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I think Sweden is very romanticized in American media and amongst the elites. Having lived there for 6 years before moving to US, I think it's an ok country but

I think Sweden is very romanticized in American media and amongst the elites. Having lived there for 6 years before moving to US, I think it's an ok country but nowhere near the paradise that is promised by the American media. They say the best thing in Sweden is its health care. In the entire time I was there I attempted to see a specialist for a condition that I had maybe two or three times, I ended up giving up every single time after I was told the wait time is between 3-4 months. I keep my American employer sponsored private insurance and employer determined time off policy, thank you very much.

urvader 7y ago
There are private health insurances here too. If the public system would be so bad as you describe it everyone would use the private ones but very few do.
- marcinzm 7y ago
  Private Health insurance without group plans does not really work well so the fact people don't choose it doesn't mean much to me. Essentially, since sick people are more likely to choose such plans the costs are going to be very high. Either that or the restrictions on the plans need to be high to prevent it. Both make such plans unattractive independent of how bad or good the public plans are.
- brobdingnagians 7y ago
  From my experience in the UK, people typically don't get private insurance because they _believe_ in the public system, not because they have a generally positive experience with the public system. They don't really realize that the service could or should be much different, so they just put up with it because they believe in the system being the way it is. They believe in chipping in, paying their fair share, and everyone being in the pot. It's a mind set, not an optimal set of circumstances. I admire the mindset in many ways, but it doesn't make for quick or efficient service. It all kind of depends on what you optimize for, and what you are willing to put up with based on your worldview of what is most important.
  - ghaff 7y ago
    It's not super-common, but some employers do offer private health insurance. The numbers I saw suggested about 10% were covered by such insurance which isn't a huge number but isn't nothing either.
    - ZeroGravitas 7y ago
      I would guess less than half of those people ever use the coverage, and those that do still use the public option for more than half their medical needs. It's often bundled with employment packages with the idea that it provides some kind of insurance when a key member of staff need treatment and can be prioritised to jump some queues, but in everyday situations like when their kid falls off a bike and spits out some teeth, they're going to use the same service as everyone else, because it's simply quicker and more effective to do so. Private insurance is very much a supplement, not a totally parallel system in the UK: https://www.moneyadviceservice.org.uk/en/articles/do-you-need-private-medical-insurance https://www.moneyadviceservice.org.uk/en/articles/do-you-nee...
  - ZeroGravitas 7y ago
    It might change depending on exactly how you define efficiency but the UK system scores highest in some global comparisons in terms of bang for buck. From the way you phrase it I assume you actually mean inefficient service, like you'd get at a high end restaurant or hotel, where they have lots of people hanging around doing nothing a lot of the time so no one ever feels they're being treated less than a VIP in busy periods.
- serf 7y ago
  >If the public system would be so bad as you describe it everyone would use the private ones but very few do. that's simply dishonest. there are tons of other variables to consider when pondering private insurance adoption rates.
- csomar 7y ago
  > If the public system would be so bad as you describe it everyone would use the private ones but very few do. Maybe they can't afford private insurance?
- strictfp 7y ago
  Wait what? I live here too, and many employers do pay for private insurance because it saves heaps of time for the employees. Why do you think the private options sprung up in the first place? The public system has serious flaws. I was told by the public system to take antibiotics for 6 months straight while waiting for a tonsil removal operation. Got my operation a few days later through my private insurance.
- ernst_klim 7y ago
  > If the public system would be so bad as you describe it everyone would use the private ones but very few do. Ah, that's simply wrong, because you pay for public healthcare anyways (through taxes), hence private one is to be paid twice. I doubt the system is `that bad`, but even in Russia, where private healthcare is super cheap (and very good) and public healthcare is a total disaster, a few people use the private one (until they are wealthy) due to exact same reason: they've already paid for the public one and feel like paying twice is not an option.
hugi 7y ago
Yeah, my cousin is a doctor in Sweden and according to him Sweden has the most failed/Americanised system of the Nordics.
tpmx 7y ago
Swede here: Yeah, Sweden tends to be romanticized by the american "progressives". As a swedish "rightist", you end up being in an annoying position. There's a lot of stupid stuff that happens here, for sure. That said, it seems like the really expensive/complicated healthcare needs gets taken care of in a competent way, "for free" (paid for via the taxes). My then 73 yo mom had a tumor that was growing behind her left eye-ball being removed, two years ago. Zero complaints about that hole produdure, and the 10+ post-prodedure checks. I spent a few hours googling the doctor that was going to perform this particular surgery on my mom - I was left with the impression that he was on the international fore-front on this particular procudure. He was doing a bunch of international speaking on the the topic. I saw videos of him lecturing hundreds of surgeons on particulars of this kind of procudure. Quite re-insuring. (And yeah, my mom ended up being okay after the surgery.)
- dontdoitpls 7y ago
  The worst insurance you can get + max out of pocket is 12,000usd per year. 10 or 20 procedures, still 12k. For the 10%ers/6 figure earners, this is 10% of the before tax income. For the 90% making 15-19$/hr, I can't even imagine managing this.
  - PopeDotNinja 7y ago
    And that's assuming you can keep working. Getting fired or laid off because you can't work means you're no longer getting paid AND you now have to pay for the healthcare you can no longer afford. It's stupid.
