It's an important point for software developers.

US healthcare for the top 1/4 is far better than what public healthcare is like in most of Western Europe.

In the US if you have good healtchare you have exceptionally fast access to among the world's best healthcare services. You also have a freedom of (ab)use when it comes to utilizing healthcare services; it's a luxury you do not get in most of Europe, where service rationing and very long wait times are normal in the public healthcare sphere (also true in Canada). There are trade-offs in all of these systems.

It sucks if you're in the middle ~40% in the US. It's spectacular if you're in the top 1/4 and your health insurance is covered by your employer.

> Of the Dutch adults surveyed, 59 percent said that they were very confident of receiving high quality and safe health care, compared to only 35 percent of the American adults surveyed.

-- https://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands

Since you were replying to a comment about Holland this seemed relevant. Don't know about a general study covering all of Europe or something.

But I guess that's where the "if you're employed by a bigcorp" part comes in. You can get better service if you pay a lot, yeah that much seems a bit obvious.

> You can get better service if you pay a lot, yeah that much seems a bit obvious.

Not exactly - larger organizations in the US are able to negotiate better rates with insurance companies. So it's more so that your buck goes further than it is you paying more bucks ;)

the issue i have with this argument, is that it makes healthcare for those who are not in a privileged non existant. (with the boatload of social issues that come with it).

Sure, you might get proper and very good healthcare, but what about those around you in your community?

It's not an argument. It's just the reality of health insurance in the US at this time.

As an argument in favour of privatised healthcare, this is valid, but in the context of Europeans moving to the US, it doesn't seem relevant. The US is not going to reform its healthcare just because a few Germans don't immigrate.

That's not true in the US.

The very non-privileged get moderately ok, free healthcare via Medicaid (along with numerous other programs for poorer people, including coverage for children, SS disability and so on). That covers the poorest/worst off quarter of the US population approximately.

It's the working poor and middle class that really get screwed with the US system. The well-off pay taxes to cover the free healthcare system that the US has. The working poor and middle class often can't afford the healthcare system, are more frequently at risk while unemployed, and their employers are less likely to provide good coverage as a benefit.

I'd like to understand this better. If I was a software engineer for 20 years and had cover and savings etc then was between jobs for a few months for whatever reason and got into a car crash how would that work.

Would I get medicare/aid?

Are all people students / unemployed expected to be paying monthly premiums to get any kind of cover?

I have had healthcare in the US for a serious accident, but I had travel insurance (UK based) which likely saved me 100,000s of dollars. Fortunately they paid up without question. I'm not sure how that would have worked if I was just some regular student from the US travelling around, would I be bankrupted for life or hoping for crowdfunding? Sounds like if you have an accident in the US you need to be rich or popular (or maybe really poor).

Even if we argue the very disagreeable notion that European healthcare is:

1) heterogeneous

2) subpar

3) public only

Then we’re still left with the fact that most big companies do offer private health coverage in Europe. Mostly this is for less than life threatening illnesses, psychological help and physiotherapy.

Well that notion is wrong anyway because every European country has their own system. Some are mainly public with a purely optional private option, like Spain. Some are kinda forced private because otherwise you have to wait for years, like Ireland. Some are absolutely mandatory private like the Netherlands.

And yes in most countries some classes are purely private. I think Britain is a big exception though I've heard the NHS is also not what it used to be.

> If you're employed by a top company in the US, your health insurance is generally much better quality than most public option in Europe

Assuming you are high up enough in the organization. Unless junior developers get the same plan and coverage as the CFO.

The bigger assumption would be that a person with a good employer plan today, had no health conditions that went under-treated as a child and are more acute in adulthood.

Someone in a UHC country may not have top-quality access to care, but it is the simple act of access to primary care itself that can have conditions diagnosed and treated early. That in turn will have a compound effect on QOL, even if you do earn the Tim Cook-level coverage plan when you're 50.

> Assuming you are high up enough in the organization. Unless junior developers get the same plan and coverage as the CFO.

Companies are required to offer the same benefits to all employees, so yes you do get the same health insurance as the CFO.

This is one reason that companies keep pushing low-level labor jobs to contractors or falsely separate contracting companies. They want to attract software engineers with good health insurance, but avoid offering it to their janitors.

not sure why you get downvoted, but yes - it is