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How difficult is it for families to move from a country with universal healthcare to the United States?It is torture.When we moved, I remained with the same overseas employer who was opening a US subsidiary. Our first challenge was selecting a plan from among the various tiers with tradeoffs between monthly premium and out-of-pocket divided between co-pay and deductible… I ended up having to create a massive spreadsheet to run all the calculations. Then having to choose a provider among those who offered plans in our state, only to then be told by my employer’s benefits administrator that they had already chosen a provider. First, they had tried to get us a group plan, but the company was “too small” to qualify so we had to get an individual plan (note that these concepts have no meaning for my employer). Except that somewhere along the way the administrator hadn’t noted that the chosen provider was pulling out of the individual market at the end of that calendar year, so we had to go though this all again just a few months later!Second challenge: proving that we were legal residents of the US. Of course we had US passports, but upon returning from overseas we were living in a hotel while waiting to close on our house (another torturous battle, which I will save for the relevant thread). The insurance provider did not accept the hotel address as proof of residence, so we were without insurance for the first 2 months until we moved into the house. (No, insurance from our previous country was not valid in the US.)So finally we had insurance and could schedule doctor visits to renew prescriptions for our chronic conditions (we’re not young)… and sticker shock set in. Just the co-pays for the visits and our prescriptions were higher than the total amounts (95+% covered by insurance) in our previous country. But I guess that’s the premium we pay for the privilege of living in the US.Then my wife needed some minor surgery that we hadn’t had time to deal with before moving (knowing what lay in store for us, we had done just about everything else we could: eyes, teeth, and some other minor surgery before leaving the other country). So she tried to follow the process: visit to PCP, referral to specialist, (both of which cost major co-pays) request for MRI from specialist to verify the extent of the damage. But the insurance company rejected the MRI until “all other possible treatments had been exhausted”. So my wife had to undergo several months of useless PT sessions (paid of course out-of-pocket but considerably less costly than an MRI) and finally got her MRI. (Side note: when talking about “long wait times” in other countries, none of which we personally ever experienced, these imposed delays by US insurance companies don’t ever seem to be mentioned. Hmmm.) The surgery itself went off without a hitch; well, almost, given that someone else’s chart information got mixed in with my wife’s and a disaster was narrowly averted when she spotted it. But then the bills started coming in. 20 years overseas and we had not seen a single bill for any procedures (and we had more than our share due to bad genes and bad luck), so we weren’t prepared for it… Fortunately, we had enough set aside to cover the hospital bill (and we got a 10% discount for paying immediately!); we pity the half of all Americans who don’t have such a cushion and would have gone into debt for this amount. But many other parts of the billing were not so straightforward, and we were on the phone constantly for over a year between the various billing offices and our insurance provider until it all finally got straightened out. Note again that in 20 years overseas we had 1 single billing issue, and it was actually our fault for neglecting to attach the appropriate receipt for one of the rare items (eyeglasses) whose billing wasn’t handled electronically.And I’m even overlooking other surprising aspects, such as not finding a single facility in our entire county that’s in network for my wife’s annual mammogram, or not finding a single dentist in the entire county who accepted our dental coverage, or the eye doctor whose annual visits are covered but not any follow-ups. These may all be considered “normal” in the US, but please believe me they are not “normal” elsewhere.ETA I had even forgotten (or blocked out the memory of) having established a relationship with the pharmacy in our town only to learn after one year that it was no longer in network and having to go since to the next town. We're still waiting for the other shoe to drop.

The following are the various HR processes: Human resource planning (Recruitment, Selecting, Hiring, Training, Induction, Orientation, Evaluation, Promotion and Layoff). Employee remuneration and Benefits Administration