Author Topic: Is anyone else freaked out about health care right now?  (Read 12185 times)

DreamFIRE

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Re: Is anyone else freaked out about health care right now?
« Reply #50 on: July 02, 2018, 06:01:36 PM »
If you can live lean enough, you qualify for medicaid. I don't see that program going away soon.

The Medicaid expansion that allowed people under certain income thresholds to become eligible is part of the ACA, which is being threatened.  Also, some states didn't expand Medicaid.
The beauty of living in a large federated Republic with 300+ million people is that you have options. Seventeen states' legislatures determined that they didn't want to provide coverage to their poorest citizens, but 33 others did. States compete on earning other states' citizens business all the time, it's a feature not a bug.

If you live in a place that is constantly enacting legislation you disagree with, you should strongly consider moving.

That's true, but the poster  I responded to didn't think the Medicaid option would go away, but it's just part of the ACA, so it's just as much under threat as the ACA marketplace and subsidies.  If that were to happen and what might happen in specific states as a result is another matter.

jim555

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Re: Is anyone else freaked out about health care right now?
« Reply #51 on: July 02, 2018, 06:19:46 PM »
That's true, but the poster  I responded to didn't think the Medicaid option would go away, but it's just part of the ACA, so it's just as much under threat as the ACA marketplace and subsidies.  If that were to happen and what might happen in specific states as a result is another matter.
The Feds pay 90% for the expansion group.  So if it goes away Federally it goes away for everyone.

Paul der Krake

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Re: Is anyone else freaked out about health care right now?
« Reply #52 on: July 02, 2018, 09:02:42 PM »
Lots of things states can do even if some federal funding disappears. Massachusetts had RomneyCare. Hawaii has had an employer mandate for 4 decades. Right now there are dozens of very smart bean counters and attorneys working for various state legislature committees, looking for solutions. And if all else fails, move to another country.

So relax everyone, you're going to be fine. You have money. Money buys flexibility, and politicians' hears. It's the working stiffs who have neither who should freak out.

EscapeVelocity2020

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Re: Is anyone else freaked out about health care right now?
« Reply #53 on: July 02, 2018, 10:40:46 PM »
There are good options in the world, just not in the US.  I'll probably get catastrophic coverage domestically and be willing to rely on things like MediClinics for minor ailments.  There are plenty of Emergency Care clinics, but that's the grey area.  If you can leverage medical tourism at that point, then maybe living in the US will still work for ER's.  I'm jealous of countries with universal health and affordable private care.

pecunia

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Re: Is anyone else freaked out about health care right now?
« Reply #54 on: July 03, 2018, 10:50:12 AM »
Escape Velocity @ 2020:
Quote
I'm jealous of countries with universal health and affordable private care.

It may alleviate some frustration to simply write an old fashioned letter to your representatives.  The more they know people are watching what they do in this area, the more they will succumb to people's wants / needs.  Right now they succumb to our corporation's wants / needs.  Supreme Court says they are people too.

LiveLean

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Re: Is anyone else freaked out about health care right now?
« Reply #55 on: July 05, 2018, 08:58:04 AM »
DW went back to work in 2010 because we saw the ObamaCare storm clouds on the horizon. Having paid escalating self-employed health insurance costs from 2004-2010 -- and until 2012 when she became a full-time teacher -- I shudder to think what we'd be paying now.

It's a shame since my self-employed income is significant. But having had pre-ObamaCare insurance and dealing with those large deductibles and always trying to figure out what's covered and what's not, I didn't want to cringe every time one of our sons broke a bone or needed treatment. Even DW's school-provided health plan, historically very good, has huge deductibles and annoying wrinkles -- kids over 10 here in Florida, for instance, no longer can go to a pediatric dentist.

I have friends sleepwalking through government desk jobs  where they do little to nothing in part because they can keep their healthcare when they retire, paying modest premiums. But those of us who are self-employed, not relying on the government for anything, get pounded not only with self-employed income taxes but also health insurance.

TheWifeHalf

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Re: Is anyone else freaked out about health care right now?
« Reply #56 on: July 05, 2018, 09:49:10 AM »
With Global warming Canada might not be too bad.  Good beer and fishing, eh?

And a Tim Horton's on every corner!!!!

EnjoyIt

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Re: Is anyone else freaked out about health care right now?
« Reply #57 on: July 05, 2018, 10:24:10 AM »
I am not freaked out.  I expect healthcare to be expensive.  I expect end of life care to be expensive.  I plan for those expenses and have plans on what to do if those expenses get to be too much.

There is a peak to healthcare cost because at some potential level it will be too expensive for a very high percentage of people.  For example it can not get so expensive that 90% of the population can't afford it. I think there is some more room for cost increase but I think we are getting very close to the top.

Also, I do not expect to see a single politician trying to remove the pre-existing condition mandates.  This is political suicide today. 

Keep in mind that those who plan on retiring very early are also likely paying very little taxes and contributing very little to the health care budget.  Maybe it is time to pay our fair share for the services we use or plan to use.  Obviously those making more can and should pay more, but paying close to nothing doesn't seam right either especially if we are able bodied people who can work and contribute our fare share.  Today healthcare costs on average a little over $10k/person per year.  How many of us have actually paid that much in taxes to cover healthcare for ourselves for our lifetime plus help cover some of our infrastructure costs?  I realize this is an unpopular sentiment amongst this forum but stuff costs money and we can't expect the working class to pay for us.

