8 ms·

You are not getting health insurance in most European countries unless you are working or registered as unemployed and remain at disposal of the local job centr

You are not getting health insurance in most European countries unless you are working or registered as unemployed and remain at disposal of the local job centre. And the whole meme that a 65% tax rate +25% vat on most products on top of it (I am in Sweden) is somehow worth it financially because "fReE HeAlThCaRe" is laughable.

mrunkel 5y ago
How do you figure you have a 65% tax rate in Sweden? Are you including social security contributions?
- admissionsguy 5y ago
  I certainly am.
ChuckNorris89 5y ago
Mostly this. Maybe it's more lax in the more worker friendly socialist regions like France or Scandinavia but in Austria you only get healthcare coverage if you work or are unemployed and registered as a job seeker which means staying in the country and proving to your local job center on a regular basis that you are looking for work. Traveling abroad for leisure while unemployed automatically disqualifies you from receiving any healthcare coverage and unemployment benefits until you return. Doesn't mean there aren't people cheating the system and taking vacations abroad while receiving unemployment but the rules are strict and being caught cheating is really bad for you. Also doing courses on your own dime during unemployment, that are not on the job center's curriculum, like a boot camp in data science, automatically disqualifies you from unemployment benefits during that period. I tried explaining to my case worker at the job center that a data science certification gives me the opportunity for a better paid job afterwards and I need the unemployment benefits for that period and her response was "sorry sir, that's the law". Yeah, the system is extremely stupid and archaic in some cases here and if you're an ambitious high achiever it can screw you over sometimes more than it helps you.
- mhitza 5y ago
  I find that strange for Austria, considering that in Romania; when unemployed, and not being registered as a job seeker, you can still have insurance. It's automatic in those situations you've described, but you can buy into the system otherwise. At today's exchange rate if you'd like to benefit from the healthcare system, for a year, you'd have to make a 271 EUR contribution, with no other criteria required.
  - ChuckNorris89 5y ago
    The system in Austria is extremely rigid and sometimes verges on idiotic in some cases due to how archaic and pro-business it is. As a Romanian I can say you'd be surprised how many things the Romanian system gets right in favor of the workers in comparison to some western countries. At least on paper.
- FabHK 5y ago
  In Germany, there is obligatory health insurance (when you're employed in a normal job up to certain income, or receiving welfare), and voluntary insurance (otherwise), but having health insurance is compulsory. In other words, if you're not obliged to have obligatory health insurance, you must take out voluntary insurance. With some historical context it can be made to make some sense, but when dealing with it the first time it is prima facie absurd.
throwaway894345 5y ago
To be clear, I'm merely saying "the complexities of the American healthcare system might be why Europeans are more inclined to take gap years". That said, I didn't know that European public health insurance was commonly contingent on employment. I would be curious to know more about this.
- Nursie 5y ago
  > I didn't know that European public health insurance was commonly contingent on employment I'm not sure it is! It's not in the UK, certainly.
  - pyb 5y ago
    Nor is it in France.
- admissionsguy 5y ago
  I am honestly very bitter about Americans glorifying the European system while happily taking home 2/3rds of their 100k+ developer salaries and enjoying much lower prices of everything. With regards to insurance: - in some countries (UK, Sweden) - the insurance is contingent on having a social security number, so the coverage is pretty much universal for residents, but people coming from other EU countries will still need to work or register as unemployed to get it. - in other countries, you generally need to be working or looking for work (i.e. answer phones / invitations from job centre and attend any interviews/courses they send you to) to be covered. Some countries (Poland for example, I'm Polish) allow you to buy insurance if you are neither working nor looking for work. But as of December 2020, about 1.5 mln Poles are not insured at all. [1] [1] https://tvn24.pl/polska/szczepionka-na-koronawirusa-czy-osoby-nieubezpieczone-beda-mogly-sie-zaszczepic-4785978 https://tvn24.pl/polska/szczepionka-na-koronawirusa-czy-osob...
  - throwaway894345 5y ago