ChuckNorris89 7y ago
Same in Austria. The healthcare system is free and very good if you have something life threatening but if not, you're looking at 2 month waiting time to see a specialist and there's no way I can be living and working with a health discomfort for that long so I pay up and see a private doctor. The current situation benefits the lower class with voting rights who have access to good healthcare without paying much taxes and the upper class can afford private anyway but if you're hard working middle class you're kinda screwed since you have to go private and pay if you want quality treatment and diagnosis in a timely manner but you're also forced to pay and subsidize the public system, which you don't use anyway, with your very high taxes. I feel Europe is slowly migrating to a two tier healthcare system, a private and quality but expensive one for the ones who can afford it and a public underfunded one for everyone else.
- the_mitsuhiko 7y ago
  > The healthcare system is free and very good if you have something life threatening but if not, you're looking at 2 month waiting time to see a specialist and there's no way I can be living and working with a health discomfort for that long so I pay up and see a private doctor. The private doctor is still cheaper than copays/deductibles in the US. So that seems like a weird argument to make.
  - ChuckNorris89 7y ago
    >The private doctor is still cheaper than copays/deductibles in the US. Skilled workers in the US also earn way more than their European counterparts.
    - hannasanarion 7y ago
      And unskilled workers earn less. So what?
      - wormseed 7y ago
        Not necessarily. One datapoint: Amazon pays fulfilment workers $15/hour in the US, but €11/hour (~$12) in Germany
strictfp 7y ago
The system is gating the specialists way too much. But the actual care once you are there is usually very good. Private insurance often just gets you past those gates.
csomar 7y ago
> In the entire time I was there I attempted to see a specialist for a condition that I had maybe two or three times, I ended up giving up every single time after I was told the wait time is between 3-4 months. It's the same thing they say about France (having a great healthcare system). But doctors [1] are going on strikes because of lack of amenities. Makes you wonder... A private system where you chose your provider will always be better, imo, because the providers will have to compete. I think the US could do much better if they improve the pricing visibility and get the free market to make the prices go down. (I'm not very well versed in this topic, I'm just reading the news) 1 - https://www.cnews.fr/france/2019-12-14/pourquoi-les-medecins-generalistes-sont-ils-en-greve-ce-samedi-908057 https://www.cnews.fr/france/2019-12-14/pourquoi-les-medecins...
- Something1234 7y ago
  I'm confused as to why you're being downvoted. But I completely agree with you on the free market. My personal issue with going to the doctor is I have no idea what my bill will be at the end of the day.
  - dmurray 7y ago
    Perhaps he's being downvoted (not by me!) because the claim is self-contradictory. Either a market based system "always will be better", or it could be "better if they improve the pricing visibility", which is it? Unless he's saying the US system is already superior to all others, but could be made better still. That seems like an ambitious claim.
    - csomar 7y ago
      A non-transparent system is not one I'll define as a free market based system.
      - dmurray 7y ago
        That's a "no true Scotsman" problem, though. If the US doesn't (or didn't pre-ACA) have a market-based healthcare system, then who does? And if no one does, how do we know it's better?
nelblu 7y ago
It took my spouse 3 months to get an appointment with a specialist in the US. She definitely didn't shop around but it was a miserable wait time considering we lived close to some of the best healthcare facilities in the world and had one of the best health insurance one could buy.
- EpicEng 7y ago
  >She definitely didn't shop around Why not? So she wanted to go to a specific doctor, and that doctor had a waiting list. How does any other system solve for that? A single doctor can only see so many patients.
- deleted 7y ago
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- philliphaydon 7y ago
  I’m really glad that I live in Asia. Here in Singapore I can ring up a specialist and go in the same day... I don’t understand why in Asia I have cheaper and better health care than if I lived in Europe or America. Some of the things I’ve heard just about Hospitals scares me to not get sick when I’m in europe... When my wife was in hospital for the birth of our daughter I slept over night in the room with my wife. While in France my wife’s friend wasn’t allowed to have her husband stay. The whole experience we had vs them was polar opposite.
  - bluerobotcat 7y ago
    Have you noticed that in Singapore all the nurses are Filipino though? I don't think they earn much and I reckon that has to help with getting costs down... I also disagree that healthcare is uniformly cheap here. GP visits are not particularly cheap. You get to spend very little time with the GP and typically are sold a bunch of drugs you don't need (in Europe there's separation of clinics and pharmacies, which introduces some checks & balances). To give another example, in Europe I used to go for a glaucoma test every year (due to family history) and pay about 20-30 euros. However, in Singapore, doctors look at you funny when you request to be tested for this as preventative health care is not really thing here. I did get tested twice for Glaucoma in Singapore (at the National Eye Center) and ended up with a bill of 250 SGD (~ 175 EUR) each time. The second time around, the doctor afterwards admitted that the bulk of the tests I had been given hadn't really been warranted. (Oh, and I couldn't exactly go in the same day by the way. There was a waiting list, though I don't recall how many days/weeks I had to book in advance.) Finally, getting cancer has been known to bankrupt people in Singapore.
mrkeen 7y ago
Regarding healthcare, my employer gives me private insurance but I tend to use both systems. Generally I get same-day care. I call up DKV, report my symptoms, they find a specialist in my area, and I pay nothing. (I mention the symptoms bit to contrast with the system where you have to see a general practitioner who then refers you to a specialist - that does not happen here AFAIK). I've used this for allergies, asthma, ear problems. I also had a knee injury where I got an x-ray (same day I think?) followed by weekly sessions of physio. My partner recently gave birth in the public system. I think the delivery was free, but the 4-night stay cost us around 4000 SEK (400 USD) total. I also had a remote doctor's appointment using the KRY app. I don't actually know how that was billed - public I'd guess.