JGS1980

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Re: Is anyone else freaked out about health care right now?
« Reply #58 on: July 05, 2018, 10:51:00 AM »
I am not freaked out.  I expect healthcare to be expensive.  I expect end of life care to be expensive.  I plan for those expenses and have plans on what to do if those expenses get to be too much.

There is a peak to healthcare cost because at some potential level it will be too expensive for a very high percentage of people.  For example it can not get so expensive that 90% of the population can't afford it. I think there is some more room for cost increase but I think we are getting very close to the top.

Also, I do not expect to see a single politician trying to remove the pre-existing condition mandates.  This is political suicide today. 

Keep in mind that those who plan on retiring very early are also likely paying very little taxes and contributing very little to the health care budget.  Maybe it is time to pay our fair share for the services we use or plan to use.  Obviously those making more can and should pay more, but paying close to nothing doesn't seam right either especially if we are able bodied people who can work and contribute our fare share.  Today healthcare costs on average a little over $10k/person per year.  How many of us have actually paid that much in taxes to cover healthcare for ourselves for our lifetime plus help cover some of our infrastructure costs?  I realize this is an unpopular sentiment amongst this forum but stuff costs money and we can't expect the working class to pay for us.

I agree with the above. Fair is Fair. If you are FIRE'd, you should expect to pay more than 0 for HealthCare, ACA or no ACA. Put it in your budget, plan accordingly.

DreamFIRE

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Re: Is anyone else freaked out about health care right now?
« Reply #59 on: July 05, 2018, 11:01:59 AM »
Keep in mind that those who plan on retiring very early are also likely paying very little taxes and contributing very little to the health care budget.

Indeed, this is especially true for some people not paying their fair share of taxes:
https://forum.mrmoneymustache.com/antimustachian-wall-of-shame-and-comedy/you-only-max-your-401(k)-because-you-don't-have-kids/msg2060125/#msg2060125

swampwiz

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Re: Is anyone else freaked out about health care right now?
« Reply #60 on: July 05, 2018, 12:07:54 PM »
Wow, it sounds like my decision to do a Roth ladder and be super cheap so that I have low enough income to get FREE ObamaObamaRomneyHeritageCare Medicaid expansion was the correct move!

swampwiz

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Re: Is anyone else freaked out about health care right now?
« Reply #61 on: July 05, 2018, 12:09:52 PM »
You know, there was a time when people didnt have health insurance and the world turned out ok.  Now, this “need” has been created.  You know, you will eventually die dont you?  So why fret over something that people never had not that long ago?
So your solution to healthcare is to just die, huh?  That's what some people call the republican plan.

*** THIS ***

swampwiz

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Re: Is anyone else freaked out about health care right now?
« Reply #62 on: July 05, 2018, 12:15:28 PM »
Folks - Maybe the time has come to pick up pen and paper and write.  Write to your favorite American politicians.

With Republicans, it is a lost cause, but you will feel better.

With Democrats, they will lie that they are in favor of single payer, and you will feel better.

With independents - You may have a chance, but will be voted down by the others - But you will still feel better

And,.......you will have done what you can.  Tides do turn.

I think the remnants of supporters bloated insurance-based health care in the Democratic Party - i.e., Lieberman, and my former senator, Landrieu - have been exorcised from the party.  They would be happy to go to single payer, but are only timid because of the reaction to ObamaRomneyHeritageCare - i.e., back before it became popular.
« Last Edit: July 09, 2018, 09:06:49 PM by swampwiz »

sol

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Re: Is anyone else freaked out about health care right now?
« Reply #63 on: July 05, 2018, 12:31:44 PM »
I'm mere days away from retiring at age 41 with a wife and three kids.  I am not worried about healthcare.

The ACA is still the law of the land, and my state's expanded coverage options are pretty good.  Care is totally 100% FREE if my family shows under $40k of paper income, which is pretty easy to do with a paid off house while just drawing on your investment accounts because return of principal isn't income.  Roth contribution withdrawals aren't income.  Gross rental income isn't income.  Spending down our massive savings isn't income.

Failing that, the subsidy is still by law capped at a sliding percentage of your household income.  For a family of 5 making $50k it's about 6% of your income and the subsidy covers the rest.  Even if we had some major medical catastrophe and had to pay the out of pocket max, I figure my family's healthcare costs at $50k of paper income would only be $4038 per year, according to my state's marketplace website.  That's for premiums plus all costs before 100% coverage kicks in, like if we all got cancer simultaneously or something.

And honestly, the extreme backup plan for healthcare is the same as the extreme backup plan in case of generic economic collapse (and associated portfolio failure):  just get another job.  I have one now, and it's tolerable.  I'm pretty sure I could get another one if I really really had to, and I'm not prepared to accept that doomsayer prediction that I should just never stop working, in case I someday have to go to work in the future.  That seems silly.

hoping2retire35

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Re: Is anyone else freaked out about health care right now?
« Reply #64 on: July 05, 2018, 12:48:30 PM »
Did I miss something? You should be paying pennies in retirement for health insurance unless of course you are drawing a huge antimustachian wad of cash from your investments. What gives?

EnjoyIt

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Re: Is anyone else freaked out about health care right now?
« Reply #65 on: July 05, 2018, 01:09:38 PM »
I'm mere days away from retiring at age 41 with a wife and three kids.  I am not worried about healthcare.

The ACA is still the law of the land, and my state's expanded coverage options are pretty good.  Care is totally 100% FREE if my family shows under $40k of paper income, which is pretty easy to do with a paid off house while just drawing on your investment accounts because return of principal isn't income.  Roth contribution withdrawals aren't income.  Gross rental income isn't income.  Spending down our massive savings isn't income.