    > I am honestly very bitter about Americans glorifying the European system while happily taking home 2/3rds of their 100k+ developer salaries and enjoying much lower prices of everything. I agree, although I think the ignorance extends to Europeans as well. Europeans are often surprised to hear that American software professional salaries are ~60% higher than European salaries even after adjusting for taxes, healthcare, vacation, etc. Some will argue that the US cost of living is more expensive, but they're almost always comparing some major US metropolis with some European village or perhaps an Eastern European city. I've seen other arguments that the cost of housing in the US is comparable or more expensive, but they're typically comparing some relatively tiny European apartment with a much larger American home. Europeans seem to fixate on medical bankruptcies, as though these are commonplace for upper-middleclass Americans. This was all a surprise to me, an American, who has tried earnestly to live in Western Europe for a few years, but found that I can either live in Europe or I can travel in Europe but trying to do both would likely be economically infeasible (even if I can find gainful work as a software professional, it would specifically be difficult for my wife who isn't in a hot field). Fortunately, now that remote work is catching on, it seems likely that my wife and I will be able to do more frequent 1-3 month stints in Europe while remaining employed by our American companies. To be clear, I think the United States healthcare system should be reformed, because it doesn't serve the poorest Americans very well. However, the US healthcare system works pretty well for the upper middle class (if not the whole of the middle class) and above, contrary to perceptions I frequently hear from some Americans and Europeans.
refurb 5y ago
Indeed. In Canada if you’re out of the country longer than 6 months you’re not longer insured (in Canada). And in fact, insurance doesn’t cover you outside the country anyways.
- jkaplowitz 5y ago
  Varies by province. In Quebec, they have a similar absence rule to what you described (for being outside Quebec even if in another Canadian province), but they entirely exclude absences of under 21 days from the calculation, and they have a bunch of exceptions, including a "once every 7 years" exception for miscellaneous personal reasons including leisure vacations that just requires you to notify them in order to qualify. And in theory they will reimburse expenses outside of Quebec, even outside of Canada, but only at Quebec's very low rates. Still, yeah, very different than how US health insurance works, agreed.
- nucleardog 5y ago
  Anything that starts "In Canada, ..." is generally suspect. Canada is a confederation. Most things are in the purview of the provinces, so there's rarely a globally applicable rule. Canada does not have a single healthcare system, but thirteen separate provincial and territorial healthcare plans. You're not guaranteed to be covered for 6 months. If you leave permanently and settle within Canada, BC will cover you for the remainder of the month plus two months (enough time to establish residency in the destination and get coverage). If you leave the country, you are covered for the remainder of the month. If it's a temporary leave, however, several of the provinces do cover you outside of the province, and many will extend your coverage for quite a long time depending on the circumstances. BC allows you to retain coverage for a 2 year trip during every 5 year period. They also (like many provinces) will extend your coverage as long as you're in school full time in another location.
  - refurb 5y ago
    Fair point on each province being different. BC does not cover care outside of Canada (assuming that’s what you meant by “2 year trip”) with the exception of emergency care at a max of $75 per day. https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/msp/bc-residents/benefits/services-covered-by-msp/medical-benefits/medical-benefits-outside-of-british-columbia https://www2.gov.bc.ca/gov/content/health/health-drug-covera...
himinlomax 5y ago
> You are not getting health insurance in most European countries unless you are working or registered as unemployed and remain at disposal of the local job centre. Not the case in France (at least for the past 20 years), and I doubt it's the case in most other European countries.
- ChuckNorris89 5y ago
  >Not the case in France (at least for the past 20 years), and I doubt it's the case in most other European countries. Nope, your parent is right, in Austria you also don't get healthcare if you don't work or are looking for work via your local job center. Maybe France is an exception due to having stronger social system that heavily favors the workers (insert memes about strikes) while in Austria the system is very rigid, designed to favor businesses and the government rather than the workers and to discourage abuse.
  - himinlomax 5y ago
    I'm pretty sure that's not the case in the UK either, given how it's financed.
    - 1991g 5y ago
      It is not - you get access to healthcare at all times (employed or otherwise, young or old) and simply pay a slightly higher tax rate when you are working to pay for it.
- campl3r 5y ago
  definitely the case in Germany. If you're unemployment and not looking for a job or exempt from it(sickness, poverty, ...), you're going to need to pay on your own.
  - morelisp 5y ago
