I don't think non-Americans appreciate the complexity here.
To anyone unfamiliar with our health care system for typical employees:
Once a year, most companies have a "benefits training" session that explains this year's crazy health care situation. They're boring and I only go to the first one when I join a company.
Anyone employed with benefits needs to have at least a vague understanding of everything in there or they're at financial risk.
So when you hear about contractors fighting to become employees so they have access to benefits, they're fighting for the opportunity to make these benefits elections.
I know plenty of people who design systems for a living that find getting their elections right to be confusing.
You'll notice that a big part of our health care cost mitigation is projecting expenses. It's like a prediction market where you can only lose less, but if you get it wrong you can lose a lot.
- you have mandatory health insurance which is a percentage of your income
- you have an extra insurance (called mutuelle) which you may not have if you are not salaried (but that you get anyway), or it may be compulsory if you are salaried.
Doctors can be in one of the two groups: 1 or 2. 1 means that your costs are fixed and regulated by law. This is for instance 25€ for a general/family doctor visit. n% of this is reimbursed by the compulsory insurance, and the other one reimburses the rest. n depends on the medical act - for instance for the visit to the MD n=70.
The group 2 fixes their prices as they wish. This is usually for specialists (but not always, there are plenty of specialists that are in the group 1)
The extra insurance covers up to M times the regular cost. M depends on the act and on the insurance.
Generally speaking - the more serious the act, the more you are reimbursed. A heart operation will be free no matter what, but something simple may cost a lot (more that the extra coverage). It is very rare, though, to go over that extra coverage.
Dental is not covered very well - it is OK for small things but implants fo instance are notoriously expensibve (you may pay, say, 1000€ out of 6000€). So is optical (you can always get glasses for free but they will not be the best ones).
To anyone unfamiliar with our health care system for typical employees:
Once a year, most companies have a "benefits training" session that explains this year's crazy health care situation. They're boring and I only go to the first one when I join a company.
But it's 2022 and we have youtube, so I found Ohio State's training in public: https://www.youtube.com/watch?v=VjAWj0f6DAc
Anyone employed with benefits needs to have at least a vague understanding of everything in there or they're at financial risk.
So when you hear about contractors fighting to become employees so they have access to benefits, they're fighting for the opportunity to make these benefits elections.
I know plenty of people who design systems for a living that find getting their elections right to be confusing.
You'll notice that a big part of our health care cost mitigation is projecting expenses. It's like a prediction market where you can only lose less, but if you get it wrong you can lose a lot.
Fun!