Of course the US healthcare system is broken so I know what you're getting at but I don't know that I want Amazon to pay their workers > $15 to subsidize a broken healthcare system for their workers I just want a functional healthcare system and for them to continue to make $15/hr.

Sorry, are you seriously trying to claim an HSA is better than universal healthcare?

>Of course the US healthcare system is broken so I know what you're getting at but I don't know that I want Amazon to pay their workers > $15 to subsidize a broken healthcare system for their workers I just want a functional healthcare system and for them to continue to make $15/hr.

I'm not even sure where you're going with this. The original claim was that $15/hr was better than you can get in Europe. I pointed out the hourly wage actually isn't much better, and oh by the way, that wage doesn't include healthcare (which it doesn't). If you want healthcare coverage you have a monthly fee, plus your co-pay and deductible. Not even REMOTELY competitive to western Europe unless you're one of the lucky few who literally never gets in an accident and never gets sick (as well as your entire family).

It's not an HSA and nothing else. It looks like it's similar to my employer plan which is actually more generous than some universal systems - I/my partner use about the same services here and in Australia and I pay less here. Mainly because universal systems don't always cover dentists/specialists/mental health.

I was attempting to nicely dismiss your comparison.

I think it can be. Depends on the details but an HSA comes with a high-deductible plan. This is normally ideal for young people, who are generally healthy and only need insurance for rare catastrophic illness or serious accidents. Normal, routine care (checkups, immunizations, etc.) can be budgeted and paid out of the HSA tax-free. I don't see why that stuff should be "free" for most people, any more than groceries or utilities or housing should be.

I do. Having a healthy population benefits me. Having people immunised, cared for and well keeps me healthier and safer. Having people lose homes and jobs and potentially their lives because they can’t afford healthcare is not something I support.

Study by the NIH: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5296930/

I started with a new doctor after finally getting insurance a few years back. I told them I needed to come in for my annual check-up, and came in with a list of the things that had been bothering me and that I hadn't been able to get looked at (this is common for people who have not had healthcare access). The doctor spent 15 minutes with me, doing the bare minimum of setting up outside testing/imaging - as in, basically no guidance that day - and then coded it as a 45-minute, in-depth consultation ("because of the number of issues addressed"). $250. Before any tests or treatment. For reference, that was about 1% of my annual take-home. For a lot of you, that's like paying a grand or more just for your doctor to direct you elsewhere.

So, yeah, certain things are "covered." But the structure of our healthcare system forces our clinics and hospitals to operate like many other American businesses, which is "in a predatorial manner."

If you say “my knee hurts lately”, then that’s separate as the physician will do an evaluation that is separate from a routine physical.

And it’s not just the US. I have family in Canada and they were told maximum of 2 complaints can be addressed as they can only bill for a certain amount of time. Beyond that the doctor is working for free. Another separate appointment is needed.

If you view a person and their health in a holistic manner, you can't just say, "Well, I've got you set up to check for diabetes and Crohn's, but if you want me to consider that mole then you'll have to pay me another $300 and/or wait a few weeks until I'm not so booked."

My point was that "free preventative care" is not a panacea. Any time a doctor is incentivized to turn that visit into a money-maker, they'll gladly attempt to. And that's wrong.

The difference is that I would not personally be out 1-3 weeks worth of food money for each visit, just establishing my baseline. In neither case would what happened be a "matter of billing" because I would never receive a bill.

The doctor gets paid $X for a preventive visit. If you start adding things on that will be flagged to ensure doctor get paid more, typically through additional billing codes.

The original comment was “why do I get billed more when I bring up issues during a preventative visit”?

That’s why.

You have no empathy for people who can never afford ridiculous health care systems in private systems. This optimises the failed "rugged individual" philosophy that has only lead to ruin.

I’m not American and have only just learned about HSAs and totally fail to understand your comment. Could you explain how they help someone poor pay for medical expenses? Doesn’t the account get low/empty and then you’re out of funds?

I'm not sure how Amazon works, but my plans works something like (I'm rounding to make it easy, the reality is slightly more complex) that I pay everything for the first $3000, then for the next $15,000 I pay 20%, and thereafter I pay nothing. My total out of pocket is $6000/year, which is also the most I can put into the HSA per year, and my employer matches some of my contributions to in reality I'm getting $7k/year while only a few rare loop holes can get me close to needing that much. It is very rare for anyone to have more than $18k in medical expense per year (I had a baby last year and still am well below that), so for most people the HSA is another retirement account.

