[HN Gopher] Tripolar Nature of Software Engineering Salaries in ...
___________________________________________________________________
Tripolar Nature of Software Engineering Salaries in the Netherlands
and Europe
Author : hacksilver
Score : 112 points
Date : 2021-03-08 17:49 UTC (5 hours ago)
(HTM) web link (blog.pragmaticengineer.com)
(TXT) w3m dump (blog.pragmaticengineer.com)
| dukeyukey wrote:
| My first tech job in London was at a medium-sized (~300
| employees) tech company HQ'd in Seattle, with London being 2nd
| largest. Not long after I joined, one of the team leads left for
| a largish fintech, and slowly brought the rest of his team with
| him over the next couple of years. Despite this constant brain-
| drain, management refused to address the salary issues.
|
| After a couple of years, I left to go there too, with a ~60%
| raise(!). I learnt from my manager, who left a month after me to
| the same fintech, that HR only benchmarked against "comparable
| companies in the same area", meaning west London suburbs, and
| ignored the pull of Central London finance, despite literally
| dozens of people leaving to go there. You gotta be realistic
| against who you're competing against, and thanks to how mobile
| tech professionals are, European companies are competing against
| not just their area or city, but often against Silicon Valley.
| 908B64B197 wrote:
| > You gotta be realistic against who you're competing against,
| and thanks to how mobile tech professionals are, European
| companies are competing against not just their area or city,
| but often against Silicon Valley.
|
| If Europeans want to get better salary there's one option. Vote
| with their feet and simply work in SV.
| dukeyukey wrote:
| Getting a visa isn't that easy, one reason salaries haven't
| gone up as much as they could have. I'd absolutely love to
| work in the US, but realistically it's a multi-year plan that
| could be scuppered by a visa lottery, HR policies around visa
| sponsorship, or an administration that decides it doesn't
| like my nationality any more.
|
| If you don't already have family in the US, getting in is a
| real arse.
| codebolt wrote:
| Not something done on a whim when you have a family. Might
| consider a remote position, though. My current job has decent
| benefits, and I do enjoy the work, but the pay absolutely
| stinks compared with the value of the work I'm performing. If
| openings start flying around with anything close to SV-level
| compensation I'd be hard pressed not to consider applying.
| blunte wrote:
| Life is pretty great here. The low salaries are a bit
| disappointing, but other aspects of life (including vacation
| time and work/life balance) is far superior. Sometimes the
| money is just not a good enough reason to leave.
|
| However, if the money can increase here, and we can stay
| here, then yes please!
| bradleyjg wrote:
| From the SV employer's perspective that's the rub in trying
| to take advantage of the "inefficiency". They can hire
| talented programmers in Europe for significantly less money
| but those programmers are going to insist on working less
| than their SV counterparts.
|
| Even if the trade off is worth it considering only first
| order effects (i.e. $/hr) will those work/life attitudes
| end up influencing the US workers as well?
|
| Not making a value statement here at all, just laying out
| the consideration.
| hilbertseries wrote:
| I work at a company that employs developers in the US and
| in Europe. The European developers are more upset that
| they're paid less, than the US developers care about the
| European benefits.
| blunte wrote:
| Having lived most of my life in the US, and only the last
| 8 years in NL, I wouldn't move back to the US to an
| onsite office unless the pay were at least 3-4x higher.
|
| If I could work remotely from the mountains in Colorado
| again, I would consider it for a 3x increase. Less than
| that, and it's just not worth it. The quality of life
| here is that much better imo.
| yrgulation wrote:
| I doubt its that easy - immigrating to the us is pretty
| difficult compared to other countries. Take canada and their
| express entry program - although salaries are pretty low
| there.
| 908B64B197 wrote:
| > Take canada and their express entry program - although
| salaries are pretty low there
|
| Canada has out of control immigrations quotas. It's no
| wonder their own government are bragging that their devs
| are worth 50K less than in America [0].
|
| [0] https://globalnews.ca/news/4178326/amazon-vancouver-
| tech-wor...
| dbetteridge wrote:
| Similar story here.
|
| Came to London with my existing (traditional) engineering
| company.
|
| After about 9 months (During COVID) got a series of offers from
| VC financed startups around London for a 90-100% raise,
|
| so after that happening for about 2 months I interviewed at a
| few places, got offered a role and then buggered off to
| somewhere willing to pay me properly.
