*REAL* RECEIPTS: What my Birth in Germany Costs in the USA | Universal vs. Private Healthcare

[@twofarg0ne763]

I hear you. I'm a retired US expat who moved to France 6 years ago. After my first 90 days in France I enrolled in the French healthcare system, which is free. Last year I had a medical crises. At 3:30 in the morning I had such intense stomach pain I could not stand upright, so I called an ambulance. They arrived at my door in 7 minutes. I was rushed to the hospital. Long story short, I was in the hospital for 4 days. I had a myriad of tests the first day. The second day, they determined the problem... my gall bladder was ready to burst. The third day I had my gall bladder removed by a laparotomic cholecystectomy. The fourth day I was sent home. Here is the funny part... when I went to the desk to get my bill the nurse started laughing and said "you must be the American". She then said "there is no bill." The ENTIRE procedure, hospital stay, tests, etc including the ambulance was free. I did pay14€, which was the cost of the cab ride home. My post op drugs were 40€, but my insurance reimbursed me 37€. I'll never go back to the US. Why is it that the richest country in the world treats its citizens like corporate slaves, when almost ALL other industrialized countries provide free health care?

[@Desticia-Sisenna]

The sad part I imagine is.. to the last part of your post, your question: Because a lot of Americans don't want it. Because 'it's socialism' or some other drivel they convinced themselves of as to why how it is for them is 'good'. Americans seemingly want control and to only ever pay for themselves, never ever for anyone else, no such thing as solidarity (which is what nearly all healthcare systems are based on in Europe, solidarity) in the US. And that's how you get what you got, together with a completely unregulated pharmaceutical free for all.. which also is something Americans seem to want.. because regulation is evil and is the path to.. again 'socialism'.

[@prosandcons-fl2cc]

@@Desticia-Sisenna Because of the long cold war era, ANY form of collectivism is now socialist or communist. Its such a pervasive culture here

[@matswinberg5045]

In Sweden you would have the cab ride home for free also 🙂

[@Kintabl]

Stop with the it's free. It's not. You pay for it like everybody else. The diference is that European hospitals don't have such highly inflated service prices. I don't know why room for 4 days is $8000?!

[@RichardIILionheart]

@@Kintabl By “free” of course the person meant “no direct out of pocket cost”.

[@HerbertLandei]

Thank you for explaining Americans what public health care really is. I talked to many people who were brainwashed into thinking this is "socialism" - total nonsense.

[@Muck006]

No "native english speaker" has the correct definitions for "left-/right-wing", "fascism/communism" AND nobody really understands that SOCIALISM DOESNT ACTUALLY EXIST. This is easy to prove, because for "an idea" to exist you need a PRECISE DEFINITION, but in the 1920s Werner Sombart counted the number of different definitions for "socialism" ... and came up with 260 ... that was a hundred years ago and back then "printing a pamphlet/book" was relatively hard compared to today.

[@korbendallas5318]

The term "socialism" almost has no meaning in the USA.

[@TheLordFragger]

@@korbendallas5318 Yep. So many people use this term without actually knowing what it means. Too many uninformed but loud "opinions" out there.

[@thorstenwolters9025]

​@@korbendallas5318'Nazi' also! That is why they use it all the time.....

[@korbendallas5318]

@@luizmonad777 Source?

[@skinnyjohnsen]

In Europe we don't only have the freedom to do things, like in the USA, but we also have freedom from things; Like getting broke because of illness. (there is no such thing as not being "insured" because of a "pre existing condition"), or giving birth. We are not getting shot on the street, nor are we afraid our children will be shot at school.

[@roberthernandez2989]

Some europe countries people get shot on the streets and crime does exist. Lets not act like there is no crime.

[@alternate1868]

Same here in Australia 🇦🇺

[@Stashix]

Not for long :)

[@bharath2508]

learning a new language in every European country is difficult

[@Demonsteel87]

@@bharath2508 Why would you need to do that? The vast majority of people in Europe do understand English, even if some (like the elderly) might not feel comfortable speaking it. You would never have an issue communicating in English at, for example, the hospital, police, hotel, or a restaurant though. Sure, if you move **move** to a European country you might want to learn the language, but "every European country" doesn't apply then as you don't need to know every European language living in a single European country.

[@anon0815de]

American in Germany here. My wive gave birth to our daughter here and the only bill from the hospital was roughly 150 Euros for an upgrade to a family room where I could stay with my wife and daughter. It also included food (nothing special, but still). I'm very greatful that we could spend the time before and after the birth of our daughter together in the privacy of our own family room.

[@vornamenachname906]

Hospital food is ment to ensure healthcare don't run out or work ....

[@theoDSP]

@@vornamenachname906 Hospital food is supposed to be bland. Nothing fancy.

[@katn1952]

​@@vornamenachname906😅

[@wolfi7106]

Je besser das Krankenhaus, desto schlechter das Essen.

[@kurtschindler360]

I'm a USA citizen living in USA. I had a medical issue that came and went several times when in the USA. Traveling in Amsterdam I got sick with the same issue again. Went to a doctor who sent me to the emergency room at OLVG hospital. She was very apologetic because the hospital was short staffed (this was soon after COVID), and it would take some time for the ER to see me. She repeated this apology and I finally asked her how much time were we talking about. “Oh,” she said, “you may have to wait 30 minutes in the ER.” It actually was about 15 minutes. (A 30-minute wait in our rural small town US hospital would be considered fast service.) My care was excellent. Even had a CAT-scan (which I would sometime have, and sometimes not have in a US hospital). Stayed in the ER about four hours. Got tested, treated, and sent on my way with instructions for self-care. Was told to stop at the desk on my way out. Lady at the desk asked for my ???? card. She saw my face, smiled, and said “oh you are a tourist, then I need your credit card.” I silently gulped, thinking here goes my budget for my vacation - as I now have to pay for a ER visit. I was not a part of Holland’s national health care, so I had to pay 100% of the costs for the ER. Total bill came to $350. In the US it would have been closer to $15,000, with my health insurance my out-of-pocket would be about $700. In addition to the $350 I had two prescription drugs to buy, which I got at the OLVG hospital pharmacy. Again had to pay 100% of the two drugs cost, for a total of $15. So my experience: $365 uninsured total cost for faster superior health care in Amsterdam compared to the same treatment for the same medical issue received in the USA.

[@theoDSP]

Yeah. You can also buy medial insurance if you are tourist

[@robertolbert3585]

@@theoDSP fun fact, as a citizen of one EU country, you are covered by your local insurence even in other EU countries. I used to work in the Netherlands and myfamily back in Slovakia was still fully covered by my universal Health insurence.

[@nialeemaria]

My son is almost 5 years old, and we are still paying off his birth. The labor, emergency c-section, and 4 day stay came to $30k. We planned ahead, but because of some fine print, insurance only covered 40%. Hospital had sliding scale prices for people without insurance. But because we had insurance, we were ineligible for the cash discounts. They “generously” put us on a 5-year at 5% payment plan.

[@TypeAshton]

oh my goodness that is both heartbreaking and extremely frustrating. It shouldn't be this way for families.

[@okaro6595]

An insurance that makes you pay more. That's nice.

[@philippschwartzerdt3431]

Time to vote blue…💙

[@Ikkeligeglad]

In Denmark it would have cost you NOTHING, pay the tax and everything is for free, no additional payment at the hospital, none!

[@UniDocs_Mahapushpa_Cyavana]

This is the Age of Exhaustion 🛌💤 and the politicians in the West especially are never going to enact such an act without doing it so mindbogglingly inefficiently to avoid work it ruins the benefit. @@philippschwartzerdt3431

[@MYTravelBF]

We are Americans in Germany who are expecting a baby soon and this was such a helpful video breaking down the differences as we've never had a baby in the US. The care here in Germany has been phenomenal, and we couldn't be happier! Another amazing video!

[@arnodobler1096]

Good luck! 🍼

[@jacksmith-mu3ee]

My nephew was born in china . Total bill for top care medical facility was 400$ . Mr and my brother spent additional 400$ to staff as a thank u gift bcz my nephew was the first born in our family so we gave tip to the hospital staff 😂

[@SaintPlayGames]

I'm from Germany myself and couldn't imagine the struggle you depicted that is going on in the US. I'm just glad that you guys are here and happy ♥

[@Londronable]

Being from Belgium I grew up with the idea that if it ain't your fault we(the state)'ll help you. The idea somebody should pay loads for something that ain't their fault is just something that's hard to compute for me.

[@seelenwinter6662]

i say everybody since decades, that i never ever would live in the usa... but the usa still find stpds who wanna live there... but why...? EVERY country in the EU is better, cheaper, safer and you dont have to have 3 jobs to survive...

[@martinjanssen79]

My son was born with a congenital heart defect. Including all the prenatal examinations, the birth followed by a 7-day intensive care unit, the heart surgery with 11 days in hospital including 3 days of NICU and the six-monthly check-ups, our costs are 0 cents. The special thing is that the operation took place in the neighboring Netherlands, since the Beatrix Children's Hospital there is specialized by the UMCG and is right around the corner on the border with Germany. All that was needed was an application with one page, four crosses and two signatures. Just 2 hours later, the promise that our statutory health insurance company would cover the full cost was there. The most expensive were the fees for the parking garage. Together about 50 to 60$ 😄

[@sanderjansen5187]

You are allowed by your health insurance to declared your parking tickets, I managed to declared the parkzone tickets of my parents and family in law.😂

[@martinjanssen79]

@@sanderjansen5187 That's correct. I did the same afterwards. All travel expenses were also reimbursed. I just wanted to emphasize that this was the only thing I had to pay for myself at first.

[@martinjanssen79]

@@gorgthesalty Yes, I've heard and read about the haphazard health insurance plans. In addition, there is the fact that in the states both the health insurance companies and the hospitals are striving to maximize profits.

[@TheWuschelMUC]

...and don't forget the co-payment of outrageous 10 € per day in a German hospital. (It is supposed to cover the food costs) ;-)

[@martinjanssen79]

@@TheWuschelMUC Children are exempt from this.

[@carolinsels-gomille4530]

I'm German, but I used to live and work in the US for 10 years. I'm very grateful that I had the choice to give birth to my son in Germany. I was shocked to find out that my US health insurance wouldn't cover any expenses related to a car accident that I was in. This and the uncertainty of what you have to pay when you need medical care is just very frustrating. That's one of the main reasons why we decided to raise a family in Germany. I understand that not everyone has this privilege.

[@Conn30Mtenor]

American insurance companies make up the rules as they go along. A friend in Washington State developed lung cancer and was promptly dropped by her insurance company. Had it not been for Obamacare she would have died, no doubt.

[@ERG173]

Hi there Carolinsels-gomille4530 ..... Insurance companies want to make as bi a profit as possible, it increases the share value, their share holders are more important than you. It seems wrong to me for people to make a profit from another's car accident.

[@micha2009]

I know pretty good how much I have to pay for my health insurance here in Germany. And who get's premium german healthcare for free, I know too. I understand the solidary system we have in Germany. Many others don't. So healthcare is getting worse. Until you bring cash. *shrug

[@lumina9995]

​@@micha2009What exactly do you understand? I've had multiple operations in my life and only ever paid for the hospital stay. It has been €20 for years. *shrug*

[@jacksmith-mu3ee]

My nephew was born in china . We paid like 400$ . That's it for to care c section and everything

[@juliegirl1989]

My boyfriend broke his leg two weeks ago when we were on holiday in Greece. I also broke my arm in the same accident. Being publicly insured in Germany (and thus the whole EU), we never once had to worry about the cost of any treatment (multiple operations), the ambulance ride, etc. We've had lots of other stuff to worry about, so I'm immensely grateful that this is not also weighing on our minds. The quality of treatment in Greece was okay and here in Germany it has been very good so far.

[@derniederrheiner4518]

Years ago I had a minor accident at work (splinter in my eye) in Austria. I then took a taxi to the clinic. Had to pay a fee there and my medication. Nothing very expensive. I handed it in at home at the company and got it back with my next pay slip. If it had been a ‘private’ accident, I would have got the money back, apart from €5 for the cost price.

