Great episode, Ashton. Long story short- as an American living in Germany since the 80s, I can only echo your experience and sentiments. Had a stroke last year. After an ambulance ride, 3 days ICU, another 5 days in hospital, CRT, MRT, physical therapy which began in the hospital, and a subsequent 3 week successful stay in a specialized therapy clinic for stroke recovery, my total co-pay was 350 USD. Sure, I pay a few hundred a month for the social health insurance system here, but when you need medical help, anxiety about costs should not be added to the stressful situation. Love your content. All the best to you and your family!
I am so so glad to hear that you received great care and are recovering today. A stroke would be a terrifying experience to go through, and like you said - having to worry about cost on top of it all is ridiculous. One should focus on recovery not financing when it comes to health.
my wife, an Austrian had a similar experience and the bill after all was said and done was negligible. As an America, I have had operations, bones set, MRI, x-rays etc etc and never paid more the a few Euros for any of it. While we were working a premium was deducted from our salaries, a tax if you will, but now that we are retired we KNOW we'll never have a problem getting the care we need and that whatever the cost, our universal health care system will take the best possible care of us. This kind of peace of mind is priceless.
Hearing that your mother's hospital stay and surgery and everything could have cost anything between 300 000 $ - 500 000 $ dollars...for that price you could probably buy an MRI machine. This is just truly insane that the system in the US is just built that way. Truly glad to hear your mother is doing well now.
No, those things are even more expensive. More than a million, could even be several. Plus maintenance. But of course they are also used a lot so the price per use is only a tiny fraction of that.
As a German who lived in the US for 4 years and had quite the (small but diverse) medical journey through that time, the health insurance and medical system in the US unlocked new levels of fear and anxiety i didn't know i had.
I had a stroke in Germany, 2016. It was some of the best medical care I had ever received, they saved my life. I had been out riding my bike for a couple hours, when I returned I sat down, and had a stroke. Could not talk correctly, my right side was not cooperating, then I hit the floor. I went to a Neurologist downtown, he did an MRI, I was then rushed to the Horst Clinikin Stroke Unit. The cost thing was very scary, but after it was all done it was minimal, you have to pay them and file your own insurance. Try that in the states and you'll owe them forever. I miss my Doctor there, he was such a nice fellow, he really cared about his patients.
Great to tell this story so open. It really shows how americans are drilled to think about cost first. When you told about dragging her down the stairs to get in to your own car, I was screaming 'Call the ambulance!'. Not being able to walk anymore is a medical emergency. And it shows how long it takes for you as americans to unlearn that.
I was thinking along the same lines: why didn't the call the ambulance, before the two men injure themselves -making some wrong move- without the proper equipment iow, an emergency folding chair.
It's very typical for Americans to not call an ambulance although it would've also cost them ~800€ more so its not nothing. I think the only non resident American I've ever seen actually going to the ER by ambulance had shatterd their shoulder to pieces plus a heamothorax and I'm a Paramedic Student whos worked in a very touristy area for over 2 years by now.
As a German, the story makes me a little proud, because we have so many problems in our society at the moment that it brought tears to my eyes that there is still something in our society that we can be a little proud of. The health care system is not the best showcase and you have to give doctors a chance and sometimes spend a long time looking for someone who is willing to determine the treatment method themselves, outside of the regulations of the health insurance companies. When I am in Freiburg, you can clearly feel that there is still mutual consideration and empathy here, which I miss a lot in other regions of my homeland. All the best to your mum and family.
Ashton's mom was very lucky. And that is certainly something to be thankful for. But what about all the people in the US who are not as lucky and end up being bankrupted, destroying entire families? Therefore, I'd say the MOST important thing is to raise awareness and to educate the woefully and dangerously misinformed Americans about how sick, dangerous and inhuman the US "health care" system is. The country is very quickly on its way to becoming a third world country. Simply because too many Americans are so poorly educated and therefore easily manipulated into voting agains their own interests.
Recently went through pregnancy and delivery in the US, and as a European it was an insane experience. Getting clear information about costs, expectations, options, *anything*, was near impossible. And I have to say, being scanned like a carton of eggs at the grocery store every single time anyone provided any service at the hospital felt utterly dehumanizing. I was prepared for that it was going to be different from what I was used to, but afterwards when the bills started rolling in and text messages to basically give my various providers yelp reviews started bombarding phone, I couldn't help but be chocked over how surreal and commercialized the entire experience has been. The American healthcare system is absolutely bonkers.
Three years ago I had a stroke in Germany. Of course, as a German employee, I'm insured through the mandatory statutary German insurance system. But I got picked up by an ambulance with an emergency doctor within 15 minutes after the stroke happened (I was lucky that I had a trained geriatric nurse sitting beside me when it happened, who recognised the symptoms and called the ambulance with the right key words to the dispatcher). The doctor started treating me right in the ambulance and about 20 minutes later I was in the emergency room of a hospital with a stroke unit (a kind of mini ICU). They did various tests with me, including a CT, a doppler sonography of my head and chest, ECG and a MRI. They found no reason for the stroke, except for an extremely high blood pressure (they were not sure if it caused the stroke or was caused by it) and the symptoms cleared within a few hours, so that I don't have any permanent damage. The whole affair, including four days in the stroke unit cost me € 40, which I had to pay out of my pocket. This money is to cover for the food I ate in the hospital and would be waived for low income people.
Hope you are doing well today! That was so fortunate that you had such a prompt response to your stroke. I don’t have any personal experience with this but have heard timing is everything. ❤️
Thank you for sharing this touching personal story on TH-cam... and for expressing your deepest gratitude to the Freiburg university hospital's staff and administration 👍🏾.
Content like this makes me cry. Most important is, all went well. Living on both sides of the ocean, I had medical care on both sides as well. Luckily, I never needed serious stuff, mainly sports injuries with a max of 3 days hospital. Nevertheless, when in Germany, I always have the feeling that everybody knows what they are doing. The nurses and doctors really know what they are talking about. In the US, it is like a step by step process. You go in and they go by a list and during each step you might have another person managing that machine to do tests. You get the feeling, that this person only knows how to handle that particular machine and if you ask something that has nothing to do with that, you get the answer "Ask the doctor", or "I don't know". We are in the midst of setting up live in Spain, and when you move to a new country, Facebook groups are a good source to talk about obstacles or asking questions. Now, pretty much all Americans in that group are shocked by the high taxes in Spain, but none understands that these are needed to pay for exactly that, a well functioning health care system, public transport and infrastructure. As an American, you only see what YOU have in your pocket at the end, not what society has. Your experience shows, that money is not the most important thing in our lives, but society. With a well set up social system, everybody can get the level of care your mom got without paying for the rest of your live.
In the fall of 2020, my son had an accident. He broke both bones in his under arm with an open fracture. An ambulance was called, the Notarzt came. We went to the ER, he had surgery with two metal rods placed. His hospital stay was two nights including some early physical therapy. We went for checks at the hospital every 3ish weeks. We also followed up with our pediatrician who removed the stitches from the surgery. In January he had an outpatient surgery to remove the rods, again checks with hospital and pediatrician. For all that, we paid €20 for the ambulance . As a child ( he was 15) everything is covered. Yes, while they were hanging another IV prior to surgery, as an American I actually thought, “ Dear God, what is this going to cost us.” Then I remembered where I was. I already paid for this with my premiums. We are good. I mentioned this to my German brother-in-law and he said with shock, you actually thought that? Yes, yes, I did. And the care was just fine, organized, professional and of high quality. Ok, there is less unimportant glitz here but the care is what is important. I won’t even go into my post birth emergency surgery and icu stay. No complaints here.
That's why I love the NHS. Anyone, and I do mean anyone, can attend A&E (Accident & Emergency = Emergency Room) for free. I've been in hospital a few times and never paid a penny because we pay for it through our taxes. Great video, Ashton and congrats on the 100K.
@@phoenix-xu9xj I assume mostly so it's not abused. Plus they don't finance it through their taxes etc. But it's also good that hospitals in other countries do recognise that foreigners might need medical help while on vacation for example and that it shouldn't be too expensive
Dear Ashton, thanks for sharing this. It’s evidently not easy to make this all of this public and yet so important you ventured doing it. It shows so clearly what it means to make healthcare a public good instead of a commodity depending on individual financial capabilities. I wonder who’s lining their pockets with healthcare in the U.S.. 8K Euros versus a half million Dollars is just bizarre. Maybe this might inspire you to dig a little deeper into this topic as well!
It is a really complex topic. Many hospitals don't publish prices, and when they do it is not often accurate because individual hospital systems negotiate prices with every individual health insurance company. So the same hospital might charge two people different prices for the same procedure.
@ …and then there is a huge market for all kinds of medical products and devices which also has great influence on the cost of healthcare - given the fact that big players like to enlarge their piece of the pie if you let them. Germany actually seems to be quite a tough market for healthcare anyway as the price for procedures and care is basically fixed and transparent. While this approach certainly causes problems of its own it does prevent a whole market to completely go haywire.
*Not only* do US hospitals negotiate prices with every individual health insurance company, *the health insurance companies* also negotiate with *every single doctor* the prices and *IF* the Doc. is taken the deal *or not.* *On Top* of all that, every US HC (Healthcare) insurance has *a list,* of hospitals and doctors you ARE (supposedly) covered, so there are hospitals & doctors, in your region, you are NOT covered. *A list,* is *a limitation.* Not only nationwide but even in your own state or town. > Imagine an accident with a car. 1st, you have to think fk US ambulance cost me 500 to 800+ bugs to get to the hospital alone. > Now, *which* hospital they are drivin to is *NOT* bound to where you are covered or not. Casino Royal in reallife. > Let's say they bring you to a hospital, your are covered. > A doctor *without* a contract with your HC insurance, *only touches you,* you are NOT covered for his interactions/doing. _Now imagine THIS doctor is the one who is operating you, ..._ You are toast. ... You want or need to go to a specific doctor, you can NOT, bc he is NOT on your HC insurance list. You still can, but NOT covered, is what I mean. ... SO for me, ...why even care to get a US insurance, paying way more per month or/and *up front,* and in the end *have NO right/law* that makes this insurance actual PAY even if all covering points are met. > To deny payment by a US HC insurance is like a sports event for them. They do this regular.* *American Hospital Association:* _Jul 8, 2024_ The Healthcare Equality Network, July 3 sent a letter to the Centers for Medicare & Medicaid Services, *expressing concerns* about *claims denials by commercial insurance companies.* "According to a KFF analysis, insurance companies, *on average, deny 1 in 5 claims,* with *one insurer rejecting 49 percent* and *another rejecting a shocking 80 percent,"* the group wrote. *"This problem extends to Medicare Advantage plans, which were created to offer more choice and comprehensive benefits and now cover more than half of all Medicare beneficiaries but are now inundated with prior authorization requirements and coverage denials."* ... Many points like that emerge EVEN while you might be covered in the US. In the end, it has LOW meaning with all the *high* risk involving being not covered still in the end. ... This is an embarrassing status for a "so said" developed country, still in progress of getting there.
I used to travel to the states a lot, for my own company, I had $10m insurance coverage on a global annual policy. Cost about £200/year. I wouldn’t even consider going to the states without this level of coverage
You can also see on that bill that the vast majority of the cost in Germany is the surgery itself. Simply the stay in the hospital per day was like 250-300€ in total in Germany, instead of nearly 3.000$.
As a German it's kind of shocking to see a hospital bill for the first time and then be able to compare it to the average US bills. Even if you have to pay out of pocket Germany is still cheaper and we have better outcomes over here on average too so you get more for less.
@@DieAlteistwiederda i think a lot of those better outcomes are because people arent afraid to go to a doctor - no threat of bankruptcy means that a lot of stuff gets caught early AND will actually be treated - no need to "walk it off" and of course you dont have to worry about losing your income while you are in medical care either
Like 20 years ago the 2000€ / day was the price for children critical care units. If you got private insurance that is (so factor 2.3 or sth). And with that I mean really critical care units with 0.5 to 1 nurse per patient.
Thank you! It was a tough edit because I didn't film anything in "real time". Normally storytelling is better with an in the moment feeling, but our priority was just getting her healthy. It wasn't until recently that my mom expressed wanting to tell her story.
How I screamed at my phone, get her to the hospital, don't get her down... Pleasaase get a Notarzt and help. Very happy that you shared this experience with us
Can you imagine that some people think it would be better to have the americab system here? And that they work actively to install it? I look at you Christian Lindner and Jens Spahn...
