptable, so she went over the border to the US and got it done in a month.
I would much rather have the option of actually getting the surgery done in a timely fashion than having to go before a board (IE: the 'death panels' that everyone talks about) to determine my fate.
The US healthcare system does need work, but many people use hyperbole and have never experienced it first-hand.
There is no single US healthcare system that someone can experience first-hand. There is a lot of variation from state to state. I take you haven't experienced the system as someone, say, making less than $25k/yr, in every single state, at various times of year (say 2 months before your deductible rolls over) with various kinds of conditions (acute, chronic, extremely rare, etc?), at various points in their careers (if they can even claim to use that word)? And you've experienced this in a range of personal contexts? with various mental issues, or with dependents, or with poor mathematical skills coming out of a bad-fit-for-them public schooling system, or no slack to even be able to take any time off, no PTO?
There are millions of Americans who can't afford $250/mo on top of food, rent, and transportation costs, working more than full-time hours spread across several jobs, all of which pay minimum wage in poor conditions that are bad for their bodies and with unpredictable scheduling.
In light of the reality of many, many people's experiences in the healthcare system that are contrary to your own, which are NOT hard to find, your comments comes across quite poorly.
"There is no single US healthcare system that someone can experience first-hand. "
Sure there is. There aren't that many private insurance companies in the US and they all work similarly.
"I take you haven't experienced the system as someone, say, making less than $25k/yr, in every single state, at various times of year (say 2 months before your deductible rolls over) with various kinds of conditions (acute, chronic, extremely rare, etc?), at various points in their careers (if they can even claim to use that word)? And you've experienced this in a range of personal contexts?"
I feel like this is the 'no true scotsman' logical fallacy creeping into the conversation. You could say the same thing about every single healthcare system (or any large system) in the world: it's not the same for everyone.
..and by the way, my wife's sister makes $35K/year. Money has little to do with it.
"There are millions of Americans who can't afford $250/mo on top of food, rent, and transportation costs, working more than full-time hours spread across several jobs, all of which pay minimum wage in poor conditions that are bad for their bodies and with unpredictable scheduling."
You say that, but many people I know won't pay for healthcare, but pay more in booze, weed, and expensive electronics and services.
When I was single, I got bare-bones care for $75/month. This is as cheap as a cellphone plan. My premiums were high, but I wouldn't go bankrupt if I had major surgery. Many people can easily afford healthcare in this country. They choose to spend their money elsewhere.
I've traveled the world and the US has the richest poor people I've ever seen. Try living on less than $2/day with starving children.
Hospitals can't refuse anyone by law. We also have lots of systems, paid for by the taxpayers, to help people on low incomes get the care they need.
"In light of the reality of many, many people's experiences in the healthcare system that are contrary to your own, which are NOT hard to find, your comments comes across quite poorly."
Your comments come off as rather naive. No system is perfect and I can point to many instances of people getting terrible care in every other healthcare system as well.
You want to paint a hyperbolic picture that the US healthcare system will make you go bankrupt and you need to be rich to get care.
My point is that this just isn't true. It needs work, but it's not nearly as bad as you make it out to be.
Note that I never said the healthcare system will make you go bankrupt and you need to be rich to get care. That's a strawman you've been fighting from the beginning.
> "Money has little to do with it."
Again, you are severely out of touch with the existence of many Americans if you think money has nothing to do with it. I guess the poor ones aren't actually poor if they would just stop spending money on vices? You would do well for yourself if you stop looking at anecdotes of people you know, and start looking at the generalized case of the hundreds of millions Americans across socioeconomic classes.
The disappointing truth is that there are indeed many hard-working Americans (many of them immigrants...) who bust ass all year long, and they don't have money to pay for even a high deductible plan. They can barely make rent. And if they did, those plans still result in many tens of thousands of $s in the event of a severe hospital stay. These are the people where a single chain of events can push them into severe poverty with no easy way out.
If you read HN then you'll know this stuff is happening, and a lot of people are talking about just how hard it is to climb these days for the bottom %s of America. Just a few months ago, we're now at the point where potential to climb, social mobility is lower than our grandfather's generation?
I would like to invite you to read some of the work done by David Belk MD and see if that changes your seemingly cavalier attitude that it's "not that bad". Here's a former comment of mine with some links. The system is very inefficient, with a lot of corruption, and people like you are genuinely hurting people by fighting as if it's otherwise.
90 percent up to out of pocket max. My out of pocket max has always been between 1k and 5k per year. So if I need 1 million dollar cancer treatment, I don't pay 100k. I pay 5k.
So no I cannot go bankrupt with health insurance in the US.
The ACA did fix some of that, but there are situations that can still be challenging. The max out of pocket can be higher than yours..close to $8k/person, and it's annual, so if you get sick late in the year, the clock starts over. It's also not uncommon to have to go out of network for certain types of treatment, which opens up more doors.
Also, many people aren't able to work when they are sick.
You called $250/month affordable, which is almost an entire week's salary full-time on the federal minimum wage. 20% of your wage for a poor person is not 'affordable'. There are 45M people poor enough to be on food stamps in the US - the average monthly net income of these people is $335[0].
Median household income is 52k. At 52k, you get massive ACA subsidies. At say 75k or 100k, yes you can afford the $250 (or more realistically $1000 or $1500) it costs to get a family health insurance.
I worked for outsourcers before as well doing support type jobs. Bad pay, ever increasing performance pressure, no benefits (no sick pay or health insurance), so if you got sick you were shit out of luck and healthcare was prohibitively expensive. Private insurance was available of course but these were all angle shooting companies in the affordable range that are barely better than having no insurance at all. The gap to the 3rd world is quickly closing in a lot of places these days unfortunately. (and not in a good way)
This was in western Europe.