[@layziek2137]

I'm Norwegian. 2 of my 3 children were born premature and needed the extra care and extra stay. As their mother I of course stayed with them both times. The only thin😢I needed to worry about was my children's health. Everything else was taken care of. In Norway we pay our taxes knowing that you never know what will happen in the future. I never planned for my children to be born premature. And one of them would certainly have died if I hadn't been at the hospital. Now she is living a great life with no complications from her birth. I don't get why universal health care is even a discussion in the US. It works and saves lives. And all I had to do when I left the hospital with my baby was saying goodbye to the other mothers I had befriended there. No bills and only a wish for good luck with my new baby.

[@youoptigan]

Inniblant er det veldig godt å være norsk. :D

[@arienyah]

As someone with a chronic condition living in Germany I can say, that I received excellent care during all my hospital stays and doctors appointments. Money was never an issue when discussing my treatment options (and my medication is sooo expensive. I looked up the price online. It is more than my monthly income and I am going to need it till the end of my life). I was even offered to see one of the best neurologists in the country just because he happened to be in the hospital at the same time I was. My case was not special or complicated. Still, we had a chat and he explained a lot of things to me. No questions asked, no extra costs for anyone. I am happy to have public health insurance. It probably saved my life more than once

[@NateLawson]

This makes me extremely grateful that both of our sons were born while I was on active duty. It didn't cost us a penny.

[@rekleif]

Is there an reaction video coming to this? Would be cool to hear your taught on this when you recover from your vacation;D God bless from Norway.

[@theoztreecrasher2647]

@@rekleif Is that "taught" the same as in "I taught I taw a Putty Tat" there, Sylvester? 😉

[@walter--]

And wouldn't you like this was possible for people not in the army?

[@foreveri9228]

My child was in intensive care for 14 weeks after his premature birth. That was the most worrying, worst and most stressful time of my life. I can't imagine how I would have felt if there had also been financial worries, because I would have to pay for part of the hospital treatment. I am so grateful about our German health care system. And my baby got excellent treatment, everyone did their best and everything had a happy ending.

[@calise8783]

With my second pregnancy here in Germany…I paid in total about €100 . I had a pretty normal pregnancy but did have an US at every appointment as I had early bleeding. No bills. As the end of my pregnancy came, we discussed the birth. I was told well you had a section the first time but there is no indication for an automatic repeat, so you will be having a VBAC unless for psychological reasons you found the first too traumatic. I said I was fine. My OB in turn gave me his private cell number and said, if you have had enough and the hospital is not listening to you, call me day or night. My first labor was 38 hours. Labor was fine, fully dilated, no meds, I hardly labored in bed at all, staff was awesome but baby would not descend. More monitoring. Baby was a bit too quiet….I was asked to have another section. I agreed. Section was fine and normal. Well, about 2 hours post section, all hell broke loose. Emergency surgery. Head surgeon of the hospital involved. 2 day ICU recovery. 11 day total stay. I was treated so well. The pediatrician came to the hospital to do standard baby checks, I was given a private room for the entire stay. Of course my home midwife ( standard care here)took care of me once I was home. Everything cost me about that €100 with amazing care. My birth is not the only example I have of care here. My son broke both bones in his arm through the skin. Ambulance ride, ER, surgery, two night stay, physical therapy, checks every 4 weeks at the hospital, second surgery to remove the rods, checks at the pediatrician, meds….we paid €20 total for the ambulance. This is all under public insurance.

[@calise8783]

I’m quite happy with the healthcare here. Whenever we have needed care ( including bringing our Bulgarian exchange student to the er), same day neurologist and cardiologist appointments, same day sick appointments, we have had great care. Like in the US, with not immediate need care ( planter’s wart) we had to wait to be seen by the dermatologist about 5 weeks but once “in” we have never had to wait longer than a week for an appointment.

[@K__a__M__I]

You had to pay for the ambulance? What? _edit.:_ Okay, forgot about Eigenanteil. Kinda weird that this applies to an ambulance ride, though.

[@turnbeutelseparatist7360]

Rechnungen aufbewahren und dem Steuerberater geben.

[@rosshart9514]

​@@K__a__M__I In DE the regular co-pay for one ambulance transportation is 10 EUR. Rest payed by your insurance. The regular co-pay for one day in hospital is 10 EUR with a max of 21 days. Rest payed by your insurance. Usually you get these bills several days or weeks after execution.

[@kilsestoffel3690]

​@@K__a__M__Ithe ambulance is paid by the insurance, who will later send you a bill for your part (Eigenanteil). I paid 10€ for the ambulance.

[@Boggart85]

Thank you for this take and sharing your experiance. I think a lot of germans should listen to it, so we can actually understand how truly valuable this is.

[@ralfmeyer9086]

Ì agree

[@olenkaki1326]

Hello from Germany! Staying longer in the hospital especially after the first birth is so important. There was a breastfeeding specialist in the hospital who came every day to help with this, who showed us how to bathe the baby etc. It was such a great chance to learn for clueless me at that point of time. Both my boys were born and raised in Germany and medical care were excellent every time we needed it. My grandparents are over 90 now and enjoying their life thanks to excellent free medicine and medical care. Abou general costs of health: only healthy people can work and pay their taxes. Ill and dead people will not be able to raise their children healthy and give them a good education, so it’s a never ending circle of poverty and misery.

[@Muck006]

IN THEORY ... you could do all these "training appointments" in one day, but IN REALITY specialists like that typically run around through the hospital serving many different people at the same time.

[@carstekoch]

​@@Muck006 Technically you could, but there is no real reason for it. The stress won't help you nor the baby and the first week after the birth is critical in post pregnancy health care, as a lot of dangerous complications happen in that time frame. Especially with C-sections you are looking at the prime reason for maternity-deaths in the US. Too early releases because of costs pressure, both by the hospital as well as the patient.

[@sabine563]

As a military family we lived in an NATO environment and the only medical treatment in the area we could receive was through the US Navy Hospital. Some of the ladies in the German community gave birth there and we were shocked to find out that the prices were 3 to 4 times higher than in Germany for a C-section. Also every check-up for the kids etc was a lot more expensive than back home. Some of my US friends explained that living abroad was the only option for them to receive certain medical services like in-vitro fertilisation or orthodontics. They tried to explain their health care system to me but honestly I never really understood it. Some of them were left with huge bills at the end of the year for treatment for chronic diseases of their kids for example. And I met US military families who said they preferred living abroad because they had a sick child and received better treatment while on duty in a foreign country. And they tried very hard not to go back to the states for that very reason. That's not a concept I was familiar with before...

[@Nezuko_91463]

US military members have completely free healthcare in the United States and abroad. Not sure why healthcare would be a reason for a service member to stay abroad.

[@sabine563]

@@Nezuko_91463 as much as I understand there a different TRICARE plans to chose from depending on your geographical location. And depending on the plan, there are some or none out-of-pocket charges. But I don't know the details to be honest.

[@Roque-Cachamuiña-gs1wd]

I know of a similar case, of a US military stationed in Rota, Spain, whose son was born with a heart problem and had to be transferred to Seville after delivery for emergency surgery. They asked to stay in Rota, another period, because in the USA his insurance did not cover the treatment that his son needed and that included three or four more operations

[@aigarskauls9200]

@@Nezuko_91463 did you miss the part where he was talking about kids needing medical help?

[@Nezuko_91463]

@@aigarskauls9200 , I am an active duty member of the US Navy. I am stationed in the United States. I have three kids. I disagree with his statement from a place of knowledge. My children and I have completely free and highly comprehensive medical care. Yes, our insurance covers everything medically necessary. It even covers gender affirming surgeries for transgender people now.

[@anthonyolson3654]

I am an American / Canadian who has lived in Germany for over 30 years, part of that time with private North American insurance, and part of that time with German public insurance. I have had diabetes, kidney failure, and a kidney & pancreas transplant while here in Germany. My impressions of the medical system here are that it is second to none in quality of care. The hospital's floors may be scuffed and the elevators a bit dinged, but the equipment that matters is state of the art. My wife gave birth to our four children in Germany, and even when we did see the bills (to submit to our US insurance), they were far less than what it would be in the States. Perhaps one of the big differences is that most German hospitals, at least in our area, are not-for-profit, whereas most in the part of the US I am from are. I had my transplant in the Uni Klinik in Freiburg, and the care and competency of the doctors was great. I will say that the German public insurance is not necessarliy cheap, 14% of your income, but so worth it.

[@korbendallas5318]

Hospitals are highly regulated, so I don't think the term "for-profit" would even be applicable in the same way as for other enterprises.

[@thorstenwolters9025]

It is better to pay 11-15% of your income to health insurance than to suffer and die for a long time because you cannot afford the doctor and/or specialist. 'go-found-me' doesn't always work....

[@korbendallas5318]

@@thorstenwolters9025 Gofundmes for medical cost are simply disgusting and shouldn't exist outside of failed states.

[@elmerallen620]

I lived and worked in Hamburg, Germany from 2014-2016. I kept telling Canadian compatriots that we are only a point ahead of USA. Compare our healthcare against Singapore, Japan, Norway, Germany, France, etc. long ways to go. We need to improve our system in Canada like having universal pharma, dental, etc. We need to stop being smug. 🍁

[@Tob1as_S.]

​@@thorstenwolters9025And if you are employed, you only play half of it, the other half is payed by your employer atleast for public healthcare for private i dont actually now. And like I guess its waaay better to pay the 7% monthly and dont you dont have to worry a bit than paying whatever amount (i dont know) in the USA monthly to still have to pay out-of-pocket money if you have an emergency.

[@lizmagno1]

I am a retired person now living in Germany. Since I did not work in Germany I now have private insurance at the Basis care (lowest) level so medical bills are not usually completely covered but this is preferable to the US. I had Cancer 5 years ago which would have bankrupted me in the US even though I had insurance through my employment. (I am fine now.) Health care is one of the main reasons I won't return to the US to live. It might be different now (doubtful?), but when I was in the US my Insurer told me I could no longer see the primary care Dr. I liked. I felt she saw me as a person and knew my medical history. The new practice they sent me to had signs stating that visits were for one illness only, you had to make a second appointment to address another concern, visits were scheduled for 15 minute intervals, and often when you saw the Dr. (there were several in the practice) you had the impression they hadn't had time to read your chart so had no idea of your medical history. There were several other specific examples (even bordering on malpractice due to time constraints) I could state these but that would be too lengthy and specific. Suffice it to say I will not live in the US again until there is a change in the health care system.

[@TypeAshton]

I feel for you. My parents live in Springfield IL and there was a huge shake up recently with Blue Cross/Blue Shield dropping Springfield Clinic (the largest healthcare provider in the city) from their "network". Overnight my mom lost all of her healthcare providers that she had built up a relationship with to treat her chronic, genetic disease. She had to start searching for a new provider and then go through all of the hoops to establish her care routine, medical history, treatment etc. with this new team.

[@e.458]

I'm glad you're better now. I can't imagine the doctors in this clinic being happy with the way they have to practice medicine there, either.

[@jonasfermefors]

Regarding quality of care here in Sweden. In 2020, just as Covid hit I had a cardiac infarction. It took about an hour from when it started to get into the operating room, so within 2 hours I'd had a stent inserted and was in recovery. This happened while they were moving wards around to have separate wards for Covid free patients but everything worked perfectly and I was in hospital for monitoring for 3 days in a private room. The total cost was about 40$ (essentially for food). Since then I do have a lot of pills to take daily which sets me back the maximum yearly amount which is about 250$ per year. I don't see much that could have improved except for entertainment: The TVs in the ward only had a few basic channels but I brought a tablet with me, so I had everything I needed (after a friend delivered a charger).

[@piffpuffpeng]

As a German who has lived in Texas for a number of years, I believe two things need to fundamentally change in the U.S. in order for any of these issues to be successfully addressed, be it health care, gun control, pensions, unemployment, furloughs, homelessness, violence in the cities, tensions between ethnic groups, etc., etc.: 1. Checks and balances must be restored (Yes, restored *is* the right word). I.e. concretely: a) There must be a news outlet that is financed by the public, without the influence of moguls who pursue their own agendas. PBS has no chance because it is not pushed and has no lobby, and b) the jurisdiction must also become independent of politics. Which idiot actually came up with the glorious idea that the highest judges should be appointed by the president - that is, by the leader of the government and the party currently in power - and that they should be irremovable? Five people I have to bribe to get my way for virtually ever? Pure idiocy. 2. Political donations must be severely limited and even more tightly controlled. Bribing politicians or parties is not free speech, no matter what your well-lubricated supreme court judges may have uttered decades ago. I bet someone will counter:"But its in the CONSTITUTION!". To those, I answer right now: Your Constitution currently has 27 *Amendments*. To answer the original question: Health care in Germany is good. Of course, there are problems here, too, but overall, I can't complain. I have never paid anything, except gold inlays for my teeth (maybe 400 Bucks ea.).

