4 ms·

Europe has much stronger labour laws, and a much deeper social safety net for people who do in fact lose their jobs. Almost all states (Montana being kind of th

Europe has much stronger labour laws, and a much deeper social safety net for people who do in fact lose their jobs. Almost all states (Montana being kind of the exception where at-will goes away after the probationary period of your job) have "At-Will" [1] employment, which basically means you can be fired for anything, at any time, without any reason needing to be given, apart from for a few carved-out exceptions; for example, it is illegal to fire you because of your skin colour. If your boss wants to fire you for wearing a blue tie on a Wednesday, you're out. In many ways worse than the immediate loss of job/income, though, is that your medical coverage is usually (and by usually, I means pretty much always) tied to your employment. So if you're pregnant, or if you're on expensive life-saving medicines, well, you have a problem. There are various band-aids to try and help people out when they lose their job, but none of them are particularly impressive, looking on them from a European perspective. I'm a Brit, been here for almost 20 years, basically for the money. I would have left and returned back to the UK 5 years or so ago (having made enough to keep us comfortably for the rest of our lives) but the kid is in school, and my (US) wife doesn't want to uproot him (which is fair). Once he's off to college, I'm going to retire, stay a while on relatively low "income" to get out of the "fuck you" tax for green-card holders leaving the country, and I'm (we're) out of here. [1] https://en.wikipedia.org/wiki/At-will_employment https://en.wikipedia.org/wiki/At-will_employment

PopAlongKid 4y ago
> your medical coverage is usually (and by usually, I means pretty much always) tied to your employment. That has not been true for ten years now, with the implementation of the Affordable Care Act (aka Obamacare). It used to be that pre-existing conditions tied you strongly to continuous employment (except for periods of COBRA coverage avaialble), but those are no longer grounds for denying you new coverage. And if your income has dropped a lot, most if not all of the coverage will be subsidized by the government.
- spacedcowboy 4y ago
  > And if your income has dropped a lot, most if not all of the coverage will be subsidized by the government This seems to be very location-dependent. Most states will be reasonably generous and extend Medicaid coverage to you. Some will not. Even when you have Medicaid coverage, it's still a crap-shoot whether a Dr. will take you on as a patient. Hospitals will, in general, but there's plenty of Dr's offices with "No Medicaid" signs in them. COBRA is an utter joke. If you've just lost your job, how are you supposed to afford $1750/month [1] for medical insurance for your family ? I think Obamacare was a step in the right direction for health-care in the US. I think it's woefully short of just about anywhere in Europe. The entire healthcare industry in the US seems to pile on huge amounts of stress right at the point where you need to just get well. In-network/Out-of-network, covered/non-covered, co-pays, crazy-high deductibles, the works. In the UK, the only thing I worry about paying for is parking at the hospital... [1]:https://www.brookings.edu/blog/usc-brookings-schaeffer-on-health-policy/2020/03/17/what-do-i-do-if-i-lose-my-job-based-health-insurance/ https://www.brookings.edu/blog/usc-brookings-schaeffer-on-he...
  - toast0 4y ago
    COBRA is what it is, if you had high priced employer paid coverage and you want to continue it, it's going to cost a lot. Otoh, there's exchange plans which tend to be lower cost. All the exchange plans have to cover the same baseline things, but of course how big your share is varies. There's subsidies if your income is low, but not too low for medicaid. Yes, there's a lot of fussyness in the details, and it can be stressful, but you just go and do your healthcare and wait and see what the bill is, and then decide if you're going to pay it or not. Mostly, there's no requirement to pay at time of service.
    - spacedcowboy 4y ago
      "It is what it is" is not an acceptable answer, from a European perspective. That's the point I was trying to make. And I stand by the original claim: "There are various band-aids to try and help people out when they lose their job, but none of them are particularly impressive, looking on them from a European perspective."
  - legitster 4y ago
    > COBRA is an utter joke. If you've just lost your job, how are you supposed to afford $1750/month [1] for medical insurance for your family ? Agreed. But that's how much your employer was paying. I'll die on the hill that the US medical system would be so much better if we just gave that cash to everyone instead.
    - ThePowerOfFuet 4y ago
      > I'll die on the hill that the US medical system would be so much better if we just gave that cash to everyone instead. You really don't get it, do you? Remove the profit from the equation. The rest of the civilised world figured it out decades ago, but the US is just too damned greedy to swallow such a pill.
ozzythecat 4y ago
AFAIK, under the affordable care act, you can get health insurance at a much more reasonable price, though I haven’t used it myself and cannot comment if it’s equal to quality of care and cost vs. other developed countries. Everything else you said is spot on. Not every company will necessarily enforce and fire people at a moments notice. While yes that can happen, I think any reasonable business cares about perception and employee morale. Aside from that, I think everything you said is spot on.

