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Comment by moozeek | Hacker News Reader

As far as I can tell from the facts given in the EU you would have paid about the same amount the author had to pay out of his own pocket (~ 700 USD). If you had no health insurance at all.

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The countries in the EU all have pretty different ways of paying for health care. In the UK if you went to a NHS hospital (which you would do if it was an emergency) you would pay nothing - there would never be any charges for the hospital treatment and drugs administered in a hospital aren't charged.

NB: Note that NHS is based on treatment being "free at the point of delivery" - everyone knows that it's not "free" and we pay for it through NI and other taxes and people who can't (or even won't) still get the same treatment.

Far from. In Stockholm, for a child she would have paid 120 SEK (~17 USD) for an ER visit. That is assuming she was a resident or in possesion of an EU/EEC insurance card. Going price for an ER visit without EU insurance would be 1650 SEK (~240 USD). So not close even there.

How do the doctors get paid if the patient is only paying $17 per visit?

Last I checked Sweden doesn't have a 0% tax rate.

That's heavily subsidized, of course, but part of it is also that doctors are only paid about half as much in Europe, on average, as in the US.

You also need to take into account how much it costs to become a doctor in the EU and the fact that in places like the UK doctors trained and employed by the NHS are free to go and augment their income by doing work on private paying patients.

The fixed cost per visit is not a payment for treatment, but a tax; it's notionally there to stop people using the system excessively.

(See also the prescription tax in England, although there the average cost of a prescribed medicine <= the prescription tax. Here in Scotland we abolished the NHS prescription tax a year ago; the system didn't subsequently collapse under the weight of freeloaders asking for prescriptions for stuff they could buy over the counter. Draw your own conclusions as to whether such taxes make sense ...)

Even before that there were pre-payment schemes, I think you could get a 3 month or annual card for ~£15/£35 or something.

Helpful mostly to people with chronic conditions (IIRC unemployment/disability benefits tend to include relief of prescription charges).

I was quite happy with the prepayment scheme, so really the only difference is I now pay them £60/yr (quarterly cards, oh the optimism) less directly.

As an additional pointless anecdote, I do actually get a prescription for Paracetamol, since it means I can get it in boxes of 100 rather than the stupid 16/32 purchase limit for OTC sales. It's easier for my doctor to tick the box than write a short note for the pharmacist, it seems.

The 16/32 limit on paracetamol (US: acetaminophen) purchases over the counter is there because paracetamol is highly hepatotoxic and in fact kills more people (through liver failure) every year in the UK than any other drug except alcohol or tobacco.

Obviously it's a bit different for you as you're receiving it under medical supervision for a chronic condition, but imposing that cap on ad-hoc purchases cut the death rate (by both pre-planned suicides and idiots who didn't take the health warnings on the label seriously) by around 20-25%.

(Personally, speaking as an ex-pharmacist, I avoid the stuff.)

Yeah, I'm well aware of the reasoning, and I'm scrupulously careful about how often I take it, and have essentially given up alcohol for the last year or more out of paranoia (erm, justified caution). Dying slowly of liver failure over several weeks doesn't sound like my idea of fun.

That fatality reduction sounds incredible though. Since just about every corner shop sells the stuff, I'm surprised it cut the suicide rate by that much - I'd have thought it more likely the aforementioned idiots who think OTC means it's harmless, and a handful is just the thing for yesterdays hangover before hitting the pub tonight.

Out of curiosity, do you have a reference? I'm wondering if it breaks down the figures for the "nuke-your-liver trying to get high on codeine" crowd against the others as well.

Best reference I can find online is here:

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj...

It's important to read beyond the initial summary, though, as this is a rather nuanced report with some interesting side-observations. For example: A study in London three years after the regulations were introduced found that 46% of people presenting with overdose had purchased potentially toxic amounts of paracetamol in a manner contravening the spirit of the 1998 legislation.

As far as I know in EU public insurance is mandatory, so you would never pay such ammount.

It varies a lot by country. In Denmark, all hospital visits are free to anyone, whether a resident or visitor. In other countries, non-EU visitors to an ER might pay substantial amounts, though usually still quite a bit less than in the US. Also, some EU countries tie insurance to payroll-tax contributions, so the unemployed may not be covered.

Well, been living in 4 European countries and never paid anything but in mine (Italy). I am also pretty sure unemployed are covered too. Don't know in Germany, where I still can't get how insurance works, but I would guess there is a way to get cover there too.

In Germany its optional starting from a certain income level. (At least it was x years ago)

First, kind Sir, describe me believeable scenario about how exactly you managed to live uninsured in EU and then we shall talk.

That's pretty easy, at least in Germany: if you are self employed you are not automatically insured, you need to pick a plan from a private insurance company on your own (or go with one of the expensive "voluntary" plans of the public insurances). If you don't, you simply don't have insurance.

I don't know what happens when they find out that you're uninsured, however it's possible to have no health insurance.

At the doctors or at the hospital just say you have private insurance and you'll get a invoice after the treatment.

My whole point is, the invoice amount would be not quite close to what that Amarican hospital charged.

[Edited for clarification]

Hmm, thats news for me. Here also self employed are insured. Even homeless are kind of ensured. Ok, if you mean that rare case when you bill in the name of your company, but do not pay yourself any salary, then yes, this is one rare way.

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