what i've found/heard in germany is this:

you may struggle/it may take long to find certain things to get a diagnosis, but once you do, it's a ball that gets rolling insanely fast.

2 anecdotal examples:

colleague's young child was fainting, took them quite a while to get through the right set of doctors/specialists to find out it was a brain tumor - after that was found though, they were scheduled for surgery the next morning. Operation successful, child okay.

I had an appendectomy in the middle of covid: went to the ER unannounced at 7 p.m. - was on the table at 1 a.m. - i paid 50 euros (10 for each day i spent there (they kept me for 3-4 days "just in case")). This was quoted to me up front (the rate, but not the number of days) and i signed a document stating i understood that charge before i was in surgery.

That’s all correct. The point is it’s incredibly hard to get to the specialist at times. I was trying to get an appointment in Belgium, they could only offer April 2022.

Same is true in the US.

In Germany, in the vast majority of cases, you can simply go to any doctor's practice (including specialists, no referral required) during office hours and see the doctor the same day, if it's urgent. They'll squeeze you in.

For non-urgent appointments, yes, the wait time for specialists can sometimes be months.

There is one major healthcare provider in my region. When I arrived here, the wait time for a physical was more than two months. The shitty US system is not giving me at-will service.

I can get an whole body MRI in Poland for ~$250 via a private healthcare provider and wait less than a week for it at that.

Why is an MRI anywhere in the world $1500, or $3500 for that matter?

Similar price in London. One provider I checked indicated $560 for their "platinum service" which included lots of mostly pointless extras, but $280 for the basic service.

Private hospitals in London largely live off a split of offering cheap convenience or extracting money from foreign patients, but there are so many of them fighting for a small pool of patients given most people just go to the NHS that they have to compete hard.

For an emergency MRI? Are you insane?

For reference, i got an MRI in two days for knee pain after i fell with a bike and the pain didn't go away after a few weeks ( so obviously nothing urgent).

And FYI, i paid for it, iirc 60-100 euros, repaid in full by my medical insurance.

The parent wasn’t saying whether it was an emergency or not.

So, yeah, there is a point on who considers what an emergency.

They were saying they had pain and nausea, the doctor suspected a kidney stone. Is this an "emergency"? I have had a kidney stone, it is intense pain. My mother had one, said it reminded her of childbirth.

But it won't kill you, probably. You could just be in intense pain for weeks or longer waiting to pass it.

Is that an emergency? I think in probably any sane medical system it is. In the USA? No idea.

For a medical emergency? This is simply false.

I live in Canada, and I've seen people put on 6+ month waitlists for (a) MRI after a concussion to make sure there's no internal bleeding (which can kill in a single day), (b) MRI after a stroke to diagnose the root cause, (c) ACL replacement surgery.

Universal healthcare is great, but when you're in a 2-party system and one party undermines it whenever they're in power, the result is terrible.

I'm sorry to hear that, but it's not quite relevant to the point that the parent was making about Europe.

For what it's worth, I live in the UK which has similar woes to how you describe Canada's two-party system. However we do normally get seen quickly for things which are a threat to life---but elective operations can take much longer. Mental health issues are also dealt with sluggishly at best.

Describe emergency. Sure, you’ll get an MRI after a car crash. But you could be in this state where you’re not dying, but still very uncomfortable. The wait list is pretty long then.

Do you have studies on waiting times that you can cite here? Genuinely asking because I know they certainly exist for Canada[1] with breakdowns down to the Province [2] so I'm just assuming you have some proof that can be used to bolster your claim.

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292524/

2. https://www.hqontario.ca/System-Performance/Wait-Times-for-D...

In most of Europe you still have the option of going private if you want that, either with private insurance on a "top up" basis, or paying per appointment.

I don't know what the prices are in Germany, but in London an abdominal MRI is in the $280-$600 range. (EDIT: And you can usually get a same or next day appointment)

Prices in Germany are set by the government. If you check the Gebührenordnung für Ärzte you'll see that in private practice an abdominal MRI is EUR 256.46.

The US are a clear outlier.

Makes sense, given the prices I've seen for London and the prices someone quoted for Poland.

Makes the US pricing in this article even more bizarre - in "normal times" you could literally fly to Europe for an MRI and save money.

Correspondingly, senior SWEs at startups in Germany struggle to earn above €100k/y.

What exactly is your point?

That it is worth it that people go bankrupt due to medical issues because it means that certain professions can earn 6 figures?

I’m really curious. What do you think you are saying? How do you think those two statements correspond? Do you genuinely believe that if the majority of Europe were to ditch its public health services that salaries would go up and that that would be a good thing?

My point is that even if you have to pay market rates for private healthcare insurance in the US (which are crazy high), the overall system in the US works better for many HN-types because while your expenses may be much higher, your income is disproportionately higher (as in 2-5x higher).

FWIW, I am a US person, resident in Germany.

So you are saying that HN-types got theirs (the huge salary), so they should not care about others? Or are you causing them of a "I got mine, fuck you" attitude? I am still not sure what you are trying to say. But the fact that you LEFT the US that has that kind of dynamic for Germany, where income inequality is smaller and many things -- including medicine -- are more widely accessible makes me scratch my head.

> So you are saying that HN-types got theirs (the huge salary), so they should not care about others? Or are you causing them of a "I got mine, fuck you" attitude?

Neither of those things, no. (Also, if you think of €100k as "a huge salary", you should recalibrate; in the industrialized world it is not.)

> I am still not sure what you are trying to say. But the fact that you LEFT the US that has that kind of dynamic for Germany, where income inequality is smaller and many things -- including medicine -- are more widely accessible makes me scratch my head.

The healthcare in Germany appears to be somewhat crap compared to the highest level of care available in the US. It's an order of magnitude cheaper, though.

I left the US because the US is a police state, not because best-in-the-world healthcare has highest-in-the-world prices.

My comment could best be summarized as "health care costs should not be a major concern in your life as a SWE because they will be cheap (to you) everywhere, so make your SWE life choices based on other things". You can inaccurately paraphrase this as a rejection of concern for social justice, income inequality, or a generalized "fuck you, got mine" at your own peril.

(FWIW, I think national boundaries are mostly irrelevant and unimportant, and drawing the boundary of your official-concern-for-the-wellbeing-of-others at an invisible line checkpoint to be somewhat closeminded. There are billions without meaningful modern healthcare access at all (or even clean water) so the selfrighteous indignation bit about the relative quality and expense of healthcare in two major industrialized western nations is sort of a silly nit to pick.)

So you believe that because you’re paying only for private healthcare you’re income is higher?

Even so, medical bankruptcies are not a thing in Germany.

That's very similar to wait times as in the US.

Fuck, a few years ago I had to switch dentists and I couldn't get even a teeth cleaning without waiting more than six months.

I would like the citation to specifically where and when someone had to wait half a year for a kidney stone to be diagnosed and treated in Europe.

I got an MRI in France a few years back, not an emergency. Booked an appointment for the next day. To be fair, 30 years ago when MRIs were kinda new and machines were extremely expensive, I remember there was not enough of them and patients and doctors complained of long wait times. That's not been an issue in a while.