Heavy question, I know. This is not intended to be political, please leave “taxes/government evil” out of it, I’m interested in a pragmatic view.
Infamously the US has mostly private health care, but we also have Medicare and -aid, the ACA, and the VA.
Most other nations have socialized health care in some format. Some of them have the option to have additional care or reject public care and go fully private.
Realistically, what are the experiences with your country’s health care? Not what you heard, not what you saw in a meme, not your “OMG never flying this airline again” story that is the exception while millions successfully complete uneventful and safe journey story. I’m also not interested in “omg so-and-so died waiting for a test/specialist/whatever”. All systems have failures. All systems have waits for specialists unless you’re wealthy, and wealth knows no borders. All systems do their best to make sure serious cases get seen. It doesn’t always work, but as a rule they don’t want people dying while waiting.
Are the costs in taxes, paycheck withholding (because some people pay for social health care out of paychecks but don’t call it a tax), and private insurance costs worth it to you?
I live in the US and was born here. This is true of my wife as well.
I hate to say it because I know how bad many people have it here, but our health care experiences have been excellent. IVF? We paid a few grand by the end of everything, but that’s it - most of the cost was one hormone in particular. My cancer that almost killed me? We paid $15 co-pays for doctor appointments and physical therapy appointments, nothing for any treatments (radiation, chemo, surgeries, hydration, etc.), and about $15 co-pays for each prescription medication. My upcoming rotator cuff surgery? I’ll pay similar to the cancer. Regular in-home therapy services for our children with special needs? Free.
This was not by accident or dumb luck. My wife and I have always chosen jobs in large part based on benefits in general and health insurance in particular. We may not make as much money on paper as job hoppers and those who chase the highest number on their paychecks. Do you know what we do have? No medical debt. Great parental leave. More vacation time than most. A legal plan that paid to set us up with every estate planning and life management document one could need.
So it’s hard. Our system is fucking broken - too many people cannot get the care they need, or they go into debt to get it. It needs to be fixed. That said, I also have friends who just made shitty choices. They actively chose direct income over benefits. They gambled and some of them lost.
We need to fix US healthcare in or much every way. In the meantime? My wife and I choose to play the game by the rules as they are currently written, and we play with intent to win.
How much are your monthly premiums?
Just because you aren’t paying when you go to the doctor doesn’t mean you aren’t paying every month for it.
That is a good point. We are not paying monthly premiums. Again, over the years we have chosen our employers very carefully. To be clear, we are lucky to have been in the place to do so.
That said, we also did very well when I was a public high school teacher. The pay was awful, but the health insurance we had was better than my wife could get at most corporate jobs at the time. We now use my wife’s corporate benefits because my family’s needs have placed me as a stay-at-home dad for several years. Once she got in with a company that actually values its employees, we made the decision to stick it out.
So you just don’t care about the people who chose differently? What about the people who just had to take whatever job they could get?
Reading comprehension
I care very much. Please read everything I wrote. The system is broken, and we need to fix it. In the meantime, since we must live within the broken system, it is wise to do a thorough cost/benefit analysis before accepting any job. Not everyone can do that, but some can.
We play pretty conservative baseball when it comes to personal finances. We have a smaller house further from the city than my wife’s peers at work. We buy cars that meet our needs, but our wants are frequently compromised in search of the lowest total cost of ownership. We make no major purchases without real research first. Our kids have not been to Disney, but they will hopefully be able to go to the college of their choice without a mountain of debt when the time comes.
We are very lucky, but most people that merch our income are not actually in as stable a place as we are. That stability comes from good decisions.