|
| Exit interview with the old company
|
| Them: "What can we do to keep staff",
|
| Me: "Pay people closer to the market rates outside comparable
| companies...",
|
| Them: "Oh we can't afford to do that".
| yrgulation wrote:
| The issue however is that demand for software engineers in
| continental europe is much lower than in the uk / london area.
| Maybe that changed with brexit and more companies relocating to
| europe, but unless eu countries invest in / stimulate tech
| companies not much will change.
| blunte wrote:
| Thanks to Brexit (well done...), Amsterdam is expected to be
| the new biggest trading center of Europe.
|
| https://www.ft.com/content/3dad4ef3-59e8-437e-8f63-f629a5b7d.
| ..
|
| I was already aware of at least two big trading firms opening
| significant offices here, and now I expect there to be more.
| For those interested in fintec, Amsterdam is going to offer a
| lot of good options soon.
| frusciante29 wrote:
| i guess this is also a way to advertise for positions, albeit
| long-winded.
| vmception wrote:
| "Yes, healthcare and the cost of living are more expensive in the
| US"
|
| They should add, [but not that much more expensive].
| Ave wrote:
| Canadian tech salaries are experiencing the exact same thing as
| described in the article in my recent experience interviewing.
| [deleted]
| anon1253 wrote:
| Interesting! I can echo these findings from from personal
| experience. For the past 5-6 years I had been doing remote work
| for a US west-coast based company from the Netherlands. My annual
| salary as a senior "data scientist" was at least double, if not
| triple, that of my fellow Dutch peers. Typically salaries around
| here seem to stall at the EUR45-60k/yr mark with very few
| positions open at higher tiers (and usually not advertised
| through any typical recruitment portals, where salaries are
| typically even lower, even when commanding decades of experience
| in obscure technologies). When I left that remote position the
| options really did seem limited, and I ended up taking a
| substantial pay cut. Short of trying to bootstrap your own
| company (VC-like funding here is also not very typical, with
| angel investors being almost non-existent) moving seemed the only
| option, which I had no real intention of doing. Even moving
| slightly east to Germany seemed to be the better option. I think
| our current predicament has really opened the market though.
| Remote work is no longer considered weird and there definitely
| are very talented and skilled engineers up for grabs here in the
| Netherlands if they are coached ever so slightly. I wonder if
| there is an opportunity here for an employment-agency-ish company
| facilitating the overseas hiring process and legalese. Exciting
| times!
| user5994461 wrote:
| 2 things when you read between the line:
|
| 1) Numbers are total compensation, the base salary is a LARGE
| amount below that. Few of the figures are hinting to bonus/shares
| being 50% of the base, if not more.
|
| That's not to say it's bad but that's something to bear in mind.
| Some of the quoted companies are worthless because non public,
| other companies might go either way (Uber is not
| Facebook/Apple/Microsoft when it comes to stock). You certainly
| want to see how the shares are allocated, on what schedules,
| how's the taxation is working (US equity in US dollar can be big
| pain in Europe). Bonus are for those who believe in them (Uber is
| not known for having nice and stable management layer).
|
| 2) These are staff engineer positions, which are incredibly rare
| and selective.
|
| - Not sure if Uber Staff is like L6 or L7, either way you're
| probably not going to achieve that in your lifetime. The later is
| like the head of a department with 100+ people below them them,
| basically a whole small company (if you want to talk about
| individual contributors it's even rarer than that). For the
| former, we're talking about a person with two decades of
| experience in tech and probably a chunk in the web industry
| (better have competing offers from Facebook London or Google
| Zurich).
|
| That's really the counterpart to the $600k developers from
| SV/NYC, a very far cry from the average developer, even a far cry
| from the usual good performer.
|
| edit: Uber only IPO'ed in 2019. The article is talking about
| offers going as far as 2016. These offers were basically
| imaginary money. Employees didn't see a penny of it unless they
| were still in 2020 (after lockup period), and if they were, the
| realized number was certainly very different than the initial
| promise (note: Uber went down after IPO).
| domano wrote:
| How do the responsibilities compare? I am at the upper end of the
| local senior positions in companies(well, well below 100k) and
| get offers for up to 100k.
|
| Currently i am doing consulting, building up the organization to
| be more modern, creating videos, system architecture positions
| for customers, golang courses and development, some frontend
| stuff. Is this something similiar to these top paying companies?
