Discussion for early retirees ....

[brandrea]

Originally Posted by joeychitwood

I retired seven years ago at 56. I have the least expensive Blue Cross health insurance policy available in Minnesota. Costs me $24,000 a year, and basically covers nothing, even though I and my spouse are incredibly healthy. Out of pocket expenses have to exceed $37,000 a year for it to kick in. Our health care system is a disaster.

I’m dumbfounded by this. I knew healthcare was expensive in the US, but that’s seems unattainable even to the wealthy 1%

My wife and I are “well off” (at least by our measure) and there’s no way we could afford this ontop of our retirement spending.

[Art 1]

Originally Posted by Rolex addict

That is crazy. How many people are you covering under that plan? The "worse" bronze plan I was offered from BCBS SC was $12K max out of pocket with monthly premiums around $125.

I was paying $800 something a month in Florida for a $7000 out of pocket plan. Now I use a Canadian travel plan for $250 A YEAR with no out of pocket or detectable for when I’m in the US. I only have to step foot in Canada every 30 days, that’s easy as I’m there often. In Canada I’m covered under the Ontario plan. Pay nothing. Americans are getting hugely ripped off. We give so much away supporting and protecting other countries that have free medical the whole time the USA citizens are paying out the nose.

[Art 1]

Originally Posted by brandrea

I’m dumbfounded by this. I knew healthcare was expensive in the US, but that’s seems unattainable even to the wealthy 1%

My wife and I are “well off” (at least by our measure) and there’s no way we could afford this ontop of our retirement spending.

Things are different here Brian. I paid some years up to $30,000 for my children to attend private schools in Orlando as the public school system is inadequate.

[brandrea]

Originally Posted by Art 1

Things are different here Brian. I paid some years up to $30,000 for my children to attend private schools in Orlando as the public school system is inadequate.

Private schools I can get my head around ... they are equally expensive here in Canada but those health insurance numbers boggle my mind.

[Art 1]

Originally Posted by brandrea

Private schools I can get my head around ... they are equally expensive here in Canada but those health insurance numbers boggle my mind.

You know how often I’m in Canada and it’s easy to see the people don’t live with the burden of health care like Americans do. In fact I’m asked often about healthcare in the US and the average Canadian cannot really understand it all.

[DCheeta]

I’m 44 and planning a semi-retirement in the coming years. I’m definitely leaving the US, partially for the reasons being discussed above and partially for other reasons, but mostly because the world is a huge diverse place and it would be a shame to spend one’s entire life in one country.

Regarding retirement activities, I have so many interests and hobbies that I’ll have absolutely no problem filling my time. First order of business: private pilot license.

[austinp]

Originally Posted by tyler1980

cost vs clinical outcome is all wrong. US has a much higher infant mortality rate than the UK... by a lot to name one example

comparing apples to apples a birth in the UK (private with insurance) costs astronomically less than in the US with insurance. So you pay less and the outcomes are better.

why does an epi pen cost $500 in the US and $12 in the UK? same product... if you dont use an NHS prescription its still only $63

Im using my own life experience. The care myself, wife and children get is exceptional. My daughter has a rare disease that requires lots of care. The support groups I'm in have members all over the world. The stories i hear from them are aweful. The UK included.

[Art 1]

Originally Posted by austinp

Im using my own life experience. The care myself, wife and children get is exceptional. My daughter has a rare disease that requires lots of care. The support groups I'm in have members all over the world. The stories i hear from them are aweful. The UK included.

But see that’s the problem. I’m sorry about your daughter. I’ve never had to go through that. I just can’t imagine. Myself am 58 and have been to the doctor maybe 3 times in 30 years. I feel like I’m paying for others. With a bad illness I would have been happy to pay over $800 per month.

[tyler1980]

Originally Posted by austinp

Im using my own life experience. The care myself, wife and children get is exceptional. My daughter has a rare disease that requires lots of care. The support groups I'm in have members all over the world. The stories i hear from them are aweful. The UK included.

i worked in US healthcare before moving here. 3 kids born in the UK. 1 NHS and 2 private. IMO there is no comparison. We specifically stayed here until we were done having kids.


US is the best place to go for rare/expensive treatments that you can't get anywhere else... for sure that is true. For regular healthcare affecting 99% of people is where they struggle. So it also depends on how you define better or best. If i had some super rare condition i would get treatment in america too. However paying for it is an option not available to everyone but if you can pay for it its a great option

[austinp]

Originally Posted by Art 1

But see that’s the problem. I’m sorry about your daughter. I’ve never had to go through that. I just can’t imagine. Myself am 58 and have been to the doctor maybe 3 times in 30 years. I feel like I’m paying for others. With a bad illness I would have been happy to pay over $800 per month.