    So... not the case in Germany. You don't need to be employed or in social programs, you can just pay money. In Germany it's a fixed amount, less than you would pay if you had income, and they can't refuse you. I know to a European this might sound like the only two options, but pre-Obamacare, and very possibly again if the US can't get its shit together, it was impossible to buy health insurance no matter how much money you had for a large number of unemployed or self-employed people.
ajuc 5y ago
> You are not getting health insurance in most European countries unless you are working or registered as unemployed and remain at disposal of the local job centre. Or your partner has health insurance. Or you are studying (even if you take gap year at university). Or you happen to have farming land. Etc, etc - lots of exceptions. Or you pay for it yourself from your savings (under 100 USD a month last I've checked).
vidarh 5y ago
The vast majority in Sweden pays nothing like "65% tax rate + 25% vat", though. To get to that tax rate you need to earn far above average. Someone who is single with no child earning 167% of an average wage pays ~35% income tax and social security contributions [1]. The effective VAT also for most ends up far lower as a proportion of income, as most people don't spend anywhere near their whole income on VAT-rated products. For starters, you can't spend what you've already paid in tax. As such the VAT rate has a relatively low impact on total tax paid - the difference between the UK vat rate when I moved here (at the time 17.5%) and the Norwegian VAT rate of 25% added up to only about 1 percentage point difference in total taxation for me. [1] Source: OECD Taxing Wages 2021
- throwaway894345 5y ago
  > The vast majority in Sweden pays nothing like "65% tax rate + 25% vat", though. To get to that tax rate you need to earn far above average. First of all, the OP is including the social security tax in the 65% figure. But more importantly, arguing that "the average Swede doesn't pay that much in tax" isn't very consoling for the American who would have to (1) take a salary hit to live in Sweden and (2) have to pay that higher tax rate. Universal healthcare doesn't remotely make up the difference in take-home pay. As a reference point, taxes, retirement/pension/social-security, and healthcare account for ~30% of my gross salary in the U.S. If I moved to just about any Western European country (not sure about Sweden in particular), my take-home pay would likely fall by 40% (conservatively) while taxes and cost of living would likely rise. Of course, the tradeoff for the Swedish system is that you have a stronger social safety net, which is certainly worth something. But the issue at hand is the notion that the European systems are better than the American system for professional employees.
  - vidarh 5y ago
    The numbers I quoted also include the social security taxes (I edited to make that clear, so apologies if you replied before I made that edit). Swedish marginal rates certainly are among the highest in Europe, but the proportion who pay that much is tiny. And yes, there are people who will end up paying more, and it sucks for them. The point is there's always this scaremongering about tax rates when it comes to Europe, and most of the time the tax rates that comes up are marginal rates that are not at all representative.
tshaddox 5y ago
How many medical bankruptcies occur in those European countries?
- kube-system 5y ago
  That might not be an accurate way to measure it, because "bankruptcy" can mean very different things by country. In some countries, individuals often don't qualify for bankruptcy. In others you might be able to restructure your debts, but they might not be discharged. In some, you may need to give up significant possessions to pay for your debts. The US, for all of its healthcare issues, actually has a relatively progressive and accessible bankruptcy system. The majority of people in the US who file Chapter 7 have all of their assets exempted from liquidation by law. For these people, bankruptcy is literally as simple as a matter of trading all of their debt for 10 years of a bad mark on their credit report.
jhrozek 5y ago
Even worse: Unless you pay private insurance yourself, the quality of the free insurance (at your nearest vårdcentralen) is absolutely laughable. My family of 4 pays about 1800 SEK/month for private insurance to actually have a chance to see a competent doctor.
- qqqwerty 5y ago
  In the US, we pay 5x-10x that amount for a crappy high deductible plan that has measurably worse outcomes than your free insurance. It is hard to overstate how bad US healthcare is for the typical American. If you are wealthy, you have access to some of the best doctors in the world, but for the rest of us we are entirely dependent on our employer for access to reasonable health care.
- brtkdotse 5y ago
  While I agree that vårdcentralen-level health care is hit or miss, the point is that _everyone_ has a basic level of health care and getting sick won’t bankrupt you. This has the second-order effect that _I_ won’t have to worry about _someone dear to me_ will be personally bankrupted by a medical condition. It saves me having to decide whether or not I should indebt myself to pay for their treatment. Not having to raise fundraisers for my family members cancer treatment is worth a whole lot of disposable income for me.

