Housing and healthcare costs are insane. When you're older, you need a lot more healthcare (and you won't have that nice insurance plan you had at your big company job when you were working), and housing keeps getting more expensive, which is a problem if you're on a fixed income. You could move to much cheaper locales (i.e. rural areas), but those are "healthcare deserts" where there's no competent doctors left and hospitals are all closing left and right, plus when you're infirm how exactly do you drive yourself? Living in a walkable city (or any city really) is much more doable when you're older for these practical reasons (less need to drive, healthcare providers close by), but then you can't afford the housing there.
Well, in Germany health care is affordable in terms of cost.
However, while 20 years ago you just went to a doctor when you were sick, these days you will wait hours and hours even at your family physician's crowded waiting room.
You need a specialist?
6 months if it's something serious like a cardiologist.
If you're on private health insurance, alright, only 3 months.
I don't know if this is specific to Germany, or similar in all of Europe.
But that is a change many people notice that I speak with.
The waiting is similar in the U.S., only the cost is wildly different. Actually, it sounds like you can see a family doctor the same day in Germany? That would make it better in Germany.
In the U.S. I can see a midlevel the same day by paying $200 for an annual membership in a mass-affluent pseudoconcierge practice plus $800ish for the appointment+labs, the $800 may be partly or entirely covered by insurance depending on how the conversation goes with the "provider". I have to wait several months if I want to see a real doctor outside of an emergency room. 6 months is about right for seeing a specialist with a preexisting relationship, might need a little more lead time for an initial consultation.
IDK this is my experience over the past few years with 10+ appointments with two specialists and three PCPs in the SFBA; my understanding is that it is typical in this area and becoming typical in other regions of the U.S. as well.
In the US before Obamacare I could make an appointment with a specialist on the same week. Now it takes more than six months. Three different specialties that I know of and the only three I tried. Apparently we're catching up with Europe.
This is literally not true if you live close to any urban center. Plenty of specialists available in any city. The US healthcare system is broken in many, many ways but "obamacare made me wait 6 months" is not one of them.
This is Albuquerque, which is a three hour drive. There used to be a couple of these specialists in a closer, smaller city, just two hours away. They have all gone. Along with more than half of the rural general practitioners in the surrounding 100 miles. One closed his practice entirely after completely failing to find a replacement. I recently went to an appointment with a specialist in Albuquerque that took me six months to get ... and spoke only with a nurse. No doctors are available even after that long. This was after six months of waiting while in pain and bleeding out of my ass daily.
Shortly before Obamacare I went to the same variety of specialist in that closer city. I called on a Monday and was in to see him on Thursday morning. Now, the three closest clinics to me have no doctors at all between them, just nurse practitioners and physician assistants. If your condition isn't on their short script you get an appointment in six months with a different nurse, or directions to the emergency room. I'm not claiming this is the general experience, but my experience has vastly enshittified.
The specialist nurse that took me six months to see? He ordered a test and scheduled me to come back and discuss it with him in another six months. Maybe I'll get another five minutes of his time then.
While that does absolutely suck, and I’ sorry you find yourself in that situation, it’s not a consequence of Obamacare. It’s just that the time you remember when things were better happens to be before Obamacare.
As another commenter said, there’s been an exodus of specialists from rural areas. This is a global phenomenon, not limited to the US.
It sounds like you live in a rural area. In those places, the providers are drying up as the doctors get old and retire, and there's no one to replace them. This has nothing to do with Obamacare; it's like this in many places, including here in Japan. They actually offer more money here for people to work in the medical field in rural areas, but people would rather get paid less to live in Tokyo, because no one with an education wants to live in rural areas these days if they don't have to.
Basically, if you want really good healthcare, you need to live in or near a very large city. (Albuquerque is not a very large city.)
Another thing that's probably changed in the US is larger healthcare companies taking over doctors' practices and enshittifying them to increase profits. Doctors are happy to sell because they're getting close to retirement, and/or tired of dealing with all the administrative hassle on top of actually being a doctor and caring for patients. I've read about this type of thing greatly affecting veterinary care in the US too.
Americans are discovering that giving universal healthcare access to everyone means those who already had access, now have to wait longer to make room for everyone else. That's how it works.
No they aren't. Americans are finding out that when you abuse medical workers by calling them "essential workers" who have to continue working during a pandemic while hundreds of thousands of patients berate you for saying things like "you should get vaccinated" or "don't eat an anti-parasite medication for horses" and overwork them and pay them shit, they quit in droves.
They are then finding out that for profit businesses have no interest in re-hiring all the workers they had before the pandemic, because they didn't lose as much business as they saved money in salary, so everyone is just running a skeleton crew that they overwork.
Meanwhile the data I find for emergency room visits are that there's barely been any increase in percentage of the population that visited an emergency room since 1997.
Companies are spending less on services and letting us just suffer because we don't have better options and YET AGAIN dumb Americans for some reason blame the government for completely independent companies making self serving choices?!
Housing in US is in fact one of the cheapest... everywhere, measured as price per square foot as percentage of income. Several times cheaper than in many countries and at least somewhat cheaper than almost every single one, rich or poor, democratic or authoritarian.
It's just that "normal" housing in the US is what's only attainable to the very rich and only because they inherited it, in most of Europe let's say: even 1% won't be able to buy an equivalent of median new US single family house, in EU - that 1% probably owns a similar or somewhat better house but simply because they bought or built it generations before.
Got a source for this?
I'm only finding sources that vehemently disagree, and say the only countries worse for this are Portugal and Canada. Everywhere in the world is better.
That's probably because what you are googling is a ratio of price of average house to average income... Which only means that American houses are much much bigger and thus more pricey, because Americans have many times more disposable income per family than just about any nation in the world.
But if you compare the price of the SAME sized house to the average income, the situation is opposite. U.S. is the 3rd best after Oman and Saudi Arabia. It's just that Americans are not satisfied with houses even twice the size of what people in many rich countries are happy with.
American houses are large and unaffordable. The usual term for a situation like that is inefficiency.
Price per square foot is not a very useful metric, because neither utility nor construction costs scale directly with the size of a house. A 3000 square foot house is not 2x as good as a 1500 square foot house, and it should not cost 2x as much to build. Roughly speaking, walls are expensive, while making the rooms larger is cheap. And bedrooms are cheap, while bathrooms are expensive.
If it's so easy why isn't everyone in Europe doing this life hack?
Could it be that moving to a place with high salaries means that job market is more competitive with higher bar to entry, with more stress, and CoL and housing is proportionally higher so once you factor in housing, healthcare, childcare expenses etc you realize that unless you scored some FANG job that pays orders of magnitude more than the local median, you're more or less at the same wealth point as in the lower CoL locations?
Feels like the solution is to find the place when you can earn more than the median there and not just blindly move to the most expensive places in the world hoping that will make you rich.
> If it's so easy why isn't everyone in Europe doing this life hack?
Language barriers, mostly. USA doesn't have those, that is the biggest difference I'd say, language barriers is such a massive hindrance to movement even if you are legally allowed to.
Even if the work language is English you still have to live with all the signs etc being in a language you don't understand, and learning a new language is a massive undertaking.
However if you don't care about that then it is really simple. And lots of people are doing just that, people spending a few years working in a high wage place isn't uncommon at all.
also the massive difference between cultures is a thing aswell.
Not to mention people tend to not move asmuch in europe compared to the US, and people like to stay close to their community and families in my experience.