|
| And do all of these require the leetcode interviews you always
| read about? Sure would like to double my salary in germany haha
| cmews wrote:
| What is missing in this article is that most developers that want
| to properly get paid in the Netherlands switch to freelancing.
| There are a lot of freelance positions where they work a couple
| of years for 75-95 euros per hour and achieve the 130-200k yearly
| income (still not as high as silicon valley).
| imhoguy wrote:
| Long-term freelancing, or I would call it _B2B contract
| employee_ , is also the only way to work remotelly for abroad
| company.
|
| Unfortunatelly EU has no means of cross-border employment yet
| other than establishing local subsidiary company. It is
| unlikely to happen if they "employ" a couple of people in
| various foreign countries. Company setup procedures and
| employment laws vary by country, salaries may vary by currency.
| It is just too complex at small scale.
|
| Then the simpler solution is to use intermediary local
| contractors agency or just directly pay Euro invoices of long
| term freelancers.
|
| It is legal but e.g. German companies prefer not to keep such
| contracts longer than 2 years. Why? That is another story...
| Avalaxy wrote:
| There are payrolling companies that take care of all this.
| They have subsidiaries in every country, will give your
| remote employees all the things they have a right for
| according to the local laws, and send you an invoice.
| cbovis wrote:
| For those who might be interested these companies are
| called Professional Employer Organizations (PEOs).
|
| An example would be Velocity Global -
| https://velocityglobal.com/
| Avalaxy wrote:
| As an extra data point: remote.com does this:
| https://remote.com/ (I'm not affiliated with them, just
| heard of them)
| sarhus wrote:
| could you point out where is the best place to look for
| contracts in the Netherlands?
| cmews wrote:
| What works for me is Linkedin to be honest and recruiters
| will approach me or my Dutch developer friends for freelance
| contracts where they basically take a cut of the hour price
| (most of the time they take 10-15 euros/hour). Also being
| asked because of people that (pleasantly) worked with you is
| common as well and you could approach them to see if they
| need another freelancer for a project.
| juskrey wrote:
| A-couple-of-years positions are definitely not freelance
| lhorie wrote:
| "Position" implies you're salaried. A long term freelance
| career is more like a one-person consulting shop.
| cmews wrote:
| They start with a 6/9/12 months contracts, but they extend
| the contract often in my experience. Freelancing is just
| charging your employer per hour with limited employee rights,
| but the period of the contract doesn't determine if something
| is a freelance job or not. Also the Dutch tax service isn't
| strict in checking freelance developers because they earn
| enough, but there is more discussion in the Netherlands for
| people that are being pushed into a freelancer position
| (Dutch people call this a `zzp'er`) for companies to lower
| the costs of the employer while the rights for the employee
| suffer.
| blank_fan_pill wrote:
| Seems like the gist is that large multinational tech companies
| pay 2-4x what local or non software focused companies do. It's
| more or less the same in the US.
|
| I am glad to hear the market is moving towards devs in Europe
| sosodev wrote:
| Yep, I've seen the same thing here in southern California.
|
| Traditional businesses hiring devs tend to pay the local rate
| for "engineers".
|
| Software businesses hiring devs tend to the pay the local rate
| for "software developers".
|
| Big tech companies with a local branch or remote position pay
| something way higher than the other two but usually expect much
| more too.
| agustif wrote:
| > Stripe and Spotify have both started to hire for permanent
| remote positions in Europe as well, expanding their hiring pool
| to all of the EU. Both companies are competing across Europe, and
| not with the local market. They join companies like GoDaddy,
| GitLab, GitHub, and others who have been doing this for years.
|
| Although I know for a fact this is true, in the case of Stripe at
| least, I haven't been able to fit any role that fits myself
| (frontend/junior) so I guess they're looking only for more senior
| positions in this remote-covid post-era...
|
| PS: If anyone at Stripe is hiring for more junior/middle frontend
| sofware engineer or fullstack
| node/ts/js/graphql/jamstack/serverless positions do let me know!
| mail on the profile
| 0xfaded wrote:
| This is fantastic news. As a reference point, in Denmark the
| highest software engineering salary I've seen is EUR120.000,
| which was at a large Danish corp. I'd love more data points.
| lokimedes wrote:
| I know of a Danish company paying double that to retain their
| full stack developers. This is second hand info but from a
| credible source.