Failing that, the subsidy is still by law capped at a sliding percentage of your household income.  For a family of 5 making $50k it's about 6% of your income and the subsidy covers the rest.  Even if we had some major medical catastrophe and had to pay the out of pocket max, I figure my family's healthcare costs at $50k of paper income would only be $4038 per year, according to my state's marketplace website.  That's for premiums plus all costs before 100% coverage kicks in, like if we all got cancer simultaneously or something.

And honestly, the extreme backup plan for healthcare is the same as the extreme backup plan in case of generic economic collapse (and associated portfolio failure):  just get another job.  I have one now, and it's tolerable.  I'm pretty sure I could get another one if I really really had to, and I'm not prepared to accept that doomsayer prediction that I should just never stop working, in case I someday have to go to work in the future.  That seems silly.

Congrats on your soon to be retirement day.  Like everyone else, we all should take advantage of any law that helps us and utilize any loophole that benefits our needs.  it is human nature and we would be foolish to not do so.

I looked and had the ACA plans in our area (until we went on my SOs insurance.) I was extremely disappointed by the providers who are in network. In particular I looked at surgeons and OB/GYN physicians and was sadly discouraged by the quality of those doctors. I am looking forward to being able to purchase non ACA complaint insurance next year to have access to better specialists.  I suspect I will be paying less as well for it which will be a nice perk.  The law of the land has changed and I am gladly opting out of the ACA.

JGS1980

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Re: Is anyone else freaked out about health care right now?
« Reply #66 on: July 05, 2018, 03:10:15 PM »
The law hasn't changed at all (they tried to repeat it and failed, remember?). The current administration is simply just selectively enforcing it, while also gutting it financially and approving state by state "waivers" that allow states to break the spirit of the law without actually breaking the law.

Be wary of what you purchase EnjoyIt. Make sure your new insurance actually covers what you want it to cover, including catastrophic costs.

JGS

EnjoyIt

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Re: Is anyone else freaked out about health care right now?
« Reply #67 on: July 05, 2018, 03:39:37 PM »
The law hasn't changed at all (they tried to repeat it and failed, remember?). The current administration is simply just selectively enforcing it, while also gutting it financially and approving state by state "waivers" that allow states to break the spirit of the law without actually breaking the law.

Be wary of what you purchase EnjoyIt. Make sure your new insurance actually covers what you want it to cover, including catastrophic costs.

JGS

Indeed....I read all the fine print.

ChpBstrd

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Re: Is anyone else freaked out about health care right now?
« Reply #68 on: July 06, 2018, 07:31:52 AM »
It kinda amazes me how many financially independent Mustachians are planning to work multiple extra years of their lives in an attempt to save 25X the ever-spiraling cost of healthcare, chasing a financial mirage essentially, and yet MOST WON'T DO ANYTHING ABOUT THE SITUATION.

Unless you have a very high income, you pay more for healthcare than you do in taxes. Imagine the outrage and riots if your taxes increased 5-15% every single year? But for whatever reason, financial fiascos in the "healthcare" category are assumed to be inevitable. Well guess what: Just as high taxes are an outcome of a given political system that can be changed, so are high healthcare costs. Literally every other developed democracy has solved this problem. Any of their templates would be better than this.

So, on our way to work as anxiety-wrecked millionaire cube monkeys, let's consider how many thousands of hours we're spending in a dusty grey/beige office versus how many hours we spend on political activism (NONE you say?). Consider the thousands of dollars in commuting expenses we pay versus our resistance to writing a $150 check to support the campaign of someone willing to solve the healthcare problem. Also, consider how the uncertain payoff of actually participating in our democracy is aversive, whereas we are somehow comfortable with a status quo that, if it continues, is certain to destroy our dreams.

Finally, consider that the reason you are still working is because everyone else is just like you - too busy running on this treadmill to work toward a solution. If you're waiting for the big collapse that somehow inevitably ushers in a better system, consider how it might eventually be you choosing to either die from a treatable illness or leave your family bankrupt (or maybe you don't even get the second option). Everyone else will continue waiting around for things to get really bad.

It only makes sense to call your reps, attend meetings, write checks, join, organize, pressure, speak, and raise hell. If you're not willing to work even that hard, I have news: You're not immigrating to Canada either.

/rant
/microphone

LaineyAZ

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Re: Is anyone else freaked out about health care right now?
« Reply #69 on: July 06, 2018, 09:20:08 AM »
ChpBastrd - Absolutely agree!!  All the energy devoted to hand-wringing and detailed discussions of loopholes could be redirected toward a better solution for everyone. 

dude

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Re: Is anyone else freaked out about health care right now?
« Reply #70 on: July 06, 2018, 10:42:59 AM »
It kinda amazes me how many financially independent Mustachians are planning to work multiple extra years of their lives in an attempt to save 25X the ever-spiraling cost of healthcare, chasing a financial mirage essentially, and yet MOST WON'T DO ANYTHING ABOUT THE SITUATION.

Unless you have a very high income, you pay more for healthcare than you do in taxes. Imagine the outrage and riots if your taxes increased 5-15% every single year? But for whatever reason, financial fiascos in the "healthcare" category are assumed to be inevitable. Well guess what: Just as high taxes are an outcome of a given political system that can be changed, so are high healthcare costs. Literally every other developed democracy has solved this problem. Any of their templates would be better than this.