mrunkel 5y ago

How do you figure you have a 65% tax rate in Sweden? Are you including social security contributions?

admissionsguy 5y ago
I certainly am.

ChuckNorris89 5y ago

Mostly this. Maybe it's more lax in the more worker friendly socialist regions like France or Scandinavia but in Austria you only get healthcare coverage if you work or are unemployed and registered as a job seeker which means staying in the country and proving to your local job center on a regular basis that you are looking for work. Traveling abroad for leisure while unemployed automatically disqualifies you from receiving any healthcare coverage and unemployment benefits until you return. Doesn't mean there aren't people cheating the system and taking vacations abroad while receiving unemployment but the rules are strict and being caught cheating is really bad for you. Also doing courses on your own dime during unemployment, that are not on the job center's curriculum, like a boot camp in data science, automatically disqualifies you from unemployment benefits during that period. I tried explaining to my case worker at the job center that a data science certification gives me the opportunity for a better paid job afterwards and I need the unemployment benefits for that period and her response was "sorry sir, that's the law". Yeah, the system is extremely stupid and archaic in some cases here and if you're an ambitious high achiever it can screw you over sometimes more than it helps you.

mhitza 5y ago
I find that strange for Austria, considering that in Romania; when unemployed, and not being registered as a job seeker, you can still have insurance. It's automatic in those situations you've described, but you can buy into the system otherwise. At today's exchange rate if you'd like to benefit from the healthcare system, for a year, you'd have to make a 271 EUR contribution, with no other criteria required.
- ChuckNorris89 5y ago
  The system in Austria is extremely rigid and sometimes verges on idiotic in some cases due to how archaic and pro-business it is. As a Romanian I can say you'd be surprised how many things the Romanian system gets right in favor of the workers in comparison to some western countries. At least on paper.
FabHK 5y ago
In Germany, there is obligatory health insurance (when you're employed in a normal job up to certain income, or receiving welfare), and voluntary insurance (otherwise), but having health insurance is compulsory. In other words, if you're not obliged to have obligatory health insurance, you must take out voluntary insurance. With some historical context it can be made to make some sense, but when dealing with it the first time it is prima facie absurd.

throwaway894345 5y ago

To be clear, I'm merely saying "the complexities of the American healthcare system might be why Europeans are more inclined to take gap years". That said, I didn't know that European public health insurance was commonly contingent on employment. I would be curious to know more about this.

Nursie 5y ago
> I didn't know that European public health insurance was commonly contingent on employment I'm not sure it is! It's not in the UK, certainly.
- pyb 5y ago
  Nor is it in France.
admissionsguy 5y ago
I am honestly very bitter about Americans glorifying the European system while happily taking home 2/3rds of their 100k+ developer salaries and enjoying much lower prices of everything. With regards to insurance: - in some countries (UK, Sweden) - the insurance is contingent on having a social security number, so the coverage is pretty much universal for residents, but people coming from other EU countries will still need to work or register as unemployed to get it. - in other countries, you generally need to be working or looking for work (i.e. answer phones / invitations from job centre and attend any interviews/courses they send you to) to be covered. Some countries (Poland for example, I'm Polish) allow you to buy insurance if you are neither working nor looking for work. But as of December 2020, about 1.5 mln Poles are not insured at all. [1] [1] https://tvn24.pl/polska/szczepionka-na-koronawirusa-czy-osoby-nieubezpieczone-beda-mogly-sie-zaszczepic-4785978 https://tvn24.pl/polska/szczepionka-na-koronawirusa-czy-osob...
- throwaway894345 5y ago
  > I am honestly very bitter about Americans glorifying the European system while happily taking home 2/3rds of their 100k+ developer salaries and enjoying much lower prices of everything. I agree, although I think the ignorance extends to Europeans as well. Europeans are often surprised to hear that American software professional salaries are ~60% higher than European salaries even after adjusting for taxes, healthcare, vacation, etc. Some will argue that the US cost of living is more expensive, but they're almost always comparing some major US metropolis with some European village or perhaps an Eastern European city. I've seen other arguments that the cost of housing in the US is comparable or more expensive, but they're typically comparing some relatively tiny European apartment with a much larger American home. Europeans seem to fixate on medical bankruptcies, as though these are commonplace for upper-middleclass Americans. This was all a surprise to me, an American, who has tried earnestly to live in Western Europe for a few years, but found that I can either live in Europe or I can travel in Europe but trying to do both would likely be economically infeasible (even if I can find gainful work as a software professional, it would specifically be difficult for my wife who isn't in a hot field). Fortunately, now that remote work is catching on, it seems likely that my wife and I will be able to do more frequent 1-3 month stints in Europe while remaining employed by our American companies. To be clear, I think the United States healthcare system should be reformed, because it doesn't serve the poorest Americans very well. However, the US healthcare system works pretty well for the upper middle class (if not the whole of the middle class) and above, contrary to perceptions I frequently hear from some Americans and Europeans.