[@doc0815martens]

You are very right about that, and I think a very important point is to change one's own way of thinking, to open oneself to other ideas, views and opinions. Only then can you think them through logically - without prejudice - and decide whether they are reasonable. By the way, one should not forget that the Constitution was written 250 years ago, many parts are in need of revision, but it has never been revised as a whole so that it is adapted to a modern society at least every few decades. On the one hand, it is treated like a holy book that contains all the answers, but on the other hand, the same people don't give a 💩 about it if it doesn't fit their views and goals.

[@TypeAshton]

10000% agree. I have made a video in the past about how much money is thrown into elections, but I an investigation into lobbying is overdue on our channel. It is such a powerful tool that is so often used not lobby for personal interest/profit than for the greater good.

[@SuperPuddingcat]

@@TypeAshton As far as I know corporate lobbying in the EU is also pretty bad. It would be interesting to see how lobbying in the EU compares to the US

[@aasphaltmueller5178]

@@SuperPuddingcat they try to curb it, and Im quite sure it is at least not worse than in the US- I think the bigger Problem in the US is the amount of money in the system, especially since "citizens united"

[@piffpuffpeng]

@@SuperPuddingcat Its not all sunshine and roses here in the EU, that much I can tell you. It is a lot harder to corrupt literally 100s if not 1000s of officials from dozens of different political parties while having to respect fairly strict donation rules than what is the case in the US. I would also argue, that many of the member countries have a strong and really independent press which is still in a position to do real investigative journalism, even if those in power are involved. But yes - it def. could be better than it is and we do get our fair share of scandals based in corruption. And we also have to deal with the negative influence of social media propaganda, we are not that different in that regard. I think the real difference is, that our systems are not (yet?) corrupted to a point, that checks and balances are basically non-existent, which is the case - I would argue - in the US. 'Georgia’s governor, Brian Kemp, signed a bill on Friday that makes it possible to oust *elected* district attorneys from office if they are believed to not be adequately enforcing the law. It’s a move that is seen a thinly veiled power grab to push out Democratic prosecutors, include some who said they would not prosecute abortion-related crimes.'

[@bjornh4664]

I live in Sweden, married to an American woman with dual citizenship. Two years ago she suffered an aneurysm in her brain, causing a brain hemorrhage that put her in intensive care in one of the premier clinics in northern Europe for four weeks to the tune of $8,000 a day. Instead of paying $224,000, we just paid a nominal fee in our public health care system. I don't dare to think what it would've cost if she had fallen ill in the US.

[@theoDSP]

Better not think about it.

[@awesome13awfulness]

I'm living in Germany and and a big proponent of one(!) Healthcare for everyone, not even secluded in privat/public, and different insurance companies. Have everyone pay a small but consistent portion of their income into said insurance. The overall quality for everyone is going to rise.

[@Chewbacca55]

Publicly insured in Germany. Never really had any problems I could complain about regarding quality or availability. I have to say though I am 36 and hardly ever have health problems. The few times I had to go to the hospital were good and I would rather "complain" that the doctors incentivised me to stay longer than just a week because I got bored.

[@maddinek]

I heard Chewbacca's are in general in a good health condition 🤓

[@wimboselie449]

A granddaughter of us got a stroke at the age of nine, was halfsided paralised. A week in hospital, nearly a month in A children's rehabilitation home. The parents the whole periode in A Ronald McDonald home. Two years of treatment and ongoing, special care at school and ongoing. Costs for the parents, zero. In the Netherlands children are are always insured at zero costs, until the become 18 years of age.

[@courtneymcwilliams6571]

As an American living in Germany who had a high risk pregnancy and NICU time with twins in the US and now I’ve had a singleton in Germany. The quality of care is a whole other topic. Insurance wise - with good insurance we were expected to pay out of pocket around 100k$. In Germany we’ve only had to be 200€ which was BEFORE I was insured.

[@johnofdebar4071]

100k out of pocket??? Hope the little ones are doing fine

[@BioBioLove]

May I ask more info on what a good insurance means? We are considering moving to the USA. We are both in the Biotech industry and companies seem to all offer very good benefits including 95%-100% subsidised health insurance. I understand the concept of a deductible, but how do you go from 20 K deductible to 100K in debt? Could you please tell me what should we look for and what questions we should ask the employer? I had my first child in Germany and though it cost me nothing, I suffered horrendously. They let me scream in agony for hours and hours while I was begging for an epidural and then I had to deliver without one cause it was too late. Probably cause epidurals are unnecessary expenses, even though because we are top tax bracket we pay the max contributions.

[@annekekramer3835]

As a non-expert, if you have a good salary, expect to save 60% of your salary for later use: healthcare, retirements, etc. If you have a low salary, you should do the same, or save even more, but that's just plain impossible then.

[@gregor2436]

​@@BioBioLovevery sad to hear, but not getting epidural had nothing to do with costs. It might be medical malpractice, as the doctors might be to much into homeopathy (there are a other experiences like this around) or there was a good reason nobody told you. Either way, contacting a lawyer to get answers (or to sue them) would be a good way I guess.

[@BioBioLove]

@@gregor2436 I could have gone to a lawyer but I wasn’t at a good place at the time. Anyway, I think it really has to do with cost cutting though. Combined with a healthy dose of the usual doctor misogyny. In the UK where I lived before, the NHS is also trying to limit epidurals to cut down on costs, as told by an anaesthesiologist working for the trust. They require a doctor to do it, more monitoring and drugs. So they avoid it/delay it/flat out refuse it. Even if it isn’t cost related though it is shitty healthcare that doesn’t reflect what I pay for it, at least IMO.

[@Armoure10]

My public healthcare, is literally the best in the world here in Norway. Without any stupid concept of ""health"insurance". The us have the dumbest and nastiest "healthcare" explotation system in the developed world!

[@rosshart9514]

Norway is part of the highly developed world, US are part of the less developed world.

[@jollyjokress3852]

if norwegians would stop their oil extraction though - i wish they would

[@teutates747474]

The US part of the developed world? Debatable.

[@kgspollux6998]

Freie Heilfürsorge dank "Brent Spar"? Wenn das stimmt, herzlichen Glückwunsch.

[@jimf671]

@Chris_1024_ The UK and Norway don't pay for health care from taxes or from oil. They are monetarily sovereign states so they can create sufficient money to pay for whatever they want limited only by the capacity of the supply side of the economy (the USA only ever does this for wars). People are the economy. If a component of the economy break then we fix it.

[@tobiaspott]

I‘m honestly baffled by the question how all this can be free in Germany. How can it not be? Isn‘t it basic human decency to assist, support and care for others, as we want it for ourselves? Surely, there is financial cost, but the question should, in my opinion, never be asked an individual but considered a responsibility of society, which strength is the multitude of individuals contributing. I‘m happy for you and your family about the care you recieved and wish you all the best.

[@edsteadham4085]

It's not free. It's paid for by taxes

[@Quotenwagnerianer]

It's not payed by taxes. It's paid by mandatory premiums. That's a considerable difference. Because taxes are not earmarked. In the UK the NHS is paid for by taxes, though.@@edsteadham4085

[@ColeTrainStudio]

@@edsteadham4085 Yeah, that's literally what the original commenter said. "Free" healthcare means no (or very little) cost for treatment above and beyond what is contributed via taxes. The point being that everyone should pay to help everyone else and oneself.

[@JennyShull]

In the US if someone if giving away an item away for free it means that the person getting the item pays $0.00 for the item plus no tax. The person giving away the item probably paid for the item or the item was given as holiday or birthday gift.

[@Eric-Marsh]

I enjoy your videos because they are so well researched. When we first moved to Spain (from the US) my wife Janet went to see the local doctor. When she wanted to pay for the visit they had no idea how she could do so. It took them several days to work it out.

[@insightsbyjackie]

I am glad & grateful that I am in Germany. Or else, I would be paying all those hospital bills until I die. It’s such a high amount which is deducted from my salary every month, but as you said, I won’t have surprise bills from the hospitals.

[@mariafrey5708]

I left Montreal when I was 27 and I've been living in Germany for almost 30 yrs now. We also have universal health care in Canada but what I hear from my family is that often there's a huge wait at ERs and scheduling of non-critical operations. Sometimes waiting months! So when Germans complain about high premiums and terrible service, I am grateful for living in Germany. Love your videos Ashton! Tell me where you find the time creating these videos with 2 small children? Respect!

[@indrinita]

I am also a Canadian living in Germany (been here over a decade), and I also have to wait months just to get appointments for health issues when they're not life or death, but still important health issues that need to be taken care of in a timely manner. That's months - just for the appointment - if there's surgery or any other procedures required, that's an additional several months on top of it. So in my own experience, I wouldn't say health care is really better in Germany than Canada. And you can just about forget about getting adequate, let alone specialized mental health care or therapy here.

[@arnodobler1096]

​@@indrinitaHere's a tip: 116 117 is the central nationwide number for arranging doctor's appointments and the medical on-call service in Germany. But only for urgent cases, please! I don't know how it is in Canada, but in the USA of the 50's and 60's there were more therapy places, psychiatric clinics and rehab places, than today!!!! Told by a US American who worked in the field.

[@jal051]

@@indrinita The situation in Spain is that the healthcare is public and it also has long waits for non esential treatments. But having the public healthcare system there are private insurances which are very inexpensive because they don't cover the expensive treatments, and do take care of the non esentials very fast. They offer single rooms in their hospitals, etc. They come about between 30 and 50 € a month. If you have them you can go there for simple surgeries, scans, general doctors, but if they find something really serious they send you to the public hospitals where the high end care is (and sometimes they take you back to your single room in their hospital for the recovery)

[@christophergagnon54]

Canadian here, YES we have long months or years for non-urgent surgeries but everything is paid by the government and you have the choice to go private if you want shorter wait times.

[@dikkiedik53]

Here a Dutch person. The € 145/month pay for health insurance and the yearly € 385 "own risk". In 2012 while on vacation in France, I got a cardio problem and was dottered in the hospital in Fréjus in France. I was asked my Dutch health insurance name and my client number. I stayed in hospital for 4 days... never saw a bill. The (medical)care was excellent but the food was minimal. Since that incident I have appointments at the University Hospital in Amsterdam for the most high level cardio care (I grew a couple of bypasses in my heart) and never see a bill. My daily cardio medication for one year doesn't even have the value of the € 385 , so some years I don't even pay the full € 385. The different KZbin video's comparing health care systems make me feel more satisfied about the Dutch health care system. I get all the care I need in a reasonable urgency. Sometimes when my local hospital (2km) is booked for a certain time for a certain treatment or diagnose, I have the option to go to another hospital just some 8-15 km more away in Amsterdam. A lot of people complain about the costs but, compared to other countries we have a good system too.

[@laulaja-7186]

From the description, it sounds like that € 385 is known in the US as a "deductible".

[@TypeAshton]

I love learning more about how different healthcare systems function in other countries and I think there is such a great lesson to be learned for the States: Universal Healthcare isn't a one-size fits all solution in Europe. There are different schemes/organizations/funding strategies in different countries that the US could look for to model a system.... and the benefit for its citizens is immense.

[@foobar8894]

The worst part, looking at it from my European point of view, isn't even how insurance is organised or who has to pay which part. It's how shockingly overpriced it seems to be, it's insanely bad value for money. Clearly the current 'let the market decide' approach is not getting anywhere near a optimal system. If nothing else changed, just getting the prices on the same level as in Europe would make a huge difference on both medical debt and the costs of insurance.

[@beyondEV]

@@TypeAshton The real trouble for the US is the extreme corruption. that's why they can't simply adopt the swiss system, the only one that is not single payer and all private. wouldn't work in the US. (it's actually still insanely expensive compared to the rest.) still it's important to keep in mind, that even in germany you do pay a lot for healthcare. it's simply hidden in the missing part of your salary which goes to taxes. especially when talking to Americans it's important to always make proper comparisons. so they can see the value we get for our taxes.