- plufz 7y ago
  Paying 4000kr for staying four nights sounds really weird since Swedish law say that the fee for staying at the hospital can’t be above 100kr/day. I also recently stayed about four nights after my partner gave birth and we payed a couple 100SEK.
  - mrkeen 7y ago
    You got me curious so I checked my records. Looks like I remembered incorrectly and paid 2300 SEK. From https://bbstockholm.se/content/practical-information https://bbstockholm.se/content/practical-information: > Each new 24 hour period cost 100 SEK from the time you arrive at the clinic. Your partner/labour support person is charged 600 SEK/24 hours from the time the baby is born. Food, towels, sheets, sanitary products and diapers are all included free of charge during your stay.
    - plufz 7y ago
      Makes more sense. I guess you are free to charge the partner whatever you like. I live in a more left leaning part of sweden so here the partner is also charged 100 sek.
ssss11 7y ago
Isnt US employer determined holidays 2 weeks per year? No thanks. Time off work is important.
- marcinzm 7y ago
  Like most everything in the US, vacation time varies by employer. Last year I took 6 weeks not counting holidays and wfh 2-3 days a week.
- sokoloff 7y ago
  It varies by employer. I get 24 days that I pick plus 9 or 10 that the company picks each year. Plus an additional 4-week block (that I pick, but has to be contiguous) every five years.
- unishark 7y ago
  There's around two weeks total of holidays (spread over the entire year). There's also a vacation benefit, which typically starts at two weeks and increases the longer you stay. Big companies give more and a senior person at a large company may get 4 or 5 weeks a year. There may also be separate sick days.
- ssss11 7y ago
  Thanks to those that replied, I learned something today.
  - deilline 7y ago
    The people that replied are likely software engineers and likely high earners in a very employee favored market. It's true that it varies by employer. Here are average numbers from the Bureau of Labor Statistics: https://www.bls.gov/news.release/ebs.t05.htm https://www.bls.gov/news.release/ebs.t05.htm
    - anticensor 7y ago
      The average is just one week a year (two weeks a year past 15 years of work), well below world average.
alexanderchr 7y ago
Of course if you are in the top 5-10% of earners (which I suppose many/most on this forum are), a privately funded system will almost always be better simply because you can afford to pay for the best. For myself I’d much, much rather live in a society where a cancer diagnosis doesn’t financially ruin you and your family for you life, and where everyone no matter their income receives quality care when it’s needed. Even if that means that I have to wait weeks/months to get something non-critical seen.
- LeoTinnitus 7y ago
  I'm personally I the camp of, why the hell can I not know how much stuff costs up front, why can I not tell them no I dont an unnecessary x-ray, and why am I not told cost owed by me until after the procedure only to find out it's just an absurd amount of money Private insurance blows cause we're all basically required to have it but it's worse than a tax because we barely ever know how much we owe.
  - EpicEng 7y ago
    >why the hell can I not know how much stuff costs up front Prices should be publicized, I agree, but you can ask to get something pre-authorized. It just takes longer. >why can I not tell them no I dont an unnecessary x-ray You can ask your doctor why you need an x-ray, why they deem it necessary, and refuse if you like >and why am I not told cost owed by me until after the procedure only to find out it's just an absurd amount of money Again, you can ask for pre-auth.
    - ridewinter 7y ago
      This doesn't seem to be something that's common knowledge. Can you point to information on how to use private health insurance like this?
      - EpicEng 7y ago
        You just ask the front desk to pre-authorize the prescribed treatment. They work with the insurance carrier and let you know what your cost will be.
fzeroracer 7y ago
You realize that American healthcare has wait times as well, right? My family has had to wait months to see specialists as well. I'm honestly just tired of people acting like American healthcare somehow doesn't have wait times. And not to mention if you're saddled with a particularly bad employer, they won't give you the time off to see the doctor in the first place.
- unishark 7y ago
  Is this an HMO? I signed up for one once and the delays were pretty stupid (even to get a referral to a specialist you needed to come back to see a different doctor first). I've never signed up for the HMO plan again since. With a PPO you can always pick another specialist that is available. Meanwhile there are companies in Canada that help Canadians get their MRI's in the US because it's so slow there. And clinics near the border advertise in Canada.
  - Cyph0n 7y ago
    In large metro areas, even a PPO doesn’t help much. Specialists are in short supply in the US and elsewhere for various reasons.
    - unishark 7y ago
      Usually people are saying the US has too many specialists, except for certain lower-paying specialties like obgyn. I've never had a problem with delays in large metro areas in california. I do recall hearing Boston was the worst big city to find a new doctor, supposedly due to Massachusetts' push have universal coverage.
    - breakbread 7y ago
      My mom lives in the DFW area and makes $50k. Within the past 5 weeks she's gone for a routine mammogram screening, seen a specialist about a grown that thankfully was benign, and been seen by a surgeon who removed the growth to be on the safe side because my mom is considered high risk.
bobthechef 7y ago
Indeed. I just found out that in 2019 alone, over 230 bombings took place in Sweden, more than any other Western country. I really don't understand why this myth persists. Ideological blinders or obstinate ignorance.
- lostmyoldone 7y ago
  Organized crime in Sweden likes grenades and some similar explosives, largely because they - by accident - was legal to import a couple years back. Grenades became much easier to get ahold of than handguns, which have had some weird effects, as they seem to have come to be used as intimidation between rivals. The use has been dropping the last few years, and should hopefully be back to the pre "legalization" levels soon. It's all certainly quite unfortunate, but the number of casualties are perplexingly low. It really seems that whomever it is that does these bomb/grenade attacks go out of their way to avoid people getting killed. Not that I understand why exactly, except that it seems to be about intimidation in the majority of cases.