So, on our way to work as anxiety-wrecked millionaire cube monkeys, let's consider how many thousands of hours we're spending in a dusty grey/beige office versus how many hours we spend on political activism (NONE you say?). Consider the thousands of dollars in commuting expenses we pay versus our resistance to writing a $150 check to support the campaign of someone willing to solve the healthcare problem. Also, consider how the uncertain payoff of actually participating in our democracy is aversive, whereas we are somehow comfortable with a status quo that, if it continues, is certain to destroy our dreams.

Finally, consider that the reason you are still working is because everyone else is just like you - too busy running on this treadmill to work toward a solution. If you're waiting for the big collapse that somehow inevitably ushers in a better system, consider how it might eventually be you choosing to either die from a treatable illness or leave your family bankrupt (or maybe you don't even get the second option). Everyone else will continue waiting around for things to get really bad.

It only makes sense to call your reps, attend meetings, write checks, join, organize, pressure, speak, and raise hell. If you're not willing to work even that hard, I have news: You're not immigrating to Canada either.

/rant
/microphone

hahaha!  Enjoyed this rant immensely.

DreamFIRE

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Re: Is anyone else freaked out about health care right now?
« Reply #71 on: July 06, 2018, 11:16:58 AM »
Unless you have a very high income, you pay more for healthcare than you do in taxes.

I wouldn't call myself very high income.

I pay about $900 total out of pocket for healthcare insurance, deductibles, co-pays in a year.

I pay 10's of thousands of dollars in taxes.

When I FIRE, total out of pocket healthcare is still expected to be less than the total of my taxes thanks to ACA subsidies and partial CSR.

sol

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Re: Is anyone else freaked out about health care right now?
« Reply #72 on: July 06, 2018, 11:21:28 AM »
I pay about $900 total out of pocket for healthcare insurance, deductibles, co-pays in a year.

Are you failing to include the employer portion of your premiums, and the employer-negotiated group rate discount?  Because those are both part of your total compensation package, which your employer spends to pay for your healthcare instead of paying to you directly.

Everyone who gets employer sponsored health insurance "pays" a lot more for their insurance than they personally pay for their insurance.

DreamFIRE

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Re: Is anyone else freaked out about health care right now?
« Reply #73 on: July 06, 2018, 11:29:09 AM »
I pay about $900 total out of pocket for healthcare insurance, deductibles, co-pays in a year.

Are you failing to include the employer portion of your premiums, and the employer-negotiated group rate discount?  Because those are both part of your total compensation package, which your employer spends to pay for your healthcare instead of paying to you directly.

I'm not "failing" to include them because I intentionally used the term "out of pocket" specifically for that reason.  My employer also pays additional taxes on my behalf, but I excluded that from the comparison as well.

Also I am extremely aware of the cost to my employer and what I would have to pay for it on COBRA or LOA, but I also do not believe my employer would automatically pay me the difference if they didn't pay most of my premium.  But since that hypothetical additional pay is not part of my current agreed upon salary, I certainly don't consider it "out of pocket" anymore than a larger raise or bonus that I didn't receive is "out of pocket".

Edit:  Even factoring in the full cost of the premium by adding in what my employer pays, then after subtracting the tax deduction from the premium cost to get my net premium cost, the total net premium cost would still be far less than my total taxes paid.  Actually, even if I don't subtract for the tax deduction to get my net premium cost, taxes are still far more than me having to pay full freight premiums for the year, albeit the difference is not as stark as it currently is for me.
« Last Edit: July 06, 2018, 12:03:25 PM by DreamFIRE »

Wexler

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Re: Is anyone else freaked out about health care right now?
« Reply #74 on: July 06, 2018, 11:35:24 AM »
It kinda amazes me how many financially independent Mustachians are planning to work multiple extra years of their lives in an attempt to save 25X the ever-spiraling cost of healthcare, chasing a financial mirage essentially, and yet MOST WON'T DO ANYTHING ABOUT THE SITUATION.

Unless you have a very high income, you pay more for healthcare than you do in taxes. Imagine the outrage and riots if your taxes increased 5-15% every single year? But for whatever reason, financial fiascos in the "healthcare" category are assumed to be inevitable. Well guess what: Just as high taxes are an outcome of a given political system that can be changed, so are high healthcare costs. Literally every other developed democracy has solved this problem. Any of their templates would be better than this.

So, on our way to work as anxiety-wrecked millionaire cube monkeys, let's consider how many thousands of hours we're spending in a dusty grey/beige office versus how many hours we spend on political activism (NONE you say?). Consider the thousands of dollars in commuting expenses we pay versus our resistance to writing a $150 check to support the campaign of someone willing to solve the healthcare problem. Also, consider how the uncertain payoff of actually participating in our democracy is aversive, whereas we are somehow comfortable with a status quo that, if it continues, is certain to destroy our dreams.

Finally, consider that the reason you are still working is because everyone else is just like you - too busy running on this treadmill to work toward a solution. If you're waiting for the big collapse that somehow inevitably ushers in a better system, consider how it might eventually be you choosing to either die from a treatable illness or leave your family bankrupt (or maybe you don't even get the second option). Everyone else will continue waiting around for things to get really bad.

It only makes sense to call your reps, attend meetings, write checks, join, organize, pressure, speak, and raise hell. If you're not willing to work even that hard, I have news: You're not immigrating to Canada either.