| MehdiHK wrote:
| I'm currently a software engineer based in Berlin and I've found
| that stock options are not common at all in Germany [1]. I'm
| curious to know, is this scene different in Netherlands or other
| places in EU?
|
| [1] https://www.ft.com/content/5778f3d0-1b3c-11ea-97df-
| cc63de1d7...
| shasts wrote:
| Startup stock options are not encouraged at a policy level in
| most of the EU countries.
|
| https://www.notoptional.eu/en/country-ranking
|
| No good stock options, not many getting rich after successful
| exits. Hence not many to fund the next good venture. A handful
| of VCs and some banks who had traditional money.
|
| Most of the successful European companies look for an
| acquisition by a US company as an exit path. Silicon valley has
| an eco system of people who had successful exits funding the
| next startup. It is quite rare in Europe.
| adrian_b wrote:
| I believe that this depends less on the country where you are
| working and more on the country of origin of your employer.
|
| During the years, I have worked for 3 German companies and none
| of them offered any stock options.
|
| On the other hand, while working for an Israeli company and for
| an US company, I have gained about the same amount from selling
| the vested stock options of those companies as from the salary,
| i.e., due to the stock options, the total compensation was
| eventually about double compared to the salary.
| blunte wrote:
| I am rather shocked at some of the numbers from his salary
| survey. I have seen many mid and senior dev Booking positions
| listed in the recent few years in that typical 50-65k range.
|
| Likewise for Catawiki. Their listed salaries were significantly
| higher than what I think is typical here, but I never saw
| anything over 100k.
|
| The #1 challenge is that most salary ranges for advertised
| positions are not listed. If you are talking to a recruiter, the
| recruiter can usually give a range, but still I've never heard
| these numbers. I get approached weekly for "senior" positions
| that are in the 50-60 range.
|
| Frankly, I don't believe the high salaries he talks about are
| numerous. There may be a few, but it would be shocking to find
| out that 150+k is typical in the examples he mentions.
|
| In the US, particularly west coast and NYC (finance), 200+k is
| not surprising. 600k? I seriously doubt that is common, unless
| you're working in a hedge fund and getting 300k bonuses based on
| company performance.
|
| Generally speaking, the Dutch workplace doesn't seem to hold
| developers in the esteem that they hold managers. Maybe that's
| reasonable, but it certainly puts the Netherlands at a
| competitive disadvantage. The company I work for would like to
| hire 5 Rails devs, but they cannot find anyone with the desired
| experience at the offered pay.
| brabel wrote:
| I am shocked too. The highest advertised salary I've seen
| recently in the constant emails I get from EU recruiters is
| around EUR7,000/month (and that was with a message saying it's
| well above market rate). I have 15 years of experience in
| software engineering.
|
| EDIT: I had written 70,000 per month but meant 7,000... which
| is 84,000 per year, or just below 100,000 USD.
| [deleted]
| d1zzy wrote:
| The stock compensation is a huge factor. $200k base salary but
| expect at least $100k/year from stock grants and with the crazy
| high increasing valuation of tech company stocks that can
| easily double.
| morei wrote:
| Prepare to be shocked. The majority of SWEs employed at Google
| in the EU (Zurich, Dublin, London) have comp packages over
| 150k.
|
| Note: 'comp packages'. Their salary won't always be over 150k,
| but when including stock and bonus, total comp will be. That's
| many thousands of SWEs.
|
| If you look at advertised salaries, you won't see those
| numbers, because it won't include bonus/stock as those are
| considered 'at risk'. But considering that to not get
| bonus/stock you need to be on a verge of getting fired, it's
| not exactly a large risk.
|
| Re 600k: It's not that uncommon. In excess of 5% of Big Tech
| SWEs make that sort of money.
| user5994461 wrote:
| >>> Prepare to be shocked. The majority of SWEs employed at
| Google in the EU (Zurich, Dublin, London) have comp packages
| over 150k.
|
| 1) It's factually wrong.
|
| 2) These 3 countries are paying in 3 different currencies so
| you might want to clarify 150k of WHAT. With an exchange rate
| of 1.4 in some directions it's actually quite important ^^
|
| 3) No matter the currency, it's still factually wrong :D
| morei wrote:
| Do you have a reason you believe it to be factually wrong?
| user5994461 wrote:
| Knowing people who worked there on lower salary.
| Recruiter invitations to interview there for a lower
| salary.
|
| If you want to be more specific, you really want to
| clarify the currency and the location because there is a
| massive disparity.