I guess im focusing more on the care than the cost. I pay quite a lot for the insurance. There are many in the US that dont pay at all. Thats one reason for the higher cost.

[austinp]

Health Insurance is obviously a very complex issue. It will be interesting to see how it changes in the years to come.

[tyler1980]

Originally Posted by austinp

I guess im focusing more on the care than the cost. I pay quite a lot for the insurance. There are many in the US that dont pay at all. Thats one reason for the higher cost.

im sorry for your situation too.

Costs are out of control i agree and its a lot of factors. Freeloaders are an easy scapegoat. However think of drug prices as many of those cost six figures a year and someone pays that (insurance or copays). Then you have medicare not being allowed by law to negotiate lower drug prices and they are just about the biggest drug buyer on the planet. Makes little sense

If they are buying the most drugs its logical to say they should have some power to get bulk discounts or to lower prices but their hands are tied... on purpose.

Then you have the inflated diagnostics. I had kidney stones once and because i had insurance they cave me a CT scan at 20X the price even though an ultra sound would have confirmed them too.

MY father in law had a pacemaker put in on medicare's dime because the doctor said he needed it. He came to the UK to visit us and it was infected, and they removed it. 3 heart doctors here confirmed he never even needed it in the first place. A US doctor upon his return confirmed it too. He almost died because of the infection. Pretty upsetting for a clinical complication for a procedure he didn't even need. Couldn't sue the Dr because of "tort reform" so the dr can keep doing it over and over again and no one can do a thing about it as a civil judgment that costs money them is the only language they understand but you can't even hold them accountable in that way.

[austinp]

Originally Posted by tyler1980

im sorry for your situation too.

Costs are out of control i agree and its a lot of factors. Freeloaders are an easy scapegoat. However think of drug prices as many of those cost six figures a year and someone pays that (insurance or copays). Then you have medicare not being allowed by law to negotiate lower drug prices and they are just about the biggest drug buyer on the planet. Makes little sense

If they are buying the most drugs its logical to say they should have some power to get bulk discounts or to lower prices but their hands are tied... on purpose.

Then you have the inflated diagnostics. I had kidney stones once and because i had insurance they cave me a CT scan at 20X the price even though an ultra sound would have confirmed them too.

Agree. I dont understand why the drug prices are different. Health Insurance is certainly a system that needs lots of improvements. The care from the docs is pretty great though.

[joeychitwood]

Originally Posted by austinp

Im using my own life experience. The care myself, wife and children get is exceptional. My daughter has a rare disease that requires lots of care. The support groups I'm in have members all over the world. The stories i hear from them are aweful. The UK included.

I'm glad your daughter and family are getting great care. I was an Emergency Physician in the US for 26 years. While I saw many individuals getting good care, the numbers show that as far as the health of the public goes, the US spends more money per person than any other country on the planet, but the US population ranks 26th in the world in overall health.

[Abdullah71601]

Originally Posted by austinp

Agree. I dont understand why the drug prices are different. Health Insurance is certainly a system that needs lots of improvements. The care from the docs is pretty great though.

I pay about $8,000 a year for BC/BS through work, with a $5,000 deductible, and generic only prescription drug coverage. I didn't choose these options, it's one size fits all.

So, I have a condition that millions of men my age have, and my GP prescribed a popular drug that doesn't have a generic alternative yet. Not covered by insurance. Out of pocket cost $370 per month (plus tax). The missus visited India, where the exact same drug at my dosage sells for $2.50 per month at the corner pharmacy.

My GP said that the way the ACA set drug prices encouraged drug companies to radically raise prices to lock in profitability for an extended period of time. Insurance companies negotiate lower prices, but if your carrier doesn't cover the drug, you get hosed with the full 15,000% markup.

And FWIW, the quality and timeliness of care I got in the UAE was far better than the US, for a fraction of the cost. No waiting weeks to see a doctor, then more weeks to get a test, then more weeks to see the doctor again, ...

[goin camping]

Originally Posted by austinp

Health Insurance is obviously a very complex issue. It will be interesting to see how it changes in the years to come.

Change may be a double edged sword. The last national health plan was horrible.

I am retired in at age 57 and I don't pay for healthcare. Which is nice as I need a $14,500 a month prescription.