/rant
/microphone

APPLAUSE

I'd add VOTE IN EVERY ELECTION as step zero to your list of activism.  We have mustachians here who write in and ask for help in figuring out how to save pennies a year on clothes, groceries, soap, electricity.  They are willing to spend hours on such pursuits for tiny gains, but I bet some of them don't even spend 20 minutes a year voting.   

DreamFIRE

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Re: Is anyone else freaked out about health care right now?
« Reply #75 on: July 06, 2018, 12:01:55 PM »
I'm mere days away from retiring at age 41 with a wife and three kids.  I am not worried about healthcare.

The ACA is still the law of the land, and my state's expanded coverage options are pretty good.  Care is totally 100% FREE if my family shows under $40k of paper income, which is pretty easy to do with a paid off house while just drawing on your investment accounts because return of principal isn't income.  Roth contribution withdrawals aren't income.  Gross rental income isn't income.  Spending down our massive savings isn't income.

That sounds like Medicaid to me, which I would rather avoid by drawing a little bit more income to get an ACA plan with PCT/CSR, which won't be difficult since my dividends and interest in my taxable accounts alone get me up around the top limit of Medicaid and into the ACA minimum income.  We single people are only allowed a maximum MAGI somewhere between $16K to $17K for Medicaid, and I'm planning for about $24K MAGI in order to provide $50K spending during the ACA years.  This will keep me under one of the CSR subsidy cliffs, although it's far from being free if I have to use much for health services in a particular year.
« Last Edit: July 06, 2018, 12:27:55 PM by DreamFIRE »

Luck12

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Re: Is anyone else freaked out about health care right now?
« Reply #76 on: July 06, 2018, 12:05:29 PM »
APPLAUSE

I'd add VOTE IN EVERY ELECTION as step zero to your list of activism.  We have mustachians here who write in and ask for help in figuring out how to save pennies a year on clothes, groceries, soap, electricity.  They are willing to spend hours on such pursuits for tiny gains, but I bet some of them don't even spend 20 minutes a year voting.

"Both sides are the same"!, "My vote doesn't matter".

GuitarStv

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Re: Is anyone else freaked out about health care right now?
« Reply #77 on: July 06, 2018, 12:19:35 PM »
APPLAUSE

I'd add VOTE IN EVERY ELECTION as step zero to your list of activism.  We have mustachians here who write in and ask for help in figuring out how to save pennies a year on clothes, groceries, soap, electricity.  They are willing to spend hours on such pursuits for tiny gains, but I bet some of them don't even spend 20 minutes a year voting.

"Both sides are the same"!, "My vote doesn't matter".

"I voted for Libertarian candidate Gary Johnson"

genesismachine

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Re: Is anyone else freaked out about health care right now?
« Reply #78 on: July 06, 2018, 04:14:15 PM »
Let's put some numbers down. I'm in Oregon and my wife and I do everything right (non-smokers, healthy weight, etc...) and we're young. We have an option for catastrophic insurance at $497/month (from Kaiser, which around here isn't great to say the least). This has no coverage until we hit $13k deductible for our family.

What's insidious about this is that if you pay under insurance, you're billed at twice the rate that if you come in without insurance. For instance, we're covered by 80% coverage health insurance and I recently went in for an MRI. The uninsured cost was $595. The insured cost was $1200. Luckily for us, 20% of $1200 was less than $595, and it counted towards our deductible, so it was an easy decision.

But if we had catastrophic insurance, which would we pay? It's a real pickle because we have no way of knowing if we would need more medical services for the rest of the year or not.

To get 'non-catastrophic' insurance would cost us a minimum of $804/month. And even this doesn't cover anything until you hit $3k out of pocket per year.

I re-ran the numbers as a 55 year old, and got $968 and $1566/month.

If you have a chronic condition, then you could easily hit $5-10k in medical expenses per year, if not more.

So let's assume one of us develops a chronic condition over the next couple decades and has to pay $10k/year in medical expenses. And assume we pay for non-catastrophic insurance. That comes out to an average of ~$24k/year. 25x that is ~600k/year.

And for those of you relying on some sort of public option during retirement, that could go away in an instant if they decide to start means testing.

Literally no other country has this problem, so we're moving rather than adding a decade or more to our working career for no reason.

sol

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Re: Is anyone else freaked out about health care right now?
« Reply #79 on: July 06, 2018, 04:59:42 PM »
That comes out to an average of ~$24k/year. 25x that is ~600k/year.

And for those of you relying on some sort of public option during retirement, that could go away in an instant if they decide to start means testing.

$24k/year sounds about right, to insure a couple of old people.  Being old is expensive.

Fortunately you don't have to pay anywhere near that much, thanks to the ACA, unless you are filthy rich.  In which case you probably don't mind it.

You're seriously moving away because you're afraid they might change the law in the future, and not provide a replacement?  That seems pretty unlikely to me.

I try to avoid making plans based on fear.  You have to work with the law as currently written, as it has stood for the past eight years.  They MIGHT quadruple your tax rates, they MIGHT draft you into the army, and they MIGHT destroy American healthcare.  I'm not terribly concerned about it though, politicians know those things would be terribly unpopular.  They just like to shout hypothetical fantasy policies during campaign season.  Chances are, very little will change soon.

PDXTabs

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Re: Is anyone else freaked out about health care right now?
« Reply #80 on: July 06, 2018, 05:01:08 PM »
Yes and no, I have employer provided health insurance and money to pay for care. But if I wasn't highly compensated I would be terrified. My asthma medication is $150/mo AFTER my health insurance. I think it retails in India for $36.