Please stay motivated. I'm a chronic pain patient in Germany and we are in dire need of doctors that can treat chronic pain. With empathy fatigue rising, I have many doctors telling me that the opioids I'm taking daily are not suited for a 35 year old patient. When we talk about options and I stay for months or years for a better treatment, in the end they realize that the "Kopfschmerzklinik Kiel" did the only right thing. I refused to take opioids for several years until I barely was living anymore. With Kiel, my neurological doctor and another clinic fine tuning the opioid dose over a couple of years, I can participate in daily activities again. This was back in 2017. Yet, more and more doctors I have to visit for another chronic disease blame me for taking the medication. We went through dozens, if not nearly a hundred options over nearly a decade. The ego of some doctors is crazy. They think of themselves as being perfect. Being a mechanical engineer that worked in the field of medical compound materials, I never felt special. I heard that new clinic trials with materials for the heart and other parts did work out. Yet I only heard back in reports. Only one doctor spoke to me in person and was thankful. It seems like all the other doctors took it for granted that engineers, chemists and other professions dedicate their life to invent things to make surgery easier.
When I was pregnant with baby no 5 my husband who is a soldier was transferred to the States for one year. We wanted to join him but could not do so becuase of the lack of health insurance. My German insurance said since there was no "Sozialversicherungsvereinbarung" between Germany and the USA and they as a public insurer could not offer to pay the enormous costs in the US for medical events. And because I was pregnant no private insurance would take me in neither. The only option for some kind of temporary insurance was extremely expensive. So the kids and I stayed at home in Germany. Only for a lack of health insurance. We were very frustrated at the time bti after all finally I had an amazing birth experience in Freiburg 😉
Noticed that while looking up the prices for my insurance company. They can't pay in the US because they are a public insurer. Luckily I can get an additional insurance from a company that cooperates with my insurer for ~15-25€ a year, assuming I only spend about 60 days in another country that year. Not something I would get while travelling in Europe since it works fine then, but definitely something for different continents
Insurance is cheap in Germany. The ADAC (for example) offers the "Incomingversicherung" for visitors (Liability- and Health-insurance), it's 84,- EUR for 2 months.
That is great to know. Jonathan's mom took out a private travel health insurance policy from her us insurer and i think she paid upwards of 200 dollars for just a 1 month stay.
The same here in the Netherlands. By the way it was an obligation to get the Schengen visa for my sister in law from Indonesia this summer, no health insurance, no visa. Strange that Americans can enter the EU without that same obligation. Thank you very much to be so open Ashton, happy your mother is fine now.
I am surprised she struggled to get her US insurance to pay. I live in South Africa and all I need to do is inform my insurance where I am travelling and they will cover any emergency.
I wager a LOT of people don't travel with a special health insurance plan, especially when they are healthy. Either they presume their insurer will pay or that if something minor does happen it won't be that expensive. The only reason her US insurer did (eventually) pay was because she could prove that she did her due diligence before she left to get it taken care of before traveling overseas.
Oh my what a nightmare, I had a lump in my throat, that must have been a very scary experience in a foreign country and most of the family far away. I am very glad that your mother is well again! Too bad there was trouble with the American health insurance, instead they should be happy that they only had to pay a small fraction of the costs that would otherwise have been incurred in the USA. Lots of health and love!
That is exactly what we thought. We were floored that the US insurer fought to not pay my parents back. I would think they would be happy to have saved 250+ thousand dollars - but instead they accused my mom of trying to skirt the system. Unbelievable.
@@TypeAshton have you ever considered that they didn't save anything because most of costs incurred in US go really to insurance company owners who are interested in incurring as much of their consumers as possible which means that owners of insurance company in reality lost the potential income?
It's great that your mom fully recovered! This video underlines a number of things: First of all, how brave you and your mom are to share this very private story with a bunch of strangers. Then of course there is the benefit of wearing a helmet. A system of universal insurance, that prioritizes saving lives over the bottom line, is superior to any other system (that might deny people treatment because of lack of insurance or ability to pay out of pocket). And lastly the value of people speaking more than one language. Imagine how much scarier it may have been (beyond the scaryness that obviously was there) if nobody at the hospital spoke english and/or if you had not been able to help with translating.
We were very, very fortunate in both regards. Thankfully the physicians spoke English, especially when we needed to make fully informed medical decisions (for example, when my mom wanted to leave the hospital to go home... normally they would advise additional monitoring and rehabilitation, for German patients, but in order to leave although she was stable she had to sign release forms stating that it was technically against their advice) . My German is about B1/B2, and I was able to be there whenever the nurses or technicians came by, but medical terminology isn't my forte.
A Belgian friend fell off a scaffold while volunteering building up a open air concert venue in Portugal. She had severe back/spine injuries. No insurance, no residence permit. She fully recovered and had to pay nothing.
In the EU (+Norway, Swiss, UK...) generally the home health insurance in a member state (e.g. Germany) covers all emergency expenses as well in the other EU states (e.g. Spain). This is mandatory and usually all citizens with insurance have or can apply for an "EU health insurance ID card". This way you wouldn't even have to prepay any costs. Terms and conditions include mostly emergency treatment and costs are reimbursed as either the home insurance cost limits or the conditions of health insurance in the visiting state, but for the most part no co-pay or only very small amounts are left to pay out of pocket!
@@ovaskerriOur mandatory basic health insurance in The Netherlands reimburse only market-based (Dutch) tariffs for emergency care abroad. If you have an additional health insurance, it may cover a part of the rest and a travel insurance with healthcare costs will cover the rest, also the bill for repatriation if you are still incapable of traveling regularly. That’s why I have all three insurances when I go abroad, especially when I used to go to the US, because they don’t have market-based tariffs. For planned care in a foreign country you need approval beforehand from your health insurer.
I went to the hospital here in Germany in March because i had serious pain in my knee......well it was not my knee, i had a arterial blockage in my leg and a light stroke, the pain was from the increasing pressure in my leg....a minor looking thing can have a serious cause...I learned my lesson, thankfully i recovered nearly completly, only need to pay more attention when using my legs.
Sooo...for the total cost of her care in Germany, she can't even spend 3 days in a hospital room in the US. That's crazy. I wish your mother all the best.
I'm so sorry you had that scare. So pleased to hear your mom is on the mend. I fully understand how appreciative you are that the doctors in Freiburg had no hesitation to treat her and to do so quickly. All the best to all of you and may you be spared from anymore of such incidents.
For me, it is above all the worry-free feeling. Even if I don't get out what I pay in as a young person, I can go to the doctor without having to do any research or worry.
exactly! and its important to realize - this isnt a "pay money in to get care later" system... we all pool our money to make sure that whatever happens - everyone gets taken care of oneself might never need the care and only contribute...or one might be unable to contribute and end up needing a lot of care... or anywhere in between - but the important thing there is... everyone on that scale gets to live (within medicines ability to make that happen of course) which is why im genuinely furious that people of wealth can extract themselves from that system and go to private healthcare... egotistical leeches...
I am glad that this ended well for your mom and for the whole family. I didnt know what Huntington disease was, so in German it's called Chorea Huntington or up to a 100 years ago Veitstanz . And I remember that's why you had in vitro fertilization for your first child. We are lucky to have you as new citizens and thank God you benefit from our health care system we often complain about.
Most important reaction: Good to hear that your mom is well again! As far as my comment: Another great episode! Same reaction as always, nothing new. But I feel I have to tell you every time 🙂
It's telling that as I was reading the intro i was like: "An American needing an emergency surgery? frick They're toast! ... Wait they were in Germany at that time... so they probably survived it. Pweeew. No travel insurance? Uuugh... the Paperwork hassle!!"
People flock to US usually to get the newest medication or treatments for diseases or conditions which were untreatable till this new drug came and as it is available in US months before Europe (because EMA has to approve it which takes another year or so after it is approved in US). In all other cases, when treatment is possible at home or in nearest foreign country (if domestic health insurance approves treatment in foreign country because there is no option for treatmen in your domestic country). For all other reasons people don't travel in US as healthcare systems in Europe are good enough to treat almost all treatable conditions.
I'm really glad your mom is back to normal and that this video had such a happy ending. However, I'm less hopeful about the situation in the US. After watching the video, I just asked a bunch of my friends and colleagues from America how much they would estimate all of those tests, the surgery and the recovery stay in the hospital to cost with and without insurance. I'm going to show them this video afterwards. I'm already approaching it like this because from past interactions I know that if I told them this story beforehand, they'd make up all sorts of excuses and tell me that it would be just as cheap in the US and that everybody has insurance over there anyway and that I'm falling for online anti-American propaganda from "europoors". The election results aren't very.. inspiring.. either. Anyway, all the best to you and your family and greetings from Austria!
That is what shocked my parents as well. When my dad saw the full bill from Germany his exact words were "We really are being scammed in the USA aren't we?". It is really amazing when you think about how many millions of Americans don't have health insurance.
Hej, I have been in more than 30 countries in my life and I have never, never ,never travelled without travel insurance. I have a friend that had to have brain surgery in China , he was treated rapidly and very professionally , he came back to Danmark healthy and it did not cost him a cent , nothing ! Last year another friend went to Thailand with his mother , the worst thing happened ,his mother died ( she had been sick earlier that year ) ,the insurance company paid for everything ,hospital and transport home . Never leave without travel insurance !
For us Europeans who always have health insurance a (short term) travel insurance is cheap, kind of 20 EUR a year in Germany. For US citizens it may be much more expensive so people think they may not need it.
Replying to the original and first reply, as a US citizen I had never heard of travel insurance until recently, and I don't understand which company and/or what coverage would be good for me. It may be more simple than I think, as opposed to the incredibly complicated and expensive US system. Also I remember a 1 month travel insurance for ~$65, but does that really cover everything when my very recently obtained insurance through my work costs nearly $150/ month and doesn't cover everything... reading some of the comments it may be a mindset that will take years to unlearn once I move to another country.
@@vtxgenie1 A travel insurance normally has to cover only emergencies, not chronical or terminal illness, thus it can be cheaper (BTW, the 150$ is only your share, I would guess your employer pays the same or more). - And as it was pointed out, US health care is insanely expensive, in Europe we typically have two types of travel health insurance, one that covers the whole world excluding US&Canada, and, at a higher premium, the other which includes US&Canada.- In Germany, I pay 20 EUR/year for an insurance that covers stays up to 8 weeks, and 220 EUR/year for a long term insurance up to one year. For details, always read the fine print.
My grandmas experience also taught me to always get some kind of travel insurance. She broke a bone in a very complicated way when she traveled through a few African countries. They could help her once they got her to a big city but of course they still needed to get her home and that was expensive. Didn't cost my grandma anything. All for paying an extra like 100€ a year to be covered worldwide.
First of all, great to hear your mum is doing well. This is by far - as you said - the most important thing. What I am always wondering (both in Germany as well as the US) is how these (in the US ridiculous) prices come to be. What is the rationale behind them? How do they really come up with these prices? Unfortunately, I doubt we would ever get an answer to that...
Good friends of ours are physicians in the USA and we asked them that exact question - and their reply was that they basically are made up numbers by the hospitals and insurance companies. The same procedure can cost different amounts between two patients at the same hospital depending on which insurance they are billing.
Whilst in Germany medicine is determined centrally by the government (well, with extra steps) which uses its immense bargaining power to keep prices low. For procedures prices are dictated and it has to be said that the government strangles the physicians a bit. 10-15% more plus inflation adjustment would be way better. Then again: Dawn was likely invoiced at the out-of-pocket price, not the even cheaper one for people with Gesetzliche Krankenversicherung.
@@TypeAshton We in Germany have a catalog for each procedure in medical treatment. For instance when it comes to surgery or hospital stay connected to the diagnose. Thats why we have DRG or ICD10. I`m a decoder of DRG.
A neurosurgeon in the US easily makes 300.000 or 400.000/year. A good specialized nurse 100.000. Then there is the anesthesiologist, and all the people who work. And on top of those high salaries, healthcare is for profit, hospitals need to make money... It's crazy
Healthcare in the US is very expensive, and to be honest, I don't understand why. The level of care is very similar, the facilities are equally equipped, the doctors have the same qualifications and the availability of care is mostly the same. What does not compare is the cost. Your mother's case is a prime example. $8000 as compared to $250000 is just crazy. Many people have good insurance that helps mitigate this, but many do not. I have read that medical care expenses are the second leading cause of personal bankruptcy in the US. It is a true national shame that this has not been fixed. The most important thing is that your mother has recovered and is doing well. I wish her the best.
It´s the profits for the private owners. You can notice in Germany as well. If you happen to be treated in a privately-owned hospital you´ll notice that nursing will be worse than in publicly-owned hospitals. It´s things like having to bring and use your own towels vs. being given towels by the hospital, quality of food, less and lower paid personall for care and nuresing and stuff like this. Since privately-owned hospitals are getting the same fixed rates by the health-insurance they have to squeeze out the 8-10% Profit from something.
