3 Shocking Differences Between Healthcare in America and Lithuana

Not a lot of people realize or know what countries across the ocean offer to their people in terms of healthcare. When a few months ago I went back home, to Lithuania, I was fascinated by some of the benefits people have access to.

However, don’t get too excited and remember, there are always two sides to a story.

Getting Sick

In America

At my work I accrue vacation time. I also get about two weeks of personal leave. When I get sick, I can stay home and use either my personal leave or vacation time. I have to admit that spending time in bed with a horrible headache and a congested nose is not how I imagine a great vacation. But I do that at least once a year. Upside: when I stay home sick, I get my usual paycheck. Downside: when I got sick in January, I had to use a pretty good chunk of my time. Now I am in a saving vacation time mode. A side note: if I get seriously ill, I would go on short-term disability that would not affect my vacation time or personal leave.

In Lithuania

My friend gets 28 days of vacation every year (compared to my 15 days) that are totally and beautifully unaffected by any sickness. If my friend gets sick, all she needs to do is to call a doctor and get a note, stating that she is sick and should stay at home. The first two days of sickness are fully paid by the employer. Starting from the third day of sickness, the government pays 40% of her salary. The employer’s portion is 60%. Upside: no vacation time is used! Downside: is there a downside? A side note: there is also a short-term and long-term disability insurance. It is somewhat similar to ours.

Health Insurance

In America

Beaker pays about 9% of his gross salary, and I pay about 4% of my gross salary for insurance premiums. Our deductible is $1,000. However, we don’t have to pay any co-payments when we visit a doctor’s office because both of us are double covered. Otherwise the co-pay is $25. All preventive care such as a physical exam once a year is fully covered by the insurance. We are not required to have insurance. If we think that we are invincible, we can choose to forgo our insurance and take our chances. Upside: our premiums are not really too high, and insurance provides pretty good coverage. Downside: I am not excited about our deductible. Not at all! A side note: You can always have a flexible spending account and save up for the deductible.

In Lithuania

Everyone pays 6% in insurance premiums of their gross salary. Health insurance is required, and it is government subsidized.

The Lithuanian government pays insurance premiums for children up to 18 years old, seniors, and the unemployed (those who are registered) and … get ready for something really awesome…full-time students. Private insurance is available to companies who want to additionally insure their employees.

My friend does not have to pay any co-pays when she visit’s a doctor. However, she has two choices: she can go to a state clinic and pay nothing. Or she can choose a private clinic and pay the difference in price. However, if she needs to fill a prescription, she will have to pay out of pocket.

Upside: insurance is not expensive. There are no co-pays and no cost if you choose to use a state clinic. There are no deductibles. Downside: if you want better care you will have to bribe (yes, bribery is still very common) a state clinic employee or go and pay a lot of money in a private clinic.

Pregnancy, Birth Control and Child Care

In America

My insurance partially covers birth control but does not cover abortions (unless medically necessary) or in vitro fertilization. However, to this day I never had to pay for my birth control because of the double coverage I have with Beaker.

Pregnancy medical expenses are covered about 80%.

If I’d ever have a baby, I would have to use all my vacation time and personal leave in order to be able to stay home with the baby. I would use the Family Medical Leave Act to make sure I still have a job when I return from maternity leave. I would be able to take up to 12 weeks off but mostly unpaid. Beaker could stay home and take care of our baby for another 12 weeks. Then what? Day care at an age of 24 weeks?! Upside: I honestly see none! Downside: all of the above.

In Lithuania

When a child is born, the government pays approximately $700 to parents. Pregnancy and any related medical expenses including labor is fully covered by the government.

My friend or her husband can take maternity leave for a duration of three years. Yes, I said it right – three years. If my friend chooses to stay home only one year, she will get paid 100% of her salary. If she chooses to stay two years, she will get paid 70% of her salary in the first year, 40% in the second year. She can work in the second year and make some additional income without losing any part of 40%. Upside: I was speechless when I heard all of this. Downside: I don’t see any.


19 thoughts on “3 Shocking Differences Between Healthcare in America and Lithuana”

  1. Interesting – I think it also depends on the employer. For instance I live in Canada so universal healthcare (woot) but, sick time is dependent on the employer. My employer gives about 125 sick days per year, plus short term and long term disability, special leave, parental leave, mat leave (they top up what the government doesn’t pay for 9 months) and pat leave.

  2. I get 10 sick days per year, no doctor’s note required (plus 3 weeks vacation time and a various amount of lieu time I bank for overtime, etc). I also have disability insurance.

    As the other poster said, here in Canada everything major is covered. My employer benefits go a step further and take care of my dental, vision, prescriptions and “other” health costs (ie. massages and yoga). Additionally there’s a medical clinic on the university campus that I have access to as staff, so I don’t have to suffer some of those horrible wait times that Canadian medicentres are notorious for.