My two main former employers pay for my healthcare as a condition of employment. I get %92 from the Courts and %100 from the Labor Union job.

I applied for and accepted both jobs as they had defined retirement and medical provisions.

Thank you Mom for smacking me upside my hollow 20 year old head and wising me up on the importance of retirement pay and medical.

[timedate]

so what if people genuinely dont earn enough, yet they work everyday and pay their dues and are decent members of society,

do they just not have any access to healthcare?

[tyler1980]

Originally Posted by timedate

so what if people genuinely dont earn enough, yet they work everyday and pay their dues and are decent members of society,

do they just not have any access to healthcare?

or retired. I know that if my grandma didn't have significant savings medicare alone wouldn't cut it. then when you factor in the average person has less than $1000 in emergency savings then i question if people can afford it.

Point being preventative (cheaper) healthcare gets avoided and then you only go in when something is really really wrong and that costs way more. I know certain annual checks are covered 100% but im talking about when you are "sick" but not deathly ill. In that case a lot of people wait too long because they are afraid of the cost.

Regardless of preference in a HC system the point is that in a nationalized HC there is incentive to keep you well because it costs less and keeping costs down is a strong motivator. In a profit based system there is less incentive for you to be well because you make more money with sick people. Both the insurance company and the hospital. You dont make money if the number of patients seeking expensive treatment goes down.

[tyler1980]

Originally Posted by Abdullah71601

And FWIW, the quality and timeliness of care I got in the UAE was far better than the US, for a fraction of the cost. No waiting weeks to see a doctor, then more weeks to get a test, then more weeks to see the doctor again, ...

that is always my biggest issue and i agree 100%. You should get the best HC in the world in the US because you pay so much for it. Its the biggest disconnect in the entire debate. Cost vs outcomes.

I would have less issue if you could actually see the benefit of the excess cost.

Having small kids we see the dr a lot. I have never waited more than a day to get them in. Almost all the time its a same day appointment in the UK. When we visit the US access is much harder and we have the best in in in insurance available. You still wait. I have never personally witnessed these "long UK waits" and in every comparable situation i have had to wait longer in the US to see a dr

Plus, after my kids were born in the UK guess what... the nurses come to your house you dont have to take a newborn in to get those first few checkups. Pretty nice if you ask me. Then you have the Health Visitor (kind of like a medical social worker) who checks up to make sure everyone is doing OK. Mother isn't struggling and the baby is doing well. They come to your house too so its very pro active.

[CamSLC]

Originally Posted by timedate

so what if people genuinely dont earn enough, yet they work everyday and pay their dues and are decent members of society,

do they just not have any access to healthcare?

A lot of working people here get subsidized insurance through their employer, at the employers discretion. It may still cost them ~$80 a month. Then work until 65 and get medicare. Retiring before that age, or being self employed means you have to pay for it out of pocket.

I'm a healthy 33 year old who never goes to the doctor. I'm self employed and pay $250 per month for essentially "catastrophe" insurance. Highest deductible that was offered ($7,900). So my max out of pocket is $10,900 per calendar year if something were to happen to me. We also can use something called a Health Savings Account and put money in annually pre-tax for medical/dental care, to save up to our deductibles or more.

It's overly complicated and most people can't wrap their heads around it, and as you asked, people who genuinely don't earn enough end up in the category of completely screwed... The numbers are refuted online, but consistently several hundred thousand bankruptcies a year can be attributed to medical debt.

[tyler1980]

Originally Posted by CamSLC

A lot of working people here get subsidized insurance through their employer, may still cost them ~$80 a month. Then work until 65 and get medicare. Retiring before that age, or being self employed means you have to pay for it out of pocket.

I'm a healthy 33 year old who never goes to the doctor. I'm self employed and pay $250 per month for essentially "catastrophe" insurance. Highest deductible that was offered ($7,900). So my max out of pocket is $10,900 per calendar year if something were to happen to me. We also can use something called a Health Savings Account and put money in annually pre-tax for medical/dental care, to save up to our deductibles or more.