@@dadalotamus3512 Exactly. American healthcare system is a giant idustry. Americans spend about 4 trillions USD anually (12k per capita) both privately and and via taxes (Medicaid, Medicare etc.). There is a lot of profit to be made there.
Because health care workers in Germany are getting pennies compared to their colleges in USA. Neurosurgeon who did the operation gets in Germany around 140 000€ p.a. pre-tax, whereas in USA for the same job he would get $686,301 (average annual salary of Neurosurgeon in USA). Every story has two sides...
Glad your mom is ok, I have shared this before on this channel. Over a period of 4 years i had to support (handle everything) for my mom, dad and sister when they all 3 got cancer and all 3 didn't make it. The care they got was perfect but life is not fair all the time. Within this almost continues period of handle stuff and being there for them not one moment did i think about the cost of the things that had to be done (netherlands). Why have a community (like a country) if you are not willing to share the costs of bad luck and common needs and be humane about it. This has very little todo with politics but in the end with companies. I love companies don't get me wrong but it is the task of a community to set the rules for companies coming in to protect the members against in the end greed. I wonder what the doctors in the states who looked at the bill from germany and compared/guessed what the bill would be if they had todo the same are thinking. Must be depressing for them to drive home knowing they are saving lives but at the same time convicting people to life of debt. Knowing that the bad luck their patients had turned into a profit engine for a small part of the community not because of real cost of his/her own income but mostly the overhead of the system they are working in.
Thank you for this personal story Ashton. Happy to hear mom is doing well. This is one of the topics that gets me riled up, whenever anyone even mentions privatization of the healthcare system. I think most European countries have a mixed system, where private companies have a role in healthcare, but are being kept in check by government bodies. I believe capitalism isn't a bad system for nice to have things, but a total disaster for need to haves on the other hand. Just hoping that we can keep our "social" medical care systems in Europe in good shape over the coming years and that the US improves it's track record.
I am so glad your mother made such a good recovery. It must have been a terrifying experience for all of you. A friend of a friend was visiting Berlin a number of years ago and had a terrible accident and no travel insurance. She spent months in the hospital recovering and in the end paid €40,000. It would have been millions in the US.
I'm German, and I've been to a decently large number of hospitals, therapists and other outpatient sites so far over the span of my life. The biggest cost I had to pay out of pocket was 53€ at a dentist, and that's only because the insurance system has not yet caught up to the "new" method of plastic filling with ceramic compounds (yet the older amalgam is outlawed, funny how that works). Beside that, it's 5-10 euros every few months for medication. To be fair some of the longer hospital stays were during my early childhood where my parents would've paid additional costs like hospital food, so that might've been larger than 53€. The state of medical insurance probably is the major aspect why I'd never want to live in the US, unless I'm already a millionaire. I read that 1/3 of all private bankruptcy is caused by medical expenses, it's insane. And that's despite paying the largest sum into healthcare per person of any country, the system simply is not designed for the patient, but for profit.
When we were still in the States, my partner had to go to the ER (fear of a stroke that ended up being instead a bad medication side effect that merely exhibited as stroke-like symptoms). We had good insurance through my employer at the time, but the out of pocket expense was still about $2000. When we first moved to Sweden, my partner had to go to the ER again before she could finish being integrated into the Swedish healthcare system, so the costs had to be paid completely out of pocket (to be reimbursed by the interim insurance my new employer was paying for) - the total cost as an uninsured person was $450. The staff was very apologetic about the extreme fee while we were looking at each other stunned at how little it cost, even before reimbursement. A couple month later, she needed emergency spinal surgery to replace two vertebrae in her neck which included a week stay to recover. By then, she was in the Swedish health care system as a legal resident and... paid nothing. The level of care was fantastic. Even costs aside, we would never want to experience what the American healthcare system put us through again.
Amazing story. As someone who's insured in Germany I freaked out when your bill was in the thousands, I only paid like 50 bucks for 5 days in the hospital + surgery for broken leg and a bit extra for ambulance ride (that wasn't even necessary lol). But when you said that would cost a quarter million in the US I almost fell out of my chair XD I really hope fda approves tartrazine soon, it's so much cheaper than a CT scan or ultrasound.
It's shocking just how much profiteering there is in the American system. That quarter of a million dollars would be going to line some shareholders pockets somewhere, rather than just to fund the system and pay the staff.
I have cystic fibrosis, a genetic metabolic disorder. People with this disease live an average of 10 years less in the USA than in Germany. The treatment is very, very expensive but allows the sick person to now live a somewhat normal life. I received 2 donor organs myself and the costs. This would have been unaffordable in the USA
While I would never wish for anyone to have to go what you went through, I am happy that you were able to receive such great care. As you mention, so many in the USA forego medical care due to cost with dire consequences.
Thanks for the video and all the best to your mother! The US healthcare system works as designed. Most of the stakeholders are businesses: Most of the universities and colleges educating the doctors and nurses are privately owned. Doctors and nurses have to pay huge fees that they have to finance by going into debt. Banks offer loans and they profit from this - especially the top management and the shareholders. Insurance companies hire expensive lawyers (which are also needed to expensive to repay their student loans) to drive down costs, which is a major concern of their shareholders. The same is true for hospitals, medical device manufacturers and pharmaceuticals. Everybody is in it for the money. This capitalistic system leads to the imbalances visible in the US if the negotiation power between the involved parties (patients, doctors, nurses on the one hand versus managers and shareholders on the other side) is unequally distributed. I prefer the way chosen by many European countries: Pooling the negotiation power of individuals into government regulated organisation that negotiate with the companies and letting the whole society pay for the education of the doctors and nurses. The american political system and the voting behavior makes it very unlikely, that the USA will change its health care system.
Hospitals in Sweden are privately owned as well. From my limited experience, the system works quite well. There are quite some queues if you are not an emergency, though.
Ultimately the profits of the banks, insurance companies, and pharmaceutical companies in the US make incredibly high profits, far and away above their costs, especially when much of the account handling and billing is automated now. Highly regulated private businesses are ok and can even add to the resources available for necessary services, but most European countries with cheap or free education and cheap or free available resources to cover human needs like food, healthcare, and housing (I'm not saying it's free to have a home of course, but in emergencies), allows for less stress about those basic needs. In the US I know that if I can't work and make money where I currently live, I'll be homeless, without food or clean water, and without healthcare except to stabilize in an emergency, there are no protections not tied to employment on a countrywide level, only occasional local programs.
@@andreasfischer9158 No there's one privately owned emergency hospital in Sweden, St Görans, it was a very well functioning before the privatization and advocates of private health care keep using it as an example. But much of the other non-emergency health care especially in the Stockholm region has unfortunately been privatized, and it has caused a disaster. The system is heavily fragmented and money flows out of the system to private profits. I have gone through this system many times and gone to everything from hole-in-the-wall doctor in an office complex who didn't even have any support staff to major clinics that are functioning like an assembly line with no time to hear out the patients concerns. In many areas of medicine we no longer even have the choice of public health care in Stockholm, it has all been privatized.
Some years ago I had an accident and needed surgery and staying in the hospital for 8 weeks after, followed by rehab-clinic for another three weeks. After the accident I was brought to a privately-owned clinic. Later I was referred to a publicly-owned clinic. So I could make the observation that you can notice in Germany as well. If you happen to be treated in a privately-owned hospital you´ll notice that nursing will be worse than in publicly-owned hospitals. It´s things like having to bring and use your own towels vs. being given towels by the hospital, quality of food, less and lower paid personall for care and nuresing and stuff like this. Since privately-owned hospitals are getting the same fixed rates by the health-insurance they have to squeeze out the 8-10% Profit from something. My conclusion is: a health-care-system should not be privatised.
I had 2 ER visits this month -- because when do you get unexpected health problems? On the weekend, of course. 1st time was 2 weeks ago; I started getting severe gastro-intestinal cramps, bad enough that at around 11pm, we called an ambulance, as I didn't think I could make it to my husband's car, much less sit upright for the 10-minute trip downtown. I needed 3 IVs, which luckily took care of the problem, plus meds for the next two days. 2nd time, last weekend. I'd pulled a back muscle on Friday, and the pain was bad enough that hubby took me to the ER again the next morning. I got an injection and a prescription for the pain, and was up and about again on Sunday, and totally pain-free by Tuesday. We're privately insured (hubby was a civil servant), so we're still waiting for the bills, but our insurance will cover most of it, and any co-pay left over certainly won't cripple us financially. Most importantly, though, we NEVER hesitated to visit the ER, just because our regular doctors were not on duty. That basic certainty, that I'd get treatment _right away_, was worth everything. Glad your mother is fine, and had such a positive experience!
There are different types of insurance. There are profit-oriented and solidary insurance companies. Next time I recommend to get an ADAC incoming health insurance for visitors from outside the EU. While it costs more for elderly people, I cannot stress enough how many times the ADAC insurance has saved us without asking questions and without discussing what they were gonna pay and what not. One time they even sent a doctor to Spain to pick up my grandma and fly on a regular airplane with her to get her back for urgent treatment in Germany. If you have 1000$ für a flight ticket you can spare the 100+-€ for the insurance.
1) Travel health insurance is reasonably cheap. Always get one when travelling to places that are not covered by your medical insurance 2) In Germany, the medical fees are highly regulated, also for uninsured or privately insured patients. There is a general fee schedule agreed between the health insurers and the doctors associations, that is then multiplied by a factor according to difficulty with at most 50% surcharge. Doctors can also work outside of this schedule, but this is rare and has to be agreed upon before the treatment. That typically applies to dentists spending multiple sessions to "rescue" a tooth or to some nationwide renowned specialists (though most of them are university professors and charge the regular fees). A typical MRI may cost you around 500 to 1000 Euros, a typical surgery a few thousand euros. Visiting the dentist for a regular filling is a couple of hundert euros. And those are the "private" fees that actually cover all cost and make profits to buy the Porsches of "private-only" doctors or cross-subsidize the publicly insured patients. 3) The freiburg university hospital is one of the best in Germany.
Dear Ashton, I wish good recovery for your mother and have to congratulate you for more than 100.000 followers on youtube. That is an extraordinary good result but that reflect your good and hard work. Yes, the costs of healthcare is different inside USA and in other western countries, but the Americans don't like the idea to pay for the sicknesses of other people, that is the reason for those differences. That means, the Americans don't see the doctor or the hospital in an early stadium of sickness because of the horrend high prices and the co-pay what thes have to pay out of their own pocket besides health insurance, they wait until the end. And than it will be a big thing. The doctors and hospitals have not enough to do, only the big cases. They than must get a lot of money for the seldom cases.
It might be interesting to you that the US system is often overwhelmed... hospitals need to stay as full as possible in order to make profit, and there are still many smaller/ less emergent visits that hospitals are asking people to go to small urgent care outpatient centers so that hospitals are free to take emergencies. The for profit system is a balancing act for hospitals, so they are nearly always busy, even though the most minor infection or allergic reaction requiring medication can cost as much as $5000 US for a few hours of care when paid in cash.
I'm glad that your mother is doing well! A very important topic. Maybe include something like "my american mum", or something like this... Maybe then at least a few more Americans will watch this video.
5 days would have been 50€ plus 10€ for the ambulance ride. So 60€ or so plus maybe some prescriptions. Overall definitely under 100€ for this entire brain surgery compared to hundreds of thousands which you then still have to pay 10k of after your shitty American insurance if not more.
@DieAlteistwiederda It's only 10k if the shitty American insurance doesn't weasel its way out of its obligations, which it might do now that the "just let them die"-guy got elected.
When I lived in Switzerland, I visited my family here in Germany and had to have some unexpected heart surgery done. My Swiss health insurance paid without me being involved. They only sent me a copy of the bill they had gotten from the hospital (which was already paid by them). It is called "civilisation". As opposed to "we are the best".
Well., within Europe, there are regulations between the countries and the insurance will reimburse the cost, they would cover in the home country and for the rest you will have a travel insurance
Travelling abroad without a proper travel health insurance is irresponsible. Your Mom was lucky that this happened in Germany. If that had happened in Asia or South America and you dont have a health insurance, your Mum would have been done. At the age of 18 I was travelling the first time to the US. Before doing so, I made sure that the coverage of the insurance was at least 50 million Dollars. Since then I have never ever travelled anywhere without a health insurance.
When I was in the hospital in Belgium for a knee replacement operation, at least 1/4 of the patients in my hallway were Americans who came for a knee replacement. There was even one American who had both his knees done at the same time, to save money, he had to practice in the hallway to learn to walk again, we heard him scream in pain, he suffered terribly.
