I have a couple more emails from readers in response to Single-Payer “Medicare for All” Proposal; Live and Let Die; Why Does Single-Payer “Work” in Europe?

Comments From a US Expatriate 

Reader David a US citizen living in Europe writes …

 Hi Mish,

I am a native born US citizen who has worked mainly outside of the USA since 2003. In 2012 I liquidated everything in the USA and moved to Europe for the foreseeable future.

In Europe the rules are different for every nation depending on whether you are working for a company, self employed, or a “person of means”. France and Luxembourg have single-payer universal coverage. In Hungary and Spain, you don't need health insurance if you can prove you can pay your medical expenses (person of means). Switzerland mandates that all people must have some form of health insurance (private). Ireland has a couple of levels:  public, private, etc. Germany allows you to take the state system or take a private system.  

In most “Single Payer” systems that I have seen, the patient pays the bill and the bill is reimbursed at 80% (or whatever) via a SEPA transfer to their account. For those “of means” with no insurance, the person simply pays the bill.

Using Luxembourg as an example, if you go to a doctor and the bill is 50 euros for the visit, You pay the doctor the 50 euros and he hands you a receipt that you submit for reimbursement. The government wires you 80% of the bill within 2 weeks.

Note that the patient sees the bill, and pays the bill at the time of treatment and is typically reimbursed later.

David

Views From a Canadian Expatriate

Reader Peter, a  now living in the US writes …