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Comments: I am on PPO with Obamacre right now. This year my investment income was low so my monthly for 2 people is $200 a month. I think you have decided that healthcare is the major reason you want to retire in Portugal which shouldn't be the case at least for me. I can get care at Mayo clinic at $200 a month Farzad: Your relatives used Medicaid (federal program) for emergency. The probably transitioned into a state program medi-cal as they got established here while they built ther lives here
Comments: Yes we the citizens of the mighty United States have higher standards. Every time I go to a any clinical site overseas for clinical trial work for my job, the hospitals I go to say in Lille France or in Leipzig or Hamburg, it feels like I am in Romania of Soviet time. Now the jail in Sweden or Denmark is like 3 star hotel.
Comments: No one in California is deprived from getting emergency care even if they have no insurance. My cousin and the family came here with green card and no jobs. And they got the state healthcare for absolutely free. I don't know what category shahin mentioned it falls in. But even my employer was covering for me I still had to pay some premium, deductible, copay and out of pocket. They did not pay a penny for care or prescription. For some of the cares including dental which my mom or siblings need I actually ask them to come and visit from Sweden and they go through private pay (discounted with known physicians) and they take care of certain things here rather than waiting for a long time or not getting the care at all. As shahin said Medicare is the best available care for over 65. And it is applicable to citizens who live abroad. Just take flight and come home and you'll be taken care of.
Comments: One thing for sure. Americans expect more and complain more about just everything. Most European and other western country citizens are used to certain things as far as government goes. Good and bad. Saying that, they complain much less about healthcare than we do. They are used to low/no cost healthcare. They walk to the pharmacy and get what they need at low/no cost. They are also used to some delay of service if they need to see a doctor. One thing I know is that emergencies are taken care of just like here. No one is left dying due to health system. Knee replacement or other non life threatening issues might take longer but in the meantime, they receive home treatment from registered nurses for free while they wait. There are no perfect systems. I personally prefer the European version but that doesn’t mean it’s that much better.
Comments: Shahin, You covered most, if not all of it. Cost is more than most other developed countries to get the insurance and the care one needs. That would be fine for people who can afford it. As you mentioned, if you are poor (really poor) them Obamacare & Medicare will provide you the HMO coverage for free. It works perfectly fine with basic needs but God help you if you need more. One needs to see a primary doctor which these days are very busy (wait time could be months) and be referred to a specialist that could take another few months depending on the type. If you have employee insurance or relatively wealthy person, it's much easier to obtain better insurance (PPO). Major problem that even Obamacare could not solve is the middle class. If a single person makes between $50-$150/year and doesn't get insurance from work, the cost is stupidly high to get better than average insurance. The cost for an individual or a couple could go as high as $2,000/month for PPO insurance with low deductible. Obama could not put the option in Obamacare for Medicare for all if chosen by the people. That would have helped middle class a lot.
Comments: ![[Screenshot-2023-08-31-at-10-50-02-AM]](https://i.postimg.cc/jqh5GVhf/Screenshot-2023-08-31-at-10-50-02-AM.png)
Comments: I think the healthcare other countries provide is like the very first category (medi-cal) I mentioned but the level of care will not be as great but then again is the same as anyone else in that country. In some countries you have to wait a while to get a procedure like knee replacement done and anything but perhaps emergencies are a challenge
Comments: Employer-based healthcare: This also has cost associated with it but since you are happily employed, you dont notice it. I remember they took $700 out of my paycheck for a family of 4 but my out of pocket was much smaller
Comments: Now let's talk about medical groups. Many people like Kaiser since you go to one place and get all the care including hospital. There are now medical groups that are formed with major facilities and some even has hospitals. I am part of the Sutter Health network with a major 3 story building may be 300 doctors, lab, colonoscopy, etc. My hospital affiliation is Stanford for major surgeries. I know someone that went to Mayo clinic in Minnesota to get a very serious condition taken care of
Comments: Non-employer health insurance: People below 65 I am now in this group as I retired about 2 years ago. This in a nutshell what Obamacare is all about. Obamacare has taken pre-existing conditions out. Lets say in middle of cancer treatment I retired and lost my employer insurance, they have to provide me healthcare. Regardless of my medical condition there is a cost insuring me based on my age. There is a schedule on age and how many in your household you have. The cost to insure someone like me (60 years old) is about 2K a month or perhaps 4K for a husband and wife. Based on my income in my retirement, Obamacare subsidize the cost. If I made 80K a year the cost for my wife and I will be around $600 a month meaning governemnt is paying $3400 of it. If my income goes up next year my cost will go up and if it goes down, then my cost goes down. If my income becomes very low, then they will send me to medi-care and is responsibilty of state of california to provide me insurance. But I will not qualify for medi-care since I have assets then I have to pay the whole 4K a month. This is government assisted heathcare not medi-care. When I went from employer insurance to Obamacare, I did not have to change any doctor. The maximum out of pockets are high like 8K per person but that really kicks in if you have some major issues. This is almost exactly like your employer healthcare but somewhat higher out of pocket Government basically is saying if you make some money, we will help you offset the cost of healthcare but it will not be zero. I did not have to change anything when i moved fro employer to this plan just a bit higher out of pocket
Comments: Midicare for people over 65: This is truly the best care. Money that you have put in the system whille you worked here now pays for majority of your health insurance. You pay another $100-$150 (Medcare supplement) a month and you hand that government payment over to a major insurance career like Kaiser, Unitedhealth, Anthem, etc. This becomes you HMO while you are on medical. Depending on your income on top of social security, there are ways to even not pay for any copays, medicine, etc. Kaiser has subsidies for it. My mom and my RIP father are (were) on it. This works as any HMO for people over 65
Comments: Medi-Cal:
People who do not have much income (single may be around 20K a year, or husband and wife perhaps around 30K a year). You will qualify for medical. You get treated by a set of mostly young dotors many are very compassionate and good. My distant relatives who moved here late in life living with their kids use this. They have gotten knee replacements, cancer surgery, etc. without paying anything and are very happy. A lot of preventive care as well. Thsi is not good if you keep wanting tp go back and forth to Iran as you need to show you live here and have no major assets and income. I am telling the level of care in my experience has been excellent
Comments: For someone who has been helping family & friends almost all my life here in California regarding health care is that you need to understand how it works. Overall there is a high cost to healthcare here and everybody is here to make money from it. This has created a healthy competition (no pun intended) among healthcare providers but overall not bad for patients but you have to have an open mind to understand it. I will explain it in the next few posts
Comments: Farzad, I’m not getting into an agreement with you but the only way you get the service you are describing is if you have a great insurance. Without a good insurance or one of those shitty ones offered by the state, there is no way to get anything done that quickly. I can’t speak to the hospital services in Switzerland as I have never used it but I haven’t heard too many complaints.
Comments: California has the best social programs. Even California has a better social program than Sweden. Healthcare or procedures or full blow surgery is available immediately for everyone. I. Sweden you have to wait in line. Hopefully you do not die before your turn. Also Dental care is not covered as part of Sweden's social program.
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