[@tobiasfritz5781]

​@@foobar8894 The reason the 'let the market decide' approach doesn't work is because the consumers, or rather people that need treatment, can't independently choose the product or service they receive. To choose you'd need to know what products or services you need and are available at which prices. Finding the right treatment requires in-depth medical knowledge. It's pretty much a hostage situation: either pay for the product/service they decide you need or don't receive treatment.

[@beckyhatt9870]

Thank-you for this. I could bore everyone for hours about our healthcare related issues in the US, but the extreme short version is that healthcare costs were the largest factor contributing to a bankruptcy and losing everything - our business, our home…really, everything. We landed in Germany, and thanks to my husband‘s and daughter’s DE citizenship, we were instantly insured. Starting our lives over, living on welfare for 6 months was humiliating and so very hard, but I could not be more grateful for the new start, at 50 years old, I was given here. Since then we have not seen A SINGLE MEDICAL BILL, despite appendicitis, 6 broken ribs, an emergency with 100 wasps in our house (now THAT’S a story - police, ambulance, firetruck…) but we paid NOT ONE PENNY. Things here are NOT perfect - but when you compare…yeah. Also, when I gave birth to our wonderful daughter back in 1997, because we’d opted for “affordable” insurance (ha) the natural birth was not covered and we paid, for pre-natal care and hospital stay $12,5000. IN 1997. (In fairness, we’d been discussing adding pregnancy coverage to our plan, but hadn’t gotten to it, so that is our fault). Even so, many people can’t afford that; we barely could, but we did. However, for many folks that would have broken them. Thanks as always for your thorough research and thoughtful presentation!!

[@pigoff123]

I was an Army civilian in Germany. My parents were retired military. Due to paperwork problems I ended up getting married 2 weeks after I had my daughter. The German hospital bill was $750 dollars for me because the army picked up my daughter bill as a military dependant. It was very affordable even without insurance.

[@Kai-ci2jg]

As a family doctor from Germany, I can assure you that at least me and every doctor that I personally know would never base their diagnostic or therapeutic dicision on the insurance of the patient. It may sometimes be a little harder for a public insured person to get a third or fourth prescription for physiotherapy, but on the other hand it is usually more difficult for the privately insured person to get a stay at a rehabilitation clinic. So there are pros and cons in both situations. So basically, every person will get the care that they need, no matter the insurance. 😊

[@atze1511]

I agree with you. But as a public insured patient it is harder to get an appointment, especialy for a "Facharzt" (Röntgen, CT). Because (some?) doctors have special dates for private insured patients. That's why your'e asked "privat oder kasse?" when you call for an appointment.

[@swanpride]

@@atze1511 Yeah, but if you have an actual emergency situation, they will pull you in front of the line, never mind how you are insured. And frankly, I don't think that getting an earlier appointment in a non-emergency situation is worth the downsides, which are higher payments in old age, that you have to pay all the costs up-front before the insurere imburses you and the danger of non-necessary tests. If you really want to have extra-perks you can always decide for an additional insurance on top of your public one.

[@m0llux]

You can ask AOK (Edit: or the involved providers, so hospitals, doctor's practices, midwives....) for a "Kostenübersicht" or "Patientenquittung" - it might take up to 6 months for all the charges taken on by AOK to be listed, but after that, it shows you everything AOK covered. You can probably get it online at the "Meine AOK" portal, or you can have it printed out at an AOK office. Might be interesting to show how much the individual charges are different, too, and how US insurance is simply overbilled. Maybe it can be used as an example for the power of large negotiation blocs?

[@steemlenn8797]

Oh, I never heard of that! Nice!

[@m0llux]

@@steemlenn8797 Every GKV needs to provide this on request. And all large ones allow you to view it in the app, too - I mean it's in their best interest to boast about "all they have ever done for you" :)

[@eastfrisian_88]

I registered at BARMER for the electronic patient file (the registration process was tricky), then the total costs of the last three years are listed there. However, also with a delay of about 6 months. I was appalled at how expensive my pills actually are (EUR 780 annually) and I only pay a quarterly co-payment of EUR 15 for them and two medications are even completely free.

[@m0llux]

@@eastfrisian_88 you don't need the ePA to receive a Leistungsübersicht - you can get it at the Meine BARMER portal.

[@chgr4674]

@@eastfrisian_88true, I also find it interesting. I cost the Barmer about 1000-1200€ annually for several chronic diseases, visits at a diabetes specialist every 3 months with full lab (blood and urine), annual feet and eye check up, annual check ups at the OBGYN and semiannual at the dentist. I have also been getting therapy for depression for over 5 years now.

[@KeesBoons]

I'm from the Netherlands and was a "NICU" baby in the late 1960s. Already too curious to stay inside for 9 months ;o). After that I've had 2 live saving treatments until today, and have some conditions which are being monitored and which I'll probably have for the rest of my life, all under our "universal" health care. My mother has had kidney failure and got treated with dialysis for almost 11 years before she past away. All covered as well. Being the care taker for my mother and with my own medical experiences I can comfortably say that I don't know how the medical treatment could have been better. The luxury options of private healthcare like private rooms (which we mostly get these days anyway) or whatever have no value for me. When I need medical treatment, I hope for the best medical treatment, not some holiday experience. What strikes me most about the healthcare costs in the US of A is not the high prices, but the the unpredictable nature of these costs and the horrendous healthcare system costs. Thank you for reminding me, and a lot of other Europeans I believe, about the fortune we have of living with these systems in place and not taking these for granted. These systems are always threatened by the same people/companies who are making a fortune out of the health care system in the States.

[@ShoaibKhanZ]

Argh! Twice! Once in Poland and once in Canada. I had to pay for the PARKING! Why is the hospital parking so expensive 😢 . That's all I had to pay for.

[@holgermessner851]

My mother died in Germany when I was 16.5 years old. Before that, she did spend 3.5 years in hospital with cancer. So her best friend, a neighbor lady, married to an American GI, tried for decades to convince me, to move to the USA. I did visit them in 1988. And you know what, I didn’t liked it a bit. People walking around with missing teeth, especially older Americans complaining about high bills or medication. My “aunt & uncle” as I called them, were disappointed. Fast forward. I lived already in Canada, right - “YOU MOVING TO CANADA…” 😮 - my uncle didn’t feel well. He then cut somehow is foot in their garden. Hospital. The hospital made some tests because the bleeding didn’t stop. Amputation of his foot and part of his leg….. and my uncle did bleed to death - literally. 😢 Visiting for the funeral service, my aunt looked at me and gave me an envelope. “Can you read it for me please. My English is still very bad. She was not only heartbroken for losing her husband, she was shaking from what was in the envelope. And no matter what language you speak, write - numbers mostly don’t need translation. My aunt in the late 70’s & I am in the middle 50’s at that time. So we did sit on the couch. I took the document out - and was close to get an heart attack! Americans! Seriously! For 9 days hospital stay & emergency care, medications - the bill was over $500,000…. I think that where my aunt was close to die when she got that bill from the hospital. I mean, my heart started pumping… and reading page 3, it said all is taken care of from my uncle’s military health insurance. I explained that to my aunt. Next morning, I asked around the neighborhood if there isn’t a service for veterans wifes who would help in this situation. I mean I had no clue what to do. Lucky me, I did find two veterans in the neighborhood. One actually called a veteran service who actually does this work. Visiting the wife or husband and giving help for all necessary documents to fill out. I had only a view days left of my stay, but I was able to meet the gentleman who took care of my aunt. - Still my aunt, after 39 years in the USA, she moved back to Germany. She said: That gave me the rest! I could never ever pay a hospital stay if I needed one. I talked to my sisters. I’m selling everything and go back - home. - I never understood why people call the USA a dreamland. It’s more of a nightmare if you get sick! // To your question: I lived 14 years in Alberta Canada. I did had a gallbladder surgery in 2012. My bill? I didn’t get one. All was covered by the Province & my health care plan. It’s like in Germany. I got a root canal done by a specialist plus my dental doctor’s bill. Pulling the tooth was covered. Root canal wasn’t. I was $1,200 out of my pocket. That’s when I thought. Seriously! My healthcare plan cashed in $400 ($200 my company & $200 from my salary) each month. And no root canal treatment was covered. Couple years, I did have problems with that tooth… Fast forward. I moved to Panama. I’m getting a tooth infection… The dentist in the public hospital in Panama is making X-rays. I personally thought, a tooth beside my crown is giving me that pain. - The dentist is checking the x-ray. “Who made that root canal treatment? I’m sure, you had a lot of pain over the years…” - Why is that? “It wasn’t cleaned out properly. You still have some nerve “leftovers” in each canal….” 😢 $8 out of my pocket, I had my 2,500 CAD crown leftovers (including the $1,200 disaster at the specialist) taken out. The $8 (US) included 10 pain killers and a control visit next day. I have no idea, why North Americans do not kick the responsible people in the health industry out of the country! It’s all about: Getting the last cent out of the people’s pockets! Nothing else.

[@tonykyle2655]

A very informative video. Thank you. One point though was missed. It was mentioned about being "in-network" but there are circumstances where the facility is "in-network" but the doctors, the nurses, the labs, are "out-of-network" because the hospital contracts all of those services out now. This has happened to us several times and it is shocking when receiving multiple bills. We do our best to stay in network but my wife's last ER visit we were advised we would be responsible for 3rd party, out-of-network care. :( The system in the United States is geared to harm and damage people at every turn or so it seems and feels.

[@TypeAshton]

Good point. That also happened to me in the States. I picked up a waterborne parasite while traveling. Came home and went to the doctor "in network", but he sent my labs to a laboratory "out of network" and was charged a small fortune.

[@TheKobiDror]

That alone should be illegal. How are you supposed to know that your "in-network" clinic outsources essential services/personal that are "out-of-network"?! That's the equivalent of a surprise clause. Nobody has tackled it legally?

[@tonykyle2655]

@@TheKobiDror should be but isn't. We've ran into this. A friend lives in a city in this state and a single entity has taken over and their hospital, for the elderly, is where the go to die because of the quality of care. It has been called out but the issue remains. The consolidation of medical care to very large companies concerned primarily with profits is what kills patients in a lot of cases because of budget concerns.

[@LucaSitan]

What I find infuriating is also that in the US hospitals and Pharma charge way more for the same services and Meds than companies in Europe - because in Europe the medical market is regulated to avoid exploitation. Most people don't know, because as you said, we never even see the bills here in Germany.

[@HH-hd7nd]

There's a video of a US congress hearing here on KZbin where AOC questions a guy from a pharma corporation why a package of a drug for AIDS treatment costs $ 8 in Australia but almost $ 1800 in the USA... The corporation's greed in the USA is insane.

[@jessicaely2521]

I wholeheartedly agree. Medical costs would be cut in half if hospitals meaning the CEO and big pharma was controlled. There's no reason why a CEO of a hospital should be making $6 million a year while the employees and, more importantly, patients are struggling to make ends reach.

[@jeihka1]

This is so true. I worked in a medical device company. Each implant aproximate cost was $400 in the rest of the world it cost $425 (25 extra for shipping) they did the sterilization process on the manufacturing plant. But the USA decided to do sterilization process in private lab or hospitals. So each implant cost $1200. Is an FDA regulated product so you have to use the same chemicals. You are not paying for higher quality you are just paying more.

[@jimf671]

@@HH-hd7nd The OECD publishes figures for things like this. The OECD healthcare cost average is less than 40% of USA costs and most high-cost nations, including Germany, are 40 to 60% of USA costs.

[@JennyShull]

To me the US was built to cater to the upper class since that is where most of the money to build the US came from. The other financial bakers to help build the US were wealthy crime families that financially helped many politicians to be in positions of power. In the US u don’t cross the wealthy crime familles. Some politicians backed by wealthy crime families were running on tough on crime policies that targeted the wealthy crime families that backed the politicians. The targeted wealthy crime families felt betrayed and took care of the people who stabbed the in the back. That has basically been going on behind the scenes in the US for decades.

[@nodwick4231]

In Austria, we do have a system that can be summed up like this (in US terms): You are automatically insured through the taxes you pay. The coverage is 100%, except for take-home prescription drugs, which cost a maximum of 6,85 Euros per box. The overwhelming majority of doctors are in-network. There are a few things you can get that cost extra, like a single room in the hospital, but everything that's required is covered.

[@LunaticDesire]

Except for lots of dental stuff :) sadly. But basic treatment is usually covered.