I fully plan to move to a country with universal coverage before I retire, although I guess Medicare is universal for people old enough to get it.
« Last Edit: July 06, 2018, 05:02:39 PM by PDXTabs »

DreamFIRE

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Re: Is anyone else freaked out about health care right now?
« Reply #81 on: July 06, 2018, 05:31:15 PM »
I re-ran the numbers as a 55 year old, and got $968 and $1566/month.

55 is still on the young side.  It will get more expensive for the unsubsidized premium until you're 65 and can get on Medicare, although that's expensive also.

Quote
And for those of you relying on some sort of public option during retirement, that could go away in an instant if they decide to start means testing.

ACA didn't include a public option, despite many people pushing for it, maybe next time.

DreamFIRE

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Re: Is anyone else freaked out about health care right now?
« Reply #82 on: July 06, 2018, 05:34:49 PM »
I fully plan to move to a country with universal coverage before I retire, although I guess Medicare is universal for people old enough to get it.

Ahhh, but Medicare can still be expensive for decent coverage.  If you get plan A, B, D, and supplemental to cover everything else, someone posted in another thread it was costing over $900/mo.

https://forum.mrmoneymustache.com/welcome-to-the-forum/what-comes-after-the-aca/msg2036422/#msg2036422

EnjoyIt

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Re: Is anyone else freaked out about health care right now?
« Reply #83 on: July 06, 2018, 10:49:34 PM »
It kinda amazes me how many financially independent Mustachians are planning to work multiple extra years of their lives in an attempt to save 25X the ever-spiraling cost of healthcare, chasing a financial mirage essentially, and yet MOST WON'T DO ANYTHING ABOUT THE SITUATION.

Unless you have a very high income, you pay more for healthcare than you do in taxes. Imagine the outrage and riots if your taxes increased 5-15% every single year? But for whatever reason, financial fiascos in the "healthcare" category are assumed to be inevitable. Well guess what: Just as high taxes are an outcome of a given political system that can be changed, so are high healthcare costs. Literally every other developed democracy has solved this problem. Any of their templates would be better than this.

So, on our way to work as anxiety-wrecked millionaire cube monkeys, let's consider how many thousands of hours we're spending in a dusty grey/beige office versus how many hours we spend on political activism (NONE you say?). Consider the thousands of dollars in commuting expenses we pay versus our resistance to writing a $150 check to support the campaign of someone willing to solve the healthcare problem. Also, consider how the uncertain payoff of actually participating in our democracy is aversive, whereas we are somehow comfortable with a status quo that, if it continues, is certain to destroy our dreams.

Finally, consider that the reason you are still working is because everyone else is just like you - too busy running on this treadmill to work toward a solution. If you're waiting for the big collapse that somehow inevitably ushers in a better system, consider how it might eventually be you choosing to either die from a treatable illness or leave your family bankrupt (or maybe you don't even get the second option). Everyone else will continue waiting around for things to get really bad.

It only makes sense to call your reps, attend meetings, write checks, join, organize, pressure, speak, and raise hell. If you're not willing to work even that hard, I have news: You're not immigrating to Canada either.

/rant
/microphone

If you can show me a single candidate that is looking to do right about our healthcare problem I would be glad to contribute cash to their cause.  I have yet to see a single one. And please keep in mind I do not think the ACA is or was a good solution.  It is just a bandaid to a much bigger problem that was never really addressed.

genesismachine

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Re: Is anyone else freaked out about health care right now?
« Reply #84 on: July 07, 2018, 11:04:28 AM »
That comes out to an average of ~$24k/year. 25x that is ~600k/year.

And for those of you relying on some sort of public option during retirement, that could go away in an instant if they decide to start means testing.

$24k/year sounds about right, to insure a couple of old people.  Being old is expensive.

Fortunately you don't have to pay anywhere near that much, thanks to the ACA, unless you are filthy rich.  In which case you probably don't mind it.

You're seriously moving away because you're afraid they might change the law in the future, and not provide a replacement?  That seems pretty unlikely to me.

I try to avoid making plans based on fear.  You have to work with the law as currently written, as it has stood for the past eight years.  They MIGHT quadruple your tax rates, they MIGHT draft you into the army, and they MIGHT destroy American healthcare.  I'm not terribly concerned about it though, politicians know those things would be terribly unpopular.  They just like to shout hypothetical fantasy policies during campaign season.  Chances are, very little will change soon.

I agree with not making choices based on fear, but much of this is either reasonable fear or guaranteed to happen. It would be reasonable to expect healthcare costs to continue going up at 10% a year at least for a little while longer, and it would be reasonable to plan for *both* of us getting some kind of chronic condition. These would blow up our costs even more. I think the $600k figure is actually pretty middle of the road and a healthy balance.

I'm planning on ~$70k a year income in retirement and we won't qualify for much if any subsidy, so it's guaranteed that unless they do socialized healthcare or something I will be paying that cost. I would love to see socialized healthcare but am not willing to bet my retirement on it.

If you look at someplace like Italy or Germany, they have comparable living costs to the US, and don't have this huge healthcare problem, so it really becomes a question of what is so great that is tying us to the US. Fortunately we're young enough that we can move and put down roots somewhere else. I can't think of anything in the US that is so great we'd want to work an extra decade to stay. And once we live somewhere else, there's nothing preventing us from visiting, we could come back 4 times a year or something fairly affordably to visit friends and family and still have it be far cheaper.

pecunia

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Re: Is anyone else freaked out about health care right now?
« Reply #85 on: July 07, 2018, 07:38:54 PM »
ChpBastrd:
Quote
It only makes sense to call your reps, attend meetings, write checks, join, organize, pressure, speak, and raise hell. If you're not willing to work even that hard, I have news: You're not immigrating to Canada either.