I always advise all our US visitors (we are a US/German household) to get insurance for coming over. You can even get it here for them. It's like 60-100€ for up to a month if I remember right. Totally worth it imo.
For the quality of care, I think the premiums are also acceptable in Germany. We pay usually 7% of salary and there is a mandatory 7% paid by employers. (I know there are other plans for privat insurance but I do not want to go into this here.) My advice is always check your insurance situation before travelling and if necessary get extra coverage.
Ich als Deutscher kann nicht verstehen warum wir hier noch soviel nörgeln über unser System. Wir haben leider auch Probleme Pflegekräfte und Ärzte zu finden die hier arbeiten wollen. Freue mich das es deiner Mutter wieder besser geht. Bleibt alle Gesund und genießt was ich habt. Gruß Paul aus Essen (NRW) As a German, I can't understand why we still complain so much about our system. Unfortunately, we also have problems finding nurses and doctors who want to work here. I'm happy that your mother is feeling better again. Stay healthy and enjoy what I have. Greetings Paul from Essen (NRW)
Thank you for sharing this. It has always been something out of a nightmare to hear about the american health system and I was never worried about the cost of health costs here in Germany. I feel like things are changing here now. The system is overtaxed, not enough doctors, rising costs for everything. I am very worried that the system is not going to work for us in Germany anymore. But glad it still was good for you guys. All the best to your mom.
As an example, in the UK, pet insurance works like the American medical system. Our dog had an operation on his leg. Without insurance, it would have cost us £4,000. I happily pay in taxes for the NHS, even with its flaws. It doesn't tie me to any job and still works out cheaper than any private insurance would.
American insurance does not pay those prices. Only none insured person pay them. They get cut in have or something crazy like that for insurance companies. Those sky high prices are due to negations with the insurance. They insisted on better rates and hospitals could not offer those. Hence they increased there normal rates to over those "discounts".
Insurance in the Netherlands must cover emergency care in foreign countries as well. If you are uninsured here, there s a special price list thats ofc a bit higher. Had a look.. MRI scan for brain 396eu (Easy) Brainsugery and max 5 day stay 6259eu. With insurance in my country, I would have to pay the out of pocket max 385eu if I had not alrdy spend that on other care earlier that calander year. 250-500k is absolutely unnecessary for a few day stay and a few holes drilled in your skull... A new CT scanner - the device and software costs 200k. New form the factory! Obsoletely unreasonable for any hospital to bill that amount ever!
Be careful. Most Dutch insurances have an exclusion for the USA. They have a maximum or want extra added insurance from travel and health... This exclusion is only for the USA as far as I know. So always check... It can change depending on the year and level of insurance. A big level of the cost of everything is the cost of payment of people. Dutch healthcare workers pay has been cut drastically years ago. So the CT / MRI is not only the machine, but also the radiologist who interprets the scan. That's why an ultrasound is more expensive... Because it takes the radiologist more time to do the ultrasound, while an MRI test is done by an assistent and only the scan looked at by the radiologist.
@@AnD-1999 Hmmm yeah, fair. As a Dutchy, I just buy travel insurance for the trip I make. Thats usually 60eu or so for just the duration of the trip. It varies a lot, but its a nobrainer for the cost. Last I ran into this, I had travel insurance back in 2010 - and the insurance covered the 600eu bill for care to fix a heavy asthma attack. I work in Dutch healthcare since 2017... I don't remember our pay getting cut some years ago o.o We were doing quite well with CAO negotiations, barely ahead of inflation, until the major post covid spike, and since we are about trailing/on the line of inflation. The numbers provided include doctor interpretation, if I am not mistaken. Even for ultrasounds though, you will see a trained medical imager, working for the doctor. They make pictures and then discuss it with the doctor. That goes for all imaging divided in the Netherlands, afaik. Radiologist, or similar specialist usually reviews images, and gets a flat fee per image - at least that was the pay scheme in a local hospital back in 2014. The academic hospital I work in now, pays doctors a flat monthly salary, if I am not mistaken. Specialist pay is really nice, but then taxes lol.
I've never heard _anything_ from the US healthcare system, other than that you pay an utterly obscene premium and the insurance then uses your own money to shield itself from your claims.
My health insurance offers worldwide coverage, meaning I will get reimbursed for most of any medical cost in any country, leaving me with a small copay. The only exception is the USA where I would need additional insurance because the cost of healthcare in the US is soooooo expensive. I just don't get how Americans accept this situation.
and as a European we just listen to all the large costs mentioned and the cost for us living here would have been like nothing in comparison. I know that's not really the point for the video here but still...
Thank you for sharing your mother's story, Ashton. I had surgery that cost about 10.000 Euro two years ago and regular check ups including blood tests and scans since then. As a retired public servant I have private insurance that costs me about 300 Euro a month. Needless to say that surgery plus additional service didn't cost me anything. The same goes for two hip and one knee replacements as well as gall bladder removal - all over the last ten years . Imagine I lived in the US . I remember a vacation in the US when a very old taxi driver in Chicago told me he still had to drive a taxi because he was paying off the bill for a kidney surgery he had had to go through. And his age and fragility were pitiful to see. I'm so glad your mother had her life saving procedure over here and is doing well now.
Yeah, we don't need medical "tourists" to our publicly funded hospitals. The reason for the relatively low bill is that all the salaries for the staff is already being paid by taxes, or in Germany some of it by the insurance companies. It's a fixed expense, even when the doctors and nurses are idle. So taking in a patient with urgent need of attention is only slightly more expensive, they only charge for the actual time and equipment for the procedure. US hospitals don't get funded to be idling... so they have to add their idle expenses to the bills they hand out. On top of that, it's a known fact that US insurance companies pressure hospitals to keep their prices so high that the general public can't afford to not having insurance... If a hospital underbids the others too much, the insurance won't cover expenses if an insured patient goes to that hospital... it's basically blackmailing. Anyway, I'm happy to hear that your mom is good and well. The US deserves a more humane system where saving a life isn't just about keeping people alive enough to pay their bills. Edit: but that gets me thinking, when I wanna enter the US visa-free, it still requires me to have a travel insurance.. isn't that required the other way around?
This is an absolute horror story! Well, let’s hope RFK does not ruin even the last remnants of medical aid in the U.S. for good…. Glad, your mom is okay again!
For interest watch Michael Moors documentary on healthcare:- Sicko available on TH-cam it’s an eye opener. Getting an ambulance in Germany, would have helped you get your mum to hospital. If she had fallen down the stairs,or injured herself more getting to hospital it could have been disastrous. Maybe worth seeing how much the cost would be for your page. Thanks for sharing
as a german, not even before hearing the rest, just that the emergency was happening here. all I thought was "glad for her", because I know that our doctors and nurses are incentivised to save lives first and anything money related or whatever comes after that. at least in life or death situation they'll try their best to help you however they can to save your life. for the most part would also try to help you out in any way with anything else ... for the most part. some might just be bigoted buttholes who take their liberty to break their medical oath and anti discrimination laws in one paragraph. I know this is oddly specific and I know who's life I may go out of my way to ruin when I have to add a physical disability to my list of issues
Amazing story. But there is a downside to this German generosity. If the 7000 Euro was really the pure cost (no subsidies costs by the state), that explains why German healthcare system is suffering a huge shortage of doctors and nurses who are truly underpaid for the type of job they do. If you ask a contractor to do a small job for a day in your garden, it already costs a few thousand Euros.
Glad you're alright, awful about the Huntington! Is that the reason why she didn't have international coverage? I can imagine US insurances being able to exclude her from getting propper travel insurance because of her condition... In the Netherlands the USA is the only country that has special exclusions for many insurances. I always check before travelling to the USA.
There is a reason, why so many Olympic athletes had a full medical check up and had stuff fixed for free in Paris, because they wouldn’t have been able to afford it in the US. This is actually pretty pathetic for a „great nation“!
6:25 you could have just called the emergency hotline and they would have carried her from the apartment with an emergency vehicle. If there is clearly signs of something not being right with her, you didn't need to drive her yourself.
if your uninsured and accustomed to US-prices you´re not doing that cause you´re afraid of the 5.000 $-bill just for the ambulance you´d get in the US. There´s a reason why people in the US refuse to be taken by an ambulance after they had a car-crash.
Hello Ashton and family. I’m so sorry to hear of your darling mums health emergency and all that she had to go through to get back on the road to recovery. I can’t imagine how scary that whole situation must have been for you and your family. Well it’s great to hear she is feeling much better. It’s unreal the expense of health care in the US. But how fantastic is the health team in Germany? It’s so amazing what they were able to do for your mum and in a timely and professional manner. God bless her 🙏🙏❤️🩹❤️🩹
I'm glad that your mother is feeling better again. What I absolutely cannot understand is traveling abroad without travel health insurance at *+ level. We have such an insurance that automatically covers everything up to 50 days per year abroad. A short email with the travel dates (start/end and which countries) to the insurance company and everything is fine. This costs less than just 1 day in the hospital. Isn't this available in the USA or is it extremely expensive?
Good there is a happy ending. About the electric bikes: Even in the Netherlands (where everybody rides a bycicle), Electric Bikes are a cause of concern. With a normal bicycle you are the power. So you are much more directly in control. With an electric bike, you are not in direct, but in indirect control. Just like with a car. The Electric Bike IS a motorcycle in the end. And reaction times do not improve as we get older. As a kid I would fall all the time. No issue. Last month I stumbled and fell on my knee. Could not walk for a week. I am not saying that Electric Bikes should be banned, but people should see the upsides AND the downsides. Most often you will go faster than with a normal bicycle, because you can. Often that is the reason people buy an elect one: because they get older and can not go as fast as they used to, and they have the financial means to buy one. So just be aware of the downsides and the upsides.
Great episode, Ashton. Long story short- as an American living in Germany since the 80s, I can only echo your experience and sentiments. Had a stroke last year. After an ambulance ride, 3 days ICU, another 5 days in hospital, CRT, MRT, physical therapy which began in the hospital, and a subsequent 3 week successful stay in a specialized therapy clinic for stroke recovery, my total co-pay was 350 USD. Sure, I pay a few hundred a month for the social health insurance system here, but when you need medical help, anxiety about costs should not be added to the stressful situation. Love your content. All the best to you and your family!
I am so so glad to hear that you received great care and are recovering today. A stroke would be a terrifying experience to go through, and like you said - having to worry about cost on top of it all is ridiculous. One should focus on recovery not financing when it comes to health.
my wife, an Austrian had a similar experience and the bill after all was said and done was negligible. As an America, I have had operations, bones set, MRI, x-rays etc etc and never paid more the a few Euros for any of it. While we were working a premium was deducted from our salaries, a tax if you will, but now that we are retired we KNOW we'll never have a problem getting the care we need and that whatever the cost, our universal health care system will take the best possible care of us. This kind of peace of mind is priceless.
Hearing that your mother's hospital stay and surgery and everything could have cost anything between 300 000 $ - 500 000 $ dollars...for that price you could probably buy an MRI machine. This is just truly insane that the system in the US is just built that way.
Truly glad to hear your mother is doing well now.
No, those things are even more expensive. More than a million, could even be several. Plus maintenance. But of course they are also used a lot so the price per use is only a tiny fraction of that.
New MRI is app. 500k tp 1.5m $.
@@hotel66de so it's payed after a weekend of use.
As a German who lived in the US for 4 years and had quite the (small but diverse) medical journey through that time, the health insurance and medical system in the US unlocked new levels of fear and anxiety i didn't know i had.
So schön, dass es deiner Mutter so gut geht. Bleiben wir alle solidarisch.
Ich glaub kaum, dass all die "Blau" Wähler hier bei uns besonders solidarisch eingestellt sind 😔
@@Nils.Minimalist Sorgen wir dafür, dass diese Leute auf Bundesebene niemals etwas zu melden haben.
I had a stroke in Germany, 2016. It was some of the best medical care I had ever received, they saved my life. I had been out riding my bike for a couple hours, when I returned I sat down, and had a stroke. Could not talk correctly, my right side was not cooperating, then I hit the floor. I went to a Neurologist downtown, he did an MRI, I was then rushed to the Horst Clinikin Stroke Unit.
The cost thing was very scary, but after it was all done it was minimal, you have to pay them and file your own insurance. Try that in the states and you'll owe them forever. I miss my Doctor there, he was such a nice fellow, he really cared about his patients.
Great to tell this story so open. It really shows how americans are drilled to think about cost first. When you told about dragging her down the stairs to get in to your own car, I was screaming 'Call the ambulance!'. Not being able to walk anymore is a medical emergency. And it shows how long it takes for you as americans to unlearn that.
