I suppose it depends a lot on how much you end up paying in taxes. In Norway you'd pay between ~35-45% income tax (and the employer pays a little more on top of that) - that amounts to ~2600-3600 USD out of a monthly 8000 USD paycheck (100.000 USD/year). For that you get (mostly) free medical care, pay during sick-leave, free education for yourself and your children through college. It's certainly more than 500/month - but 500/month doesn't sound like that much assuming it will cover all kinds of illnesses, including things like life-term cancer treatment with followup even if you lose your job.