Sound like some positive actions that can eventually get some positive changes.

TheWifeHalf

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Re: Is anyone else freaked out about health care right now?
« Reply #86 on: July 09, 2018, 02:41:52 PM »
In my experience, those who say anything medical is not needed because years ago people never had it, sing a different tune when they are on their deathbed. All of sudden, it's important!

Or, "I never see a doctor, who needs em, I'm not paying for anyone else to use one either." The tune changes when they need one.

This is my experience only, and makes me believe that one's experience in life forms their opinion on many things. Some opinions, I just feel sorry for that person, that he had such a life.

SugarMountain

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Re: Is anyone else freaked out about health care right now?
« Reply #87 on: July 09, 2018, 02:56:18 PM »
You're seriously moving away because you're afraid they might change the law in the future, and not provide a replacement?  That seems pretty unlikely to me.

I try to avoid making plans based on fear.  You have to work with the law as currently written, as it has stood for the past eight years.  They MIGHT quadruple your tax rates, they MIGHT draft you into the army, and they MIGHT destroy American healthcare.  I'm not terribly concerned about it though, politicians know those things would be terribly unpopular.  They just like to shout hypothetical fantasy policies during campaign season.  Chances are, very little will change soon.

I get what you're saying, but for good or bad the current administration is different than normal political beasts.  The individual mandate is already gone and now they are blocking payments to insurance companies that end up with above expected #s of insured sick.  I suspect that this will lead to two things in the short term: 1) much higher insurance rates and 2) insurance companies pulling out of some markets and/or the exchanges altogether.   We'll see how much damage they can do to the subsidies before they get voted out.

I'm not worried about social security and/or medicare cuts.  Those will likely happen, but will be minor and more likely to be delays in eligibility and slower COLAs.  But, health insurance from my 51-65 years?  That keeps me up a bit.  If healthcare costs hadn't been so distorted over the years, self insuring would be an option, but it really doesn't take a long hospital stay to destroy your stache.

DreamFIRE

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Re: Is anyone else freaked out about health care right now?
« Reply #88 on: July 09, 2018, 06:27:10 PM »
You're seriously moving away because you're afraid they might change the law in the future, and not provide a replacement?  That seems pretty unlikely to me.

I try to avoid making plans based on fear.  You have to work with the law as currently written, as it has stood for the past eight years.  They MIGHT quadruple your tax rates, they MIGHT draft you into the army, and they MIGHT destroy American healthcare.  I'm not terribly concerned about it though, politicians know those things would be terribly unpopular.  They just like to shout hypothetical fantasy policies during campaign season.  Chances are, very little will change soon.

I get what you're saying, but for good or bad the current administration is different than normal political beasts.  The individual mandate is already gone and now they are blocking payments to insurance companies that end up with above expected #s of insured sick.  I suspect that this will lead to two things in the short term: 1) much higher insurance rates and 2) insurance companies pulling out of some markets and/or the exchanges altogether.   We'll see how much damage they can do to the subsidies before they get voted out.

It sounds like the usual comments same as last year.  But insurers got back into the market, and I just heard that insurers were profitable and more are getting into the markets in 2019.  Premiums will keep going up for those who don't get subsidies for the foreseeable future.

Quote
I'm not worried about social security and/or medicare cuts.  Those will likely happen, but will be minor and more likely to be delays in eligibility and slower COLAs.

COLA is only once a year as it is.  The eligibility age will probably be raised for younger workers.  But there are several ways to prop up SS as I mentioned in the "ss is not going bankrupt" thread so that those in and nearing retirement aren't hurt by the changes while giving younger workers more time to prepare.

PDXTabs

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Re: Is anyone else freaked out about health care right now?
« Reply #89 on: July 09, 2018, 08:55:36 PM »
I agree with not making choices based on fear, but much of this is either reasonable fear or guaranteed to happen. It would be reasonable to expect healthcare costs to continue going up at 10% a year at least for a little while longer, and it would be reasonable to plan for *both* of us getting some kind of chronic condition. These would blow up our costs even more. I think the $600k figure is actually pretty middle of the road and a healthy balance.

So, not to derail the conversation too much, but for a €350K investment in Portuguese real estate you could have a golden visa. But you get to keep the real estate and you would (eventually) get access to state paid for health care. Just a thought.

SugarMountain

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Re: Is anyone else freaked out about health care right now?
« Reply #90 on: July 10, 2018, 09:03:38 AM »
It sounds like the usual comments same as last year.  But insurers got back into the market, and I just heard that insurers were profitable and more are getting into the markets in 2019.  Premiums will keep going up for those who don't get subsidies for the foreseeable future.


And things have gotten considerably worse in the last year with ACA.  Average cheapest Silver plan is up over 30%, many locales are down to one insurer on the exchange.  Obviously, it's not sustainable, the exchange market is basically collapsing.  Whether it gets replaced with something better remains to be seen. 

jim555

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Re: Is anyone else freaked out about health care right now?
« Reply #91 on: July 10, 2018, 09:50:36 AM »
And things have gotten considerably worse in the last year with ACA.  Average cheapest Silver plan is up over 30%, many locales are down to one insurer on the exchange.  Obviously, it's not sustainable, the exchange market is basically collapsing.  Whether it gets replaced with something better remains to be seen.
Actually it is stabilizing despite all the efforts to sabotage it.  Remember 87% on ACA get subsidies so their exposure to increases is limited.  Also the millions on Medicaid do not pay premiums.

effigy98

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Re: Is anyone else freaked out about health care right now?
« Reply #92 on: July 10, 2018, 10:09:40 AM »
Another reason I plan on having no debt, 100% self sustaining house with solar/wind, farm, etc so I can lower my income to as low as needed to get the best subsidies. Making too much income cuts you out of a lot of subsidies, and not just for health care. My parent is low income and we got free school lunches, low rent, college, low healthcare cost, energy discounts, water discounts, property tax discounts, dental, and the list goes on and on.