peisistratos 7y ago
> I attempted to see a specialist for a condition that I had maybe two or three times, I ended up giving up every single time after I was told the wait time is between 3-4 months. I keep my American employer sponsored private insurance and employer determined time off policy. I am in the US and go to good dentists and doctors, who are out of my insurance network incidentally, and they and the specialists they refer me to can easily have three month waiting times. Also Sweden has been following the US lead of cuts and privatization since the 1990s, often led by the Social Democrats. It's a great strategy for the idle class - push through public health spending cuts due to costs, then bemoan the inevitable wait times as reason to privatize.
xzel 7y ago
I’ve had to wait to see endocrinologists about 6 months at multiple practices while having very good insurance in the US. It’s mostly a location and a supply and demand issue with most specialist medical professions, not an insurance issue (which it’s often conflated as in the media).
Cyph0n 7y ago
Wait times for specialists are a thing in the US too, even with good employer-sponsored insurance. Specialists are a limited resource - usually artificially - in virtually every country.
mjayhn 7y ago
I'm on good private insurance in the USA right now and on a 3 month waiting list after calling 35 specialists and taking the only one who was even accepting patients with an under 6 month wait. I'm on Aetna, a huge health insurance company here and when I call a specialist my first question is "Do you accept Aetna?" because I only have a 30% chance that they do. The only way to speed up the process would have been to pay cash to a specialist who doesn't accept any insurance, which would be a $350 consultation then $250-350/hr each visit after the fact.
deleted 7y ago
[deleted]
raz32dust 7y ago
Your argument for why Sweden is no paradise makes sense, but your argument for American system being better just because of your personal experience alone is not sound.
meerita 7y ago
> 3-4 months Welcome to the magical universal healthcare.
heavyset_go 7y ago
> In the entire time I was there I attempted to see a specialist for a condition that I had maybe two or three times, I ended up giving up every single time after I was told the wait time is between 3-4 months. I keep my American employer sponsored private insurance and employer determined time off policy, thank you very much. I've waited 6 months to see a specialist here in the US. The fact is that countries with universal healthcare have shorter wait times than the US does[1], and they manage to cover all of their citizens. [1] https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/ https://www.healthsystemtracker.org/chart-collection/quality...
- refurb 7y ago
  Usually long wait times in the US are provider specific. I’ve also experienced long wait times, but it’s because I wanted to go to the top academic system in my city. If I was willing to go to any specialist, I could have seen one pretty quickly.
  - heavyset_go 7y ago
    In this case, this was across the board for the types of specialists I wanted to see. I had called dozens of practices, and spent hours with insurances representatives trying to find a provider who wasn't booked for the next 5 months. For mental health specialists, I had to wait on two different waiting lists for both someone who could prescribe medication and for someone who provides therapy. Specialists who could do both had even longer waiting lists. It isn't just the mental health field. I have a colleague with a daughter who needed an addiction specialist, and that was another 6 month waiting list. People die waiting on those lists.
ta999999171 7y ago
Counterpoint, in an affluent area of the US, I was told 6 weeks for a gastro appointment when I reported vomiting of blood - top-notch private "insurance".
LIV2 7y ago
Aussie in Sweden here. I had to wait 4 weeks to see a GP and then 4 more weeks for them to refer me each time they said "wait 4 weeks and come back if it's still an issue" Public healthcare works way better in Australia, I went home and saw a doctor there, got to see a doctor straight away, got scans & referral etc within a week. Other expats have told me I should go to Germany or the UK if I urgently need health care
- jamesblonde 7y ago
  If you want to see a doctor here in Sweden, you do what the Swedes do: call at 8am to the Vårdcentral. Then say whatever you have is urgent (akut). You get a time the same day, 90% of the time. Otherwise, most vårdcentral have "akuttider" (emergency times) when you can just drop in.
  - LIV2 7y ago
    I went to the vårdcentral drop in that morning, saw a nurse who said "come back in 4 weeks if you still have an issue" they decided me suddenly having ringing in my ears that has not stopped was not an urgent issue or a problem
    - jamesblonde 7y ago
      That's bad luck. I agree it's a crap system, designed to keep costs down. If you live in Stockholm, you can pay 500kr and go to cityakuten.
    - jamesblonde 7y ago
      There's also a few 'apps' - "kry", which are cheap and give you an immediate time. The docs on those apps can give you a referral.
alpinemeadow 7y ago
Hej! I’ve been in Sweden now nine years. It’s true that it takes time to get to certain specialists, but only if you are in a non-threatening situation. The system works with a triage concept, and the moment your condition is deemed serious you are in the front of any cue, meaning you get care immediately. I know some people with skin cancer that got amazing care , fast, at no cost. I have a coworker that had an extremely premature born : 24 weeks. the level of care he described, the team around his son and 10 different surgeries had cost him nothing. Luckily they are home now , with oxygen equipment provided to theM and nurses visiting every other day to monitor him. This in the US would probably have meant a bankruptcy for someone in his income bracket. The system is not perfect but after living in the US for 13 years I can tell you you never worry about health care here. Edit: Nobody mentions you can also pay extra and visit a specialist right away! The wait is if you want the visit for the government price: 12 dollars for initial visit, 30 dollars for a specialist.

