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Comment by torginus | Hacker News Reader

I'm not sure what you are claiming. You probably won't get $300k in the EU, but if you do, a greater proportion of it will go to taxes - the things you get in return, like pensions or healthcare aren't as attractive at that income level. While US healthcare is very expensive, it's a service, which means it's tied to how much you pay, and not defined as a percentage of your gross income. If you make that much money, you can easily retire early, which wouldn't be possible with government pensions.

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> a greater proportion of it will go to taxes

Is this true? Taxes in the US are pretty high if you have a high income, and remember to include state and local taxes, and property taxes.

> the things you get in return, like pensions or healthcare aren't as attractive at that income level

Perhaps, but it's also attractive that _other_ _people_ get those benefits because ultimately the level of stress everyone else is under has an effect on your quality of life, one way or another.

I've looked into this and it seems the biggest difference is where the brackets are. They're much higher in the US, even if the marginal tax rate for high earners in California is not much lower than Germany.

curious, did you then add medical insurance in? My understanding is that at the highest marginal rates, the two countries are similar, but then you consider that those in the US are also paying additional health insurance premiums.

The people in the US making enough money to pay top marginal rates are not paying for health insurance in any meaningful way. It is paid for by the company as a benefit and very high quality. Even if that wasn’t the case, if you are paying those kinds of tax rates then the cost of the very best insurance is essentially inconsequential relative to your income.

An experienced software engineer might take home, after taxes, $15-20k/month in my US tech city. High-quality health insurance for an entire family is on the order of $1-2k/month, assuming you had to pay for it yourself. If you are a FAANG-level engineer, not only are you not paying for that but you are being paid twice as much.

The cost of health insurance in the US is a real concern for the lower half of the middle class. Software engineers live in a completely different universe of concerns.

I'll take your numbers at face value though they seem high to me as take home pay. So $15k/mo at around 35% taxes, and let's skip marginal rate, as that will round numbers in favor of health insurance being negligible. So total pay around $240k/yr. I spend $600/mo or around $7k/yr on health insurance. 7/240 ~= 3%.

So even for a very well paid software engineer, health insurance could effectively push you up 3% as your effective tax rate. Plus all the headaches that go with it.

at that pay level in Europe you are almost certainly not going to social healthcare because in most of them you will not get the same level of service as in private hospital and will lose more time. so u usually end up paying the healthcare and using it only in extreme circumcises. there is Switzerland where that is different.

Also here in Spain, the public healthcare system is just fine. I wouldn't use private. Public is good enough.

But it's more about peace of mind. What if I lose that high paying job? I'll suddenly be in trouble for medical fees. Or income for that matter.

That kind of security is really great to have. I wouldn't want to live in a country without it. The US has a kind of "every man for himself" attitude. It feels like it stems from the 'frontier' mindset. You can climb really high but also fall all the way down. And that's fine, to each their own. But it's not for me. I'm happy to just have enough to live comfortably and have a nice job and not have to worry too much. This is also why I'll never be an entrepreneur. I'm very happy being a salaried employee with the lower income but the rights and stability that come with it.

Im from Germany and was insured privately during my childhood and my parents still are. The public healthcare system is just as good, you have less stress with doctors using you to earn good money but have to wait sometimes longer for getting an appointment (which still is pretty fast in the international comparison)

> you have less stress with doctors using you to earn good money

This is the most significant and initially intangible difference between US and EU healthcare. It takes a while to realize that in the US you are a source of money and a cost at the same time. At literally every step of the treatment process, everyone you meet will make it clear, either straight up or through an extreme efficiency, dehumanizing the whole process and leaving little room for a holistic approach to medicine, which is still predominant in the EU. The doctors in latter will actually spend time with you and if they figure problem is elsewhere, send you off to another specialist. In contrast, you and your insurer will be milked no matter what in the US.

> at that pay level in Europe you are almost certainly not going to social healthcare

Even if you do, for anything more serious, especially emergency, you still use the public health care. And you won't get a massive bill because an ambulance brought you to an out-of-network hospital.

The private healthcare is for regular outpatient care and, as such, substantially cheaper than the cost of insurance in US + all of the co-pays, coinsurance and out-of-network bills.

Source: EU citizen in the US since 6 years.

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