Another strategy is to get 3-6 month IT job contracts with health insurance (very common in my area), do all the non emergency health care visits, dental, etc... Then get laid off after the contract ends and can collect unemployment for 6 months and just repeat that cycle if I feel like making a little more money.

TheWifeHalf

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Re: Is anyone else freaked out about health care right now?
« Reply #93 on: July 10, 2018, 01:12:30 PM »
I remember when I was in 3rd and 4th grade, we were eligible for free lunches at school. Dad wouldn't take them, it was a pride thing.

PDXTabs

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Re: Is anyone else freaked out about health care right now?
« Reply #94 on: July 10, 2018, 01:14:11 PM »
I remember when I was in 3rd and 4th grade, we were eligible for free lunches at school. Dad wouldn't take them, it was a pride thing.

My whole childhood was free school lunches. I think I would have literally starved to death without them. There were days where that one meal was the vast majority of my calories.

EnjoyIt

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Re: Is anyone else freaked out about health care right now?
« Reply #95 on: July 10, 2018, 03:17:57 PM »
And things have gotten considerably worse in the last year with ACA.  Average cheapest Silver plan is up over 30%, many locales are down to one insurer on the exchange.  Obviously, it's not sustainable, the exchange market is basically collapsing.  Whether it gets replaced with something better remains to be seen.
Actually it is stabilizing despite all the efforts to sabotage it.  Remember 87% on ACA get subsidies so their exposure to increases is limited.  Also the millions on Medicaid do not pay premiums.

So who pays for that?

tipster350

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Re: Is anyone else freaked out about health care right now?
« Reply #96 on: July 10, 2018, 05:29:33 PM »
It sounds like the usual comments same as last year.  But insurers got back into the market, and I just heard that insurers were profitable and more are getting into the markets in 2019.  Premiums will keep going up for those who don't get subsidies for the foreseeable future.


And things have gotten considerably worse in the last year with ACA.  Average cheapest Silver plan is up over 30%, many locales are down to one insurer on the exchange.  Obviously, it's not sustainable, the exchange market is basically collapsing.  Whether it gets replaced with something better remains to be seen.

We are on our way back to the days when people desperately hold on to jobs for healthcare, jobs they would otherwise leave and let the next generation take over. If I lose my job or the pre-medicare plans are no longer offered, that will be me, instead of leaving at 60 or 61 I will be working until 65, if a job is available to me. And I'll still be among the lucky ones compared to many others.

tipster350

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Re: Is anyone else freaked out about health care right now?
« Reply #97 on: July 10, 2018, 05:36:56 PM »
I agree with not making choices based on fear, but much of this is either reasonable fear or guaranteed to happen. It would be reasonable to expect healthcare costs to continue going up at 10% a year at least for a little while longer, and it would be reasonable to plan for *both* of us getting some kind of chronic condition. These would blow up our costs even more. I think the $600k figure is actually pretty middle of the road and a healthy balance.

So, not to derail the conversation too much, but for a €350K investment in Portuguese real estate you could have a golden visa. But you get to keep the real estate and you would (eventually) get access to state paid for health care. Just a thought.

That intriguing. I hear the lifestyle in Portugal can be wonderful. Beautiful scenery, friendly people, good food, lots of culture, inexpensive in most areas. It's worth looking into.

pecunia

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Re: Is anyone else freaked out about health care right now?
« Reply #98 on: July 10, 2018, 06:50:47 PM »
Been working with this guy from South America.  he had to go to the doctor.

When he got back I showed him how the US ranks in terms of medicine with other countries.  He just shook his head.

Then there's the ambulance story in Massachusetts.

http://thehill.com/homenews/media/395409-story-of-injured-woman-begging-people-not-to-call-ambulance-due-to-costs-gains

Makes me want to get alone in a dark room with some of those right wing politicians and give them the opportunity to avail themselves of THEIR excellent health care.

This health care thing can be can be fixed.

jacquespluto

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Re: Is anyone else freaked out about health care right now?
« Reply #99 on: July 10, 2018, 07:38:08 PM »
It's an embarrassment for this country.  There are plenty of working models out there in the world.  Too much greed out there though including corporate, politicians and individuals.  Same thing with guns.  At the end of the day, money is more important than lives.

Not surprised when I see stories like this out there. 

Family considering divorce to afford daughter's health care costs
https://www.wfaa.com/article/news/family-considering-divorce-to-afford-daughters-health-care-costs/287-572210331

We are looking into the possibility of moving out of the country in the future and the biggest reasons are healthcare and guns.  We don't want to spend 30% of our income on healthcare and we don't want our kids to get shot at school.  Those are two issues that you just don't worry about in any other developed country.  My wife's mother is a Canadian citizen which may give us the option to seek citizenship for my wife.  I hope we don't have to do that, but our country certainly is trending in the wrong direction for us in these two important areas.