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In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is su

In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is subpar (waiting lists huge, best specialists often work at private clinics, etc.) so you end up going private but you still end up paying a huge chunk of your income in tax. Eg. impressions of Germany is that it's a nice place and all but they insist on paperwork/formalisms too much (for example apartment rental process is ridiculous) and it doesn't seem to be very upwardly mobile (you get taxed a lot so it's hard to accumulate capital when starting from mid level income for eg.).

deleted 7y ago
[deleted]
onion2k 7y ago
In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is subpar (waiting lists huge, best specialists often work at private clinics, etc.) so you end up going private but you still end up paying a huge chunk of your income in tax. That's not true here in the UK. People do use private healthcare but they're in the minority and it's usually for expediency rather than quality. Many very rich people still get treatment on the NHS. It's very, very good.
- qwsxyh 7y ago
  In fact most private healthcare delegates back to the NHS anyway.
Ididntdothis 7y ago
" it doesn't seem to be very upwardly mobile (you get taxed a lot so it's hard to accumulate capital when starting from mid level income for eg.)." I don't think that's true. You can get free/cheap schooling and health care is always there for you. I would agree it's easier to move upward than in the US where it seems one of the big secrets for success is to have wealthy parents. Coming from Germany and now living in the US I am also not sure if the taxation in the US is that much lower when you add all taxes together. And if you or your partner has any serious health issue it's very likely that this will cost way more than any taxes you pay less.
wickerman 7y ago
I agree, but this isn't the issue here. The issue is that poor people can't even access basic healthcare (can't even call an ambulance) without falling into massive debt. Free healthcare > no healthcare at all.
- mrlala 7y ago
  This exactly. And hell in the US it's not even "poor people". My family makes over $100k but are self employed, so any little medical thing turns into a huge fucking bill every time. At least I can (mostly) afford it when that comes up.. But yeah how is 80% of the country supposed to function when they can't even feel comfortable medically?
ticmasta 7y ago
This reflects my experience in Canada. It's really hard to figure out how much of your taxes goes specifically towards health care, but we put a significant amount of effort into a calculation a few years ago and came up with a number in the same ballpark as the premiums for a very good private plan in the US. The problem is then trying to compare the composition; there are lots of aspects of the Canadian public plan that are superior to the USA, notably access to frontline services and certain widely used drugs (in the news: cheap insulin w/o a prescription). There are also many components that are vastly inferior, like timely access to diagnostics or procedures that seem "quality of life" related but really are not (ex: delayed hip replacements lead to major health issues). So it's not just free vs. pay, but also what exactly you're buying. Unfortunately the single public payer in Canada system is a sacred cow, much like the idea of "socialized medicine" in the US is a non-starter. Everyone just digs their heels in and holds to the extremes, so the idea of small experiments of change never gets much traction...
- AlexandrB 7y ago
  > It's really hard to figure out how much of your taxes goes specifically towards health care, but we put a significant amount of effort into a calculation a few years ago and came up with a number in the same ballpark as the premiums for a very good private plan in the US. The magic is that everyone gets this healthcare. Not only those able to afford the premiums for a very good private plan. On the one hand this is straight socialism. On the other it prevents bankruptcy (and downward economic mobility) due to serious health issues and allows access to quality healthcare to students, entrepreneurs, those between jobs, etc. I don't understand how someone in the US can consider themselves more "free" than in more socialist countries when they're deeply beholden to their employers for basics like medical care.
  - toasterlovin 7y ago
    Medicaid provides free health care to 74 million low income Americans: https://en.wikipedia.org/wiki/Medicaid https://en.wikipedia.org/wiki/Medicaid.
    - 7y ago
mtrovo 7y ago
Really? Can you give some ballpark estimatives? I’m really interested on how much of your salary can you save after paying not just taxes but kindergarten, health insurance, unemployment insurance, pension plan, 25-ish paid vacation days etc. Living in Germany I manage to get around 45% of take home money after fixed costs and taxes, from this I manage to save around 35% and could probably push a little bit more if I wanted to have a more miserable life and didn’t travel that much on vacations.
Paul-ish 7y ago
> In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is subpar (waiting lists huge, best specialists often work at private clinics, etc.) so you end up going private but you still end up paying a huge chunk of your income in tax. My impression is that this varies a lot by country. For example that might be true in Australia and Canada, but not France or Germany. There are many different ways to implement universal healthcare.
magnamerc 7y ago
My experience is completely different. I'm in Canada and the ER wait lists are usually a couple of hours. I'm also seeing a specialist in Toronto for procedures requiring image guided sclerotherapy. I bet I'd be fighting tooth and nail with insurance companies to cover that sort of procedure, which would likely run in the 100s of thousands of dollars, yet here I am getting it for "free" no questions asked. I've never once even thought about money or insurance at all when receiving healthcare and I couldn't imagine thinking about costs when I'm already worried about my health. Americans are delusional if they think their system is better.
- refurb 7y ago
  What makes you think Canadians don't need to battle for coverage? "Then I found out that this other country — which I thought had a healthcare system that was so superior to the U.S. — doesn't test for the tumour marker that saved my life, and doesn't cover this drug that is responsible for pushing my cancer into remission after traditional chemotherapy failed to do that."[1] [1]https://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-friends-with-breast-cancer-1-has-coverage-for-costly-drug-the-other-forced-to-pay-1.4495123 https://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-...
  - magnamerc 7y ago
    It's not a perfect system, and of course cutting edge drugs take longer to get approved for coverage under pharmacare. This is an election issue, and it's very possible that we get national pharmacare coverage over the next few years, and cases like these are the driving force. The difference is that we as a country are willing to pay more taxes so that every single person gets drug coverage, and it's reasonable to expect that this will happen in the near future, even for expensive cutting edge drugs.
orwin 7y ago
>In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is subpar (waiting lists huge, best specialists often work at private clinics, etc.) so you end up going private but you still end up paying a huge chunk of your income in tax. This is true, but this is not that bad. The basic social security indeed stop being a thing once you earn enough. But if you earn that much, your work will provide you with an insurance that start at 50€/month to 250€/month that will cover A LOT of what you would have to pay in a private care clinic. You will still have to pay for the surgeon (especially if he is well known), but not the full cost.