[@0men916]

Sweden and more or less rest of nordic has almost identical system as Austria (also almost identical including the dental stuff). that makes at least 5 countries in europe has this. My estimate its 15-20 countries at this level . AND NON OF THEM are socialist in any means. This will blow your mind. US is actually in some aspects more socialist county than any of these countries. We Europeans. in particular smaller countries, who have worked in a huge US global company. Has over the years often nick named our US company as the last remains of the old sovjet state ruling !

[@Vittrich]

also in austria: If the prescription fee exceeds 2% of your net annual salary, there is a medication exemption until 31 December of this year.

[@Eysenbeiss]

@@Vittrich Almost the same in Germany

[@JennyShull]

How much does your health care cost the tax payers? In the US that probably is what some people are worried about when it comes to changing health care systems.

[@davidhoffmann5737]

In Canada we do not pay insurance premiums and all we pay is for parking

[@insu_na]

The biggest difference imo is that in Germany, if you're publicly insured, it's literally impossible to go bankrupt for any kind of medical treatment. You can still go into debt with elective surgeries or experimental treatments that are not yet covered by insurance, but at least in the latter case you can often sue and get the cost awarded if you win. Importantly tho it will never be a surprise. You always have a choice

[@nobodx]

something that should also be mentioned, if you loose your insurance in germany (which is extremly difficult itself), emergency treatments can be covered no charge as well

[@grmpflz]

@@nobodx You can't loose your insurance in Germany, because you must be insured by law. If anything happens (perhaps you would loose your job), your public healthcare fees are paid by your social welfare office. You only have to proof your residence. If you are homeless, social welfare pays directly for emergency treatments as you said. And even refugees (as for example Ukrainians), that never paid into the system are insured in public healthcare like Germans, mostly by AOK (Allgemeine Ortskrankenkasse), financed by the state.

[@tadeotentakel]

A third point worth mentioning, in my opinion, is the obligation to be insured and the consequences that arise from it. Since it is obligatory to be insured, the state and the statutory health insurance companies must ensure that every citizen also has the opportunity to be insured. This leads to a completely different kind of "cooperation" between doctors, the insurance companies and the patient. When there are problems, it really feels like all three parties are working together in the best interest of the patient's health. When I was 20 years old, I needed a pacemaker very suddenly. The insurance company gave the doctor feedback for a standard model. My doctor then called the insurance company, said "The boy is 20 years as and will probably need the pacemaker for the rest of his life, so I will fit him with the super new, ultra rad model XYZ. I guess the insurance company just said "meh, makes sense, yeah okay." And so instead of getting an 8k€ model, I got a model,which cost 25k.

[@paulinemoira8442]

@@tadeotentakel I'm so glad you got cared for so well. My mum needed half of her teeth replaced when she was pretty young, her dentist send her to a specialist and then their was a bunch of communication between our dentist her new dentist and our insurance company so she could get a more specific insurance plan. Instead of 40k she ultimately payed 800.

[@Puepuevortex]

Same for private insurance. There is always a backup plan, they need to offer which is comparable to public insurance.

[@danielhofig8429]

All hospitals should be run by the state on a none profit based Model.

[@JohnDoe-us5rq]

I'm from Germany. I also was both insured privately and via the GKV. And I have to say, I couldn't see any differences. And, although my premiums for the statutory health insurance are staggeringly high, I am glad to be part of this concept and happy to pay my share, even if private would be way cheaper, at least first glance. I can see the point made about the closure of hospitals. As soon, as you are not allowed to bill fantasy prices, the market will take over and shutdown uneconomical businesses. But that is, by itself, not necessarily a bad thing. Healthcare is nothing one could make a profit of and also help the people. It is a costintensive task, helping people getting better. But when everybody is participating in something like a statutory health insurance, the people, in this case the government, of course, then can decide how much healthcare is worth to society. And even if a hospital is not profitable anymore, it might be necessary to the society, so the society can decide to put extra funding into that specific hospital. With all the money currently bound to the medical care system in the United States redistributed, there are almost endless opportunities. Although that money won't end 100% in the Medicaid programs, it sure will suffice to fund those programs for all Americans. It is as always, when you cut out the middleman, you win.

[@patrickmundhenk-koch7407]

Hey Ashton, thanks for your videos and also sharing your private life. Since you're member of the AOK, you can check in their APP what the hospital / doctors billed there. It is not detailed to an invoice but categorized and summed quarter-yearly. Might give you a better idea of comparison to the billing done in the US. Probably the AOK will share the bills with you directly, if you ask.

[@DeltaCortis]

I think something that is really important as well is that neither I nor any Doctor has to worry about if I can pay for treatment. Usually payment is never mentioned. Only my treatment and I think that's so important for recovery.

[@samfetter2968]

Ha...can answer that without watching. In the US it would have cost too much.😔

[@irminschembri8263]

I am privately insured as I am a civil servant and had the choice when I started my careeer as a teacher. My husband has mandatrory insurance with the same insurer like you. Being in our seventies we had operations and hospital stays etc etc. Both of us are/were cared for really well so far independent from our type of insurance. Maybe we are lucky as we live in a city with a university clinic like you ? What we noticed is a strain on our local GP center since Covid but.

[@rosebrent9440]

My son was born in Adelaide, South Australia. We also have a Medicare scheme, so I had no out-of-pocket expenses. While my pregnancy was fairly non-eventful, my labour was not. I ended up with a stalled labour, not fun. For the most part the staff were excellent. All rooms in my ward were single/private rooms and we were recommended to stay a full 7 day week to ensure we were both okay. On ward was a fridge full of ice packs and a lactation consultant. Also each new Mum was sent home with a gift pack containing samples of pads, nipple protectors, nappies, wipes, moisturisers, etc, etc, etc.

[@jeannettewilke205]

I gave birth to our eldest child in Australia. Our two younger children were born in Germany. In Canberra I was alone with two midwives and only after the delivery an obstetrician turned up to check on me. The ward was fine though. Our two younger kids were born in Germany . There the whole pregnancy was closer monitored by my gynaecologist. Frequent ultrasounds, blood testing ect. plus a very professional medical team in the clinic. During the childhood of our children they were regularly checked and treated from infancy up to 18 years of age by paediatricians. The orthodontic treatment was basically for free. Kids also get free physiotherapy, speech therapy and occupational Therapie. I think Australia could do more for the heath and development of it’s children.

[@mikegraham7078]

My wife had a high-risk pregnancy and gave birth to our twin girls by planned c-section. Twins are usually brought out early if possible (less wear and tear on the mother) so my wife had hormone shots to help the babies develop their lungs faster. It worked on one but not the other. Despite the fact that my girls had a tag-team weight of 15 pounds, one of my girls was in an incubator for most of a week. My wife was able to keep her room in the hospital until we were all done (i.e. most of a week) and then we all left at once, rather than have us day-trip-it back and forth to see the one in the incubator. Cost us nothing but parking and vending machine snacks. We are Canadian.

[@RobertWeigelt-df6lb]

Congratz!! ALL da best for you and your family! 🎉 great having u here in germany!

[@JohnMckeown-dl2cl]

You made a valiant effort to cover this complex subject in a 25 minute video and I complement you on the result. Having lived in Germany, the US and now Spain I have seen the huge differences between the healthcare systems and their costs. The US system is vastly overpriced for the same, and many times lower, level of care. Unfortunately, I do not see the US system changing for the foreseeable future for many reasons. The main reason is that who provides the care has changes in the last couple of decades. This has been a change for the worse, not the better, when there was a chance to make the changes for the good. In the past the model for hospitals had been more of a public or non-profit ownership and management. Now a majority of the hospitals, labs and other service providers has moved to being owned by "for profit" corporations. Many of these company's goal is not to serve the community, but to squeeze every last penny out of the operations to please the CEO (via his multi-million dollar bonus) and the stockholders. When this much money and self-interest are involved, change will be difficult if not impossible. One note: You are comparing what are the best (Germany) and what may be the worst (US). Others in Europe are not so lucky. Here in Spain the public health sector is in trouble. Lack of funding, understaffing, poor management and a terrible administrative plan have brought it close to failure. The bureaucracy involved, that would make Machiavelli jealous, and the waits for care have driven many to private insurance, at personal cost, just to get timely and adequate care.

[@DanielRMueller]

> Lack of funding, understaffing, poor management and a terrible administrative plan have brought it close to failure. The bureaucracy involved, that would make Machiavelli jealous, and the waits for care have driven many to private insurance, at personal cost, just to get timely and adequate care. It really seems this isn't unique to Spain. Or the US. Or Germany. It happens everywhere. I think fundamentally, providing health care is expensive and difficult. Bureaucracy is added to ensure that the cost are tracked well and they don't spend money on pointless costly procedures, or to ensure that proper health care is given, but creates a massive overhead for the people that are supposed to provide the care. The job is psychologically demanding, you care for people that are suffering, in pain, and might die despite your best efforts, it's probably not for everyone. And as a patient - if you're not healthy, there is also a good chance you are poorer, either because being sick made it harder to earn good money, or you couldn't afford to take care of yourself. Or you're too old or too young to still work and live on pension or welfare, or off your parent's income. Kinda the biggest chance to need health care the people the least likely to be able to pay for it.That's why you need some kind of social health care to "balance" the cost. And because people hate paying for stuff they don't personally direclty benefit from, there is a strong drive to find ways to lower the cost, and that leads to understaffing, rules and regulations that are supposed to ensure maximum cost benefit while at the same time increasing the bureaucracy. I am not sure there are any meaningful metrics to tell whther it would be better to have doctors and nurses do some unccessary treatments over doing unneccessary paperwork. Particularly because having such metrics would already require additional paperwork and more bureacracy. (and of course, you still don't want them to make mistakes that could have been avoided by more rigorious demands for documentation of individual health care plans and diagnoses....)

I'm from Sweden and we had 2 children in the 1970s, we had bad finances but it didn't cost us anything. Later in life I have had 4 operations, shoulders, stomach. Free except for a cost of SEK 200 per day at the infirmary. All tests and x-rays are included.

[@NormanF62]

I looked up the cost of open heart surgery where I live and if I didn’t have Medicaid, I would faced a bill of $60,000 and the rest of the expenses could have been in the area of $150,000. The quality of my health care was excellent but truthfully, I wouldn’t have been able to pay for my health care without public assistance. None of us is financially prepared for a catastrophic condition and I have to confess I never thought about long term health care insurance when I was young because I never thought I would need it and I would remain in good health my entire life. That didn’t turn out to be the case and it was a lesson learned. Invulnerability is an illusion where our health is concerned. You can never begin planning too early for major life events.

[@HH-hd7nd]

No one - and I mean no one - stays healthy forever. Everyone gets sick eventually, and the higher the age the greater the risk is. And that doesn't even include the risks of accidents which can happen even to the healthiest person on the planet. Whenever I hear US americans talking about the merits of the so-called "healthcare" in the USA I can only listen in disbelief because of how ignorant of reality the people are.

[@dutchman7623]

The advantage of living in western Europe is that you do not have to plan for them. Financially you will survive and get the care you need. Even when your employer goes bankrupt and you lose your job, you will be paid until you find another job. We not only have freedom of expression, freedom of press, freedom of/from religion, but also freedom from too many worries...

[@BasementEngineer]

@@dutchman7623 Freedom of speech? Don't make me laugh. Speak out against the official narrative regarding certain "historical", non proved, occurrences and you find yourself in prison.

[@katn1952]

​@@dutchman7623Well said 😊

[@mikapeltokorpi7671]

In Northern Europe roughly all neo natal babies having Asian background stay in hospital / go ICU for 3-7 days due to genetics, as their liver starts processing bilirubin after a couple of days.

[@LadyQuotes]

I used to work at a call center. We serviced Microsoft. After about 2 years, Microsoft pulled out and the call center was reassigned to a US Health Insurance Provider. I would not work there, because "refusing payment for health services not refusing health care" is still refusing health care, and the entire system is immoral.

[@jaorlowski]

I sometimes get the impression that the US is about value over people as people are a risk. Whereas in Europe it's more people centered. Not entirely maybe but in relation to the US it seems correctly.

[@walkir2662]

Yep, I bet many people heard that "saving medical cost" as "this industry will lose so much money!" There seems to be no idea of what healthy, educated people mean for society as opposed to short term cash.

[@oscarbecker7843]

You are correct... for now! I have the impression that it is changing slowly but more in other areas like jobs and consuming.

[@courtneymcwilliams6571]

I 💯 agree with you.

