...my sis just had an organ transplant...at the tune of 500,000$. Shes on medicare, SSI and no supplement. she lives in Idaho ( NO Medicaid expansion) but the surgery was in Wash state. Shes reallllly mad cuz she has to pay 6500$ out of pocket and shes blaming it on the ACA 'scam. She said all her other insurance had a 25-50$ co pay. Just wondering how this would have been paid for in another country... Personally I think $6500 is a bargain...( but she only had 10,000 in savings)...so I'm not completely heartless in understanding her frustration.

Copays are out the window for expensive surgeries. For those types of services, you typically pay a percentage of costs (usually 20-40%), up to an annual cap (say, $6500).

Before ACA, there was no ceiling so your sis would have been responsible for the entire 20-30%, or whatever she's required to pay out of pocket for a surgery and hospital stay. On a $500K surgery, 20% = $100K. She should be very thankful for the ACA instead of denigrating it b/c that's what she would have paid w/out the cap. Ppl went bankrupt or lost their homes before ACA.

When I first got on Medicare I learned I'd be responsible for 20% of medical services and some services at 100% (vision, dental). I went out and got supplemental b/c I'm a cancer survivor. Supplemental is worth it for my peace of mind. My surgery was around $200K and my chemo around $250K, at least according to the fantasy provider numbers on my statements.

Also, I lived in Canada and paid a quarterly premium based on our family income. Canadian provinces also typically have high sales taxes and fees, which cover health care costs, college tuition and subsidies for child care if needed. I did not see one bill and my son was born in Canada.

In the above situation, I would pay zero, nada, zilch, nothing.

And if it ever goes bad later, at least her husband and kids will not have to sell the house to treat her.

... also an American residing in Canada like myself, passed in May 2015 of cancer.

He required innumerable tests, treatment by specialists, at-home care, and $10,000-per-month worth of drugs. Not only were we never out-of-pocket for these services, we NEVER had to apply for them. Visiting doctors, social workers, household equipment providers bearing wheelchairs, canes, shower-chairs, etc., literally just arrived at our doorstep.

The gov't even assigned us a home worker, who showed up three times a week to do household chores so that I was free to spend time with my husband instead of doing laundry or vacuuming.

My husband spent his last days in hospital, tended to by doctors and nurses who made his final days as comfortable as possible.

We spent not a dime for these services. Everything was covered by our gov't healthcare coverage, right down to covering the fees to have his remains cremated.

THIS is what universal healthcare is all about.

I am english and can state with full confidence that the bill would be 0. Two years ago, my Mom had emergency heart surgery (no waiting list for emergencies obviously) and received a stent in her heart. She was put on blood-thinning tablets (cost in USA over $100 per pill) for a year. The cost was $0.

She also had 2 cataract operations (she had to wait 3 months). The cost was $0.

She also had an ankle operation so she could walk properly. She waited 2 months for this. Cost $0.

While recovering from the heart operation and ankle surgery, she had home help provided to clean the house, get shopping,etc. Cost $0.

Not really, but what a great country!

Nothing, to the best of my knowledge. There is co-pay for *some* meds. So if those meds are involved, the co-pay would be 10% of med costs, minimum 5€, maximum 10€ for each med. Also, there's a limit (depending on income, whether or not you're married, number of kids, etc) for how much you are expected to co-pay each year, so if you have to buy a lot of meds all the time, or if you're on a low income, it's free for the remainder of the year after some time.

A few years ago there was a "Praxisgebühr" (doctor's office fee), where you had to pay 10€ whenever you see a doctor for the first time in a quarter. Since it appeared rather unfair for poor people vs. wealthy people, as the system is supposed to be based on solidarity, and because of the management overhead, that fee was "repealed and not replaced".

For dental stuff only "cheap" things are included. So if you want implants or technically advanced root canal (I don't know.. lasers and microscopes and special 3D X-Ray and stuff like that) instead of bridges / very basic root canal / in some cases even amalgam fillings, you need to buy additional insurance or pay out of your own pocket. Also, I think glasses are not or only partially covered (might have changed recently to include more costs). You can get very decent glasses relatively cheap in Germany though.


Not everyone is eligible to use that normal health plan though, e.g. lifetime public servants or freelancers can't use it. Also, if you have a higher income (> ~50k EUR / year) you are not legally REQUIRED to use the "not-quite-but-almost-state-run system", so you can opt out of it. In those cases you are legally required to buy private insurance like in the US right now. So it depends on the tarif. As the son of lifetime public servant mom and dad, my private insurance covered everything I ever needed in full, as far as I know, but I'll be on the state-run plan soon. Some plans might have (small) deductibles. Private insurance patients are generally prefered by doctors because private insurance companies pay more, so you usually get priority treatment for non-urgent matters. Of course, your insurance doesn't matter if you need urgent help. Those private insurance plans also cover more methods of treatment and some other nice things, so you're pretty well covered in most cases, no need for additional insurance for dental treatment, or having a private room in hospitals, or having the chief physician care for you in hospitals. Privately insured patients are usually considered to be "first class patients" while everybody else is just second class. That's why liberal politicians want to change this and force everyone into non-private insurance, which I support.

Cost? Zero.

They even will pay travel and lodging costs for immediate family to be near the patient.

I would pay the higher taxes if everyone had care.

When you go into hospital, there are different costs for your treatment. These hospital costs depend on whether you are in a public or private hospital, or have private health insurance. It is important to know what treatments you are covered for when you go to hospital, so you do not have any unexpected out-of-pocket costs after your hospital visit. You can choose to go into hospital as either a public or private patient. Even if you have private health insurance, you can still choose to be a public patient in a public hospital.
Public hospital costs

Most treatment in Victoria’s public hospitals is free for all Australian citizens and most permanent residents. These costs are mainly paid for by Medicare.

You will not have to pay for hospital clinical services, doctors’ and specialists’ fees, medication, hospital accommodation and operating theatre fees. However, you may have to pay extra costs for some services such as TV or internet connection.

If you are a private patient in a public hospital, Medicare covers75 per cent of medical costs listed on the Medicare Benefits Schedule (MBS), and you have to pay for the rest of your hospital and medical costs. Your private health insurance may pay for some or all of these costs, depending on your plan.