deleted 7y ago

[deleted]

onion2k 7y ago

In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is subpar (waiting lists huge, best specialists often work at private clinics, etc.) so you end up going private but you still end up paying a huge chunk of your income in tax. That's not true here in the UK. People do use private healthcare but they're in the minority and it's usually for expediency rather than quality. Many very rich people still get treatment on the NHS. It's very, very good.

qwsxyh 7y ago
In fact most private healthcare delegates back to the NHS anyway.

Ididntdothis 7y ago

" it doesn't seem to be very upwardly mobile (you get taxed a lot so it's hard to accumulate capital when starting from mid level income for eg.)." I don't think that's true. You can get free/cheap schooling and health care is always there for you. I would agree it's easier to move upward than in the US where it seems one of the big secrets for success is to have wealthy parents. Coming from Germany and now living in the US I am also not sure if the taxation in the US is that much lower when you add all taxes together. And if you or your partner has any serious health issue it's very likely that this will cost way more than any taxes you pay less.

wickerman 7y ago

I agree, but this isn't the issue here. The issue is that poor people can't even access basic healthcare (can't even call an ambulance) without falling into massive debt. Free healthcare > no healthcare at all.

mrlala 7y ago
This exactly. And hell in the US it's not even "poor people". My family makes over $100k but are self employed, so any little medical thing turns into a huge fucking bill every time. At least I can (mostly) afford it when that comes up.. But yeah how is 80% of the country supposed to function when they can't even feel comfortable medically?

ticmasta 7y ago

This reflects my experience in Canada. It's really hard to figure out how much of your taxes goes specifically towards health care, but we put a significant amount of effort into a calculation a few years ago and came up with a number in the same ballpark as the premiums for a very good private plan in the US. The problem is then trying to compare the composition; there are lots of aspects of the Canadian public plan that are superior to the USA, notably access to frontline services and certain widely used drugs (in the news: cheap insulin w/o a prescription). There are also many components that are vastly inferior, like timely access to diagnostics or procedures that seem "quality of life" related but really are not (ex: delayed hip replacements lead to major health issues). So it's not just free vs. pay, but also what exactly you're buying. Unfortunately the single public payer in Canada system is a sacred cow, much like the idea of "socialized medicine" in the US is a non-starter. Everyone just digs their heels in and holds to the extremes, so the idea of small experiments of change never gets much traction...

