If Europe is more expensive, why do Americans pay more for healthcare?

Just this weekend my wife told me about a co-worker who was bragging about taking the ambulance to the ER the last time her son had a slight cough. Normally she goes through all the trouble of driving him there herself, but she didn&#x27;t want to waste any gas. Apparently, any and all health matters end with a trip to the ER in her family. She said several other co-workers claimed to do this as well. Part of the reason is that they can ask for prescriptions for Pediasure and other baby-related goods while they are there, so that it&#x27;ll be covered and they don&#x27;t have to pay for it. I&#x27;d never heard of this.<p>For most of these families, the fathers of their children stay home all day and don&#x27;t work. I admire how these women pull long shifts and work everyday of the week. But when it comes to healthcare, I&#x27;ve heard some ponderous stories that shed some light on how some systems come to get over-worked and require so much money to operate. Maybe our community is the only one in America that this common, but it&#x27;s a reality where I live.<p>Yeah I get a little ticked off when my premiums continue to rise when I hardly ever seek any healthcare and my family is rarely sick, and insurance companies count on my never going to help shoulder the burden of the people who do go. I don&#x27;t mind contributing some to help people who need it, but honestly it&#x27;s reaching a breaking point with me. The company I work for can&#x27;t afford to offer a plan better than Obamacare, so even the PPO plan is terrible.

The reason healthcare costs so much in the US is insurance. When insurance pays for everything patients don&#x27;t care how much the medical providers are charging, and patients don&#x27;t care if medical providers are providing unnecessary services. When somebody else (i.e., insurance) is paying, the individual consumer is encouraged to consume without any restraint. When all consumers behave this way, providers are able to charge high prices, which in turn causes insurance premiums to go up. (Look up &quot;tragedy of the commmons&quot;).<p>The solution is to make the consumer participate in driving costs down. One employer I know of has an excellent solution to the problem: Make employees pay 100% of the bill up to a certain amount, such as $6000. That&#x27;s a large amount, but the employer then contributes a large amount to your Health Savings Account (HSA), such as $4000. This amount is for you to keep regardless of whether you have any health bills or not. (This money can be used for medical expenses only, either in the current year or in the future). This means the max you will spend out of pocket per year is $2000. How does this encourage the consumer to scrutinize medical spending? Because the first $6000 of medical spending in a year is &quot;your money&quot;. This is money you&#x27;d be able to keep in your HSA if you didn&#x27;t have any medical expenses. This gives the consumer a strong incentive to reduce costs, question charges, avoid unnecessary services, and so on.

I think the basic premise of the question is utterly flawed. Europe is NOT more expensive when it comes to just about anything except for certain categories of items (like cars and for good reason!). Take Germany for example. Childcare? Free or 200 EUR per month if you want extended hours. College tuition? Free. Rent? Fairly cheap. Food? Again, fairly reasonable. Almost any kind of -care or -service is cheaper in Germany as compared to the US.

Most people are aware that the US pays the most for healthcare per capita.<p>Most people are not aware that the US pays more per capita on socialized medicine than any country except Norway:<p><a href="https:&#x2F;&#x2F;en.m.wikipedia.org&#x2F;wiki&#x2F;List_of_countries_by_total_health_expenditure_per_capita#&#x2F;media&#x2F;File%3AOECD_health_expenditure_per_capita_by_country.svg" rel="nofollow">https:&#x2F;&#x2F;en.m.wikipedia.org&#x2F;wiki&#x2F;List_of_countries_by_total_h...</a><p>In fact, the US spends more in <i>socialized</i> medicine per capita than many countries spend in <i>total</i> (public and private): France, the U.K. and Japan, for example.<p>I think unfortunately only a collapse will offer opportunity for reform.

There are some things that are expensive about the U.S. healthcare system that are totally unnecessary - for instance the epidemic in prescription painkillers of the opium variety - tens of millions of Americans are hooked on those things. The expense here is not the main problem, it is the millions of lives ruined by big pharma.<p>There are other curious upsells that go on in U.S. healthcare, e.g. off-label prescriptions. That does not happen in Europe as the incentive is not there, the hospital&#x2F;doctor is not profit motivated to get their patient on the hard drugs, as per the U.S. situation.<p>Expense begins at birth if you are male - when medical staff get paid for circumcisions then they happen, in Europe there is not this financial imperative so the only people getting themselves circumcised are doing so for religious or actual medical reasons, not just because it is an upsell from the hospital.<p>The more I find out about U.S. healthcare the leas I see it as that.

Europe was more expensive a couple of years ago. Now is much cheaper, just pick equivalent cities and compare them on Numbeo.<p>e.g. Hamburg vs Seattle <a href="https:&#x2F;&#x2F;www.numbeo.com&#x2F;cost-of-living&#x2F;compare_cities.jsp?country1=United+States&amp;country2=Germany&amp;city1=Seattle%2C+WA&amp;city2=Hamburg&amp;tracking=getDispatchComparison" rel="nofollow">https:&#x2F;&#x2F;www.numbeo.com&#x2F;cost-of-living&#x2F;compare_cities.jsp?cou...</a><p>The past years I used to travel each year to US, in different parts (Dallas, Chicago, Seattle etc...) and I always had the impression that USA is way more expensive - from the perspective of someone who goes to a restaurant and enjoys good food and a good bottle of wine.<p>Also health insurance is cheaper here, and my coverage is very good.

I read somewhere, don&#x27;t remember where that your healthcare system is more costly because of you&#x27;re legal system.<p>There are more legal risk and cost for doctor, hospital, etc.. in the US, so their insurance is (way) more costly, so their price is higher.<p>But I don&#x27;t have any data, so that&#x27;s just an hypothesis. But if this is true, good luck to change that.