I was thinking along the same lines: why didn't the call the ambulance, before the two men injure themselves -making some wrong move- without the proper equipment iow, an emergency folding chair.
@@conniebruckner8190I suspect because in the USA the ambulance costs extra again.
@@MonkeyDRuffy82 IT can cost you thousands of $$$ If you are in a bad Spot because Most abulance Services are privat companies
It's very typical for Americans to not call an ambulance although it would've also cost them ~800€ more so its not nothing. I think the only non resident American I've ever seen actually going to the ER by ambulance had shatterd their shoulder to pieces plus a heamothorax and I'm a Paramedic Student whos worked in a very touristy area for over 2 years by now.
I now wonder what an ambulance costs without insurance in Germany.
As a German, the story makes me a little proud, because we have so many problems in our society at the moment that it brought tears to my eyes that there is still something in our society that we can be a little proud of. The health care system is not the best showcase and you have to give doctors a chance and sometimes spend a long time looking for someone who is willing to determine the treatment method themselves, outside of the regulations of the health insurance companies. When I am in Freiburg, you can clearly feel that there is still mutual consideration and empathy here, which I miss a lot in other regions of my homeland. All the best to your mum and family.
Also a reminder why the NHS is the UK is such a hot button issue.
Perhaps other things in Germany are also not as bad as some people think ....
above all, the most important thing is that your mom is back to her usual self and doing well!
Yes! Absolutely, we are very thankful she is happy and healthy today.
Ashton's mom was very lucky. And that is certainly something to be thankful for. But what about all the people in the US who are not as lucky and end up being bankrupted, destroying entire families? Therefore, I'd say the MOST important thing is to raise awareness and to educate the woefully and dangerously misinformed Americans about how sick, dangerous and inhuman the US "health care" system is. The country is very quickly on its way to becoming a third world country. Simply because too many Americans are so poorly educated and therefore easily manipulated into voting agains their own interests.
Recently went through pregnancy and delivery in the US, and as a European it was an insane experience. Getting clear information about costs, expectations, options, *anything*, was near impossible.
And I have to say, being scanned like a carton of eggs at the grocery store every single time anyone provided any service at the hospital felt utterly dehumanizing.
I was prepared for that it was going to be different from what I was used to, but afterwards when the bills started rolling in and text messages to basically give my various providers yelp reviews started bombarding phone, I couldn't help but be chocked over how surreal and commercialized the entire experience has been.
The American healthcare system is absolutely bonkers.
I wish your mother a good further recovery.
Three years ago I had a stroke in Germany. Of course, as a German employee, I'm insured through the mandatory statutary German insurance system. But I got picked up by an ambulance with an emergency doctor within 15 minutes after the stroke happened (I was lucky that I had a trained geriatric nurse sitting beside me when it happened, who recognised the symptoms and called the ambulance with the right key words to the dispatcher). The doctor started treating me right in the ambulance and about 20 minutes later I was in the emergency room of a hospital with a stroke unit (a kind of mini ICU). They did various tests with me, including a CT, a doppler sonography of my head and chest, ECG and a MRI. They found no reason for the stroke, except for an extremely high blood pressure (they were not sure if it caused the stroke or was caused by it) and the symptoms cleared within a few hours, so that I don't have any permanent damage.
The whole affair, including four days in the stroke unit cost me € 40, which I had to pay out of my pocket. This money is to cover for the food I ate in the hospital and would be waived for low income people.
well, you would have had to eat at home, as well...
Hope you are doing well today! That was so fortunate that you had such a prompt response to your stroke. I don’t have any personal experience with this but have heard timing is everything. ❤️
@@peterkoller3761 Exactly. Therefore I have no problem with this charge. And e.g. people living of welfare would not have to pay anything.
@@TypeAshton Thanks!
@@TypeAshton time = brain cells...
Thank you for sharing this touching personal story on TH-cam... and for expressing your deepest gratitude to the Freiburg university hospital's staff and administration 👍🏾.
Content like this makes me cry. Most important is, all went well.
Living on both sides of the ocean, I had medical care on both sides as well. Luckily, I never needed serious stuff, mainly sports injuries with a max of 3 days hospital. Nevertheless, when in Germany, I always have the feeling that everybody knows what they are doing. The nurses and doctors really know what they are talking about. In the US, it is like a step by step process. You go in and they go by a list and during each step you might have another person managing that machine to do tests. You get the feeling, that this person only knows how to handle that particular machine and if you ask something that has nothing to do with that, you get the answer "Ask the doctor", or "I don't know".
We are in the midst of setting up live in Spain, and when you move to a new country, Facebook groups are a good source to talk about obstacles or asking questions. Now, pretty much all Americans in that group are shocked by the high taxes in Spain, but none understands that these are needed to pay for exactly that, a well functioning health care system, public transport and infrastructure. As an American, you only see what YOU have in your pocket at the end, not what society has.
Your experience shows, that money is not the most important thing in our lives, but society. With a well set up social system, everybody can get the level of care your mom got without paying for the rest of your live.
In the fall of 2020, my son had an accident. He broke both bones in his under arm with an open fracture. An ambulance was called, the Notarzt came. We went to the ER, he had surgery with two metal rods placed. His hospital stay was two nights including some early physical therapy. We went for checks at the hospital every 3ish weeks. We also followed up with our pediatrician who removed the stitches from the surgery. In January he had an outpatient surgery to remove the rods, again checks with hospital and pediatrician. For all that, we paid €20 for the ambulance . As a child ( he was 15) everything is covered. Yes, while they were hanging another IV prior to surgery, as an American I actually thought, “ Dear God, what is this going to cost us.” Then I remembered where I was. I already paid for this with my premiums. We are good. I mentioned this to my German brother-in-law and he said with shock, you actually thought that? Yes, yes, I did. And the care was just fine, organized, professional and of high quality. Ok, there is less unimportant glitz here but the care is what is important. I won’t even go into my post birth emergency surgery and icu stay. No complaints here.
That's why I love the NHS. Anyone, and I do mean anyone, can attend A&E (Accident & Emergency = Emergency Room) for free. I've been in hospital a few times and never paid a penny because we pay for it through our taxes. Great video, Ashton and congrats on the 100K.
Tourists do have to pay something now. Obviously not American amounts of money.
@@phoenix-xu9xj For surgery. The A&E is still totally free.
@@phoenix-xu9xj They pay the NHS tariff plus a % for surgery. A&E remains free for everyone.
@@phoenix-xu9xj I assume mostly so it's not abused. Plus they don't finance it through their taxes etc. But it's also good that hospitals in other countries do recognise that foreigners might need medical help while on vacation for example and that it shouldn't be too expensive
Dear Ashton, thanks for sharing this. It’s evidently not easy to make this all of this public and yet so important you ventured doing it. It shows so clearly what it means to make healthcare a public good instead of a commodity depending on individual financial capabilities. I wonder who’s lining their pockets with healthcare in the U.S.. 8K Euros versus a half million Dollars is just bizarre. Maybe this might inspire you to dig a little deeper into this topic as well!
It is a really complex topic. Many hospitals don't publish prices, and when they do it is not often accurate because individual hospital systems negotiate prices with every individual health insurance company. So the same hospital might charge two people different prices for the same procedure.
@ …and then there is a huge market for all kinds of medical products and devices which also has great influence on the cost of healthcare - given the fact that big players like to enlarge their piece of the pie if you let them. Germany actually seems to be quite a tough market for healthcare anyway as the price for procedures and care is basically fixed and transparent. While this approach certainly causes problems of its own it does prevent a whole market to completely go haywire.
*Not only* do US hospitals negotiate prices with every individual health insurance company, *the health insurance companies* also negotiate with *every single doctor* the prices and *IF* the Doc. is taken the deal *or not.*
*On Top* of all that, every US HC (Healthcare) insurance has *a list,* of hospitals and doctors you ARE (supposedly) covered, so there are hospitals & doctors, in your region, you are NOT covered. *A list,* is *a limitation.* Not only nationwide but even in your own state or town.
> Imagine an accident with a car.
1st, you have to think fk US ambulance cost me 500 to 800+ bugs to get to the hospital alone.
> Now, *which* hospital they are drivin to is *NOT* bound to where you are covered or not. Casino Royal in reallife.
> Let's say they bring you to a hospital, your are covered.
> A doctor *without* a contract with your HC insurance, *only touches you,* you are NOT covered for his interactions/doing.
_Now imagine THIS doctor is the one who is operating you, ..._ You are toast.
...
You want or need to go to a specific doctor, you can NOT, bc he is NOT on your HC insurance list. You still can, but NOT covered, is what I mean.
...
SO for me, ...why even care to get a US insurance, paying way more per month or/and *up front,* and in the end *have NO right/law* that makes this insurance actual PAY even if all covering points are met.
> To deny payment by a US HC insurance is like a sports event for them. They do this regular.*
*American Hospital Association:*
_Jul 8, 2024_
The Healthcare Equality Network, July 3 sent a letter to the Centers for Medicare & Medicaid Services, *expressing concerns* about *claims denials by commercial insurance companies.* "According to a KFF analysis, insurance companies, *on average, deny 1 in 5 claims,* with *one insurer rejecting 49 percent* and *another rejecting a shocking 80 percent,"* the group wrote. *"This problem extends to Medicare Advantage plans, which were created to offer more choice and comprehensive benefits and now cover more than half of all Medicare beneficiaries but are now inundated with prior authorization requirements and coverage denials."*
...
Many points like that emerge EVEN while you might be covered in the US. In the end, it has LOW meaning with all the *high* risk involving being not covered still in the end.
...
This is an embarrassing status for a "so said" developed country, still in progress of getting there.
@@aw3s0me12they Play with other people‘s life. Horrifying
I used to travel to the states a lot, for my own company, I had $10m insurance coverage on a global annual policy. Cost about £200/year. I wouldn’t even consider going to the states without this level of coverage
You can also see on that bill that the vast majority of the cost in Germany is the surgery itself. Simply the stay in the hospital per day was like 250-300€ in total in Germany, instead of nearly 3.000$.
Great catch! Crazy to think of it as a ten fold difference in price.
As a German it's kind of shocking to see a hospital bill for the first time and then be able to compare it to the average US bills. Even if you have to pay out of pocket Germany is still cheaper and we have better outcomes over here on average too so you get more for less.
They probably have better food quality there 😂 and you forgot the tips for waitress.
@@DieAlteistwiederda i think a lot of those better outcomes are because people arent afraid to go to a doctor - no threat of bankruptcy means that a lot of stuff gets caught early AND will actually be treated - no need to "walk it off"
and of course you dont have to worry about losing your income while you are in medical care either
Like 20 years ago the 2000€ / day was the price for children critical care units. If you got private insurance that is (so factor 2.3 or sth).
And with that I mean really critical care units with 0.5 to 1 nurse per patient.
I am only a few minutes into the story and I already really enjoy the editing of the video. Also I am glad your mom is doing better!
Thank you! It was a tough edit because I didn't film anything in "real time". Normally storytelling is better with an in the moment feeling, but our priority was just getting her healthy. It wasn't until recently that my mom expressed wanting to tell her story.
Thanks also to your mom for sharing her story. Give her our regards. We are glad that she is doing well!
How I screamed at my phone, get her to the hospital, don't get her down... Pleasaase get a Notarzt and help.
Very happy that you shared this experience with us
Can you imagine that some people think it would be better to have the americab system here? And that they work actively to install it? I look at you Christian Lindner and Jens Spahn...
Daran sollten wir denken wenn wir im Februar wählen gehen.
Power corrupts. Neither are experts in their field. Beware of imposters
Both Lindner and Spahn are clowns..
@@RivaDog1100 and so is trump... thats the problem
we need to get these grifters out of positions of power
Well this helps staying motivated while studying medicine in Germany, so all the best to your mum and thx ^^
Please stay motivated. I'm a chronic pain patient in Germany and we are in dire need of doctors that can treat chronic pain.
With empathy fatigue rising, I have many doctors telling me that the opioids I'm taking daily are not suited for a 35 year old patient. When we talk about options and I stay for months or years for a better treatment, in the end they realize that the "Kopfschmerzklinik Kiel" did the only right thing. I refused to take opioids for several years until I barely was living anymore. With Kiel, my neurological doctor and another clinic fine tuning the opioid dose over a couple of years, I can participate in daily activities again. This was back in 2017.
Yet, more and more doctors I have to visit for another chronic disease blame me for taking the medication. We went through dozens, if not nearly a hundred options over nearly a decade.
The ego of some doctors is crazy. They think of themselves as being perfect.