refurb 5y ago

Indeed. In Canada if you’re out of the country longer than 6 months you’re not longer insured (in Canada). And in fact, insurance doesn’t cover you outside the country anyways.

jkaplowitz 5y ago
Varies by province. In Quebec, they have a similar absence rule to what you described (for being outside Quebec even if in another Canadian province), but they entirely exclude absences of under 21 days from the calculation, and they have a bunch of exceptions, including a "once every 7 years" exception for miscellaneous personal reasons including leisure vacations that just requires you to notify them in order to qualify. And in theory they will reimburse expenses outside of Quebec, even outside of Canada, but only at Quebec's very low rates. Still, yeah, very different than how US health insurance works, agreed.
nucleardog 5y ago
Anything that starts "In Canada, ..." is generally suspect. Canada is a confederation. Most things are in the purview of the provinces, so there's rarely a globally applicable rule. Canada does not have a single healthcare system, but thirteen separate provincial and territorial healthcare plans. You're not guaranteed to be covered for 6 months. If you leave permanently and settle within Canada, BC will cover you for the remainder of the month plus two months (enough time to establish residency in the destination and get coverage). If you leave the country, you are covered for the remainder of the month. If it's a temporary leave, however, several of the provinces do cover you outside of the province, and many will extend your coverage for quite a long time depending on the circumstances. BC allows you to retain coverage for a 2 year trip during every 5 year period. They also (like many provinces) will extend your coverage as long as you're in school full time in another location.
- refurb 5y ago
  Fair point on each province being different. BC does not cover care outside of Canada (assuming that’s what you meant by “2 year trip”) with the exception of emergency care at a max of $75 per day. https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/msp/bc-residents/benefits/services-covered-by-msp/medical-benefits/medical-benefits-outside-of-british-columbia https://www2.gov.bc.ca/gov/content/health/health-drug-covera...

himinlomax 5y ago

> You are not getting health insurance in most European countries unless you are working or registered as unemployed and remain at disposal of the local job centre. Not the case in France (at least for the past 20 years), and I doubt it's the case in most other European countries.

ChuckNorris89 5y ago
>Not the case in France (at least for the past 20 years), and I doubt it's the case in most other European countries. Nope, your parent is right, in Austria you also don't get healthcare if you don't work or are looking for work via your local job center. Maybe France is an exception due to having stronger social system that heavily favors the workers (insert memes about strikes) while in Austria the system is very rigid, designed to favor businesses and the government rather than the workers and to discourage abuse.
- himinlomax 5y ago
  I'm pretty sure that's not the case in the UK either, given how it's financed.
  - 1991g 5y ago
    It is not - you get access to healthcare at all times (employed or otherwise, young or old) and simply pay a slightly higher tax rate when you are working to pay for it.
campl3r 5y ago
definitely the case in Germany. If you're unemployment and not looking for a job or exempt from it(sickness, poverty, ...), you're going to need to pay on your own.
- morelisp 5y ago
  So... not the case in Germany. You don't need to be employed or in social programs, you can just pay money. In Germany it's a fixed amount, less than you would pay if you had income, and they can't refuse you. I know to a European this might sound like the only two options, but pre-Obamacare, and very possibly again if the US can't get its shit together, it was impossible to buy health insurance no matter how much money you had for a large number of unemployed or self-employed people.