[@TimEssDub]

The best way to look at US health care is through the eyes of an investor.

[@rodh1404]

Yet another excellent deep dive into the topic. The only thing I would suggest you add is how much your yearly insurance payment works out to be, and compare that to what you (or your employer) might pay in the USA. I live in Australia, and even though Medicare is a kind of universal heathcare, it's been considerably weakened over the years and we're becoming more and more like the USA. That said, when I had a heart attack about 10 years ago, the only bill I received was for the medications I took home, and I consider the care that was given to me to be excellent. Were I living in the USA at the time, I fully expect I would have become yet another medical bankruptcy.

[@spiritualanarchist8162]

This must lead to some awkward conversations between couples. Man: Let's have some fun tonight, 'Woman : We can't afford contraception this month if we want a baby next calendar year. Man: Siigh... I'll take a cold shower 😅

[@jamesharrison2374]

Lived 16 years in Germany with AOK, and it was great. Back in the USA am on group insurance with my employer. At the time the cost was $12k per year, and needed a minor knee surgery after a fall. My out of pocket was $9K. Mine was one of the better insurance plans.

[@viarnay]

Universal Healtcare system is not free, you know?

[@arnodobler1096]

Wahnsinn!😢

[@ebt12]

Nearly 10 years ago, a friend of my wife and I moved to New Zealand, and then invited us and a goo dnumber of our friends, to join her. I wish we could. The cost of moving, and the difficulty of finding employment, are barriers we do not know how to break down. Our friend's stories of her experience with the healthcare system there makes moving to New Zealand more desirable.

[@Tiniuvielle]

Here in Belgium, the state pay a big part of the bill (but that's one of the reason my country is the one where you're the most taxed) and the insurance cost you pay is even called "complementary insurance fee" as it is used for additional perks like glasses reduction, sport licences reductions... We also have Hospital and Dental insurances but they exist to cover non life-threathening things or confort supplements. Also, the price of most medical action is fixed by the state. Doctors can charge more ifor their work out of hospital buildings and if they do the difference is paid by the patient then. Overall, Belgian health care system is often considerate as one of the best of the word and I was never scared of the cost of it so... I'm pretty happy with what I have here :D

[@galdavonalgerri2101]

8:09 „Ibuprofen 6 pills $18.30“ That's more than $ 3 for one Ibuprofen pill 😞 One can probably assume that a hospital buys this standard drug in large quantities at favorable conditions. In Germany you can buy for €1.29 (1.41 USD) per pack of 10 in a retail box with pretty colored cardboard around it, so one is $ 0.14 and 6 of them are $ 0.84, so in this example the price is about 21 times as high. (edited: 18.30 / 0.84 = 21.7 times)

[@tubelious]

same ratio in all medical & care costs. American insurance companies and medical companies are making a killing.

[@johanmolin3213]

No wonder, perinatal mortality in the US is 5.7 / 1,000 births, as apart form for instance Sweden with 1.7. The US figures are actually higher than the Swedish ones when I started out as an obstetrician 40 years ago (this very year ...)! One little comment on the blood flow examinations: It's true that increasing resistance in the umbilical arteries is associated with fetal growth restriction, CP damages (if not detected at an early stage) and perinatal death. What DECREASING blood flow resistance signifies is still incompletely known however. As far as I know, there hasn't been found any radical increase in risk.

[@hellome8826]

I was wondering if she was going to bring up infant mortality rate. Also, not just infant mortality rate but overall mortality rates here in the U.S. compared to other countries. People are known to put off care to try and avoid medical costs.

[@johanmolin3213]

@@hellome8826 - There i a difference between perinatal mortality and infant mortality. Perinatal mortality = stillborn children + children dying within the first week after birth. Infant mortality = child mortality during the first year of life. And the figures get worse the longer time span you study. If you look at the 5-year mortality it is 2.6 / 1,000 live births in Sweden, but 6.3 in the US. Two very important factors are 1. Access to maternity care free of charge. Sweden has had that since 1940. 2. Parental leave after birth. In Sweden, you have the right to 18 months of paid parental leave, preferably shared between the two parents (if there are).

[@hellome8826]

@@johanmolin3213 thank you for the clarification I didn’t know the exact medical term between the two

[@johanmolin3213]

@@hellome8826 Most people don't, if it's not their job to know the difference ...

[@rekleif]

Also the maternal mortality in the us is 32.9 and in a country like Norway it's 2.0. Let that sink in.. It should not have to be this way. Love your neighbor as yourself is a Biblical command that gets more and more outdated in this world, were profit is everything and we become colder with less empathy by the day? I see a lot more humanity in the most capitalist country on earth, India, but I fear you US citizens are heading were they are. One caste of ultra rich and well connected ruling the people like slaves with no rights, and a religion designed to prevent a revolution so the rich can stay rich for every generation....

[@hughtube5154]

I lol'd at 02:10. Your baby's waving hello for the picture.

[@janlis001]

I was diagnosed with cancer last year. After the operation I stayed in hospital for ten days. After 3 weeks, 33 times daily radiotherapy startet including 2 weeks of chemotherapy in hospital. Due to some complications ( a severe pneunomina and some other things), it ended up by 4 weeks. Then I went to rehab for 3 weeks. The most expensive thing I had to pay by myself was the Wifi bill in the hospitals (Euro 30,- in total, including 2 free headphones🙄🤤!!!

[@johnhendriks4085]

Here in the Netherlands it is almost the same as in Germany. I pay a premium for myself only 155,00 euro a month and I have an own risk to pay every year of 385,00 a year. About 2 years ago the doctors in hospital detected a tumor in the colon and metastase in the liver. They started with an intensive chemotherapy and I am still on a ;lighter chemo at home. It is going well so far. But if you look at the bills my health insurance had to pay every month, it is huge. I think only last year it was more than 30.000 euro. I did not have to pay for anything.

[@norrinradd2364]

Stay strong 💪! I wish you all the best and fast recovery 🍀.

[@johnhendriks4085]

@@norrinradd2364 Thank you for the good wishes

[@diwatazapf3135]

Thanks for ANOTHER very informative, well researched blog. Truly amazing. Good luck n best wishes to your GUYS. ❤

[@Roel_Scoot]

If you have an income in 2023 below €31998 for singles and € 40944 for families, and less than € 127.582 resp. € 161.329 capital you can get a monthly health allowance of €154 -€265 max. in the Netherlands.

[@invertlog]

Also a dutchie here, who has had health complications in the US in the past. 10 years ago, the dutch system was a lot more like the German system than it is now. For instance, we have "in network" and "out of network" healthcare providers. Insureres are responsible to ensure that a hospital is available within a 45 min car ride, but this does mean that I had to drive 42 min to a hospital to receive covered care, unless I paid a premium of 15e a month (its nothing compared to americans, I know) for the "free selection" premium. For americans, a 45 min drive might not mean much, but its driving through 1/3rd of the country to get to a place. But, when I got a lot of ribs heavily bruised in America, my healthcare and travelinsurance paid for most of it. Except for the "perscription strength" oxicodon, which was apparantly too heavy a drug to be paid. So I had a cost of around 80 dollars for pain medication, in addition to a lot of covered healthcare for a two day hospital stay. So when I need to pay "personal deductable" on some medications I need, for instance anti biotics, I laugh when I need to pay a 1,34. I mean, its annoying as you can see it glide toward the american model of incomebased healthcare, but we are still a loooooong way off.

[@annh.8290]

When we moved to the Netherlands we were pleasantly surprised at how low our insurance costs were. In the US we were paying per month about what we pay here in the NL per year, and here we also have opted to include dental, which wasn't even an option in the US. Also when my husband was in an accident here, there was no bill for his visit to the ER, or followup visits. One thing you missed in your coverage, is when you have an issue in the US you in general lose your insurance, but are offered COBRA, which since, it's not supplemented by your employer is twice as expensive. It happened to me, and was out of the question, since my disability payment was so low. I ended up on medical.

[@Anonymoose66G]

May I ask where you live in The Netherlands, pros and cons and quality of life in The Netherlands? Also why do you choose The Netherlands over say Switzerland, Denmark, Sweden, Norway, Finland, Iceland, Luxembourg, Etc.

[@UtamagUta]

@@Anonymoose66G People in NL watch British TV from childhood thus their english is perfect. Other countries catching up due to SM and hollywood influences

[@Barricm1966]

I am from Portugal and at our public hospitals we don’t pay nothing !!! We have an excellent health care systems !!!!

[@RealConstructor]

@@Barricm1966Don’t pay nothing means you pay for healthcare. You probably mean you pay nothing. Well directly that is, you pay through taxes probably.

[@laulaja-7186]

Another comment said in Netherlands they paid 145 Euro per month. In US it is typically 300 to 400 USD per month, if you have health insurance through employer. Of course there are other gotchas, like a US insurer only covering 90% of your bill, and taking months to reimburse while you have to pay immediately etc. But just in terms of cost of insurance, the above is a 2:1 ratio. Nothing like the free healthcare other Europeans here are posting about.

[@patrickhanft]

I actually don't want to criticize your choice of sponsors, but as you were talking intensively about how your public health insurance here in Germany never showed you a bill, I think it is quite important if you talk about someone helping you choose between public and private health insurance here to explain, that there are significant differences how private health insurance works here. Perhaps I am a burnt child in this respect, as I realize how my financial advisor repeatedly tried to lure me away from statutory health insurance into private health insurance without explaining its long-term and very serious disadvantages to me in a reasonable manner. Yes, of course, private health insurance in Germany has a reputation for providing better health care. In practice, however, in most cases this simply means faster appointment scheduling, as this makes patients more welcome at the doctor's office. However, the quality of statutory health care is absolutely sufficient. If it's a matter of life and death, I can be completely sure of receiving equally good care in Germany. On the other hand, it is not uncommon for private patients to be persuaded to undergo nonsensical examinations simply because more money can be billed here. And in the long term, the risk of slipping into old-age poverty due to the much higher increase in premiums is simply too great for me. The fact that I already get to see the bill in private health insurance and only then submit it to the insurance company is actually only a small inconvenience, but one should also be aware of it.

[@walkir2662]

Yep, that wasa bad surprise.

[@likesc]

I know there are a lot of bad insurance companies in the US, however my Insurance company was great. My wife gave birth to our son, stayed in the hospital for two days and my son had to stay in the nicu for a few days because he was jaundiced. My grand total for everything was just a $100 co-pay. Compared to the stories I have traded with other parents they paid a lot more, so it is bad here in the US. Really depends on what insurance company you get. Most are horrible.

[@timo1383]

Switzerland here, our health insurance is a bit of a mix. We have a monthly rate plus deductable, you can define your deductable. If you pick a low deductable, the monthly rate usualy increase, but not as much that it simply moves from deductable to monthly. So if you have a health issue that requires you to see a doctor regulary, you pick lowest deductable which is 300 CHF (~340 $) or if you healthy you can pick up to 2500 CHF (~2840 $). If you fully paid your deductable you also have to pay 10% of the other receipts but only up to a total of 700 CHF (~795$). Montly payment is between 250-350 CHF in relation of your deductable. The healthcare does not pay for dentist visits at all. This part really sucks but beside that, you get really quick access to good healthcare/doctors. In Germany, if you want to visit a specialist (non-emergency) you sometimes have to wait up to 6 month for an appointment. In Switzerland, you usualy get an appointment within a few days if not instant.

[@diwatazapf3135]

Thanks for another informative, well researched blog. Always looking forward to ALL your posts. Best regards to your GUYS.❤

[@marienoemi812]

Thanks so much for this interesting video! I gave birth to my first son last summer here in Germany and for some reason, I was sent a copy of the bill which was sent to my insurer. This way, I know exactly what the insurer had to pay for my relatively easy birth at a "normal" clinic (not a specialized clinic): ***1800 €***. To be fair, I didn't have any operation and didn't need any pain meds. Also, my partner and I only stayed for one night and I got further care from my midwife who visited us at home and helped with breastfeeding and all the things you don't know as first time parents. It's always shocking to me how much more medical services cost in the US!

