US without a doubt. Also dominates the healthcare technology market. I'm glad I'm not in India paying 7k / dose for biologics not available there.

I don’t mind paying for private insurance. The problem is that even with insurance, people can go into major debt bc of medical costs. I also wish it wasn’t associated with employment. Losing a job can be catastrophic not just bc of loss of income but also health insurance. Cobra is too expensive for many people. And many employers keep their employees just under FT status to not provide benefits like insurance. And those people also end up making “too much money” to qualify for Medicaid. I don’t know what the solution is though…

Anonymous wrote:Apparently the reason UK, Canada and elsewhere get cheap medications is that the US basically pays for them for the entire world and any small amount the drug companies get from government healthcare countries is just gravy.

We could probably reduce the prices we pay here by forcing the drug companies to charge all countries the same amount.

Do you have something to back that up?

Anonymous wrote:

or the peace of mind of having free healthcare at the point of service

Other countries do not have "free healthcare." Their healthcare is funded at least partially centrally through taxes. And in many/most of these countries you can opt to pay for private care. Basically, everyone has a safety net, but the wealthier can soar high above it and pay for private care.

That is something so many people do not understand. No we don't get huge hospital bills. But it isn't free, and all aspects of health are not covered.

Prescriptions, physiotherapy, any of those are not covered. A friend of mine is deaf. She has to pay out of pocket for her hearing aid. Her insurance through work covers $500 every five years. Her hearing aid costs about $4000.

That being said I don't know how anyone can afford to have surgery or give birth in the US.

Ugh. I mean Belgium obvs.

Brussels

I hate these conversations that are I’ll informed and myopic. I loved in the UK for years and worked in the healthcare sector. The NHS is great for acute care. It is horrible for

Preventative care (there is not such thing as the annual physical there that we all get for free with most health insurance in the US, and women do not get annual Pap smears via NHS until the age of 25).

Also horrible for elective surgeries. Think rotator cuff, hip transplant, ent surgery. In the US these surgeries can be scheduled in 4-6 weeks. I’m the UK these are delayed by YEARS.

Also horrible for innovative medical treatments. I literally had a doctor tell me to get a specific treatment when I visited the US again bc the UK is not advanced and the treatment would not make it to the Uk for another 5 years.

Also - yes we have to pay for healthcare through deductibles copay and employee portion of healthcare premiums. But the Uk and most other Europe countries have a 40% TAX RATE. So if they think they aren’t paying for insurance they are deaf dumb and blind to the actual mechanisms of how the NHS (which is going bankrupt btw Google it) is funded.

Anonymous wrote:

Anonymous wrote:Apparently the reason UK, Canada and elsewhere get cheap medications is that the US basically pays for them for the entire world and any small amount the drug companies get from government healthcare countries is just gravy.

We could probably reduce the prices we pay here by forcing the drug companies to charge all countries the same amount.

amen to that.

It's not just drugs, though.

I paid $1000 for a 3d ultrasound years ago, out of pocket. In the UK, that would've cost me the equivalent of $200, out of pocket.

I had a csection in the US years ago. With insurance, it cost me $6k (insurance was $700/mo). My friend in the UK got a csection right around the same time. It cost her 10gbp for the pain killer.

https://www.nytimes.com/2019/12/27/upshot/expensive-health-care-world-comparison.html

There is something deeply wrong with our healthcare system. We are basically paying to keep healthcare costs low for the rest of the world.

No offense, but why did you need a 3d ultrasound? I've had 3 babies. 2 with MFMs and were high risk and never needed a 3D one.

My vaginal births in 2018 and 2021 were free, prior one was $500 for the hospital stay. I paid $20 copay to find out I was pregnant and everything after was covered.

I don't disagree that insurance costs are crazy and drug prices are crazy. But I think a lot of Americans are thinking they'll get more elective procedures, more therapists, and less referrals needed.

Anonymous wrote:i am from the uk, and while i dont think it is the best, I think it is amazing and integral to being a developed country that there is free healthcare for anyone who needs it.

I think what's really misunderstood is you can also get private healthcare just like you can here. but there is a safety net.

But there is free healthcare in the US as well to those in need. It's called medicaid. ERs also can't turn people away. We also have the healthcare marketplace where plans are really affordable. No one is supposed to be uninsured. Except people don't get the plans still. Dh's friend wasn't okay with spending $55 a month on it.

A lot of my family is on medicaid in a LCOL area. It's really not bad.

We have been to ER three times while abroad in the same country. One time 6-month old got a very high fever after having fund in cold lake.
Ambulance showed up to our house, checked him out, gave us fever medicine as we had to be on the plane the next day. We didn't pay anything.
Second kid had an allergic reaction to a cat. Ambulance was going to come out but I was already racing towards the ER. No wait in small town. They were expecting us and he got some shots right away.
Third time was when our 12-year old decided to get on ATV first time and broke his wrist or hand. Since their flight was 12-hours away, and they didn't want to miss it, he was simply tied up and told to get to hospital in US asap after landing. Bill was under 60 euros for that.
I have been to dentist here and there and dentist is definitely better there and much cheaper. Here they will do anything to get money. I'm being pushed procedures now and I will not return.
I had planned skiing and horse-back riding in EU with the two kids, but ER is guaranteed clearly. I think that country takes anything happening to children seriously. Grow-ups would probably have to wait longer.
My father's little tractor was rear ended many years ago. He fell off and rolled into the creek. Ambulance came very fast as the person who caused the accident was the nearby hospital director. He was reaching for his phone.

