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How does your healthcare actually work?

So I'm Scottish and my company is multinational, so I work with a number of people from North America and specifically from the U.S. Occasionally the topic of healthcare comes up (some of them live over here, some other places in Europe, some are still stateside), and to be perfectly honest, I sometimes feel nervous to ask for even the most basic (potentially traumatising) clarifications of my U.S. colleagues and friends when they tell me the latest thing they've been through. It just does not come intuitively to me. For instance, I cannot wrap my head around co-pays – they pay for insurance every month, that's the thing that comes out of their paycheque in the same way our taxes come out of ours, that's the equivalency I've seen drawn by people defending private healthcare (and usually disparaging ours in turn by highlighting our mind-blowing tax rates or whatever). Surely…


So I'm Scottish and my company is multinational, so I work with a number of people from North America and specifically from the U.S.

Occasionally the topic of healthcare comes up (some of them live over here, some other places in Europe, some are still stateside), and to be perfectly honest, I sometimes feel nervous to ask for even the most basic (potentially traumatising) clarifications of my U.S. colleagues and friends when they tell me the latest thing they've been through. It just does not come intuitively to me. For instance, I cannot wrap my head around co-pays – they pay for insurance every month, that's the thing that comes out of their paycheque in the same way our taxes come out of ours, that's the equivalency I've seen drawn by people defending private healthcare (and usually disparaging ours in turn by highlighting our mind-blowing tax rates or whatever). Surely that's them sorted? Why do they STILL need to pay sometimes when they pay insurance so that they're covered if something happens to them??

How exactly does 'sick pay' work? One American I've been working with on a lengthy project has been unwell recently and she was telling me she was 'running out' of sick days so I have to presume her contract is very different from mine, I don't know how they can limit the number of days you don't work while unwell since you can't exactly control being unwell? I mean I'm pretty sure there's a limit as to how long they'll keep you employed here too if you end up with a long-term illness that renders you unable to ever do the job you signed up to do, but I think that becomes a drawn-out arrangement with medical assessments and so on. I think there's also a certain amount of days over which a doctor has to give an official assessment of how long you'll be unfit to work so your managers can juggle things appropriately.

Also how can hospitals enforce a charge for skin-to-skin contact after the birth of a baby? What do they do, refuse to hand the baby over?? That's a swift backhand from any mother I've ever known.

I've obviously googled a few of these questions I have before but the answers are all so varied, I also don't know what applies on a local -> state -> federal level which I guess means it can be different for everyone. What is your personal situation and am I stupid for not understanding the basics/risking annoying my U.S. colleagues by asking things like this?

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