PopAlongKid 4y ago

> your medical coverage is usually (and by usually, I means pretty much always) tied to your employment. That has not been true for ten years now, with the implementation of the Affordable Care Act (aka Obamacare). It used to be that pre-existing conditions tied you strongly to continuous employment (except for periods of COBRA coverage avaialble), but those are no longer grounds for denying you new coverage. And if your income has dropped a lot, most if not all of the coverage will be subsidized by the government.

spacedcowboy 4y ago
> And if your income has dropped a lot, most if not all of the coverage will be subsidized by the government This seems to be very location-dependent. Most states will be reasonably generous and extend Medicaid coverage to you. Some will not. Even when you have Medicaid coverage, it's still a crap-shoot whether a Dr. will take you on as a patient. Hospitals will, in general, but there's plenty of Dr's offices with "No Medicaid" signs in them. COBRA is an utter joke. If you've just lost your job, how are you supposed to afford $1750/month [1] for medical insurance for your family ? I think Obamacare was a step in the right direction for health-care in the US. I think it's woefully short of just about anywhere in Europe. The entire healthcare industry in the US seems to pile on huge amounts of stress right at the point where you need to just get well. In-network/Out-of-network, covered/non-covered, co-pays, crazy-high deductibles, the works. In the UK, the only thing I worry about paying for is parking at the hospital... [1]:https://www.brookings.edu/blog/usc-brookings-schaeffer-on-health-policy/2020/03/17/what-do-i-do-if-i-lose-my-job-based-health-insurance/ https://www.brookings.edu/blog/usc-brookings-schaeffer-on-he...
- toast0 4y ago
  COBRA is what it is, if you had high priced employer paid coverage and you want to continue it, it's going to cost a lot. Otoh, there's exchange plans which tend to be lower cost. All the exchange plans have to cover the same baseline things, but of course how big your share is varies. There's subsidies if your income is low, but not too low for medicaid. Yes, there's a lot of fussyness in the details, and it can be stressful, but you just go and do your healthcare and wait and see what the bill is, and then decide if you're going to pay it or not. Mostly, there's no requirement to pay at time of service.
  - spacedcowboy 4y ago
    "It is what it is" is not an acceptable answer, from a European perspective. That's the point I was trying to make. And I stand by the original claim: "There are various band-aids to try and help people out when they lose their job, but none of them are particularly impressive, looking on them from a European perspective."
- legitster 4y ago
  > COBRA is an utter joke. If you've just lost your job, how are you supposed to afford $1750/month [1] for medical insurance for your family ? Agreed. But that's how much your employer was paying. I'll die on the hill that the US medical system would be so much better if we just gave that cash to everyone instead.
  - ThePowerOfFuet 4y ago
    > I'll die on the hill that the US medical system would be so much better if we just gave that cash to everyone instead. You really don't get it, do you? Remove the profit from the equation. The rest of the civilised world figured it out decades ago, but the US is just too damned greedy to swallow such a pill.

ozzythecat 4y ago

AFAIK, under the affordable care act, you can get health insurance at a much more reasonable price, though I haven’t used it myself and cannot comment if it’s equal to quality of care and cost vs. other developed countries. Everything else you said is spot on. Not every company will necessarily enforce and fire people at a moments notice. While yes that can happen, I think any reasonable business cares about perception and employee morale. Aside from that, I think everything you said is spot on.