My experience of spending the best part of a year in and out of NHS hospitals in the UK was that the care was generally excellent. If you are young and have a rare condition I think the care you get there can be on a par, or even better, than the US. My daughter spent several months in a NICU and when she was discharged we had nurses coming two nights a week to help with the ng feeding, tracheotomy etc. All the equipment was provided for free. We never saw a bill for what must have been hundreds of thousands of dollars of treatment.

The care my parents received was much more variable, but generally it was good and caring.

I understand that if you have money the US can be better, and certainly in terms of things like getting a private room or decent food, and there are serious issues now with waiting lists etc in the UK, but I think there is something very moving about a national commitment to ensuring free healthcare for the whole population.

OP I am also interested in this but it’s hard to put together anecdotal data from personal experience and those of family and friends with macro data. I often wonder toward which the truth skews.

Macro data is usually US is the worst - highest cost, worst quality of care, worst outcomes, long wait times (not the worst but not great)

However my personal experience as a normal person isn’t so grim. I was on university healthcare for many years due to a PhD and paid nothing for primary care, prescriptions, and a somewhat complex pain problem. Wait times were next to nothing.

Now I am just an average white collar office drone with Aetna for insurance. I’ve had to interact with the health system a ton the past couple of years - giving birth, more complex health issues, car accidents. Never had to wait more than a week for care, all the doctors I had were respectful and empathetic, very patient with their time and eager to get me help if they can’t figure out or solve the problem themselves. Sometimes it almost felt like they themselves are aware of the image of the patient conveyor belt and are self-consciously trying to make me feel how much they are not treating me as just a number. I pay a couple hundred in monthly premiums (family plan) and sometimes do get frustrated that NOTHING is free, even with health insurance you are constantly still paying out of pocket. But I also put things in perspective : my son had an overnight stay due to seizures and were seen by multiple doctors and technicians with years of training, diagnosed /treated with very expensive medical technology, not to mention the many nurses that were involved. I paid 200 out of pocket. The total amount billed was over 20,000. Yes I understand the amount billed in US healthcare can be inflated, but clearly I was able to afford care that would otherwise cost a lot more than 200 dollars, thanks to health insurance. Similar experiences with things like surgery , child birth, etc. none of those were completely free but I felt like I got very good care (including the quality of facility I had to use) for a manageable cost.

My biggest gripe with US healthcare is how confusing insurance and billing can be. It’s maddening.

Almost every American I know in a similar position - ie on some sort of company plan - has the same experience. No one has ever complained about not being able to get an appointment for something truly time sensitive or getting crappy care.

Anonymous wrote:The US has the best healthcare and actually does make high quality healthcare accessible to a larger range of people.

EU countries have healthcare systems that greatly vary. Some are a combination of public with private insurance. Small countries like Switzerland and Denmark can fare very well but have very different dynamics making comparison nearly impossible.

I find many problems with the US systems but the quality of healthcare isn't so much the problem. It's the bureaucracy and how it's financed (ever so complicated!) and the opaqueness of information that makes it so frustrating.

I don't think anyone will argue that the quality of care in the US is subpar compared to most other countries, just that the system is so broken that we are paying ridiculous amounts for something that other countries charge half the amount for private care.

Anonymous wrote:Apparently the reason UK, Canada and elsewhere get cheap medications is that the US basically pays for them for the entire world and any small amount the drug companies get from government healthcare countries is just gravy.

We could probably reduce the prices we pay here by forcing the drug companies to charge all countries the same amount.

amen to that.

It's not just drugs, though.

I paid $1000 for a 3d ultrasound years ago, out of pocket. In the UK, that would've cost me the equivalent of $200, out of pocket.

I had a csection in the US years ago. With insurance, it cost me $6k (insurance was $700/mo). My friend in the UK got a csection right around the same time. It cost her 10gbp for the pain killer.

https://www.nytimes.com/2019/12/27/upshot/expensive-health-care-world-comparison.html

There is something deeply wrong with our healthcare system. We are basically paying to keep healthcare costs low for the rest of the world.

The US has the best healthcare and actually does make high quality healthcare accessible to a larger range of people.

EU countries have healthcare systems that greatly vary. Some are a combination of public with private insurance. Small countries like Switzerland and Denmark can fare very well but have very different dynamics making comparison nearly impossible.

I find many problems with the US systems but the quality of healthcare isn't so much the problem. It's the bureaucracy and how it's financed (ever so complicated!) and the opaqueness of information that makes it so frustrating.