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Comment by anon291 | Hacker News Reader

Are you paying for the same thing? I can see a doctor or specialist usually within a week. Less if it's urgent. I think wait times in these countries are never mentioned. Paying for a service tomorrow vs paying for one a few months from now are entirely different classes of goods.

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> I can see a doctor or specialist usually within a week

That might be true to your specific location and set up, but I have some experience and family in healthcare, both in the US and outside of it, and it is definitely not like that for much of the US.

That's true of any medical system? Still we can look at the data on Canadian v American health care wait times and the data tell the story.

Possible in some cases, triaging and wait times are a thing in other places too, with the difference being that you don’t get a bill at the end. I have multiple anecdotes from people outside the US having little trouble getting primary care, or even psych care, much faster than what I’ve seen here.

When looking at comparative data, I think it’s worth breaking it down a bit by socio status, for example. In complex systems with a wide spread averages can be misleading. My impression is that we are not seeing the whole story.

Depends on the urgency and the specialist, but generally yes, I can get an appointment in a week. Mental health is the only specialty where I’ve seen multiple months wait times. For a specialist you generally first go through a generalist who gives you a voucher for your insurance. But you can also go directly and pay yourself if you want to skip that step.

Even if you have slightly more wait time, the cost is still way lower. Unless you have a US employer that pays the whole insurance for you (I don’t know if that’s possible)

I'm not familiar with the german system... is it private or public insurance?

As for US employers paying for everything... yes it's common. It used to be that they'd just cover everything via a 'PPO' plan with minimal 'co-pays'. Usually you'd pay $5-15 for a GP, ~$50 for urgent care, and ~$100 for an ER visit.

These days, many have switched to a 'High Deductible' plan, where the insurance comes with a 'max out-of-pocket'. After you've paid that amount, then everything is fully covered, but nothing is covered until you hit the deductible.

My current company has this plan, but puts the entire 'max out of pocket' value in what's called an 'HSA' (healthcare savings account). This money grows tax free and will eventually turn into a retirement account. So, if you have no health issues, then this becomes a free income stream. If you do have health issues, then you just spend this money every year and then insurance takes over and pays for the rest. This is common in the tech world these days... not sure about other industries TBH.

> As for US employers paying for everything... yes it's common.

Hmm, I think it's better to use a percentage than a fuzzy word like "common":

https://www.kff.org/health-costs/health-policy-101-employer-...

Figure 8

12% of covered single workers and 3% for families have the employer cover their premiums in full

Germany has mandatory health insurances, with both a private and public system. By default you’re in the public system and can opt into private insurances if you have a high income (the threshold increases every year, moving more people to the public system over time).

When you have to pay a co-pay it is 5€ per prescription. You don’t pay for generalists, and do not pay for specialists if you get a recommendation from a generalist first.

There is no deductible.

Not everything is covered though, dental care often has limited coverage (only for the most basic services), so you end up paying yourself.

I never heard of a healthcare saving account, that’s an interesting and strange concept

> I can see a doctor or specialist usually within a week.

What kind of Northern Exposure bullshit is this?

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