Being a mechanical engineer that worked in the field of medical compound materials, I never felt special. I heard that new clinic trials with materials for the heart and other parts did work out. Yet I only heard back in reports. Only one doctor spoke to me in person and was thankful. It seems like all the other doctors took it for granted that engineers, chemists and other professions dedicate their life to invent things to make surgery easier.
When I was pregnant with baby no 5 my husband who is a soldier was transferred to the States for one year. We wanted to join him but could not do so becuase of the lack of health insurance. My German insurance said since there was no "Sozialversicherungsvereinbarung" between Germany and the USA and they as a public insurer could not offer to pay the enormous costs in the US for medical events. And because I was pregnant no private insurance would take me in neither. The only option for some kind of temporary insurance was extremely expensive. So the kids and I stayed at home in Germany. Only for a lack of health insurance. We were very frustrated at the time bti after all finally I had an amazing birth experience in Freiburg 😉
Noticed that while looking up the prices for my insurance company. They can't pay in the US because they are a public insurer.
Luckily I can get an additional insurance from a company that cooperates with my insurer for ~15-25€ a year, assuming I only spend about 60 days in another country that year.
Not something I would get while travelling in Europe since it works fine then, but definitely something for different continents
Insurance is cheap in Germany. The ADAC (for example) offers the "Incomingversicherung" for visitors (Liability- and Health-insurance), it's 84,- EUR for 2 months.
That is great to know. Jonathan's mom took out a private travel health insurance policy from her us insurer and i think she paid upwards of 200 dollars for just a 1 month stay.
The same here in the Netherlands. By the way it was an obligation to get the Schengen visa for my sister in law from Indonesia this summer, no health insurance, no visa. Strange that Americans can enter the EU without that same obligation.
Thank you very much to be so open Ashton, happy your mother is fine now.
Touching story, I am really glad everything went well for your mum. It's nice to hear, that this place is way brighter as it sometimes appears.
As a German, what I'm appalled of most is how people can travel without insurance.
I am surprised she struggled to get her US insurance to pay. I live in South Africa and all I need to do is inform my insurance where I am travelling and they will cover any emergency.
I wager a LOT of people don't travel with a special health insurance plan, especially when they are healthy. Either they presume their insurer will pay or that if something minor does happen it won't be that expensive. The only reason her US insurer did (eventually) pay was because she could prove that she did her due diligence before she left to get it taken care of before traveling overseas.
@@TypeAshton it's a shame. And they actually VOTE for people who make the situation worse
@@TypeAshtonThe thing is that most Germans automatically are insured and even if they weren’t companies like the ADAC offer similar services.
@@michaelgoetze2103 I assume that because of the Huntington's disease, they excluded neurological problems as preconditions.
Oh my what a nightmare, I had a lump in my throat, that must have been a very scary experience in a foreign country and most of the family far away. I am very glad that your mother is well again! Too bad there was trouble with the American health insurance, instead they should be happy that they only had to pay a small fraction of the costs that would otherwise have been incurred in the USA. Lots of health and love!
That is exactly what we thought. We were floored that the US insurer fought to not pay my parents back. I would think they would be happy to have saved 250+ thousand dollars - but instead they accused my mom of trying to skirt the system. Unbelievable.
@@TypeAshton have you ever considered that they didn't save anything because most of costs incurred in US go really to insurance company owners who are interested in incurring as much of their consumers as possible which means that owners of insurance company in reality lost the potential income?
It's great that your mom fully recovered!
This video underlines a number of things:
First of all, how brave you and your mom are to share this very private story with a bunch of strangers. Then of course there is the benefit of wearing a helmet. A system of universal insurance, that prioritizes saving lives over the bottom line, is superior to any other system (that might deny people treatment because of lack of insurance or ability to pay out of pocket).
And lastly the value of people speaking more than one language. Imagine how much scarier it may have been (beyond the scaryness that obviously was there) if nobody at the hospital spoke english and/or if you had not been able to help with translating.
We were very, very fortunate in both regards. Thankfully the physicians spoke English, especially when we needed to make fully informed medical decisions (for example, when my mom wanted to leave the hospital to go home... normally they would advise additional monitoring and rehabilitation, for German patients, but in order to leave although she was stable she had to sign release forms stating that it was technically against their advice) . My German is about B1/B2, and I was able to be there whenever the nurses or technicians came by, but medical terminology isn't my forte.
Wunderbar- das Video und dankenswert der glückliche Ausgang. 🙏. All the best to you and your Family
A Belgian friend fell off a scaffold while volunteering building up a open air concert venue in Portugal. She had severe back/spine injuries. No insurance, no residence permit. She fully recovered and had to pay nothing.
That's amazing!
In the EU (+Norway, Swiss, UK...) generally the home health insurance in a member state (e.g. Germany) covers all emergency expenses as well in the other EU states (e.g. Spain). This is mandatory and usually all citizens with insurance have or can apply for an "EU health insurance ID card". This way you wouldn't even have to prepay any costs. Terms and conditions include mostly emergency treatment and costs are reimbursed as either the home insurance cost limits or the conditions of health insurance in the visiting state, but for the most part no co-pay or only very small amounts are left to pay out of pocket!
@@ovaskerriOur mandatory basic health insurance in The Netherlands reimburse only market-based (Dutch) tariffs for emergency care abroad. If you have an additional health insurance, it may cover a part of the rest and a travel insurance with healthcare costs will cover the rest, also the bill for repatriation if you are still incapable of traveling regularly. That’s why I have all three insurances when I go abroad, especially when I used to go to the US, because they don’t have market-based tariffs. For planned care in a foreign country you need approval beforehand from your health insurer.
I went to the hospital here in Germany in March because i had serious pain in my knee......well it was not my knee, i had a arterial blockage in my leg and a light stroke, the pain was from the increasing pressure in my leg....a minor looking thing can have a serious cause...I learned my lesson, thankfully i recovered nearly completly, only need to pay more attention when using my legs.
Sooo...for the total cost of her care in Germany, she can't even spend 3 days in a hospital room in the US. That's crazy.
I wish your mother all the best.
I'm so sorry you had that scare. So pleased to hear your mom is on the mend.
I fully understand how appreciative you are that the doctors in Freiburg had no hesitation to treat her and to do so quickly.
All the best to all of you and may you be spared from anymore of such incidents.
For me, it is above all the worry-free feeling.
Even if I don't get out what I pay in as a young person, I can go to the doctor without having to do any research or worry.
exactly! and its important to realize - this isnt a "pay money in to get care later" system... we all pool our money to make sure that whatever happens - everyone gets taken care of
oneself might never need the care and only contribute...or one might be unable to contribute and end up needing a lot of care... or anywhere in between - but the important thing there is... everyone on that scale gets to live (within medicines ability to make that happen of course)
which is why im genuinely furious that people of wealth can extract themselves from that system and go to private healthcare... egotistical leeches...
I am glad that this ended well for your mom and for the whole family. I didnt know what Huntington disease was, so in German it's called Chorea Huntington or
up to a 100 years ago Veitstanz . And I remember that's why you had in vitro fertilization for your first child. We are lucky to have you as new citizens and thank God you benefit from our health care system we often complain about.
Glad to hear that your mom is happy and healthy again!
Most important reaction: Good to hear that your mom is well again!
As far as my comment: Another great episode!
Same reaction as always, nothing new. But I feel I have to tell you every time 🙂
Glad to see your mother doing OK❤
All the best for your mum and our family. Thanks for sharing this personal story.
It's telling that as I was reading the intro i was like:
"An American needing an emergency surgery? frick They're toast! ... Wait they were in Germany at that time... so they probably survived it. Pweeew. No travel insurance? Uuugh... the Paperwork hassle!!"
People flock to US usually to get the newest medication or treatments for diseases or conditions which were untreatable till this new drug came and as it is available in US months before Europe (because EMA has to approve it which takes another year or so after it is approved in US). In all other cases, when treatment is possible at home or in nearest foreign country (if domestic health insurance approves treatment in foreign country because there is no option for treatmen in your domestic country). For all other reasons people don't travel in US as healthcare systems in Europe are good enough to treat almost all treatable conditions.
I'm really glad your mom is back to normal and that this video had such a happy ending. However, I'm less hopeful about the situation in the US. After watching the video, I just asked a bunch of my friends and colleagues from America how much they would estimate all of those tests, the surgery and the recovery stay in the hospital to cost with and without insurance. I'm going to show them this video afterwards. I'm already approaching it like this because from past interactions I know that if I told them this story beforehand, they'd make up all sorts of excuses and tell me that it would be just as cheap in the US and that everybody has insurance over there anyway and that I'm falling for online anti-American propaganda from "europoors". The election results aren't very.. inspiring.. either.
Anyway, all the best to you and your family and greetings from Austria!
That is what shocked my parents as well. When my dad saw the full bill from Germany his exact words were "We really are being scammed in the USA aren't we?". It is really amazing when you think about how many millions of Americans don't have health insurance.
@@TypeAshtonthat´s probably the main-reason for average live-expectancy being lower in the US than in Germany and other western-european countries.
Hej, I have been in more than 30 countries in my life and I have never, never ,never travelled without travel insurance. I have a friend that had to have brain surgery in China , he was treated rapidly and very professionally , he came back to Danmark healthy and it did not cost him a cent , nothing ! Last year another friend went to Thailand with his mother , the worst thing happened ,his mother died ( she had been sick earlier that year ) ,the insurance company paid for everything ,hospital and transport home . Never leave without travel insurance !
For us Europeans who always have health insurance a (short term) travel insurance is cheap, kind of 20 EUR a year in Germany. For US citizens it may be much more expensive so people think they may not need it.
Replying to the original and first reply, as a US citizen I had never heard of travel insurance until recently, and I don't understand which company and/or what coverage would be good for me.
It may be more simple than I think, as opposed to the incredibly complicated and expensive US system. Also I remember a 1 month travel insurance for ~$65, but does that really cover everything when my very recently obtained insurance through my work costs nearly $150/ month and doesn't cover everything... reading some of the comments it may be a mindset that will take years to unlearn once I move to another country.
@@vtxgenie1 A travel insurance normally has to cover only emergencies, not chronical or terminal illness, thus it can be cheaper (BTW, the 150$ is only your share, I would guess your employer pays the same or more). - And as it was pointed out, US health care is insanely expensive, in Europe we typically have two types of travel health insurance, one that covers the whole world excluding US&Canada, and, at a higher premium, the other which includes US&Canada.- In Germany, I pay 20 EUR/year for an insurance that covers stays up to 8 weeks, and 220 EUR/year for a long term insurance up to one year.
For details, always read the fine print.
My grandmas experience also taught me to always get some kind of travel insurance. She broke a bone in a very complicated way when she traveled through a few African countries.
They could help her once they got her to a big city but of course they still needed to get her home and that was expensive. Didn't cost my grandma anything. All for paying an extra like 100€ a year to be covered worldwide.
First of all, great to hear your mum is doing well. This is by far - as you said - the most important thing. What I am always wondering (both in Germany as well as the US) is how these (in the US ridiculous) prices come to be. What is the rationale behind them? How do they really come up with these prices? Unfortunately, I doubt we would ever get an answer to that...
Good friends of ours are physicians in the USA and we asked them that exact question - and their reply was that they basically are made up numbers by the hospitals and insurance companies. The same procedure can cost different amounts between two patients at the same hospital depending on which insurance they are billing.
Whilst in Germany medicine is determined centrally by the government (well, with extra steps) which uses its immense bargaining power to keep prices low. For procedures prices are dictated and it has to be said that the government strangles the physicians a bit. 10-15% more plus inflation adjustment would be way better. Then again: Dawn was likely invoiced at the out-of-pocket price, not the even cheaper one for people with Gesetzliche Krankenversicherung.
@@TypeAshton We in Germany have a catalog for each procedure in medical treatment. For instance when it comes to surgery or hospital stay connected to the diagnose. Thats why we have DRG or ICD10. I`m a decoder of DRG.
A neurosurgeon in the US easily makes 300.000 or 400.000/year. A good specialized nurse 100.000. Then there is the anesthesiologist, and all the people who work. And on top of those high salaries, healthcare is for profit, hospitals need to make money... It's crazy
Healthcare in the US is very expensive, and to be honest, I don't understand why. The level of care is very similar, the facilities are equally equipped, the doctors have the same qualifications and the availability of care is mostly the same. What does not compare is the cost. Your mother's case is a prime example. $8000 as compared to $250000 is just crazy. Many people have good insurance that helps mitigate this, but many do not. I have read that medical care expenses are the second leading cause of personal bankruptcy in the US. It is a true national shame that this has not been fixed. The most important thing is that your mother has recovered and is doing well. I wish her the best.