It's overly complicated and most people can't wrap their heads around it, and as you asked, people who genuinely don't earn enough end up in the category of completely screwed... The numbers are refuted online, but consistently several hundred thousand bankruptcies a year can be attributed to medical debt.

my best friend has insurance and is a personal trainer so being healthy is essential. Anyway he had to have surgery on his neck... something with his vertebrae. In any case it was all approved by insurance and he waited to get approval even though it was kind of an emergency. All went well so he thought. One year later he got a $30k bill from the anesthesiologist and insurance denied it because he was "out of network". The surgeon, nurses, hospital were all in network so how was he supposed to know that? In any case its a pretty crappy bill to get a year after the fact and yes he has to pay it. The bill had been bouncing back and forth between the Dr and the insurance company the entire time and he had no idea.

what percentage of the US population has $30k sitting around to cover stuff like that? hardly anyone statistically

that is in addition to also paying the maximum out of pocket/decuctables

[timedate]

what a shocking thing for people who did everything right, but just dident earn enough.

[austinp]

I have never had to wait for an unscheduled emergency Dr appointment. We walk in and get seen. If we get a cold or something minor we head to the minute clinic at Walgreens. Its very convenient. The regular visits for the family Dr. we make appointments for. Both my kids births were 100% covered by insurance with excellent pre and post care. My personal situation doesn't seem to match the picture many people paint.

[brandrea]

Originally Posted by Abdullah71601

I pay about $8,000 a year for BC/BS through work, with a $5,000 deductible, and generic only prescription drug coverage. I didn't choose these options, it's one size fits all.

So, I have a condition that millions of men my age have, and my GP prescribed a popular drug that doesn't have a generic alternative yet. Not covered by insurance. Out of pocket cost $370 per month (plus tax). Thne missus visited India, where the exact same drug at my dosage sells for $2.50 per month at the corner pharmacy.

My GP said that the way the ACA set drug prices encouraged drug companies to radically raise prices to lock in profitability for an extended period of time. Insurance companies negotiate lower prices, but if your carrier doesn't cover the drug, you get hosed with the full 15,000% markup.

And FWIW, the quality and timeliness of care I got in the UAE was far better than the US, for a fraction of the cost. No waiting weeks to see a doctor, then more weeks to get a test, then more weeks to see the doctor again, ...

Dumbfounded twice in one thread

Seriously, those drugs prices are insane.

[tyler1980]

Originally Posted by austinp

I have never had to wait for an unscheduled emergency Dr appointment. We walk in and get seen. If we get a cold or something minor we head to the minute clinic at Walgreens. Its very convenient. The regular visits for the family Dr. we make appointments for. Both my kids births were 100% covered by insurance with excellent pre and post care. My personal situation doesn't seem to match the picture many people paint.

experiences vary. My point is mainly that considering how much you pay for that service it should be better. Its like paying Rolex money and getting Casio quality.

Its undeniable that cost of care is astronomically higher than everywhere else and you dont get a lot to show for that extra expense.

Costs may be masked in insurance premiums, employer contributions, insurance payments, co pays, deductibles, etc but adding it all up for a total cost its way way too high for what you get. At the hospital where i worked, the business office was the largest department in the hospital by far. Dealing with insurance, billing, payments, collections is a massive amount of resources.

[Gaijin]

Originally Posted by tyler1980

experiences vary. My point is mainly that considering how much you pay for that service it should be better. Its like paying Rolex money and getting Casio quality.

Its undeniable that cost of care is astronomically higher than everywhere else and you dont get a lot to show for that extra expense.

Costs may be masked in insurance premiums, employer contributions, insurance payments, co pays, deductibles, etc but adding it all up for a total cost its way way too high for what you get. At the hospital where i worked, the business office was the largest department in the hospital by far. Dealing with insurance, billing, payments, collections is a massive amount of resources.

I literally swiped my visa card on the way out of the hospital last week in Japan. No middlemen. No insurance companies. No wasted red tape.

18 days. Private room. 3 hots a day and the actual surgery. Total knee replacement. Blood transfusion needed from the drain in my knee.


My total out of pocket expenses? $ 2617.16. Imagine what that would have cost me back home. Under insured or unable to afford insurance? 50 grand? More?

My monthly premiums for national healthcare are less that $200 a month for full medical and dental.

My rehab sessions are about $5 a pop.

[austinp]

Evidently, experiences do indeed very.

[crazymcmichael]

I Am retired and 28 years old.. I certainly miss some normal things to do

[timedate]

a knee or hip is about 8k private in the uk if you dont want to wait on the nhs,

you dont get 18 days in a room, they throw you out in 48 hrs.

[Fat_ninja]

Originally Posted by Art 1

You know how often I’m in Canada and it’s easy to see the people don’t live with the burden of health care like Americans do. In fact I’m asked often about healthcare in the US and the average Canadian cannot really understand it all.

Hey Art 1, really curious how to access the Canadian healthcare. Do you have to be Canadian? Or is there a loop hole