|
| The highest paying by far is Zurich, in CHF, that also
| happens to have the lowest exchange rate (though it's
| been climbing steadily over the past decade).
| morei wrote:
| Ok, it's mildly funny that that was enough for you to
| errantly declare 'factually wrong'.
|
| 1. 'salary' != 'total comp'. The bonus + stock components
| are substantial.
|
| 2. 'The majority' does not mean 'everyone'. There are def
| SWEs that have less than EUR150K as total comp, they are
| just the minority of all SWEs employed.
|
| 3. 'total comp' is very strongly affected by performance.
| High performing engineers at the same level can see a
| total comp twice what their lesser performing peers get.
| Looking at only 1 or 2 people can given a very skewed
| picture versus the real overall data.
|
| 4. Recruiter invitations will NOT be for total comp, only
| salary, because BigTech are careful to avoid any sort of
| implied contract or commitment for the bonus/stock
| portion of the comp. This creates a slightly odd dynamic
| where the recruiters can't talk about the real comp for
| the position. Given that bonus/stock is such a large
| fraction of comp it means that people will turn down
| recruiters in the mistaken belief that the comp is too
| low (as you apparently did?)
|
| 5. Zurich does pay a bit higher but on an absolute scale,
| it's nothing to do with the exchange rate. (ZRH total
| comp converted from francs to pounds is still likely to
| be a bit higher than the equiv London SWE total comp).
| Scarblac wrote:
| > The majority of SWEs employed at Google in the EU (Zurich,
| Dublin, London) have comp packages over 150k.
|
| Nitpick: of those three, only Dublin is in the EU.
| nilkn wrote:
| 600k in Silicon Valley is certainly not unheard of. That's
| within range for Staff Engineer and EM roles at top companies,
| and there are a lot of Staff Engineers and EMs. In fact, it can
| go up quite a bit from there. M2 [0] pay can be in the
| 700k-900k range, and Director pay is typically 1M+. Keep in
| mind that salaries rarely go above 250k -- most of this
| compensation is in stock grants.
|
| [0] M2 is an engineering manager with quite a bit of scope,
| possibly with some M1s as reports. Imagine a group of 20-50
| people total. Exact headcount can vary because "scope" is a bit
| of an abstract concept that is correlated with -- but not
| perfectly matched to -- headcount.
| ecedeno wrote:
| When I was promoted to mid-level developer at Booking in
| 2017/2018, the salary range for the position started at around
| 60k. These days, it's probably in the low 70s.
| mistrial9 wrote:
| I made $55k per year in 1990 as a software developer in the
| San Francisco area, but then Apple/Adobe and others here
| entered into an illegal hiring pact to fight it.. later,
| Internet.. things changed. Wages for working people, even to
| some extent software, have been stagnant for thirty years,
| while the cost of higher education and distinctive homes rose
| 300 percent, depending on your setup, health care too..
|
| literal evidence, I can see cars advertised for sale that are
| essentially the same price point as they were in the 1990s
| (working person's market), yet the Dow Jones market average
| went from "breaking ten thousand" to what, thirty thousand
| plus now?
|
| Something is very, very suspect with the high-end money game
| in the last thirty years. People who do actual work? see
| George Carlin, he will tell you
| zeku wrote:
| For comparison I make mid 70s as a mid level dev in a medium
| cost of living area of the US.
|
| I feel that very often when Europe compares itself to the US
| on this, they only look at the super HCOL areas like SV,
| Seattle, NYC.
|
| I feel like we are underpaid still, compared to SV and NYC
| devs.
|
| For another comparison my coworker was recently promoted to
| senior dev and he is starting in the mid 90s.
|
| Also there is no fancy comp, we have employee health
| insurance(that we still have to pay for both monthly and when
| we use any medical service -- for non Americans this is very
| standard), we have a 401k(retirement portfolio) that our
| employer matches the first 5% of everything that goes into
| it. We also have a few other niche benefits, but no fancy
| comp.
|
| I just wanted to give a more realistic portrayal of the usual
| American dev.
| blunte wrote:
| I guess this is worth remembering. There are a lot of lower
| paying dev jobs in the US, but they don't get much
| publicity :).
|
| Part of the problem is lack of awareness, and prior to more
| recently, lack of remote options. There are countless job
| boards and recruiting firms, and millions of "candidates"
| (many of whom fail FizzBuzz, but that is not visible in a
| simple resume).
