So, for example, if a young person from the US or elsewhere comes to Germany to study they will get health care basically for free.
I think (and I might be wrong) if you move to Germany as retiree the public health care system would not be open to you. You could choose a private insurance but, very much like in the US, the premiums depend on age and existing preconditions. I cannot tell if this would be cheaper than in the US, but I doubt that it could be much cheaper. Also, I think it would be similar in most other EU countries.
Of course you could move to a country with significantly lower living standards to save on medical cost, but then you would increase your likelihood of medical issues and not really gain any real advantage.
That's simply not true: per capita spending on healthcare (regardless of how that spending happens) is dramatically higher in the U.S. than anywhere else on the planet. For example, Germany spends 60% Per Capita compared to the U.S. https://www.pgpf.org/chart-archive/0006_health-care-oecd Spain spends just over 30% compared to the U.S.
And I've paid for/received healthcare in Portugal, Thailand, Nepal, and England. It's more cost effective (I started to say cheaper and better, but "better" is a loaded word) pretty much everywhere else.
When you say cheaper do you mean (private) health insurance or directly paying for medical services, or both?
Thailand: paid out of pocket, no insurance. A trip to the ER for digestive issues took under an hour and the visit plus antibiotics cost under $200. This was at Bumrungrad, one of the best hospitals in Thailand.
I'll double-check, but I'm pretty confident my wife's care in the UK was under the NHS. Nepal was also her, I think it was out of pocket, but I'll check.
Nepal: she had some form of insurance. She doesn't know how much it cost, but presumably not much (she was volunteering for a non-profit) and her out-of-pocket costs were zero for a multi-day stay at a hospital.
UK: she doesn't remember having insurance, but thinks she must have (she was a student at the time). She used the NHS, again with no out-of-pocket expenses.
The most advanced MRI in Bulgaria costs without insurance cost a fraction of the copay in the States.
Same for labs. I recently got a comprehensive labs including advanced lipid profile (with lipoprotein(A) and ApoB, cholesterol fractions, etc.) for less than $20 out of pocket with no insurance. Same with my wife's thyroid test - full picture, not just TSH for less than $15. All self-ordered by the way! No need for intermediary companies to authorize it - you just go directly to a lab, which keeps the costs low as there's fierce competition for your business unlike in America where Labcorp and Quest keep the prices ultrahigh!
An quantified American (by Abbott) COVID-19 IgM + IgG antibody test in Bulgaria was less than $20 - here a yes/no test starts at $75.
Again, I'm talking about paying pure cost plus hefty private companies' margins here - no subsidy, no insurance, all up-to-date technology and materials.
The margins in America are unimaginable for any humane organization anywhere in the world. Healthcare should never be a business!
For most people health care is expensive no matter where they are.
[0]: https://www.berlin-chemie.de/en-us/about-us/our-history
> Healthcare should never be a business!
... seems to me like Healthcare should actually be a normal business. Instead of whatever it is in the US - which as you explain, really makes no sense.
For example, Walmart sells a month supply of levothyroxine for $4 if you don't get your PBM involved.
[0]: https://www.washingtonpost.com/business/2023/04/04/big-pharm...
* Germany has an Obamacare-like system: Insurance is private, but mandatory.
* You can choose and change your insurance provider freely, and they cannot reject you
So if that is true, health insurance companies have the risk of older residents joining, whether or not the previously resided in Germany, and it's not like they benefited from their contributions before.
So how exactly would this exclusion work? Is insurance not mandatory for immigrants after a certain age? Do insurance companies have a right to reject them?
I was not able to find a direct discussion of the question, but this page discussing the health problems of older immigrants (including "access to the health care system") does not mention the possibility that they would be excluded from the health care system altogether: https://heimatkunde.boell.de/de/2013/11/18/ältere-migrantinn...
One of those things is not like the others.