urvader 7y ago

There are private health insurances here too. If the public system would be so bad as you describe it everyone would use the private ones but very few do.

marcinzm 7y ago
Private Health insurance without group plans does not really work well so the fact people don't choose it doesn't mean much to me. Essentially, since sick people are more likely to choose such plans the costs are going to be very high. Either that or the restrictions on the plans need to be high to prevent it. Both make such plans unattractive independent of how bad or good the public plans are.
brobdingnagians 7y ago
From my experience in the UK, people typically don't get private insurance because they _believe_ in the public system, not because they have a generally positive experience with the public system. They don't really realize that the service could or should be much different, so they just put up with it because they believe in the system being the way it is. They believe in chipping in, paying their fair share, and everyone being in the pot. It's a mind set, not an optimal set of circumstances. I admire the mindset in many ways, but it doesn't make for quick or efficient service. It all kind of depends on what you optimize for, and what you are willing to put up with based on your worldview of what is most important.
- ghaff 7y ago
  It's not super-common, but some employers do offer private health insurance. The numbers I saw suggested about 10% were covered by such insurance which isn't a huge number but isn't nothing either.
  - ZeroGravitas 7y ago
    I would guess less than half of those people ever use the coverage, and those that do still use the public option for more than half their medical needs. It's often bundled with employment packages with the idea that it provides some kind of insurance when a key member of staff need treatment and can be prioritised to jump some queues, but in everyday situations like when their kid falls off a bike and spits out some teeth, they're going to use the same service as everyone else, because it's simply quicker and more effective to do so. Private insurance is very much a supplement, not a totally parallel system in the UK: https://www.moneyadviceservice.org.uk/en/articles/do-you-need-private-medical-insurance https://www.moneyadviceservice.org.uk/en/articles/do-you-nee...
- ZeroGravitas 7y ago
  It might change depending on exactly how you define efficiency but the UK system scores highest in some global comparisons in terms of bang for buck. From the way you phrase it I assume you actually mean inefficient service, like you'd get at a high end restaurant or hotel, where they have lots of people hanging around doing nothing a lot of the time so no one ever feels they're being treated less than a VIP in busy periods.
serf 7y ago
>If the public system would be so bad as you describe it everyone would use the private ones but very few do. that's simply dishonest. there are tons of other variables to consider when pondering private insurance adoption rates.
csomar 7y ago
> If the public system would be so bad as you describe it everyone would use the private ones but very few do. Maybe they can't afford private insurance?
strictfp 7y ago
Wait what? I live here too, and many employers do pay for private insurance because it saves heaps of time for the employees. Why do you think the private options sprung up in the first place? The public system has serious flaws. I was told by the public system to take antibiotics for 6 months straight while waiting for a tonsil removal operation. Got my operation a few days later through my private insurance.
ernst_klim 7y ago
> If the public system would be so bad as you describe it everyone would use the private ones but very few do. Ah, that's simply wrong, because you pay for public healthcare anyways (through taxes), hence private one is to be paid twice. I doubt the system is `that bad`, but even in Russia, where private healthcare is super cheap (and very good) and public healthcare is a total disaster, a few people use the private one (until they are wealthy) due to exact same reason: they've already paid for the public one and feel like paying twice is not an option.

hugi 7y ago

Yeah, my cousin is a doctor in Sweden and according to him Sweden has the most failed/Americanised system of the Nordics.

tpmx 7y ago

Swede here: Yeah, Sweden tends to be romanticized by the american "progressives". As a swedish "rightist", you end up being in an annoying position. There's a lot of stupid stuff that happens here, for sure. That said, it seems like the really expensive/complicated healthcare needs gets taken care of in a competent way, "for free" (paid for via the taxes). My then 73 yo mom had a tumor that was growing behind her left eye-ball being removed, two years ago. Zero complaints about that hole produdure, and the 10+ post-prodedure checks. I spent a few hours googling the doctor that was going to perform this particular surgery on my mom - I was left with the impression that he was on the international fore-front on this particular procudure. He was doing a bunch of international speaking on the the topic. I saw videos of him lecturing hundreds of surgeons on particulars of this kind of procudure. Quite re-insuring. (And yeah, my mom ended up being okay after the surgery.)

dontdoitpls 7y ago
The worst insurance you can get + max out of pocket is 12,000usd per year. 10 or 20 procedures, still 12k. For the 10%ers/6 figure earners, this is 10% of the before tax income. For the 90% making 15-19$/hr, I can't even imagine managing this.
- PopeDotNinja 7y ago
  And that's assuming you can keep working. Getting fired or laid off because you can't work means you're no longer getting paid AND you now have to pay for the healthcare you can no longer afford. It's stupid.