[@mega_dtm]

maybe you have a private insurance? In that case, you receive a bill and give it to your insurance company. Officially you have to pay the bill and it will be refunded to you by your IC. In most cases you get the money and can pay the bill afterwards^^

[@marienoemi812]

@@mega_dtm Hey, I have public health insurance (Gesetzliche Krankenversicherung). Maybe what I wrote was unclear: I only got a copy of the bill but didn't have to pay the bill. I still don'tknow why I was sent the copy of the bill but found it very interesting to know

[@pyrrhus70]

It is not "only" the costs, it is also the worries that would accompany me every day in the USA. Nobody wants to get sick because it affects their health, their life. But then to have the additional worry of not being able to get the care I need without financial reserves or income in case of an emergency would be extremely stressful for me. Illnesses or accidents don't really happen intentionally or planned. On top of that, it takes a lot of time and energy to wade through all the insurance catalogs and offers, to compare them, to understand the fine print and, in the end, to research forever which hospital and which doctor you're allowed to go to, so that the insurance company doesn't stress you out - while you're lying on the floor bleeding. And since there have been a lot of TV series in the USA since time immemorial that show a health care system in which costs are almost never addressed, but all the doctors virtually sacrifice themselves for the patient (Dr. House, etc.) - and in the end everyone leaves the hospital cured - it is naturally part of the consciousness that medical care in the USA must be the best on earth - if one were to live in a TV series. This image has certainly taken root in people's minds like a national myth over the decades of "General Hospital," "ER," and the like.

[@StochasticUniverse]

The actual hospital care in the US is very good, but the US has worse health outcomes than some other advanced countries because there's a strong culture in the US of people waiting to go to the hospital until they're literally dying, and by then, it might be too late to save them. (This is because people pay per visit to the hospital, so rather than visit doctors routinely for issues and stay on top of small things before they become big, Americans tend to wait until small things become very big before they ever see a doctor, just to save cost.) This causes marginally higher mortality statistics in the US. But if you correct for that, the job the hospitals do is on par with any other advanced country, and the very best hospitals in the US are pretty much the best in the world, which is why you'll see rich foreigners (including Europeans) come to elite American hospitals for treatment of rare or difficult conditions. Of course, regular Americans generally don't have access to those hospitals.

[@grischakugelmann2660]

I was in a German hospital recently and it was my first stay ever. I have had a private insurance in the past and have to pay still some money for an extra insurance - I thought that it was for consulting the hospitals chief doctor. So I told the woman at the hospitals check-in that I am willing to pay the difference from 2 to one-bed-room my self and that I own an extra insurance to consult the chief doctor. Later when I had my check-out it bacame clear that I didn't had the insurance I thought I had and that I just get some money for each day I stay in hospitals, so I exspected a hughe bill. All I had to pay was arround 300€ and most of it was because of the private section I stayed in because in the normal section there where no single or double bedrooms left. (I think I still have the bill somewhere) So the German healthcare system is brilliant and my insurance is (my opinion) the best universal one - TK (Techniker Krankenkasse) cheers

[@annediss8706]

Another great video! My first child was born in a public hospital in France, and it was fabulous. Epidural, three days in a private room (I did pay a little for that, maybe 100€ total?), overall a fantastic experience and free if I hadn’t had a single room. The other two were born in a semi-private hospital which was closer to where I lived , a little more expensive (it was awhile ago but I’d say 300€). The French ‘secu’ (sécurité sociale, social security system) is phenomenal!

[@Baccatube79]

As a point of ihterest: AOK stands for "Allgemeine Orts-Krankenkasse", meaning roughly "Common Local Healthcare Provider". AOK are the non-profit statutory health insurance providers founded by Otto v. Bismarck in 1876. Ever since, it is mandatory in Germany to contribute to healthcare as soon as a person enters the wotkforce, the contributions being split halvesies between employer and employee. There is also a possibility of getting private insurance which only means you pay way more for minimally better service... however: the systwm is not perfect but good enough so as to provide almost everybody with medical care, even homeless people and hookers.

[@indrinita]

I'm really curious - how does it work exactly if you're a sex worker in Germany? Btw, as an aside, in English the word "hooker" to talk about a sex worker is considered derogatory and definitely very old fashioned at this point. I'm not sure if English is your first language, hence the explanation.

[@Baccatube79]

@@indrinita I'd have said "Nutte" in German, but, yeah, sexworker is the nicer word. How it does work exactly, I don't really know, but always supposing the person is in Germany on a legal basis, they'd be either have private or "voluntarily statutory" insurance and tax their revenue like any other self-employed person. If the person, again supposing they have a legal status, does the sexworking as moonshine work, they either have a normal job whence their healthcare, or they are on "Bürgergeld", which is social security money and also includes healthcare. Of course, the poor women that have no legal status, mostly victims of human trafficking, fall through the net.

[@thiloreichelt4199]

I am German. I had private health insurance for some time but now I am back to public insurance. I did not experience any real problems with public insurance. What I did notice: As a private patient you are likely to get an appointment sooner and there tend to be more "frills". One MD really has a separate waiting room, which is more nicely decorated (I do not mind, that is very low on my priority list). I am not a MD myself, but I had the distinct impression that I occasionally received treatments chiefly because of financial reasons instead of medical reasons while being on private insurance. (They just found somebody whom they could bill more).

[@sonjagatto9981]

I agree! I know from a friend in Germany. I married in Canada for many years now... I miss my first wonderful 30 years I had in "meiner Heimat". ♥♥♥♥♥ The difference in healthcare and other things are like day and night. Please my dear Germans enjoy your life. Thilo, I belief you did the right thing. 👍 Best wishes and good health to you from Ontario, Canada 😘

[@RustyDust101]

Hi Ashton, another well researched video on a sad topic: the difference between civilized and extortionist healthcare, ie the rest of the world vs the US system. The more I hear about the practices that are common both by hospitals as well as doctors and I can't but be forced to conclude that the US Americans in the States suffer under a legal version of mafia like proportions. When you have no choice but die or go broke in a potentially life threatening situation the vast majority will select the "go broke" option over either permanent disfigurement, disability, or even death. Even if at the time of their choice they have absolutely NO idea how high their debt will be. Heck, mobsters are usually fairer than hospitals and doctors because the mobsters will usually tell you ahead of time what their "protection" is going to cost you. Agreed, mobsters rarely provide any real services except not rob or harm you. But usually mobsters also cut down their extorting to a level that their victims can reasonably pay. The US health business doesn't give a damn about how much they charge you, or how outrageous their prices are compared to other civilized countries. They charge whatever they can get away with, even if that leaves a patient that is already under pressure due to a medical condition under the potential threat of privately defaulting on their debts, leaving them broke and destitute. That's why I don't feel smug; I feel pity for US Americans still in the States who haven't woken up from the dream that their health business is worth the name of health CARE only for the ultra-rich. Edit: I am more than happy to contribute to the public health care system here in Germany. Thus I have participated a tiny, tiny amount to the outcome of your and Theo's birth; which is sooo satisfying in a strange way. I feel no, none whatsoever, reluctance to pay into the system when I hear stories like yours that validate my conviction that despite all of its flaws the German system still works. That's something I can really be proud of, as it helps the most people to improve our society in general. Thank you, Ashton, for sharing and reaffirming my belief in our shared system. It does improve my outlook on life in general. 😘❤ Edit 2: returning after your question. Nuanced answer: for the vast majority of my care, both GPs and specialists, as well as hospital care, I would give the answer: outstanding care. However, when it comes to mental health there is a significant dearth of psychiatrists, neurologists, and therapists in Germany. To find a therapist still taking in new patients in your area is fortunate. Finding a therapist that takes you in during an emergency is very difficult. However during an emergency you normally can find specialized mental health clinics that do take in emergency cases. But don't expect very warm, pleasant stays in the emergency departments of these clinics; the best you can hope for is being dosed up to the gills with certain antidepressants like Tavor, until an open spot is found in the department that deals with your special case. That can take anywhere from 14 days to several months, if you're unlucky. That's the caveat I have to throw out. My own medical history included way over two years of hospital or clinical stays in total over my 53 years of life. With my Krankenhauszusatzversicherung / add-on hospital insurance at the Barmenia in addition to my DAK standard public health insurance I usually got the perk of a single room, Chefarztbehandlung/chef doctor's treatment, and a few other minor goodies. But the total time in hospitals here in Germany or the rest of Europe cost me faaaar less in regular insurance premiums over my lifetime than even ONE expensive stay in the USA would have. So, yepp, I am incredibly happy, and consider myself fortunate to have been insured here instead. On the note of: has the care changed: yes, a bit; the more privatized the care became the more overworked, right up to overwhelmed the staff became while receiving far too low wages. That's a sad truth that with MORE privatization in hospitals the care has gone DOWN in Germany.

[@StochasticUniverse]

I realize that English probably isn't your first language so you may not know this, but you don't need to say "US Americans in the States". You can just say "Americans" -- much more succinct. ;) Greetings to a European German in Germany, hehe.

[@PascalGienger]

The US still is defacto an agricultural society plus some big cities. God, scriptures and strong "Christian" faith let them make kids and people prefer to die as they have children to continue the family. That's why that part of society doesn't care about medical bills. Sad but true. The evemy is the city dweller and "it's their fault if they need treatment for living their bad lifestyle choices". It's shocking, yes, but that's what I see and experience daily since I moved to the US for employment reasons.

[@brigitteebert5827]

​@@StochasticUniverseoh, I also do differ 😉 Americans are south, middle and north American people. North America is basically the USA and Canada. And they are vastly different from another 😊

[@jal051]

@@brigitteebert5827 México is North America too. But it doesn't matter. I agree with you. South Americans often feel hurt when US isn't specified.

[@peterdung8308]

Maybe I missed that information in the video, but in case I didn't: Costs are not only significantly lower for the insured individual in Germany, but overall as well! According to an Viactiv (German Health Insurance Company), a birth costs the insurance company in average about 2-3.000 Euro. In the US the average birth costs about 13.000 €. That's about 5 times the costs in Germany! This is the perfect example for why free markets may lead to very inefficient solutions, when information is distributed asymmetrical and multiple principal-agent-problems are involved.

[@canadianicedragon2412]

Canadian here... I love our system. Sure it is imperfect, sure it could be better, and all that... but I love that I can go when I need to get whatever I need, and not worry about it. I've been to the ER twice in the last 10 ish years... go my issue diagnosed and dealt with, and went home to recover with no worries except when would the painkillers kick in.

[@TheSameWorld]

Hello from poland! The biggest issue I faced with universal healthcare are wait times for appointments with specialists and even for family doctors in some areas. Thats one of the reasons why many peoplehave private insurance or just go private out of pocket. My father for example had to have knee surgery but would wait even two months for one through universal healthcare, so he did it privately. We are blessed enough that we could afford it. It created a funny situation, that in our capital you can sometimes get a visit with a family doctor under universal healtcare faster then private, because so many people don't even try scheduling under UH. The looks of some hospitals and clinics also could be better and pay for doctors, nurses, paramedics and rest of the staff, so more people would go into this careers in poland than moving abroad for better earnings.

[@Merrsharr]

It should be noted that wait times for an appointment with a specialist are very long in private healthcare too, unless you have the means to pay to skip the queue.

[@broniusbronka2703]

At least in Lithuania, if you go to private doctor, universal healthcare still cover some cost, because all prices are negotiated for every procedure... So for example in all public hospitals insurance pay 20$ (prices are not accurate, its just for explanation how it works) for every consultation doctor do, but there is usually long waiting times, you can go to private, lets say its 50$ for private consultation, insurance will still pay 20$ and you will pay 30$. But if you have emergency or your life is really in danger you will be treated as fast as possible, even if you don't have insurance, but if it was life threatening, for citizens it will be for free! I had to go to hospital for emergency two times without insurance At that time is was working some seasonal work abroad, and just spend like 4-5 months a year in Lithuania just relaxing :). First time appendix almost 3 days in hospital, 2nd time broken leg it took few hours to put me in cast, my cost was 0$ both times.

[@kiru5661]

Hi Ahston, just fyi, you can get a copy of the bill as a patient, most just don't do it or even know about it. But if you ever need a bill for a video :), ask for a Patientenkopie/patient receipt. Hospitals and doctors are obliged to give you a copy according to § 305 para. 2 SGB V.

