You dont have free healthcare. You pay for it like tech employees in the US do and you probably get worse service. At least there is a chance in the US to make generational wealth for a middle class, but no way in hell in Europe.

> You dont have free healthcare

If you’re going to use that sort of reasoning, then you don’t get free anything other than air.

Yes, it’s paid for by taxes (or through insurance depending on country; yes we have cheap private insurance here). Thank you for bringing that to our attention, our feeble European brains were unable to deduce that on our own.

In Germany, my wife and I pay together about ~2,000 USD per month for public health insurance. It's not cheap!

Nor is it universal: I can count at least one extended family member who is not insured and is one accident away from bankruptcy - not unlike some people in the US - except that personal bankruptcy is exceedingly difficult process in their EU country, and it would be quite doable (if not straightforward) to go to prison for the debt.

Which is about what a good family plan on the exchanges would be in the US.

Not good. Basically bankruptcy insurance, you pay for all your typical health expenses outside disaster. I don't know what Germany offers for that price, but given the overall lower cost of healthcare, presumably it actually covers your healthcare.

It's fairly good coverage without frills (i.e. you get a shared room in the hospital). Doctors tend to de-prioritize public insurance when giving appointments, because they earn less from them, particularly for elective or non-urgent issues, so you usually have to wait a bit longer than privately insured patients.

On the other hand, the insurance costs ~15% of income with a cap, so it has an element of solidarity to it - if you earn less, you pay less, and children and non-working spouse get covered without extra cost.

It's not public insurance though. It's private insurance companies on a given state's exchange which may be pretty similar to what you have through an employer. The big thing with Obamacare is that you can now get private insurance even with pre-conditions. I'm not going to especially defend health insurance in the US but the idea that you can only get it through an employer is just not true.

There's also Medicaid if you're poor of course.

If you pay $2000 per month combined (which btw includes all children up to the age of 18 and all children not in full employment up to the age of 25) you're paying the maximum rate.

Your public health insurance rate in Germany is based on your annual income up to €59,850 (i.e. you pay the same whether you make €59,850 per year or €200,000 per year). At the maximum rate, you usually pay €807.99 per month for health insurance (including the average extra fee of 1.6%, which varies slightly by insurer) if you're a salaried employee.

In addition to the public health insurance you also pay for public nursing care insurance, the rate of which depends on whether you have children or not and are older than 23. Assuming both of you are self-employed, have no children, are older than 23 and have not opted out of public sick pay (which for employed people giving birth includes a combined 14 weeks of pre and post-natal leave known as "maternity protection", or a combined 18 weeks for early births or twins) and assuming the same average of 1.6% for the extra fee, you indeed pay €977.50 or just above $1000 per month each.

For the record, if you're self-employed, the absolute minimum you have to pay for public health insurance is €158.43 (without sick pay) plus public nursing care insurance plus the variable extra fee. This basically assumes your income is at least €1131.67 in any given month even if you make less than that: you can't pay less than that as long as you're self-employed unless you switch to a private insurer instead.

Another issue for self-employed people is that because your insurance rate is paid by you in full (unlike salaried employees where 50% of it is paid by your employer and your rate is adjusted automatically if your salary changes in either direction) your rate is much less dynamic and will often have to be adjusted retroactively. Public health insurers are legally only allowed to adjust your insurance rate based on your tax returns which means even if you magically manage to file your taxes in January of the following year and the tax agency immediately processes it, you may end up having to backpay (or be refunded) the difference for an entire year if your rate changes. If you are self-employed and not incorporated, you can file quarterly tax advances and the insurers are allowed to use these to temporarily adjust your rate until the final tax return is available but once you incorporate you're stuck in the worst of both worlds.

As this hopefully illustrates, there are many problems with how the public health insurance system works, especially for self-employed people and founders (and especially people who can get pregnant as it's not common knowledge that "sick pay" includes "maternity protection" and self-employed people often opt out of sick pay because it's an easy way to cut costs), but pretending our public health insurance is "not cheap" is a bit dishonest.

To reiterate for emphasis: if you pay a combined 2000 USD together per month that means the two of you each make at least 60k USD per year and you will not pay a single cent more for health insurance no matter how much more money you make. Arguably this ceiling is the main problem and if it were abolished, the rates could be considerably lowered for everyone else. The insurance rate is very painful if you're self-employed and make less than 60k EUR per year. It becomes increasingly less painful the more you make beyond that and that doesn't seem very fair.