ChuckNorris89 7y ago

Same in Austria. The healthcare system is free and very good if you have something life threatening but if not, you're looking at 2 month waiting time to see a specialist and there's no way I can be living and working with a health discomfort for that long so I pay up and see a private doctor. The current situation benefits the lower class with voting rights who have access to good healthcare without paying much taxes and the upper class can afford private anyway but if you're hard working middle class you're kinda screwed since you have to go private and pay if you want quality treatment and diagnosis in a timely manner but you're also forced to pay and subsidize the public system, which you don't use anyway, with your very high taxes. I feel Europe is slowly migrating to a two tier healthcare system, a private and quality but expensive one for the ones who can afford it and a public underfunded one for everyone else.

the_mitsuhiko 7y ago
> The healthcare system is free and very good if you have something life threatening but if not, you're looking at 2 month waiting time to see a specialist and there's no way I can be living and working with a health discomfort for that long so I pay up and see a private doctor. The private doctor is still cheaper than copays/deductibles in the US. So that seems like a weird argument to make.
- ChuckNorris89 7y ago
  >The private doctor is still cheaper than copays/deductibles in the US. Skilled workers in the US also earn way more than their European counterparts.
  - hannasanarion 7y ago
    And unskilled workers earn less. So what?
    - wormseed 7y ago
      Not necessarily. One datapoint: Amazon pays fulfilment workers $15/hour in the US, but €11/hour (~$12) in Germany

strictfp 7y ago

The system is gating the specialists way too much. But the actual care once you are there is usually very good. Private insurance often just gets you past those gates.

csomar 7y ago

> In the entire time I was there I attempted to see a specialist for a condition that I had maybe two or three times, I ended up giving up every single time after I was told the wait time is between 3-4 months. It's the same thing they say about France (having a great healthcare system). But doctors [1] are going on strikes because of lack of amenities. Makes you wonder... A private system where you chose your provider will always be better, imo, because the providers will have to compete. I think the US could do much better if they improve the pricing visibility and get the free market to make the prices go down. (I'm not very well versed in this topic, I'm just reading the news) 1 - https://www.cnews.fr/france/2019-12-14/pourquoi-les-medecins-generalistes-sont-ils-en-greve-ce-samedi-908057 https://www.cnews.fr/france/2019-12-14/pourquoi-les-medecins...

Something1234 7y ago
I'm confused as to why you're being downvoted. But I completely agree with you on the free market. My personal issue with going to the doctor is I have no idea what my bill will be at the end of the day.
- dmurray 7y ago
  Perhaps he's being downvoted (not by me!) because the claim is self-contradictory. Either a market based system "always will be better", or it could be "better if they improve the pricing visibility", which is it? Unless he's saying the US system is already superior to all others, but could be made better still. That seems like an ambitious claim.
  - csomar 7y ago
    A non-transparent system is not one I'll define as a free market based system.
    - dmurray 7y ago
      That's a "no true Scotsman" problem, though. If the US doesn't (or didn't pre-ACA) have a market-based healthcare system, then who does? And if no one does, how do we know it's better?

nelblu 7y ago

It took my spouse 3 months to get an appointment with a specialist in the US. She definitely didn't shop around but it was a miserable wait time considering we lived close to some of the best healthcare facilities in the world and had one of the best health insurance one could buy.

EpicEng 7y ago
>She definitely didn't shop around Why not? So she wanted to go to a specific doctor, and that doctor had a waiting list. How does any other system solve for that? A single doctor can only see so many patients.
deleted 7y ago
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philliphaydon 7y ago
I’m really glad that I live in Asia. Here in Singapore I can ring up a specialist and go in the same day... I don’t understand why in Asia I have cheaper and better health care than if I lived in Europe or America. Some of the things I’ve heard just about Hospitals scares me to not get sick when I’m in europe... When my wife was in hospital for the birth of our daughter I slept over night in the room with my wife. While in France my wife’s friend wasn’t allowed to have her husband stay. The whole experience we had vs them was polar opposite.
- bluerobotcat 7y ago
  Have you noticed that in Singapore all the nurses are Filipino though? I don't think they earn much and I reckon that has to help with getting costs down... I also disagree that healthcare is uniformly cheap here. GP visits are not particularly cheap. You get to spend very little time with the GP and typically are sold a bunch of drugs you don't need (in Europe there's separation of clinics and pharmacies, which introduces some checks & balances). To give another example, in Europe I used to go for a glaucoma test every year (due to family history) and pay about 20-30 euros. However, in Singapore, doctors look at you funny when you request to be tested for this as preventative health care is not really thing here. I did get tested twice for Glaucoma in Singapore (at the National Eye Center) and ended up with a bill of 250 SGD (~ 175 EUR) each time. The second time around, the doctor afterwards admitted that the bulk of the tests I had been given hadn't really been warranted. (Oh, and I couldn't exactly go in the same day by the way. There was a waiting list, though I don't recall how many days/weeks I had to book in advance.) Finally, getting cancer has been known to bankrupt people in Singapore.

mrkeen 7y ago

Regarding healthcare, my employer gives me private insurance but I tend to use both systems. Generally I get same-day care. I call up DKV, report my symptoms, they find a specialist in my area, and I pay nothing. (I mention the symptoms bit to contrast with the system where you have to see a general practitioner who then refers you to a specialist - that does not happen here AFAIK). I've used this for allergies, asthma, ear problems. I also had a knee injury where I got an x-ray (same day I think?) followed by weekly sessions of physio. My partner recently gave birth in the public system. I think the delivery was free, but the 4-night stay cost us around 4000 SEK (400 USD) total. I also had a remote doctor's appointment using the KRY app. I don't actually know how that was billed - public I'd guess.