There are a lot of bad reasons for this, and a lot of bad impacts, but there is at least one benefit for humanity: American healthcare dollars create intense competition to do to do aggressive and innovative biomedical research and product development.

Other relevant reasons: single payer healthcare is less expensive because otherwise hospitals have more market power, which allows them to charge prices way above what it costs. Also, insurance companies here don&#x27;t use cost effective analysis as much as Europe and will pay for the latest experiemental treatment, whereas Europe might ration its care for expensive relatively ineffective treatments.

Maybe Americans pay more for healthcare because we underwrite most of the medical innovation in the world.<p><a href="https:&#x2F;&#x2F;www.forbes.com&#x2F;sites&#x2F;matthewherper&#x2F;2011&#x2F;03&#x2F;23&#x2F;the-most-innovative-countries-in-biology-and-medicine&#x2F;#403f5f5c1a71" rel="nofollow">https:&#x2F;&#x2F;www.forbes.com&#x2F;sites&#x2F;matthewherper&#x2F;2011&#x2F;03&#x2F;23&#x2F;the-mo...</a>

I had a recent medical issue with my daughter in the Philippines. We brought her to the emergency room in Manila at the best hospital that had US trained doctors.<p>All the tests, the stay, the treatment all came out to a total of about $140.<p>Contrast this with a recent visit I had to the ER in the US. I have insurance, and my copay for the visit was $150. There is definitely something wrong with the pricing of healthcare in the US.<p>I am not sure how to solve it given all of the parties involved, but I think adding transparency to the pricing would be a good first step. To those that do not know, the medical industry in the US has an anti-trust exemption. What that means is that they are not required to publish prices. That is why one patient can get a totally different price than another patient getting the same exact procedure.<p>How can you begin to solve something if you cannot even measure it?

Based on my experiences as an American living in Europe, the premise of this is entirely wrong. At least in some cases- I&#x27;m a freelancer without kids living in Germany. For someone who is employed, older, has kids, or lives in a different country, the calculation may be different. But overall, Europe isn&#x27;t the healthcare utopia people make it out to be.<p>The cost of living in Europe is significantly lower than the US, not higher as the article suggests. Housing, food, everything. Overall I can live on much much less money than I did in the US. This may vary from city to city, but I think in many places in Europe this is true.<p>But health care is much more expensive in Europe. For me, part of this is due to being a freelancer- the public system is unaffordable for me because I would have to pay double, and pay double with my income calculated at a higher rate than I actually make. The private system is similarly expensive. It costs far more than health insurance in the US would for me. But in general, health insurance is not cheap.<p>Insurance also includes far less here than in the US. It doesn&#x27;t include even basic preventative care when you are under a certain age. It also doesn&#x27;t include stuff like birth control or STD tests. And even for things it covers, it&#x27;s difficult to get any reimbursement at all from private health insurance. I&#x27;ve also found the medical system in Germany to be atrocious when you actually go to see a doctor. If you end up in the emergency room, you can get good care. But doctors seem to just wait until it gets that bad before doing much and often spout nearly-superstitious nonsense to justify not providing medical care. Maybe they just do this to me because I&#x27;m an immigrant though- possible Germans get better care.<p>As a result, I only have cheap, crappy insurance here. It&#x27;s currently cheaper and more effective for me to have decent insurance in the US, and fly home whenever I need to go to the doctor. The US medical system under the ACA is amazing, better than nearly all Americans realize.

As a tourist in SF I got whitlow. I went to a medic. He looked at my finger and then gave me a box of antibiotics. Then his assistant asked for $300. I balked and they reduced to $200.<p>This sample of size 1 (one) is enough to tell me that something is off in the US.

&quot;Free&quot; childcare, tuition etc in Europe is a myth. There&#x27;s no such thing as free.<p>on a salary of $150,000 you pay more than $75,000 in income tax in many EU countries, then add to that various other taxes like real estate tax etc.<p>For that you get poor public schools, poor healthcare etc.<p>Last time I scheduled an appointment at the FREE doctor I had to wait 4 weeks for him to see me.<p>So I had to go to a private one and pay cash, after already paying huge sums of money for this supposedly cheap and awesome european healthcare.

In urban areas, housing in Europe is typically cheaper than in the US. Rural and suburban housing is much more, though of course the US has a far larger supply of land.

for one thing, we Americans demand instant service even for the more expensive things. For example, I live in a small-ish town, and yet there are 3 clinics with an MRI machine within 15 minutes of where i live. If I needed one, I would be on the slab in the amount of time it took me to drive there and fill out the paperwork. Maybe an hour or two if someone was there ahead of me. I would never have to wait a day or more. I don&#x27;t have the stats on other countries, but I bet most are not like that.<p>And that shit is expensive. The way medical competition works in the US is that prices go up when there is more competition because the competing clinics need to keep purchasing the latest technology to keep up. As long as insurance covers the alternatives, we go to the best and most expensive.<p>In the US we have WAY too much health care.

Sad, but true: &quot;the fact that this treatment is more readily available means U.S. patients (insured ones, anyway) who might not need it go under the knife just to be safe&quot;<p>I only had to make that choice once, namely with the removal of my wisdom teeth. I&#x27;m glad I insisted on local anesthetic.

Don&#x27;t worry, the Tories will make our healthcare as expensive as yours soon enough.

What stops US from adopting the Canada healthcare system? It&#x27;s not perfect but at least reasonable. Why re-invent the bicycle?

Because imho insurance companies is a sort of mafia, for me it looks like a conspiracy to rob people out is happening.

Because the healthcare costs are pushed onto everything else in Europe.