|
| If the qualified supply and the demand had awareness of
| each other, and if remote were an option, it would be
| better for most people. The companies would be able to
| acquire the talent they needed, and the talent would have
| better options.
|
| On the other hand, the current system works enough... there
| may be some low quality developers working at some
| companies, but they just may be getting enough done that
| the companies can function. And the more skilled, more
| motivated people will obviously seek and possibly move for
| the better jobs and pay.
| mjmahone17 wrote:
| Your shock at 600k is understandable, but note that the people
| pulling those numbers mostly don't need to exist at smaller or
| less tech oriented companies.
|
| It's primarily either senior engineers who consistently have
| outsized business impact (for instance identifying and building
| systems that generate tens of millions of new recurring revenue
| for the company each year), or are significantly beyond senior,
| such that they're having a similar business impact as would be
| expected of the C-suite of a 10-100 million/year company.
|
| When you have a tech company with 10 billion/yr revenue, you
| need hundreds of people that fit into the above scopes. It's
| definitely not most employees, but a career path into those
| positions becomes possible. Whereas in a smaller or less tech
| focused business there wouldn't be enough scope for those
| people to justify their outsized pay.
| blunte wrote:
| I think the key here is "tech oriented" companies. If the
| product of the company is tech, then it's more possible for
| the devs to make a significant positive revenue impact.
|
| In those cases, if the numbers add up (600k dev generates
| +3+MM revenue per year because of what and how they do), then
| it makes sense.
|
| Perhaps the biggest shift in EU developer salaries will come
| from a shift in what types of businesses operate here. If
| that begins with US tech companies expanding here, then
| great. But I would like to see EU founded and grown tech
| companies to compete. I'm afraid what probably happens is the
| good ideas get built here and bought up by the US giants.
| tomrod wrote:
| IME, recruiters in the US will give a range from lowest to no
| higher than midpoint (and often lower).
| sammorrowdrums wrote:
| I had a friend work as snr. engineer at a startup taking a pay
| cut down to 80k, then went to work for big US tech company
| presumably for a significantly higher salary. All in Amsterdam
| (with some time remote). Certainly no senior dev in Amsterdam
| worth their salt would _need_ to work for EUR55k or even
| probably EUR65k unless they chose to work at a startup that
| cannot pay competitive rate, or have other priorities
|
| Edit I should add I'm also earning well above that as snr
| engineer in Amsterdam at a startup.
| returningfory2 wrote:
| > Yes, healthcare and the cost of living are more expensive in
| the US
|
| I feel Europeans looking in on the US from the outside
| consistently have a misleading view on healthcare. I'm saying
| this as a European in the US working in big tech.
|
| My plan's maximum out-of-pocket in a year is ~$3k, which I can
| pay pre-tax thanks to an HSA. It is less than 2% of my total comp
| in the worst case (in 2020 I spent less than $300 on healthcare).
| In return I get coverage that is generally better than the free
| public healthcare back in Europe.
|
| I think CoL is similar, but not as clear cut. One thing CoL
| discussions often miss is that many expenses are independent of
| the local CoL; for example, a Macbook Pro costs the same in every
| US city. If your salary adjusts exactly for CoL, you're actually
| doing better because of this.
| lstoll wrote:
| This is fine while you're employed, but what if you lose your
| position or decide to take a couple years off? Then it becomes
| a different equation.
|
| Spread out over time, in the places I lived outside of the US
| that was not really a concern. Same with most other "social
| care" situations. In the US, it all felt a lot more tenuous
| which was a source of constant low-key anxiety.
| bradleyjg wrote:
| COBRA coverage is very affordable for tech company ex-
| employees because their workforces skew young, male, and
| healthy. So that's another 18 months.
|
| It's certainly not perfect, and in my citizen hat I think
| it's quite flawed, by as experienced by most software
| engineers it is not a huge concern.
| dukeyukey wrote:
| My worries about US healthcare don't revolve around the cost or
| the quality, but more about the instability. If I know roughly
| how much I'll need to pay I can plan for it, even if it's quite
| a bit. But if I get into a crash in another state and taken to
| an out-of-network hospital without even being conscious, that
| can fuck up your finances straight away.
|
| What I'd like to know is how much NHS-level healthcare would
| cost me in the US. Given a monthly payment, I want 100% of
| everything covered all the time. No out-of-pocket, no out-of-
| network, everything with no exceptions. I'm happy with
| generics, a bit of a wait and a non-private room, but I want 0
| unexpected bills.