plufz 7y ago
Paying 4000kr for staying four nights sounds really weird since Swedish law say that the fee for staying at the hospital can’t be above 100kr/day. I also recently stayed about four nights after my partner gave birth and we payed a couple 100SEK.
- mrkeen 7y ago
  You got me curious so I checked my records. Looks like I remembered incorrectly and paid 2300 SEK. From https://bbstockholm.se/content/practical-information https://bbstockholm.se/content/practical-information: > Each new 24 hour period cost 100 SEK from the time you arrive at the clinic. Your partner/labour support person is charged 600 SEK/24 hours from the time the baby is born. Food, towels, sheets, sanitary products and diapers are all included free of charge during your stay.
  - plufz 7y ago
    Makes more sense. I guess you are free to charge the partner whatever you like. I live in a more left leaning part of sweden so here the partner is also charged 100 sek.

ssss11 7y ago

Isnt US employer determined holidays 2 weeks per year? No thanks. Time off work is important.

marcinzm 7y ago
Like most everything in the US, vacation time varies by employer. Last year I took 6 weeks not counting holidays and wfh 2-3 days a week.
sokoloff 7y ago
It varies by employer. I get 24 days that I pick plus 9 or 10 that the company picks each year. Plus an additional 4-week block (that I pick, but has to be contiguous) every five years.
unishark 7y ago
There's around two weeks total of holidays (spread over the entire year). There's also a vacation benefit, which typically starts at two weeks and increases the longer you stay. Big companies give more and a senior person at a large company may get 4 or 5 weeks a year. There may also be separate sick days.
ssss11 7y ago
Thanks to those that replied, I learned something today.
- deilline 7y ago
  The people that replied are likely software engineers and likely high earners in a very employee favored market. It's true that it varies by employer. Here are average numbers from the Bureau of Labor Statistics: https://www.bls.gov/news.release/ebs.t05.htm https://www.bls.gov/news.release/ebs.t05.htm
  - anticensor 7y ago
    The average is just one week a year (two weeks a year past 15 years of work), well below world average.

alexanderchr 7y ago

Of course if you are in the top 5-10% of earners (which I suppose many/most on this forum are), a privately funded system will almost always be better simply because you can afford to pay for the best. For myself I’d much, much rather live in a society where a cancer diagnosis doesn’t financially ruin you and your family for you life, and where everyone no matter their income receives quality care when it’s needed. Even if that means that I have to wait weeks/months to get something non-critical seen.

LeoTinnitus 7y ago
I'm personally I the camp of, why the hell can I not know how much stuff costs up front, why can I not tell them no I dont an unnecessary x-ray, and why am I not told cost owed by me until after the procedure only to find out it's just an absurd amount of money Private insurance blows cause we're all basically required to have it but it's worse than a tax because we barely ever know how much we owe.
- EpicEng 7y ago
  >why the hell can I not know how much stuff costs up front Prices should be publicized, I agree, but you can ask to get something pre-authorized. It just takes longer. >why can I not tell them no I dont an unnecessary x-ray You can ask your doctor why you need an x-ray, why they deem it necessary, and refuse if you like >and why am I not told cost owed by me until after the procedure only to find out it's just an absurd amount of money Again, you can ask for pre-auth.
  - ridewinter 7y ago
    This doesn't seem to be something that's common knowledge. Can you point to information on how to use private health insurance like this?
    - EpicEng 7y ago
      You just ask the front desk to pre-authorize the prescribed treatment. They work with the insurance carrier and let you know what your cost will be.

fzeroracer 7y ago

You realize that American healthcare has wait times as well, right? My family has had to wait months to see specialists as well. I'm honestly just tired of people acting like American healthcare somehow doesn't have wait times. And not to mention if you're saddled with a particularly bad employer, they won't give you the time off to see the doctor in the first place.

unishark 7y ago
Is this an HMO? I signed up for one once and the delays were pretty stupid (even to get a referral to a specialist you needed to come back to see a different doctor first). I've never signed up for the HMO plan again since. With a PPO you can always pick another specialist that is available. Meanwhile there are companies in Canada that help Canadians get their MRI's in the US because it's so slow there. And clinics near the border advertise in Canada.
- Cyph0n 7y ago
  In large metro areas, even a PPO doesn’t help much. Specialists are in short supply in the US and elsewhere for various reasons.
  - unishark 7y ago
    Usually people are saying the US has too many specialists, except for certain lower-paying specialties like obgyn. I've never had a problem with delays in large metro areas in california. I do recall hearing Boston was the worst big city to find a new doctor, supposedly due to Massachusetts' push have universal coverage.
  - breakbread 7y ago
    My mom lives in the DFW area and makes $50k. Within the past 5 weeks she's gone for a routine mammogram screening, seen a specialist about a grown that thankfully was benign, and been seen by a surgeon who removed the growth to be on the safe side because my mom is considered high risk.

bobthechef 7y ago

Indeed. I just found out that in 2019 alone, over 230 bombings took place in Sweden, more than any other Western country. I really don't understand why this myth persists. Ideological blinders or obstinate ignorance.

lostmyoldone 7y ago
Organized crime in Sweden likes grenades and some similar explosives, largely because they - by accident - was legal to import a couple years back. Grenades became much easier to get ahold of than handguns, which have had some weird effects, as they seem to have come to be used as intimidation between rivals. The use has been dropping the last few years, and should hopefully be back to the pre "legalization" levels soon. It's all certainly quite unfortunate, but the number of casualties are perplexingly low. It really seems that whomever it is that does these bomb/grenade attacks go out of their way to avoid people getting killed. Not that I understand why exactly, except that it seems to be about intimidation in the majority of cases.

