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Comment by mindjiver | Hacker News Reader

Pretty sure I have to pay for health insurance with my actual salary in Germany, the employer does however cover half the cost of it. It does not come included (e.g. 100% payed by the employer) like with the national insurance system in Sweden. Also, I might be mistaken but only 20 vacation days are required by law and I have 24 days currently.

I do agree with the first grade medical card and the general cheapness of the country.

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The point is, that in US the second you stop paying your medical insurance as a result of financial problems caused by job loss/illness/family issues/whatever, you don't have health insurance anymore. Sure, you can go to an emergency room and will be helped, but you are still going to get a bill for it. In Germany(and most of EU) even if you are paying nil towards the national health insurance, you are still fully covered for everything - no bill will ever be produced for any treatment that you receive. Various EU countries have the payments for national insurance structured in different ways - so in Sweden, the employer pays 100% - maybe in Germany it's split in half. It doesn't matter - the point is, you are covered regardless of your personal situation.

You're pushing a lot of misinformation.

COBRA covers your health insurance if you're fired, for up to 18 months or so. You do generally have to pay premiums on it.

The US has free healthcare for people without an income. If you're making the federal minimum wage, you qualify for free healthcare via Medicaid in every state (someone correct me if there's an exception).

The US has numerous government healthcare assistance programs for people that are in some kind of bad position.

Nearly half of all healthcare coverage in the US is public healthcare at this point, not employer sponsored.

So how come 50% of all bankruptcies in US are due to medical bills, while "medical bankruptcy" is literally unheard of in EU? What is that about?

Your 50% number is false. That derives from a 2009 study that goosed the numbers by including some odd qualifications such as if you missed work due to illness at any point in the year you declared bankruptcy.

The numbers are bad enough to not need pushed higher artificially frankly. It's closer to 1/4 of all bankruptcies having been impacted by medical bills (2011 Northwestern study indicating 26% of all bankruptcies are partially - not solely - caused by out of pocket medical costs).

There are roughly 288 million people in the US that have health coverage.

The medical bankruptcies you're referring to affect less than 1% of the adult US population across ten years. Among that 1% are common repeat medical bankruptcies, so the number is in fact even smaller.

If you look at the total number of bankruptcies in 2016 - 770,000 - and the share of those that were entirely caused by medical bills, you're probably talking about 100,000 to 150,000 (out of ~250 million adults). The ACA, it is speculated, has improved the medical bankruptcy numbers since its 2010 passage, and the economy has improved dramatically since 2010-11.

Is it terrible? Yes it is. Did you expect me to say otherwise? However it does in fact affect a small portion of the US population. It's obvious that if you could pick a few things to change about the US financial system, one would be to be able to more easily discharge medical debts.

> Pretty sure I have to pay for health insurance with my actual salary in Germany.

Yes, that part is mainly relevant when comparing net income.

> Also, I might be mistaken but only 20 vacation days are required by law and I have 24 days currently.

You're right, but 24 is really low. 28 to 30 are very common.

Often depends on industry and age (you gain additional days over time).

True, it causes problems with recruitment since it is very hard to get people to drop up to a week of holiday to join us. I would love to have 28 or 30 days..

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