    For maternity leave if I had a child, I would get 1 year of maternity leave at my full salary (the government gives a certain percentage of that to a maximum, and then my employer tops up the difference).

    I appreciate the Canadian healthcare system, but I know I’m lucky because I have additional employer coverage. I don’t think it could actually get better than it is =\ I feel like I can’t live or work anywhere else because I’ve been so spoiled now. A $1000 deductible is crazy!

    1. Interesting… apparently if I ever decide to have a child I will need to move to Canada. You guys have great benefits there!

  3. It depends on your employer here. I don’t have sick days and I just have to call in if I’m sick. It doesn’t affect my vacation time.
    I think healthcare is better if you are poor in Thailand/Lithuania. If you’re poor and have some long term health issue here, you are pretty much screwed. In Thailand, you can at least see a doctor and get healthcare similar to Lithuania.

    1. Oh I agree. Don’t be poor in the US. Or if you are poor, please don’t get sick.
      Nice perk Joe – get sick and just call in? I wish we could have the same at my job.

  4. Here I have PTO which covers any reason I may not show up at work (sick time, doctor’s visit, hungover, vacation, mental health days, etc…). While sucky that it’s all lumped together, this is still better than my last job that allwed 3 sick days/year. I’m seriously liking this Lithuanian health care situation, except that part where I have to bribe the doctors for better care. That part doesn’t sound so good. I remember the days of the HDHP. Unfortunately for me the only time I got really sick was when I had it. Those medical bills are atrocious. I hit that deductible super fast, then I hit the out of pocket maximum. That was painful.

  5. If you have to be employed to afford healthcare, something is really screwed up with the system. Sorry no fan of the healthcare system here.

  6. I thought that the downsides for many of the “Over There” categories was “higher taxes”. But it turns out that Lithuania has a 15% income tax rate for all people so clearly that’s not the case!

    My next guess is then “lower salary.” I think if I did the same job over there, i’d have to get paid less since I get so much vacation and benefits.

    Either way, thanks for sharing! I had no idea what it was like “across the pond”

    1. Getting paid over there is a whole different story. That will require a new and long post. 🙂 I can say that I think what I am doing here, in the US, I would not be doing over there. I think it does not exist yet. 🙂 I leave it at that.

  7. Daisy – 125 sick days a year?!? That’s insane!

    We get 12 sick days with no doctors note required. If we’re off for longer than a week we need a doctor’s note, and it turns into short-term disability (100% pay for up to 16 weeks). If we’re off longer than 16 weeks it changes to long-term disability at 80% pay… for up to three years.

    However, we pay 4% of our salary towards LTD premiums… why? because so many people abuse it! I work in an organization that’s fairly small, and of all the people that go off on LTD – pretty much all of them max out the full 3 years! I think it’s ridiculous. That’s exactly the reason why our premiums are so high…

    1. I can;t believe how abusive some people are to the benefits. We have some employees like this, so I can relate. People like this make me really angry.

  8. Healthcare in the US is completely unbelievable. Here in Thailand they have very few public assistance programs, but they do have healthcare. Any citizen can get healthcare at the government hospitals for just $1 per visit.

  9. Kari@Small Budget Big Dreams

    I have an employee who has been very ill over the past year (hospitalizations and procedures, not just calling in here and there). I’ve been told if she uses all of her sick time and has to start taking unpaid sick leave we’ll have to “enter the disciplinary process”. I couldn’t believe it. Not only has she been sick, but now HR’s going to get involved to help her make a plan on how to better use her sick time (or likely encourage her to quit because she’s a liability to the company when using so much time and resources). Sad! Healthcare, and employers management of employee’s healthcare in this country is terrible sometimes.

  10. I dont mean to be a hater, but the Lithuania model is unsustainable. All these payments and healthcare come from somewhere, it is not free. It has to come from their tax payers. The Lithuania government has run budget deficits every single year with the public debt increasing the same. Quick google searches and I can already see articles about new taxes, increasing taxes on some people and cutting benefits to others.

    I used to enjoy sick days as well, but in reality getting sick is part of life and you should have your own emergency fund of some sort to take care of it, same with having a baby (although I do agree with the law that requires your job to be there when you come back) making employers cover your salary for up to year hurts the business as they also have to hire some one now to do your work load. This just increases costs which is passed on in the product or service they provide, making life for everyone more expensive.

    just my thoughts

  11. This is REALLY interesting – I love your specific examples. When I had my first child I (well, we – my daughter too) was double covered – I paid zero for the whole thing. When I had my son, neither of us was double covered and we paid $3500 out of pocket. It pays to double cover yourself if you KNOW you’ll be using the policy!

Comments are closed.