peisistratos 7y ago

> I attempted to see a specialist for a condition that I had maybe two or three times, I ended up giving up every single time after I was told the wait time is between 3-4 months. I keep my American employer sponsored private insurance and employer determined time off policy. I am in the US and go to good dentists and doctors, who are out of my insurance network incidentally, and they and the specialists they refer me to can easily have three month waiting times. Also Sweden has been following the US lead of cuts and privatization since the 1990s, often led by the Social Democrats. It's a great strategy for the idle class - push through public health spending cuts due to costs, then bemoan the inevitable wait times as reason to privatize.

xzel 7y ago

I’ve had to wait to see endocrinologists about 6 months at multiple practices while having very good insurance in the US. It’s mostly a location and a supply and demand issue with most specialist medical professions, not an insurance issue (which it’s often conflated as in the media).

Cyph0n 7y ago

Wait times for specialists are a thing in the US too, even with good employer-sponsored insurance. Specialists are a limited resource - usually artificially - in virtually every country.

mjayhn 7y ago

I'm on good private insurance in the USA right now and on a 3 month waiting list after calling 35 specialists and taking the only one who was even accepting patients with an under 6 month wait. I'm on Aetna, a huge health insurance company here and when I call a specialist my first question is "Do you accept Aetna?" because I only have a 30% chance that they do. The only way to speed up the process would have been to pay cash to a specialist who doesn't accept any insurance, which would be a $350 consultation then $250-350/hr each visit after the fact.

deleted 7y ago

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raz32dust 7y ago

Your argument for why Sweden is no paradise makes sense, but your argument for American system being better just because of your personal experience alone is not sound.

meerita 7y ago

> 3-4 months Welcome to the magical universal healthcare.

heavyset_go 7y ago

> In the entire time I was there I attempted to see a specialist for a condition that I had maybe two or three times, I ended up giving up every single time after I was told the wait time is between 3-4 months. I keep my American employer sponsored private insurance and employer determined time off policy, thank you very much. I've waited 6 months to see a specialist here in the US. The fact is that countries with universal healthcare have shorter wait times than the US does[1], and they manage to cover all of their citizens. [1] https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/ https://www.healthsystemtracker.org/chart-collection/quality...

refurb 7y ago
Usually long wait times in the US are provider specific. I’ve also experienced long wait times, but it’s because I wanted to go to the top academic system in my city. If I was willing to go to any specialist, I could have seen one pretty quickly.
- heavyset_go 7y ago
  In this case, this was across the board for the types of specialists I wanted to see. I had called dozens of practices, and spent hours with insurances representatives trying to find a provider who wasn't booked for the next 5 months. For mental health specialists, I had to wait on two different waiting lists for both someone who could prescribe medication and for someone who provides therapy. Specialists who could do both had even longer waiting lists. It isn't just the mental health field. I have a colleague with a daughter who needed an addiction specialist, and that was another 6 month waiting list. People die waiting on those lists.

ta999999171 7y ago

Counterpoint, in an affluent area of the US, I was told 6 weeks for a gastro appointment when I reported vomiting of blood - top-notch private "insurance".

LIV2 7y ago

Aussie in Sweden here. I had to wait 4 weeks to see a GP and then 4 more weeks for them to refer me each time they said "wait 4 weeks and come back if it's still an issue" Public healthcare works way better in Australia, I went home and saw a doctor there, got to see a doctor straight away, got scans & referral etc within a week. Other expats have told me I should go to Germany or the UK if I urgently need health care

jamesblonde 7y ago
If you want to see a doctor here in Sweden, you do what the Swedes do: call at 8am to the Vårdcentral. Then say whatever you have is urgent (akut). You get a time the same day, 90% of the time. Otherwise, most vårdcentral have "akuttider" (emergency times) when you can just drop in.
- LIV2 7y ago
  I went to the vårdcentral drop in that morning, saw a nurse who said "come back in 4 weeks if you still have an issue" they decided me suddenly having ringing in my ears that has not stopped was not an urgent issue or a problem
  - jamesblonde 7y ago
    That's bad luck. I agree it's a crap system, designed to keep costs down. If you live in Stockholm, you can pay 500kr and go to cityakuten.
  - jamesblonde 7y ago
    There's also a few 'apps' - "kry", which are cheap and give you an immediate time. The docs on those apps can give you a referral.

alpinemeadow 7y ago

Hej! I’ve been in Sweden now nine years. It’s true that it takes time to get to certain specialists, but only if you are in a non-threatening situation. The system works with a triage concept, and the moment your condition is deemed serious you are in the front of any cue, meaning you get care immediately. I know some people with skin cancer that got amazing care , fast, at no cost. I have a coworker that had an extremely premature born : 24 weeks. the level of care he described, the team around his son and 10 different surgeries had cost him nothing. Luckily they are home now , with oxygen equipment provided to theM and nurses visiting every other day to monitor him. This in the US would probably have meant a bankruptcy for someone in his income bracket. The system is not perfect but after living in the US for 13 years I can tell you you never worry about health care here. Edit: Nobody mentions you can also pay extra and visit a specialist right away! The wait is if you want the visit for the government price: 12 dollars for initial visit, 30 dollars for a specialist.