ajuc 5y ago

> You are not getting health insurance in most European countries unless you are working or registered as unemployed and remain at disposal of the local job centre. Or your partner has health insurance. Or you are studying (even if you take gap year at university). Or you happen to have farming land. Etc, etc - lots of exceptions. Or you pay for it yourself from your savings (under 100 USD a month last I've checked).

vidarh 5y ago

The vast majority in Sweden pays nothing like "65% tax rate + 25% vat", though. To get to that tax rate you need to earn far above average. Someone who is single with no child earning 167% of an average wage pays ~35% income tax and social security contributions [1]. The effective VAT also for most ends up far lower as a proportion of income, as most people don't spend anywhere near their whole income on VAT-rated products. For starters, you can't spend what you've already paid in tax. As such the VAT rate has a relatively low impact on total tax paid - the difference between the UK vat rate when I moved here (at the time 17.5%) and the Norwegian VAT rate of 25% added up to only about 1 percentage point difference in total taxation for me. [1] Source: OECD Taxing Wages 2021

throwaway894345 5y ago
> The vast majority in Sweden pays nothing like "65% tax rate + 25% vat", though. To get to that tax rate you need to earn far above average. First of all, the OP is including the social security tax in the 65% figure. But more importantly, arguing that "the average Swede doesn't pay that much in tax" isn't very consoling for the American who would have to (1) take a salary hit to live in Sweden and (2) have to pay that higher tax rate. Universal healthcare doesn't remotely make up the difference in take-home pay. As a reference point, taxes, retirement/pension/social-security, and healthcare account for ~30% of my gross salary in the U.S. If I moved to just about any Western European country (not sure about Sweden in particular), my take-home pay would likely fall by 40% (conservatively) while taxes and cost of living would likely rise. Of course, the tradeoff for the Swedish system is that you have a stronger social safety net, which is certainly worth something. But the issue at hand is the notion that the European systems are better than the American system for professional employees.
- vidarh 5y ago
  The numbers I quoted also include the social security taxes (I edited to make that clear, so apologies if you replied before I made that edit). Swedish marginal rates certainly are among the highest in Europe, but the proportion who pay that much is tiny. And yes, there are people who will end up paying more, and it sucks for them. The point is there's always this scaremongering about tax rates when it comes to Europe, and most of the time the tax rates that comes up are marginal rates that are not at all representative.

tshaddox 5y ago

How many medical bankruptcies occur in those European countries?

kube-system 5y ago
That might not be an accurate way to measure it, because "bankruptcy" can mean very different things by country. In some countries, individuals often don't qualify for bankruptcy. In others you might be able to restructure your debts, but they might not be discharged. In some, you may need to give up significant possessions to pay for your debts. The US, for all of its healthcare issues, actually has a relatively progressive and accessible bankruptcy system. The majority of people in the US who file Chapter 7 have all of their assets exempted from liquidation by law. For these people, bankruptcy is literally as simple as a matter of trading all of their debt for 10 years of a bad mark on their credit report.

jhrozek 5y ago

Even worse: Unless you pay private insurance yourself, the quality of the free insurance (at your nearest vårdcentralen) is absolutely laughable. My family of 4 pays about 1800 SEK/month for private insurance to actually have a chance to see a competent doctor.

qqqwerty 5y ago
In the US, we pay 5x-10x that amount for a crappy high deductible plan that has measurably worse outcomes than your free insurance. It is hard to overstate how bad US healthcare is for the typical American. If you are wealthy, you have access to some of the best doctors in the world, but for the rest of us we are entirely dependent on our employer for access to reasonable health care.
brtkdotse 5y ago
While I agree that vårdcentralen-level health care is hit or miss, the point is that _everyone_ has a basic level of health care and getting sick won’t bankrupt you. This has the second-order effect that _I_ won’t have to worry about _someone dear to me_ will be personally bankrupted by a medical condition. It saves me having to decide whether or not I should indebt myself to pay for their treatment. Not having to raise fundraisers for my family members cancer treatment is worth a whole lot of disposable income for me.