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Ireland. Public health is high quality but it can be slow to get into the system. If you want high quality and fast you pay for insurance which is about 2K per year, depending on age and cover.
All prescribed medicine maxes out at 80 euro / about 95 USD a month for our entire family. Government covers the rest.
You pay for trips to the GP (local doctor) which are about 60 euro / 75 USD unless you're low income in which case they're free. They will refer you to the hospital if necessary and that is free.
At that point if you're not private things can get slow but my most recent example was fast. Daughter had ongoing headaches for a while. Third trip to the GP she wrote the referral letter and we went to the emergency room. She got seen quickly and they set up an MRI for the following week. After that we had two follow ups with a consultant (high level specialist doctor). All free.
There is huge room for improvement but I honestly couldn't imagine living in a place that will let you die if you don't have enough money. I honestly find that notion both crazy and disgusting.
Edit: I forgot to add, if you just show up to accident and emergency without a referral it's 100 euro / 120 USD. Regardless of treatment that's the full cost. Triage can mean that if you don't actually have an emergency you'll be waiting hours. If you show up with life threatening symptoms you'll be seen very quickly though.
Ambulance is always free.
There are other supports for folks who need regular trips to the hospital but can't drive (e.g. regular chemo). There's a community car here in my town for example (10k people) with volunteers but I think they cover taxis in many cases.
Last edit: you can claim any medical expenses for the year off your tax bill
Just to give you context from abroad, in America insurance plans have no legal minimum standard of care so there is a dramatic variation in coverage. But generally copays on an decent insurance plan are $25-50 for a primary GP visit. Generally medication maxes out at $50-75 per covered medication, but getting actually getting something covered is a bitch, and is usually like 10-25 bucks for regular medication, and you can save more by buying 3-6 month supplies.
If you are low income AND in a state with expanded medicaid subsidies, IF those subsidies keep getting expanded, you get access to medicaid. Which is a fantastic program that is basically single payer health insurance. All care is free, its accepted by 95% of places, its cost effective for the tax payer, etc…
Couple of big problems here though is that there’s no good public option for still struggling middle income earners, and lots of people don’t apply for Medicaid (especially homeless people); So this causes a lot of debt that the healthcare system doesn’t get paid for (especially emergency rooms which can’t deny people), which means to compensate they have to charge insane prices for everything. Thats why an ambulance is $1500.
Medication is expensive for a different reason, but thats all greed and profit there… I’m sure your system does it better
OK that sounds ass loads better then the internet had me believe.
I've a few questions if you don't mind and some observations...
The minimum level of coverage here for health insurance is pretty high given the alternative of free public care but they do have quite a few perks including money back for GP visits and "swift care" centres dotted around. We had to bring my young lad to one after he busted his lip badly and needed a stitch. We were in and out in under thirty minutes for 50 euro.
That's really the edge case if where health insurance for kids is used. It's very cheap.
One of the things I love about the US is the bulk buying. Last time I was there I bought 500 Ibuprofen for pennies. You can't do that here. 48 is the max without a prescription and even generic are comparatively expensive.
I did forget to mention that all prescribed meds are free for low income.
Is that access free?
It truly all depends on your insurance. If you have decent insurance it is absolutely still a functional system.
But like to give you an idea of the bad end, some plans have no copays and a flat $5000 deductible, so your paying the full out of pocket price of $400-600 a visit until you hit that deductible, then after the deductible they will still leave you to pay the last 30%. Absolutely could bankrupt somebody if shit goes bad. Makes every little visit a massive expense.
And even with the best insurance, all the insurers love to make you submit an application for every little thing to get it covered, which they love to endlessly deny until you give up out of exhaustion.
To answer your question, yes medicaid is completely free. It really is a great program despite how much shit it gets, and is some of my proudest tax dollars :)
To me it's abhorrent that Ireland is seen as having good healthcare. That just goes to show how shitty the system is in the USA. I lived in Ireland for 4 years, had a health plan paid by the company I worked, still had to pay 50% of every visit, and to get to any specialist you need to go to your GP (€60) and then, if your GP agrees (which he might not), they will contact the specialist for you which you will have to pay for out of your own pocket (usually €150-€300 depending on specialty), that specialist will ask for exams (blood works are €80 on the GP, but specialist might require specific tests that GP doesn't offer, I have paid around €600 for some blood exams), then you go back to the specialist (and pay €150 again for a consultation) for him to check the results of the exams and tell you there's nothing wrong so you can do another round of exams to see if they find anything... We're already at around €1000 and the health insurance will only return me half at some point... The max €80 in prescription medicine was quite nice though.
Sorry to tell you but you were being robbed blind.
Bloods are free at my GP. If I'm going private (after the initial consult which I did forget to mention), once I've been referred it's all been covered. Public it's all free of course.
That's fucking wild shit. Honestly never heard of it. Not doubting you for a second. I've just never come across it.
Edit: I wonder did your employer just pay for an absolutely shit private cover?
Yeah, there's a very real chance that the issue was my GP, but since you're essentially stuck with the GP that you can get it is what it is. I don't live there anymore so I can share these details in case it saves someone else. I lived in Dublin so obviously both are there, the GP was in Kilmainham medical center and the hospital for the specialist and expensive blood work was Black rock hearth Hermitage Clinic. I have a friend who just went through a similar situation so it's not exclusive to me, but he does live in the same building I used to so he might go to the same GP, and that GP might have some arrangement or something with the people from that other hospital, not to mention he blocked me from seeing a cardiologist for years saying I didn't needed it (wanted to do a checkup because my entire father's side family died of heart related conditions, and after the ridiculous amount of money it costed to see the other specialist I just let it go.
I'm saddened to think it could all have been due to a bad GP, my time in Ireland was very badly affected by these experiences with medical care. And speaking with friends they had had similar experiences so I never thought it could have been a bad GP.
The health plan from the company wasn't bad, at least I don't think it was, but I don't have any parameters to compare it to. I worked for 2 companies while I lived there and both used the same health plan. I don't remember what it was, but at the specialist they said that I needed to pay and then talk to my health plan, and the health plan only refunded half of the value. I still work for the same company but on a different country, and here the health plan seems to cover everything, so I doubt they would have a good plan on one country and a bad one on the other, but it could happen.