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The US has a lot more to offer than Florida, especially when it comes to the complaints (heat, health care and mass shootings) in the article.


Can you explain the healthcare differences? From what I know it is pretty bad all over the USA compared to say France or Germany.


Healthcare is one of those areas where your experience varies dramatically based on how rich you (or your employer) are. I had nothing but good experiences when I was on Google's health plan - basically walk in to any of a number of top-notch, very wealthy clinics, don't pay a cent, get great care. Ditto when I was on my mom's government-employee plan. I was hospitalized with an acute kidney infection when I was 15, one that would've killed me had I lived 50 years earlier. Immediately got referred to a top-notch children's hospital, attentive doctors, pumped full of antibiotics and made all better again, and my family didn't pay a cent of what would've been a $200-300K hospital bill. Similarly, my dad's hospitalization at the end of his life cost close to a million bucks, of which we didn't pay anything.

At the other end of the spectrum, if you don't have health insurance, you will be bankrupted by the slightest medical emergency. You'll get care, but the doctors generally won't care about you. Oftentimes you end up going to hospitals that are poorer, with more overworked nursing staff that more frequently make mistakes. Even having private health insurance these days or a HDHP from a smaller organization still is a much lower level of service, with much higher amounts paid out of pocket. When I left Google I bought a private individual plan from Anthem, the same insurer I had at Google; despite it being the same company, my existing doctor wouldn't take the new plan, and I couldn't even see the same doctor I'd just waltzed in to see on Google's plan without paying $400 out of pocket or so.

Much of Obamacare's achievement and Obamacare's pain comes from being an attempt to spread the misery around, so that we don't have a caste system for healthcare in the U.S. It's meant that 20-30M people who were previously unable to see doctors at all now have basic health care, but it's also meant that many people for whom health care used to be completely covered, free, now have to pay something close to the real cost of their care, and they're finding out just how much the experience sucked for the rest of America.


Ok, but the number of people employed by companies such as Google is very low compared to the total number of Americans.

So statistically speaking chances are that you'll find yourself on that 'other end of the spectrum'.


Statistically speaking yes, health care in the U.S. sucks more than in countries with socialized medicine.

You are not a statistic. Evaluate your expected experience accordingly.


From a rich persons point of view such expected experience will vary drastically compared to a poor person's. They can evaluate all they want it will likely not make much difference.


How will your insurance change after you retire? Will a retired google engineer be able to afford a google-class health insurance? I am asking to learn, not to imply anything.


After 65 you go on Medicare which is a gov't program. Quality is quite good from what I've heard however some doctor's limit the number of Medicare patients as the reimbursement is quite low.


Well, to be clear Health Insurance and the US companies that supply it often do so poorly (Kaiser isn't too bad except for mental health), but the healthcare itself can be top notch. People travel from all over the world to get the best treatment, but basic healthcare (preventative etc.) is expensive and not even uniformly acceptable.


The quality of health care is so high in Europe that I really cannot imagine any European going to the US for treatment apart from perhaps very few experimental treatments that are not permitted in Europe.


Unsure what it's like in Europe, but when my Canadian cousin had a brain tumor, he went to the U.S. for treatment. Canada's health care system is on average better than the U.S, but when you have a brain tumor, you don't want an average doctor, you want the best. And by and large, these are still in the U.S. because they can make an order of magnitude more money than they could in a country with socialized medicine.


The US has a much larger number of inhabitants than Canada does, so a much larger number of people that could be outliers in any one profession. On top of that the bigger pay draws the top players from Canada as well. So it is no surprise that that 'best' doctor is in the US, it would be far more surprising if they were in Canada (and stayed there).


Are they actually better doctors or just doctors that make more money?


Quality migrates towards compensation. It’s like how the best programmers are in the US.


From what I've seen, compensation isn't a great indicator of skill or quality. And how do you even measure the "best programmer"? I don't buy it.


And the best lawyers too ;)


This was my experience in Canada as well. Everybody get the same level of care, but when the shit hits the fan, I'd prefer to get care in the US.

A good example is cancer. Cutting edge cancer drugs are pretty universally covered by both public and private insurance, right after FDA approval.

In Canada it can take years before the gov't agrees to pay for it and sometimes they say "no".[1]

"It's crazy that I live in Canada, but now I'm looking at having to sell my house for coverage of my medication."

[1] http://www.cbc.ca/news/canada/british-columbia/a-tale-of-2-f...


Overall it's good in Europe. But there are some specialists and specialist clinics in USA (high priced of course!) which can be better than in Europe. E.g. Houston medical center is a big area of specialist clinics (e.g. cancer) and I can imagine rich people do medical tourism to this places. It's somehow comparing Europe Universities with US ones... they are not on the same level.




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