[@NickfromNLondon]

Brit here. Medical care is free at the point of delivery, however there are severe pressures owing to the lack of resources and staff shortages with lots of posts vacant. Large numbers of General Practioners (family doctors) are due to retire without sufficient young doctors coming through. Dentists are self employed contractors to the NHS patients have to make contributions to dental treatment, they can also offer private 24:10 treatment. However many parts of the country finding an NHS dentist is difficult. Two years ago my grand daughter was born during Covid restrictions but daughter in law (who funnily enough is German) and baby had excellent treatment including a post natal stay to treat our grand daughter for jaundice. Did not cost them a penny. The NHS is funded from taxation so at the end of the day the government determines the amount of resources allocated. I used to have work based private insurance which is taxable. That did mean minor surgery etc could take place sooner than if I had to rely on the NHS but anything serious was taken care of by the NHS.

[@trueamnisias]

As a German expat in the UK having worked in the NHS for over 25 years I can tell you the system is in shambles and the 'free at point of access' is somewhat misleading. It is funded by the goverment, so basically via what they get via National Insurance, taxes etc. Therefore there is no protection, each goverment can decide how much (more accurately how little) of their budget to funnel into healthcare. In Germany, the money for health care is 'ring fenced' through use of independent, not-for profit health care insurence providers and therefor the cost transparent. Not to say the Germany system is perfect and does not have any challenges, but I have maintained my German insurance for a quarter of a century so that if get seriously sick I know I have immidiate access to care and do not have to languish on NHS waiting lists. They also pay all my dentist bills (which incedentally is not really free at point of access even though I use and NHS dentist.

[@tilljerschabek5891]

Eure Videos zeigen mir immer wieder das man mit einer gewissen Dankbarkeit auf unser Sozialsystem in Deutschland schauen sollte. Perfekt ist vieles nicht und auch (grade mit Blick auf die AOK) gibt es viel zu verbessern.

[@CornyCF]

As an adult cystic fibrosis patient, I am happy to be able to live in Germany. The life expectancy of cystic fibrosis patients in the United States is 10 years less than in Germany. a cystic fibrosis mother in the USA once showed the cost of her insurance. I think it was about $800. Only part of the costs are covered. I am very satisfied with my AOK health insurance. I am now 42 years old, even though I only had a life expectancy of around 15 years. I owe that to good healthcare.

[@arnewengertsmann9111]

My parents as well as I are chronically ill (rheumatism for me and my mom, the aftermaths of a brain bleeding for my dad). We never had anything serious to complain here in Germany. The medical team in our clinic sure safed my dads life when he had that bleeding and the clinic in Heidelberg did good as well, so he is mostly healthy today with minor issues. And I as well was taken gread care of when my rheumatism came up 2 years ago. I have to pay 10 Euro for my medicine as co pay, but if the yearly costs exceed 1% of my income, I can reclaim that amount (normally it is 2%, but that is halved when you're cronically ill).

[@thomaswollenweber4588]

I am German, but lived in the U.S. for almost 10 years and both of my children were born there. Ou first daughter was born while my wife was studying at the University of Minnesota as a foreign student. Therefore, my wife was insured through the University‘s health plan for (foreign?) students. She received exceptional care, had a spontaneous birth without complications, stays in the hospital for two nights. Co-Pay was ZERO. At the time she gave birth to our second child, she was covered through my health plan as an employee (in a management position). As I had no point of reference, I believed my co-workers that our plan was „very good”. our second child was also born without any noteworthy complications, however, my wife received an epidural. The stay was also 2 nights. Co-Pay: 8.000 USD. And yes, EVERYTHING would have been free of charge in Germany, except, of course, our monthly contribution to the social health care system.😊

[@57thorns]

So you pay enough for a small house in a rural location, or a decent small city car, even everything goes well?

[@patrickd9551]

There is nothing social about the health care systems enacted by the european union. All is privatized, they only let you think it's social, but a loooooot of money is going around in the medical care industry. Germany included. The fact you don't get a medical bill in germany is a big red flag. It doesn't allow you, as a citizen, to criticize the system. The companies are allowed to do their dealings without much checks and balances. GKV isn't cheap either. For a regular worker with 40k income you still pay €250/month and the more you earn, the higher the "social insurance". Then there is a private insurance, PKV, which you are allowed if you earn above 50k, which sometimes is cheaper then the social version, go figure. So where do I comes from? NL to be exact. My monthly insurance is 160/month (premium package), low incomes get a kickback from the government. But I DO receive my medical bills and the costs are insane sometimes. But because we receive our bills, we are allowed to criticize the system keeping is partially in check, but medicine is still crazy expensive when billed through the medical system (just not yet 3 dollars/tab) I'm 40 years old and I actually lived through the entire privatization crap the EU forced upon us. My monthly insurance for the actual social system was about €40/month including dental and no co-payments. When I had to have braces there was a co-pay, because it wasn't medically necessary, but even that was only 600 euro or so for the entire two year treatment. Now I pay 4 times the insurance and I have co-pay for medicine, health care and mental healthcare as individual categories, adding another possible 1000 annually (usually around 400 for me personally). If my sons would require braces, I cannot not imagine the costs. How is this "social"?

[@johniron7269]

8000 for a small House where can i find that please Tell me

[@57thorns]

@@patrickd9551Not at all sure what you are babbling about except that health care funding has been cut in later years. I will not say you are wrong, especially not when you say that the total cost for health care is less in Europe than in the US.

[@patrickd9551]

@@57thorns I thought I was pretty clear. There is nothing social about the current systems that are in place in Europe. Insurance rates are through the roof and everybody in the medical industry is milking the patient to their maximum. For example: One tab of paracetamol in the pharmacy is like 3 cents. The hospital charges 30 cents. Good for the hospital and the pharmacist. Or specialists are now hired consultants, instead of being employed by the hospital for a fixed salary, they are now consultants with rates three times higher as before. Pharmaceutical companies are buying up patents, remarketing medicine and jacking up prices ten-fold (sometimes even way more). Or "new" cancer treatments that are 4 times as expensive, without any real improvement in life expectancy. That is NOT a social system, that is just a system designed to rip people off. And it gets crazier every year. Because one way or the other. YOU WILL pay for those bills. Either through increased insurance costs or higher taxes (of which germany and the netherlands already has a lot)

[@irmaescobari50]

I have a "decent" insurance (since I work for a hospital In Oregon, USA), but because my baby is due in January and my year deductible is $3000 which I will probably have to pay again in January and have no idea of what other complications or charges I could have. I decided to go home with my family in Bolivia and spend that money there. Where I have a support system, and even without insurance, I can choose any private clinic I trust and still pay less than just the deductibles in case I need a C-sectio compared to the US after deductibles. I would also have a consistent provider and better care. It is sad, but it is the reality. Insurance companies in the US are a complete scam! 😂

[@erejnion]

You know, prices aside, it's really nice to see a baby getting born two months early AND surviving to grow up healthy. We've been getting better at this, really.

[@monilip]

Just FYI, the earliest baby being born and surviving without pernament damage (though it took some of physical therapy) was born just after 21th week of pregnancy. That is 5th month. Yes, babies born that early have a very small chance of survival (about 5%) but yes, we are getting better at saving babies :) Oh, and baby was born in the USA, in 2014 and first thing doctor did after baby was out, even before cutting cord, was asking mother if she even wants to try to safe her because healthcare gonna cost a lot, so yeah... Amazing talented doctors vs American healthcare costs

[@bazoo513]

0:10 - I _love_ how you say " _we_ recently gave birth...". As much as I expect Jonathan to be a wonderful husband and parent, it _was_ you who did the heavy lifting, so to say, eh? 😀

[@MichaEl-rh1kv]

Healthcare in Germany is currently confronted with massive problems mainly due the "Fallkostenpauschale" (case-dependent flat-rate allowance) system, introduced in the 1990s. Within this system clinics get a fixed sum for each case based mainly on diagnosis and treatment duration, which is pre-negotiated by the association of statutory health insurances and the umbrella organization of hospital owners (DKG, Deutsche Krankenhausgesellschaft = German Hospital Corporation). That however led to misallocations, unnecessary surgery treatments and financial difficulties of hospitals due to unpaid costs for provisions (including e.g. providing capacities for events like a pandemic), underpaid "conservative" treatments, uncovered complications and so on. That's the reason for the currently debated reform which (inter alia) aims to appreciate the providing of excess capacities for emergencies etc. and also to offer better payment for hospital staff.

[@stefanleppert5305]

Thanks for bringing this up. As a german I am extremely happy with our health care in comparison to the US, but there are things that should be improved. The mentioned Fallkostenpauschale is one, another is the working conditions of hospital staff („Pflege“ - e.g. nurses). Many of them work very long hours in a demanding role for comparably low pay.

[@betaich]

Falpauschale were introduced in the early 2000s not the 1990s

[@ernestmccutcheon9576]

Your experience relects my experience and that of my kids (with 5 births between them). In other words, very postive. However, I have often heard the statement "in Germany, privately nsured patients subsidize publicly insured patients". In the US, the hospital bills are at best a joke, at worst a scam. I think that the numbers are just made up to scare patients into being happy to pay high deductibles, because the insurance companies don't pay what's on the bill either, rather only a fraction of it.

[@Henning_Rech]

"However, I have often heard the statement "in Germany, privately insured patients subsidize publicly insured patients" - there is some thruth in this statement. Other than in the US, cost of healthcare is regulated; each doctor charges the same amount to the health insurance for the same (covered) service. But if the patient is privately insured, there is a factor between 1.15 to 3.5 (typically 2 or higher) allowed for the doctor to cash up. So they make a good share of their money from privately insured patients (about 10% of the population).

[@thiloreichelt4199]

The typical factor is 3.6 for a privately insured patient.

[@Henning_Rech]

@@thiloreichelt4199 Wrong: Einfachsatz Regelhöchstsatz Höchstsatz Persönlich-ärztliche Leistung (GOÄ) 1,0 2,3 3,5 Medizinisch-technische Leistung (GOÄ) 1,0 1,8 2,5 Laborleistung (GOÄ) 1,0 1,15 1,3 Zahnärztliche Leistung (GOZ) 1,0 2,3 3,5 "Regelhöchstsatz" ist the "normal" factor, "Höchstsatz" will often be applied and just needs a simple (written) justification. The factor 3.5 only applies to service by the doctor in person, not for blood tests, radiology (the instrumental part) etc. Anything above 3.5 needs a special contract between doctor and patient and will normally not be covered by the private health insurance.

[@jeihka1]

I work for a call center that sometimes has USA medical issues. The fact that I can't say to them that healthcare is a scam and they're better off without it, hurts me 😢

[@user-221i]

healthcare isn't a scam

[@jeihka1]

@@user-221i I mean the insurance

[@user-221i]

@@jeihka1 It is but If you don't have one you are in big trouble

[@jeihka1]

@@user-221i outside the USA is good to have Insurance but in the USA is not worth it. You can get charity discount and pay way less in you don't have Insurance. Unless you get medicaid the other Insurance in the USA are a scam

[@mbwoods2001]

In the UK, we have 2 deductions out of our wages, so as well as paying taxes, we also pay National Insurance (NI) that goes towards the NHS. So any trips to the hospital for pregnancy, injuries etc are all taken care off. The only thing is the costs of the prescriptions afterwards for medicines or tablets costs under £10 a time, or free if receiving benefits. Same with dentists for checkups and opticians for eye tests and if on benefits, towards your glasses(even thou i have to pay additional if i spec my glasses).

[@chrislaurenson]

I am a UK cancer survivor. If there were no NHS, I would not be here today, as I could not have afforded private health care. So, yeah, I am grateful for our NHS, even if it is a bit creaky round the edges sometimes, and I truly believe that the quality of care is comparable to that given in private practise.

[@libbypeace68]

I'm in Australia, have had three children through the public health system and didn't pay for a thing for their births. I cannot imagine living with a system like the US - it seems so inhumane. I recently watched footage of elderly and sick patients being walked by security guards away from the hospital and being left on the footpath a block away because they had no insurance. One lady was laid on the footpath with a towel thrown over her head and her belongings in a plastic bag nearby.

[@nordwestpassage]

Wow, that’s very sad!

[@StochasticUniverse]

You can't be denied access to an emergency room at any public hospital in the US, but many things that cause mortality aren't treatable in an ER setting (heart disease other than acute, crisis, diabetes, etc). So, for what it's worth, this can't legally happen to someone who is actively dying, but for someone receiving care for a chronic condition, it is possible.

[@spencers4121]

These were the uninsured, and basically people near the end of life with no money. I doubt anything will change anytime soon here in the US, not with how we have let corporation and money into politics. I should add even with insurance, most people living on the edge still are not able to afford care. Not when you factor in co-pays and deductibles.