|
| Maybe companies like Kaiser do things like that?
| dcolkitt wrote:
| Zero out of pocket seems like a silly line in the sand. Why
| wouldn't you care about out-of-pocket max? The only reason I
| can see about a well-paid professional caring about $20 co-
| pays is because of a psychological aversion to being paid for
| healthcare.
|
| (Not saying this feeling is necessarily wrong. Humans may
| have evolved a feeling that their community should take care
| of the sick and injured. Demanding more for this act, I think
| makes a lot of people feel tawdry and icky, in a similar way
| to paying for sex. Still this is a psychological, not an
| economic argument.)
|
| Imagine, that you insisted on car insurance that covered
| every oil change and car wash starting at dollar zero. It'd
| probably be astronomically expensive.
| dukeyukey wrote:
| Ah, sorry for not being clear; if I moved to the US, I
| wouldn't look for a plan like this. I'm convinced a US
| developer salary/benefits would be more than enough for me.
| I'm more curious what an NHS level of healthcare would
| cost, so set the parameters based on my experience.
| danlugo92 wrote:
| Hes thinking not of 20$ out of pocket but more like the
| $20k horror stories we sometimes hear about.
| lhorie wrote:
| My beef w/ the US healthcare system is that doesn't even need
| to be an accident. My wife went to see a specialist for a
| checkup. At the front desk, they said she had to pay around
| $200. She's the type to decide whether to do things based on
| cost, so she asked: "That's all?" Them: "Yes."
|
| Six months later, I get a letter from a collections agency
| saying I owed $700. Confused, I call Kaiser to find out that
| not only was the $200 not the entire amount, they also
| apparently had no way of quoting accurately ahead of time
| (even though they knew exactly what she was coming in for),
| and as the icing on the cake, _they forgot to mail us the
| bill_ , which is how it ended up going to collections.
|
| I had to then press them to get an actual bill with itemized
| numbers, but it doesn't matter because the numbers make no
| sense anyways: none of the numbers match up to the amounts we
| paid, the insurance quoted price or the collections amounts.
| When pressed they all basically shrugged and said they don't
| understand how any of it works, and that's just how it is.
|
| And the reason for this whole ordeal? We changed health
| insurance plans and Kaiser said they couldn't renew a
| prescription because it was a 2-in-1 and insurance only
| covered the two drugs if they came in separate vials.
| cgriswald wrote:
| That wasn't the reason. I went to the ER with no insurance.
| While I was lying in a bed between visits from the doctor a
| woman came in and wanted payment for the ER. I asked in no
| uncertain language if it covered my ER visit and explained
| I knew the doctor would charge me separately. She said yes,
| so I paid.
|
| I went home. The doctor billed me. I paid. The X-ray tech
| billed me (a surprisingly small amount). I paid. The
| hospital never billed me. Then the collections calls
| started.
| nostromo wrote:
| > What I'd like to know is how much NHS-level healthcare
| would cost me in the US.
|
| If you're employed by a tech company, the out-of-pocket costs
| to you will be $0, and your standard of care will probably go
| up.
|
| Yes, you will occasionally have a $10 or $20 co-pay, but on a
| tech salary costs are negligible unless you're on a ton of
| meds.
|
| The problem with care in the US is how it's impacting the
| lower-middle class and the poor. The professional class
| generally have great care and don't pay much for it.
| kmonsen wrote:
| Not sure why parent is downvoted, as a European that has
| lived in Zurich, London and Oslo + NYC and SF healthcare
| cost is a non-issue for those of us lucky enough to work at
| a company that provides healthcare. This applied from what
| I understand to even the smallest startups.
|
| US healthcare sucks in general, but for the wealthy (and
| most of the people reading this site falls into this
| category) it is actually pretty good.
|
| Health care cost, or the predictability of it, is not an
| issue to not move to the US IMHO.
| capableweb wrote:
| > for the wealthy [...] it is actually pretty good.
|
| Yeah, I mean no shit. It's like that all over the world.
|
| What is really important is how healthcare is for the 99%
| rest of population, who needs help more than you who are
| wealthy. That's the problem.