Profit.
It´s the profits for the private owners.
You can notice in Germany as well. If you happen to be treated in a privately-owned hospital you´ll notice that nursing will be worse than in publicly-owned hospitals. It´s things like having to bring and use your own towels vs. being given towels by the hospital, quality of food, less and lower paid personall for care and nuresing and stuff like this.
Since privately-owned hospitals are getting the same fixed rates by the health-insurance they have to squeeze out the 8-10% Profit from something.
@@dadalotamus3512 Exactly. American healthcare system is a giant idustry. Americans spend about 4 trillions USD anually (12k per capita) both privately and and via taxes (Medicaid, Medicare etc.). There is a lot of profit to be made there.
Because health care workers in Germany are getting pennies compared to their colleges in USA.
Neurosurgeon who did the operation gets in Germany around 140 000€ p.a. pre-tax, whereas in USA for the same job he would get $686,301 (average annual salary of Neurosurgeon in USA).
Every story has two sides...
@@nikonikovic5844 140k is compensation one can make a good living on ...
Ich bin sehr froh das es ihrer Mutter wieder gut geht.
👍😊
Glad your mom is ok, I have shared this before on this channel. Over a period of 4 years i had to support (handle everything) for my mom, dad and sister when they all 3 got cancer and all 3 didn't make it. The care they got was perfect but life is not fair all the time. Within this almost continues period of handle stuff and being there for them not one moment did i think about the cost of the things that had to be done (netherlands). Why have a community (like a country) if you are not willing to share the costs of bad luck and common needs and be humane about it. This has very little todo with politics but in the end with companies. I love companies don't get me wrong but it is the task of a community to set the rules for companies coming in to protect the members against in the end greed. I wonder what the doctors in the states who looked at the bill from germany and compared/guessed what the bill would be if they had todo the same are thinking. Must be depressing for them to drive home knowing they are saving lives but at the same time convicting people to life of debt. Knowing that the bad luck their patients had turned into a profit engine for a small part of the community not because of real cost of his/her own income but mostly the overhead of the system they are working in.
Thank you for this personal story Ashton. Happy to hear mom is doing well. This is one of the topics that gets me riled up, whenever anyone even mentions privatization of the healthcare system. I think most European countries have a mixed system, where private companies have a role in healthcare, but are being kept in check by government bodies. I believe capitalism isn't a bad system for nice to have things, but a total disaster for need to haves on the other hand. Just hoping that we can keep our "social" medical care systems in Europe in good shape over the coming years and that the US improves it's track record.
crazy. good story. my sister and i went through that with our dad.
I am so glad your mother made such a good recovery. It must have been a terrifying experience for all of you. A friend of a friend was visiting Berlin a number of years ago and had a terrible accident and no travel insurance. She spent months in the hospital recovering and in the end paid €40,000. It would have been millions in the US.
I'm German, and I've been to a decently large number of hospitals, therapists and other outpatient sites so far over the span of my life.
The biggest cost I had to pay out of pocket was 53€ at a dentist, and that's only because the insurance system has not yet caught up to the "new" method of plastic filling with ceramic compounds (yet the older amalgam is outlawed, funny how that works). Beside that, it's 5-10 euros every few months for medication.
To be fair some of the longer hospital stays were during my early childhood where my parents would've paid additional costs like hospital food, so that might've been larger than 53€.
The state of medical insurance probably is the major aspect why I'd never want to live in the US, unless I'm already a millionaire. I read that 1/3 of all private bankruptcy is caused by medical expenses, it's insane. And that's despite paying the largest sum into healthcare per person of any country, the system simply is not designed for the patient, but for profit.
When we were still in the States, my partner had to go to the ER (fear of a stroke that ended up being instead a bad medication side effect that merely exhibited as stroke-like symptoms). We had good insurance through my employer at the time, but the out of pocket expense was still about $2000.
When we first moved to Sweden, my partner had to go to the ER again before she could finish being integrated into the Swedish healthcare system, so the costs had to be paid completely out of pocket (to be reimbursed by the interim insurance my new employer was paying for) - the total cost as an uninsured person was $450. The staff was very apologetic about the extreme fee while we were looking at each other stunned at how little it cost, even before reimbursement.
A couple month later, she needed emergency spinal surgery to replace two vertebrae in her neck which included a week stay to recover. By then, she was in the Swedish health care system as a legal resident and... paid nothing. The level of care was fantastic.
Even costs aside, we would never want to experience what the American healthcare system put us through again.
Amazing story. As someone who's insured in Germany I freaked out when your bill was in the thousands, I only paid like 50 bucks for 5 days in the hospital + surgery for broken leg and a bit extra for ambulance ride (that wasn't even necessary lol). But when you said that would cost a quarter million in the US I almost fell out of my chair XD
I really hope fda approves tartrazine soon, it's so much cheaper than a CT scan or ultrasound.
Could you please inform me how Tatrazine is supposed to help in this case? You said it could replace a ct scan.
It's shocking just how much profiteering there is in the American system. That quarter of a million dollars would be going to line some shareholders pockets somewhere, rather than just to fund the system and pay the staff.
I have cystic fibrosis, a genetic metabolic disorder. People with this disease live an average of 10 years less in the USA than in Germany. The treatment is very, very expensive but allows the sick person to now live a somewhat normal life. I received 2 donor organs myself and the costs. This would have been unaffordable in the USA
While I would never wish for anyone to have to go what you went through, I am happy that you were able to receive such great care. As you mention, so many in the USA forego medical care due to cost with dire consequences.
I guess if the hospital makes two thousand dollars a night keeping you there they're not going to be in a hurry to operate on you.
Thanks for another great video!
WTF, dont carry her ot the car! Call an Ambulance, let the professionals with equpment carry her! That was way to dangerous!
Likely induced by the price worries as well. Ambulance rides alone are ridiculously expensive in the US.
Thanks for the video and all the best to your mother!
The US healthcare system works as designed. Most of the stakeholders are businesses: Most of the universities and colleges educating the doctors and nurses are privately owned. Doctors and nurses have to pay huge fees that they have to finance by going into debt. Banks offer loans and they profit from this - especially the top management and the shareholders. Insurance companies hire expensive lawyers (which are also needed to expensive to repay their student loans) to drive down costs, which is a major concern of their shareholders. The same is true for hospitals, medical device manufacturers and pharmaceuticals. Everybody is in it for the money. This capitalistic system leads to the imbalances visible in the US if the negotiation power between the involved parties (patients, doctors, nurses on the one hand versus managers and shareholders on the other side) is unequally distributed.
I prefer the way chosen by many European countries: Pooling the negotiation power of individuals into government regulated organisation that negotiate with the companies and letting the whole society pay for the education of the doctors and nurses. The american political system and the voting behavior makes it very unlikely, that the USA will change its health care system.
Hospitals in Sweden are privately owned as well. From my limited experience, the system works quite well. There are quite some queues if you are not an emergency, though.
A large part of the Dutch healthcare sector is privately owned, but that does not mean that the market is not very, very, very regulated.
Ultimately the profits of the banks, insurance companies, and pharmaceutical companies in the US make incredibly high profits, far and away above their costs, especially when much of the account handling and billing is automated now.
Highly regulated private businesses are ok and can even add to the resources available for necessary services, but most European countries with cheap or free education and cheap or free available resources to cover human needs like food, healthcare, and housing (I'm not saying it's free to have a home of course, but in emergencies), allows for less stress about those basic needs.
In the US I know that if I can't work and make money where I currently live, I'll be homeless, without food or clean water, and without healthcare except to stabilize in an emergency, there are no protections not tied to employment on a countrywide level, only occasional local programs.
@@andreasfischer9158 No there's one privately owned emergency hospital in Sweden, St Görans, it was a very well functioning before the privatization and advocates of private health care keep using it as an example. But much of the other non-emergency health care especially in the Stockholm region has unfortunately been privatized, and it has caused a disaster. The system is heavily fragmented and money flows out of the system to private profits. I have gone through this system many times and gone to everything from hole-in-the-wall doctor in an office complex who didn't even have any support staff to major clinics that are functioning like an assembly line with no time to hear out the patients concerns. In many areas of medicine we no longer even have the choice of public health care in Stockholm, it has all been privatized.
Some years ago I had an accident and needed surgery and staying in the hospital for 8 weeks after, followed by rehab-clinic for another three weeks.
After the accident I was brought to a privately-owned clinic. Later I was referred to a publicly-owned clinic. So I could make the observation that you can notice in Germany as well. If you happen to be treated in a privately-owned hospital you´ll notice that nursing will be worse than in publicly-owned hospitals. It´s things like having to bring and use your own towels vs. being given towels by the hospital, quality of food, less and lower paid personall for care and nuresing and stuff like this.
Since privately-owned hospitals are getting the same fixed rates by the health-insurance they have to squeeze out the 8-10% Profit from something.
My conclusion is: a health-care-system should not be privatised.
I had 2 ER visits this month -- because when do you get unexpected health problems? On the weekend, of course. 1st time was 2 weeks ago; I started getting severe gastro-intestinal cramps, bad enough that at around 11pm, we called an ambulance, as I didn't think I could make it to my husband's car, much less sit upright for the 10-minute trip downtown. I needed 3 IVs, which luckily took care of the problem, plus meds for the next two days. 2nd time, last weekend. I'd pulled a back muscle on Friday, and the pain was bad enough that hubby took me to the ER again the next morning. I got an injection and a prescription for the pain, and was up and about again on Sunday, and totally pain-free by Tuesday. We're privately insured (hubby was a civil servant), so we're still waiting for the bills, but our insurance will cover most of it, and any co-pay left over certainly won't cripple us financially. Most importantly, though, we NEVER hesitated to visit the ER, just because our regular doctors were not on duty. That basic certainty, that I'd get treatment _right away_, was worth everything.
Glad your mother is fine, and had such a positive experience!
Just believe me, life is so much better with holistic healthcare.
There are different types of insurance. There are profit-oriented and solidary insurance companies. Next time I recommend to get an ADAC incoming health insurance for visitors from outside the EU. While it costs more for elderly people, I cannot stress enough how many times the ADAC insurance has saved us without asking questions and without discussing what they were gonna pay and what not. One time they even sent a doctor to Spain to pick up my grandma and fly on a regular airplane with her to get her back for urgent treatment in Germany. If you have 1000$ für a flight ticket you can spare the 100+-€ for the insurance.
1) Travel health insurance is reasonably cheap. Always get one when travelling to places that are not covered by your medical insurance
2) In Germany, the medical fees are highly regulated, also for uninsured or privately insured patients. There is a general fee schedule agreed between the health insurers and the doctors associations, that is then multiplied by a factor according to difficulty with at most 50% surcharge. Doctors can also work outside of this schedule, but this is rare and has to be agreed upon before the treatment. That typically applies to dentists spending multiple sessions to "rescue" a tooth or to some nationwide renowned specialists (though most of them are university professors and charge the regular fees). A typical MRI may cost you around 500 to 1000 Euros, a typical surgery a few thousand euros. Visiting the dentist for a regular filling is a couple of hundert euros. And those are the "private" fees that actually cover all cost and make profits to buy the Porsches of "private-only" doctors or cross-subsidize the publicly insured patients.
3) The freiburg university hospital is one of the best in Germany.
Health insurance for guests to Germany is only a few bucks.
When you have guests - Never forget !!!
Dear Ashton, I wish good recovery for your mother and have to congratulate you for more than 100.000 followers on youtube. That is an extraordinary good result but that reflect your good and hard work. Yes, the costs of healthcare is different inside USA and in other western countries, but the Americans don't like the idea to pay for the sicknesses of other people, that is the reason for those differences. That means, the Americans don't see the doctor or the hospital in an early stadium of sickness because of the horrend high prices and the co-pay what thes have to pay out of their own pocket besides health insurance, they wait until the end. And than it will be a big thing. The doctors and hospitals have not enough to do, only the big cases. They than must get a lot of money for the seldom cases.
It might be interesting to you that the US system is often overwhelmed... hospitals need to stay as full as possible in order to make profit, and there are still many smaller/ less emergent visits that hospitals are asking people to go to small urgent care outpatient centers so that hospitals are free to take emergencies.
The for profit system is a balancing act for hospitals, so they are nearly always busy, even though the most minor infection or allergic reaction requiring medication can cost as much as $5000 US for a few hours of care when paid in cash.
I'm glad that your mother is doing well! A very important topic. Maybe include something like "my american mum", or something like this... Maybe then at least a few more Americans will watch this video.
Ah good idea! Thanks for the recommendation!