Now the HSA does mean I'm not paying $100/month for my insurance, but instead $600/month. However most of the money is invested using the HSA as a retirement account for my medical needs. The idea of the HSA (which has not worked out in practice) is because the money is mine I'll have incentive to shop around for cheaper medical procedures to make sure there is more money for my future retirement, and this should lower costs (in practice most medical things can't be shopped around for, but a few people do look at their itemized bills and sometimes notice a billed procedure that wasn't done).

Now that $600 is $3-4/hr, which is not insignificant to someone making $15/hr. However here again things get complex. That money is pre-tax income, so your taxes are almost cut in half for the year (granted this is only $500 - and only for a single person who can't claim anything else).

It’s a phenomenal sum of money to spend, and while you have clearly considered your options, it really shows how expensive it is in the US.

That said, I was surprised to see how high it is in New Zealand where I am ($4204) and how much less you are spending than the average in the US ($10906).

https://www.healthsystemtracker.org/chart-collection/health-...

The median person in the US doesn't spend much more on healthcare than the median European and their income is much higher. (Median income in a poor state like Alabama is higher than the UK.)

Plus we have working clothes dryers. Meanwhile in Sweden they're so poor they have to ration the tvättstuga.

That’s the same everywhere though. If you want to record the most expensive year of healthcare in someone’s lifetime, it’s a safe bet that the last year is going to be at, or near the top. Like has been compared with like.

> Plus we have working clothes dryers.

I’m missing something, and I suspect it’s obvious. What’s this about sorry?

You're right it is comparable, although it's affected by the country's demographics. I just mean if you're moving to the US as a working-age person, it is not going to represent your situation. A median or age distribution would be more informative.

> I’m missing something, and I suspect it’s obvious. What’s this about sorry?

That's just a fun quality of life fact about the US. Europe has better transit, we have better and bigger housing and our appliances work better. We're more likely to have air conditioning too.

(Clothes dryers don't work very well unless they're vented to the outside, and in older brick buildings like Europe, and for some reason also in Japan, they aren't always.)

I likewise had some of the best American specialists in GI and oncology. I also ended up with six figures in medical debt despite having incredible insurance and a great job. I also experienced excruciating wait times at emergency rooms that dwarfed anything I’ve encountered at the A&E in the UK.

The NHS obviously has massive scope for improvement and isn’t even the healthcare system I have felt the most secure in (that was the Swiss) but I am confident that the NHS is almost certainly better for the average Brit than the US medical system is for the average American.

I'm glad you've had a better experience with the NHS than I have; my wife has a chronic condition and has had a pretty bad time in the NHS - she hates going to the doctors now from how many times she's been called a liar or accused of just trying to feed a painkiller addiction (despite not actually asking for painkillers). All because many doctors seemingly struggle to admit that they don't know what's wrong.

I just bring this up because I think (and I could be wrong) that some people see socialised healthcare as a panacea but my experience with it is that it's actually very inconsistent and regularly lets people down (not just my wife, a good few others that I know as well). I still wouldn't choose the US system over the NHS though, not by a long shot.

Do they? Every socialised healthcare system is crying out for money and is in need of help. I don’t think I’ve ever seen anyone claim one is perfect.

Oh, and granted it was just the one experience, but the wait time seemed on par with an urgent care here in the US.

That sounds really weird. Why would a UK doctor not fix a break?

I’m guessing there was a medical reason rather than anything to do with the NHS or quality of care?

I've had other NHS experiences that make this not particularly surprising.

incorrect. they are OFFERED healthcare coverage. By this use of the word have, I have a private jet because I could buy one if I had the resources.

Did you know that the United States is the wealthiest country in the world?

In aggregate, sure; its somewhere between 5th-8th by per capita GDP, which is the more relevant comparison, depending on source.

But the UK isn’t even close to the US, or particularly near the top in Western Europe (which yas countries ahead of the US.)

Is it fair to compare the average wage of a warehouse worker across the entirety of the U.K. with the starting wage of a warehouse worker in a single deeply impoverished town?

https://www.amazon.jobs/en/landing_pages/warehouse-operative

And if it's just plane fare, there are probably a lot of places you can make it with a bus ticket that have better prospects without needing to go to Europe.

Top of mind why someone would NOT want to work in "Europe": - lower salaries - much higher tax rate - stuff in general is more expensive (higher VAT + everything that's imported)

Healthcare in the UK is not as good as you may think it is. Unless you love waiting lines for life-threatening conditions.