| vmception wrote:
| [but not that much more expensive, you can just make a fuckton
| of money its as simple as that]
| capableweb wrote:
| > I feel Europeans looking in on the US from the outside
| consistently have a misleading view on healthcare
|
| Maybe. All I know is that if I get sick or any other health
| emergency, I go to the hospital, they patch me up and I go home
| or stay there until I'm better. I literally have to do nothing
| else.
|
| Even knowing what HSA or anything else is, is too much for 90%
| of the people, including me. Some of us view healthcare as
| something that should be there for everyone and with as little
| complications as possible, even if it is more expensive
| overall. When you're dealing with healthcare, you're most
| likely in a situation where you want to deal with as little as
| possible, so free public healthcare really help then.
| kmonsen wrote:
| So you are right on the general principle (at least I think
| so), that healthcare should just be available for everyone
| etc. That is not the case in the US.
|
| But as a software engineer in the US it is not a worry. Like
| not at all.
| pavlov wrote:
| A few messages below in this thread, someone writes:
|
| "San Francisco's only level 1 trauma center does not take
| private insurance, so if you are taken there, expect an
| absolutely massive bill despite how good your employer-
| provided health insurance is."
|
| Sounds like this would be a worry for anyone in the city,
| software engineer or not.
| capableweb wrote:
| > But as a software engineer in the US it is not a worry.
| Like not at all.
|
| Cool. What about the rest of you, the majority of people
| who are not in tech? I get the feeling that many Americans
| don't worry about services as long as they themselves are
| covered, while many go without.
| carlsborg wrote:
| How about if you're a seed stage startup?
| ghaff wrote:
| It's a cost you probably need to have or you're going to
| have trouble hiring people.
| deanclatworthy wrote:
| I think the key difference here is that you are ultimately at
| the behest of your insurance company. I don't like the idea of
| insurers making decisions over my health. I'd take the British
| NHS over US system any day as I know ultimately if I'm sick I
| can rely on it. You don't have a plan B in US - or am I
| mistaken?
| kmonsen wrote:
| You are mistaken, in the good plans all they do is serve as a
| middleman that pays most of the bills, and all the bills
| after a certain number.
|
| Having lived in London, NYC and SF and broken bones in all
| locations I can say if I could choose to have a big issue I
| would probably do it in SF but they all gave good treatment
| and I am thankful and think the healthcare is good enough in
| all places that I would not even take that into account when
| choosing where to live of those places.
| deanclatworthy wrote:
| I'm genuinely surprised you trust the intentions of an
| insurance company over a nationalised health system.
| Insurance companies are famous for weasling their way out
| of claims.
|
| Maybe you can elaborate a bit more on this.
| Xcelerate wrote:
| San Francisco's only level 1 trauma center does not take
| private insurance, so if you are taken there, expect an
| absolutely massive bill despite how good your employer-
| provided health insurance is.
| arebop wrote:
| You make it sound as if your healthcare cost is limited to 2%
| of your total comp. My credit cards/atm records show that I
| spent nothing on healthcare in 2020, as I am "young and
| healthy" and skipped my annual checkup because Covid. But my W2
| box 12 dd entry says that $19246 was paid on my behalf.
|
| Also when I go to coveredca.org I find that the maximum cost
| for healthcare this year if I were unemployed and 64 years old
| would be 76k.
|
| Sadly, each of these figures is substantially more than 2% of
| my total comp. Sure, my wages as a Bay Area FANG engineer are
| high compared to European counterparts at less prestigious
| employers, but the elevated costs of healthcare are still
| material to me and in fact it is by far the largest expense in
| my retirement budget (savings for retirement being by far the
| largest sink for my present income).
| jfim wrote:
| Keep in mind that the plan is tied to your employment, paid by
| your employer, and better than what many Americans do have as a
| healthcare plan.
|
| It's a good place to be if you're in the upper middle class and
| above, but people working in the service industry have worse
| healthcare outcomes in the US than in Europe.
| uoaei wrote:
| That is true as long as you are employed. Once you lose
| employer-provided healthcare or fall on hard times and your
| expenses mount with no income, things get a lot more tenuous.
| The folks perched at the top of the heap are not the ones who
| are the determinant factor in the quality of healthcare
| provisions in a country.
| sanxiyn wrote:
| > COVID helped a lot too, IMO. Companies realised full remote is
| an option and you can increase your talent pool to include the
| entire planet.
|
| I think this will be the most important legacy of COVID.
| blub wrote:
| That and long Covid.
| juskrey wrote:
| Entire planet talent pool but also all the noise
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