As a german if she had an insurance(Versicherung) in germany she had only payed maybe 10€/day for the room... 🤣
And in Denmark she would have to pay nothing at all
5 days would have been 50€ plus 10€ for the ambulance ride. So 60€ or so plus maybe some prescriptions. Overall definitely under 100€ for this entire brain surgery compared to hundreds of thousands which you then still have to pay 10k of after your shitty American insurance if not more.
@DieAlteistwiederda It's only 10k if the shitty American insurance doesn't weasel its way out of its obligations, which it might do now that the "just let them die"-guy got elected.
How scary! I am glad your mom in ok
When I lived in Switzerland, I visited my family here in Germany and had to have some unexpected heart surgery done. My Swiss health insurance paid without me being involved. They only sent me a copy of the bill they had gotten from the hospital (which was already paid by them).
It is called "civilisation". As opposed to "we are the best".
Well., within Europe, there are regulations between the countries and the insurance will reimburse the cost, they would cover in the home country and for the rest you will have a travel insurance
Travelling abroad without a proper travel health insurance is irresponsible.
Your Mom was lucky that this happened in Germany. If that had happened in Asia or South America and you dont have a health insurance, your Mum would have been done.
At the age of 18 I was travelling the first time to the US. Before doing so, I made sure that the coverage of the insurance was at least 50 million Dollars.
Since then I have never ever travelled anywhere without a health insurance.
Good to know that your mom is okay again. And I am a little bit proud of Germany's health system.
When I was in the hospital in Belgium for a knee replacement operation, at least 1/4 of the patients in my hallway were Americans who came for a knee replacement. There was even one American who had both his knees done at the same time, to save money, he had to practice in the hallway to learn to walk again, we heard him scream in pain, he suffered terribly.
I always advise all our US visitors (we are a US/German household) to get insurance for coming over. You can even get it here for them. It's like 60-100€ for up to a month if I remember right. Totally worth it imo.
For the quality of care, I think the premiums are also acceptable in Germany. We pay usually 7% of salary and there is a mandatory 7% paid by employers. (I know there are other plans for privat insurance but I do not want to go into this here.)
My advice is always check your insurance situation before travelling and if necessary get extra coverage.
Ich als Deutscher kann nicht verstehen warum wir hier noch soviel nörgeln über unser System. Wir haben leider auch Probleme Pflegekräfte und Ärzte zu finden die hier arbeiten wollen. Freue mich das es deiner Mutter wieder besser geht. Bleibt alle Gesund und genießt was ich habt. Gruß Paul aus Essen (NRW)
As a German, I can't understand why we still complain so much about our system. Unfortunately, we also have problems finding nurses and doctors who want to work here. I'm happy that your mother is feeling better again. Stay healthy and enjoy what I have. Greetings Paul from Essen (NRW)
If i were to travel anywhere in the world, i have a health insurance covering me world wide. Cost, not kidding: 10 bucks per year.
In the case of a trip abroad you should always take out a suitable health insurance.
Thank you for sharing this. It has always been something out of a nightmare to hear about the american health system and I was never worried about the cost of health costs here in Germany. I feel like things are changing here now. The system is overtaxed, not enough doctors, rising costs for everything. I am very worried that the system is not going to work for us in Germany anymore. But glad it still was good for you guys. All the best to your mom.
As an example, in the UK, pet insurance works like the American medical system. Our dog had an operation on his leg. Without insurance, it would have cost us £4,000. I happily pay in taxes for the NHS, even with its flaws. It doesn't tie me to any job and still works out cheaper than any private insurance would.
The biggest question for me is: Why are the American insurances willing to pay these prices? Don’t they have any negotiation power?
American insurance does not pay those prices. Only none insured person pay them. They get cut in have or something crazy like that for insurance companies. Those sky high prices are due to negations with the insurance. They insisted on better rates and hospitals could not offer those. Hence they increased there normal rates to over those "discounts".
The insurance makes more money with 10% from 100K than 10% from 10K. It's not the insurance paying, don't get that wrong!
Insurance in the Netherlands must cover emergency care in foreign countries as well. If you are uninsured here, there s a special price list thats ofc a bit higher.
Had a look..
MRI scan for brain 396eu
(Easy) Brainsugery and max 5 day stay 6259eu.
With insurance in my country, I would have to pay the out of pocket max 385eu if I had not alrdy spend that on other care earlier that calander year.
250-500k is absolutely unnecessary for a few day stay and a few holes drilled in your skull...
A new CT scanner - the device and software costs 200k. New form the factory! Obsoletely unreasonable for any hospital to bill that amount ever!
Be careful. Most Dutch insurances have an exclusion for the USA. They have a maximum or want extra added insurance from travel and health... This exclusion is only for the USA as far as I know. So always check... It can change depending on the year and level of insurance.
A big level of the cost of everything is the cost of payment of people. Dutch healthcare workers pay has been cut drastically years ago. So the CT / MRI is not only the machine, but also the radiologist who interprets the scan. That's why an ultrasound is more expensive... Because it takes the radiologist more time to do the ultrasound, while an MRI test is done by an assistent and only the scan looked at by the radiologist.
@@AnD-1999 Hmmm yeah, fair. As a Dutchy, I just buy travel insurance for the trip I make. Thats usually 60eu or so for just the duration of the trip. It varies a lot, but its a nobrainer for the cost.
Last I ran into this, I had travel insurance back in 2010 - and the insurance covered the 600eu bill for care to fix a heavy asthma attack.
I work in Dutch healthcare since 2017... I don't remember our pay getting cut some years ago o.o We were doing quite well with CAO negotiations, barely ahead of inflation, until the major post covid spike, and since we are about trailing/on the line of inflation.
The numbers provided include doctor interpretation, if I am not mistaken.
Even for ultrasounds though, you will see a trained medical imager, working for the doctor. They make pictures and then discuss it with the doctor. That goes for all imaging divided in the Netherlands, afaik. Radiologist, or similar specialist usually reviews images, and gets a flat fee per image - at least that was the pay scheme in a local hospital back in 2014.
The academic hospital I work in now, pays doctors a flat monthly salary, if I am not mistaken. Specialist pay is really nice, but then taxes lol.
While none of this is news to me, every time I hear about the state of American healthcare, I am completely baffled.
It seems completely bizarre.
New to the channel. Thanks for sharing
Glad to have you and thank you for watching!
I've never heard _anything_ from the US healthcare system, other than that you pay an utterly obscene premium and the insurance then uses your own money to shield itself from your claims.
My health insurance offers worldwide coverage, meaning I will get reimbursed for most of any medical cost in any country, leaving me with a small copay. The only exception is the USA where I would need additional insurance because the cost of healthcare in the US is soooooo expensive. I just don't get how Americans accept this situation.
and as a European we just listen to all the large costs mentioned and the cost for us living here would have been like nothing in comparison.
I know that's not really the point for the video here but still...
Ask Krankenkasse if they will return mony when accesssing emergency abroad. They did pay it back to me
Thank you for sharing your mother's story, Ashton.
I had surgery that cost about 10.000 Euro two years ago and regular check ups including blood tests and scans since then.
As a retired public servant I have private insurance that costs me about 300 Euro a month. Needless to say that surgery plus additional service didn't cost me anything.
The same goes for two hip and one knee replacements as well as gall bladder removal - all over the last ten years . Imagine I lived in the US .
I remember a vacation in the US when a very old taxi driver in Chicago told me he still had to drive a taxi because he was paying off the bill for a kidney surgery he had had to go through. And his age and fragility were pitiful to see.
I'm so glad your mother had her life saving procedure over here and is doing well now.
Yeah, we don't need medical "tourists" to our publicly funded hospitals.
The reason for the relatively low bill is that all the salaries for the staff is already being paid by taxes, or in Germany some of it by the insurance companies.
It's a fixed expense, even when the doctors and nurses are idle.
So taking in a patient with urgent need of attention is only slightly more expensive, they only charge for the actual time and equipment for the procedure.
US hospitals don't get funded to be idling... so they have to add their idle expenses to the bills they hand out.
On top of that, it's a known fact that US insurance companies pressure hospitals to keep their prices so high that the general public can't afford to not having insurance...
If a hospital underbids the others too much, the insurance won't cover expenses if an insured patient goes to that hospital... it's basically blackmailing.
Anyway, I'm happy to hear that your mom is good and well.
The US deserves a more humane system where saving a life isn't just about keeping people alive enough to pay their bills.
Edit: but that gets me thinking, when I wanna enter the US visa-free, it still requires me to have a travel insurance.. isn't that required the other way around?
she wasn't a medical tourist. As I understood, it was an emergency, you cannot plan an emergency...
@lannifincoris6482 I was referring to how she wouldn't encourage it, just agreeing with the video. Sorry if that could be misunderstood.
This is an absolute horror story! Well, let’s hope RFK does not ruin even the last remnants of medical aid in the U.S. for good…. Glad, your mom is okay again!
For interest watch Michael Moors documentary on healthcare:- Sicko available on TH-cam it’s an eye opener. Getting an ambulance in Germany, would have helped you get your mum to hospital. If she had fallen down the stairs,or injured herself more getting to hospital it could have been disastrous. Maybe worth seeing how much the cost would be for your page. Thanks for sharing
as a german, not even before hearing the rest, just that the emergency was happening here. all I thought was "glad for her", because I know that our doctors and nurses are incentivised to save lives first and anything money related or whatever comes after that. at least in life or death situation they'll try their best to help you however they can to save your life.
for the most part would also try to help you out in any way with anything else ... for the most part. some might just be bigoted buttholes who take their liberty to break their medical oath and anti discrimination laws in one paragraph.
I know this is oddly specific and I know who's life I may go out of my way to ruin when I have to add a physical disability to my list of issues
Amazing story. But there is a downside to this German generosity. If the 7000 Euro was really the pure cost (no subsidies costs by the state), that explains why German healthcare system is suffering a huge shortage of doctors and nurses who are truly underpaid for the type of job they do. If you ask a contractor to do a small job for a day in your garden, it already costs a few thousand Euros.
Glad you're alright, awful about the Huntington! Is that the reason why she didn't have international coverage? I can imagine US insurances being able to exclude her from getting propper travel insurance because of her condition...
In the Netherlands the USA is the only country that has special exclusions for many insurances. I always check before travelling to the USA.
There is a reason, why so many Olympic athletes had a full medical check up and had stuff fixed for free in Paris, because they wouldn’t have been able to afford it in the US. This is actually pretty pathetic for a „great nation“!
Providing free health care to athletes is an Olympic thing, though. First Olympics where that happened was in Los Angeles.
6:25 you could have just called the emergency hotline and they would have carried her from the apartment with an emergency vehicle. If there is clearly signs of something not being right with her, you didn't need to drive her yourself.
if your uninsured and accustomed to US-prices you´re not doing that cause you´re afraid of the 5.000 $-bill just for the ambulance you´d get in the US. There´s a reason why people in the US refuse to be taken by an ambulance after they had a car-crash.
@AlexRadler-bw9js yes, I'm just saying it for future reference and for anybody else traveling to Germany.
Hello Ashton and family. I’m so sorry to hear of your darling mums health emergency and all that she had to go through to get back on the road to recovery. I can’t imagine how scary that whole situation must have been for you and your family. Well it’s great to hear she is feeling much better. It’s unreal the expense of health care in the US. But how fantastic is the health team in Germany? It’s so amazing what they were able to do for your mum and in a timely and professional manner. God bless her 🙏🙏❤️🩹❤️🩹
I'm glad that your mother is feeling better again. What I absolutely cannot understand is traveling abroad without travel health insurance at *+ level. We have such an insurance that automatically covers everything up to 50 days per year abroad. A short email with the travel dates (start/end and which countries) to the insurance company and everything is fine. This costs less than just 1 day in the hospital. Isn't this available in the USA or is it extremely expensive?
Remember also that in Europe, clinical care decisions are made by doctors. In the US, they're made by insurance companies.
Good there is a happy ending. About the electric bikes: Even in the Netherlands (where everybody rides a bycicle), Electric Bikes are a cause of concern. With a normal bicycle you are the power. So you are much more directly in control. With an electric bike, you are not in direct, but in indirect control. Just like with a car. The Electric Bike IS a motorcycle in the end. And reaction times do not improve as we get older. As a kid I would fall all the time. No issue. Last month I stumbled and fell on my knee. Could not walk for a week.
I am not saying that Electric Bikes should be banned, but people should see the upsides AND the downsides. Most often you will go faster than with a normal bicycle, because you can. Often that is the reason people buy an elect one: because they get older and can not go as fast as they used to, and they have the financial means to buy one. So just be aware of the downsides and the upsides.