AlexandrB 7y ago
> It's really hard to figure out how much of your taxes goes specifically towards health care, but we put a significant amount of effort into a calculation a few years ago and came up with a number in the same ballpark as the premiums for a very good private plan in the US. The magic is that everyone gets this healthcare. Not only those able to afford the premiums for a very good private plan. On the one hand this is straight socialism. On the other it prevents bankruptcy (and downward economic mobility) due to serious health issues and allows access to quality healthcare to students, entrepreneurs, those between jobs, etc. I don't understand how someone in the US can consider themselves more "free" than in more socialist countries when they're deeply beholden to their employers for basics like medical care.
- toasterlovin 7y ago
  Medicaid provides free health care to 74 million low income Americans: https://en.wikipedia.org/wiki/Medicaid https://en.wikipedia.org/wiki/Medicaid.
  - 7y ago

mtrovo 7y ago

Really? Can you give some ballpark estimatives? I’m really interested on how much of your salary can you save after paying not just taxes but kindergarten, health insurance, unemployment insurance, pension plan, 25-ish paid vacation days etc. Living in Germany I manage to get around 45% of take home money after fixed costs and taxes, from this I manage to save around 35% and could probably push a little bit more if I wanted to have a more miserable life and didn’t travel that much on vacations.

Paul-ish 7y ago

> In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is subpar (waiting lists huge, best specialists often work at private clinics, etc.) so you end up going private but you still end up paying a huge chunk of your income in tax. My impression is that this varies a lot by country. For example that might be true in Australia and Canada, but not France or Germany. There are many different ways to implement universal healthcare.

magnamerc 7y ago

My experience is completely different. I'm in Canada and the ER wait lists are usually a couple of hours. I'm also seeing a specialist in Toronto for procedures requiring image guided sclerotherapy. I bet I'd be fighting tooth and nail with insurance companies to cover that sort of procedure, which would likely run in the 100s of thousands of dollars, yet here I am getting it for "free" no questions asked. I've never once even thought about money or insurance at all when receiving healthcare and I couldn't imagine thinking about costs when I'm already worried about my health. Americans are delusional if they think their system is better.

refurb 7y ago
What makes you think Canadians don't need to battle for coverage? "Then I found out that this other country — which I thought had a healthcare system that was so superior to the U.S. — doesn't test for the tumour marker that saved my life, and doesn't cover this drug that is responsible for pushing my cancer into remission after traditional chemotherapy failed to do that."[1] [1]https://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-friends-with-breast-cancer-1-has-coverage-for-costly-drug-the-other-forced-to-pay-1.4495123 https://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-...
- magnamerc 7y ago
  It's not a perfect system, and of course cutting edge drugs take longer to get approved for coverage under pharmacare. This is an election issue, and it's very possible that we get national pharmacare coverage over the next few years, and cases like these are the driving force. The difference is that we as a country are willing to pay more taxes so that every single person gets drug coverage, and it's reasonable to expect that this will happen in the near future, even for expensive cutting edge drugs.

orwin 7y ago

>In my experience "free" healthcare stops being a thing once you get above certain income level as the service provided by the public healthcare facilities is subpar (waiting lists huge, best specialists often work at private clinics, etc.) so you end up going private but you still end up paying a huge chunk of your income in tax. This is true, but this is not that bad. The basic social security indeed stop being a thing once you earn enough. But if you earn that much, your work will provide you with an insurance that start at 50€/month to 250€/month that will cover A LOT of what you would have to pay in a private care clinic. You will still have to pay for the surgeon (especially if he is well known), but not the full cost.