I'm not sure what is dishonest about what I said.

My point is that the German system is not a magical system of free healthcare. Rather, it's financially backed by charging a considerable chunk of earnings.

As a side note, the idea that the employer pays 50% of the contribution is a political slight of hand - an employee's labor covers 100% of the health insurance payment.

I just spent 3 hours calling around every damn pediatrician in Ireland to have somebody, ANYBODY check my 3 year old daughter who hasn't grown in 5 months and is under the 1st percentile in height now. I am happy to pay them a lot of money to do so.

There IS No healthcare in this dump of a country. I am looking at flying to Barcelona to have her seen, and moving out of this dysfunction as soon as possible while I'm at it.

In Europe you don't go bankrupt on healthcare because you just die.

Yeah, yeah, anecdata, but right now I'm liking the "I get an appointment quickly and pay lots of money but that's OK because I earn lots of money" model more and more.

> You dont have free healthcare. You pay for it like tech employees in the US do and you probably get worse service.

True, but there's no stress due to possible crazy variations in prices, "in network" - "out of network" garbage, etc. When people talk about "free healthcare", what they're really saying is: "out of pocket healthcare expenses are very small and always capped at a decent level, and I have access to healthcare even without a job".

> At least there is a chance in the US to make generational wealth for a middle class, but no way in hell in Europe.

https://www.oecd.org/economy/growth/49849281.pdf

TL;DR: The US has worse social mobility that many equivalent Western European countries.

What the US does is amazing marketing for their big outliers (and amazing marketing for everything, even piles of rocks in a desert, for that matter). I.e. 1 person in 100 million becomes a billionaire and suddenly you'd think 1 in 10 000 people did it :-)

Also:

https://en.wikipedia.org/wiki/Global_Social_Mobility_Index

The US is in 27th spot, after 21 (!) European countries.

The problem with those social mobility scores is they rank it by “chance of going from lowest quintile to highest quintile”.

But the quintiles aren't the same.

A good example is Canada vs the US vs the UK.

The top US income quintile is 153,000 USD.

Canada is 131,000 CAD (98,000 USD).

The UK is 87,000 GBP (105,000 USD).

So you could have less social mobility in the US (going from 1st to 4th quintile) than Canada (1st to 5th), but end up better off financially.

I think the reasoning is that you likely won't get out of 1st at all.

But that's not how economic mobility is generally measured. It's usually movement from bottom to top quintile. The measure is relative mobility within a society, not absolute mobility.

But the WEF reference for the grandparent uses a "social mobility index" which includes such factors as: "Adolescent birth rate per 1,000 women", "Pupils per teacher in pre-primary education (%)", "Extent of staff training (1–7 best)", "Internet users (%)", "Meritocracy at work (1–7 best)", so it's clearly quite subjective when it comes to "social mobility".

It might interest you to look up income and social mobility rankings. In short, you are much more likely to build generational wealth in the Nordics.

Yeah, I'm not sure why people are surprised that having a safety net allows poorer people to take more risks.

There are plenty of chanses to make generational whealth for the middle class in europe. Especially in the nordic countires.

You should look up "Temporarily Embarrassed Millionaire."

> And when you factor in the municipal bus network, a $40k salary at Klarna in Stockholm is basically the same as a $350k salary at Stripe in the US.

Sorry, I'm European but this is just silly.

There's no way $40k in Sweden buys you equivalent quality of life as $350k in the US, even when taking all the welfare state factors into account.

I think it was a joke.

I guess too much time spent on the internet does that to a person (me).

¯\_(ツ)_/¯

Is it? The numbers may be pushed a bit to their respective limits, but with all the talk about cost of living in the Valley, $200k there may poorly approximate a similar quality of living as a sub-$100k salary does in a European city. Something about apples, oranges, and generalization.

They are talking about how the municipal bus network makes up for a roughly 900% difference in two salary figures. It's definitely a joke.

$40k is less than the average salary in Sweden while $350k is probably at least top 5% in the US (even without all the very relevant differences).

Sweden for the most part sucks these days but part of that is the idea that you can lounge through some average free education and then get $350k while leaving early on Fridays.

Yes, some Americans are born wealthy and some have a lot of privilege. Everyone else, at least that I've known, works at it. Often for 15 years. Then they might get $350k, or laid off.

$350k is top 1%, $175k is top 5%