The Hidden Cost of Retiring Early

[Spanky]

And keep in mind that most vets are not even able to enroll in VA system to begin waiting for care. Enrollment is based on a strict Priority system (e.g. service-connected disability, ex-POW's, low-income/low net worth, etc.).
VA Health Care Eligibility | Military.com

I am a Vietnam vet but not eligible to enroll because of not meeting the requirement of income/net worth.

 

[nun]

T I would certainly support national health insurance through a VAT that hit everything. I am sure this would cost me way more than I am presently paying. And I definitely don't want to say what I think about should happen to people who drive vehicles without car insurance and cause a wreck!

One approach to insurance is to leave it to the individual to buy, another is to mandate it and a final one is for the Government to provide it and pay for it through taxation.

In the UK the Government gives everyone heath care and pays for it through taxation, but car insurance is mandated and left up to the individual to buy. This means that there are some idiots driving illegally without insurance...just like in the US...which obviously leads to some nasty consequences when those idiots have accidents. So how about the Government pays for car insurance so that everyone is covered? It's an interesting argument with some obvious flaws like how you'd deal with insurance for terrible drivers, teenagers and the owners of very expensive cars. You could make the same cost arguments against Government paid for health insurance too.

 

[Spanky]

My view has been that if the state can retroactively change its contract with its former employees, it should be able to also do that for other contracts, for example, road repair.

Dear Acme Road Repair Company, 10 years ago we paid you 5 million dollars to fix the state highway near Plainville. We now realize we paid you to much. We really could not afford to pay that amount. Please refund us one million dollars by the end of the year, or we will be forced to take legal action to seize your property and sell it. Yours truly, the State of Confusion.

Now that will never happen. What we really need is for retirement payments to be made to an individual's personally owned retirement account, controlled completely by the individual, and hopefully tax deferred or tax free. Otherwise, retirment money will always tempt politicians to be irresponsible in some way.

Asking for a refund and suspending current/future payments is not the same.

 

[daylatedollarshort]

I would certainly support national health insurance through a VAT that hit everything. I am sure this would cost me way more than I am presently paying.

I think Nun's point various threads on this topic is that health care actually costs less per capita in countries with universal care type systems:

In a 2010 report by the nonprofit Commonwealth Fund, the United States, despite spending twice as much on healthcare, came in dead last compared with six peers - Britain, Canada, Germany, Netherlands, Australia and New Zealand.

U.S. health 'mediocre' compared to other wealthy countries despite spending the most of any nation on Earth | Mail Online

For all we spend on health care here, life expectancy is less than other developed nations:

"US life expectancy in 2011 ranked below that of every Western European country in the study, and hovered just above Chile, the Czech Republic, Poland, Estonia, the Slovak Republic, Hungary and Turkey. It was below Greece, Portugal, South Korea and Slovenia."

We spend more and yet get poorer results.

"The high per capita health care spending in the US is not resulting in dramatically improved health care services, but rather in higher profits for the private insurers, giant hospital chains and drug companies."

OECD report: US life expectancy below international average - World Socialist Web Site

 

[nun]

I think Nun's point various threads on this topic is that health care actually costs less per capita in countries with universal care type systems

The vast majority of other developed nations have some form of universal healthcare and how ever they are financed they are all less expensive per capita than in the US and generally provide as good or better results. But that's not my point. I'm not making an economic argument, more a moral one.

 

[nun]

Asking for a refund and suspending current/future payments is not the same.

This is a good point. The question is whether the promise or contract to pay someone in the future can be changed by one party over the objections of the other.....obviously in the US today it can be done as has been proved in Detroit and with numerous Magacorps. This is unsettling to me as it seems to go against some of the founding principles of America, particularly as it is always individuals who seem to come off worse and large political or commercial organizations see the benefits.

 

[daylatedollarshort]

The vast majority of other developed nations have some form of universal healthcare and how ever they are financed they are all less expensive per capita than in the US and generally provide as good or better results. But that's not my point. I'm not making an economic argument, more a moral one.

I get that that is your point in this thread. I posted the part about "various" threads on this topic because of this posts like this you have made in other threads:

"I'd never claim that healthcare is free and if I neglected to say things like "free at point of service" or "no out of pocket costs or premiums" I'm sorry. UK healthcare will cost the average person half that of the average US person and there's never a worry about being covered. The thing that saddens me is that many Americans with health insurance aren't more outraged that they pay twice as much as people in other countries for poorer coverage. "

http://www.early-retirement.org/forums/f28/average-health-care-costs-in-retirement-63797-3.html

I think you have good points from both a moral and a cost standpoint in quite a few threads on this forum.

 

[Mulligan]

One approach to insurance is to leave it to the individual to buy, another is to mandate it and a final one is for the Government to provide it and pay for it through taxation.

In the UK the Government gives everyone heath care and pays for it through taxation, but car insurance is mandated and left up to the individual to buy. This means that there are some idiots driving illegally without insurance...just like in the US...which obviously leads to some nasty consequences when those idiots have accidents. So how about the Government pays for car insurance so that everyone is covered? It's an interesting argument with some obvious flaws like how you'd deal with insurance for terrible drivers, teenagers and the owners of very expensive cars. You could make the same cost arguments against Government paid for health insurance too.

I agree with all your points, Nun. No perfect solutions. I guess my possibly flawed thinking comes from "skin in the game". I would rather pay $75 for something and the other guy pay $25, than I pay $50 and he $0 for the same service. The car issue definitely has no simple solution, though one local officer trained in dispensing on site "Singapore Caning" would maybe convince the next guy to sell his car if he can't afford the insurance!


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[nun]

I agree with all your points, Nun. No perfect solutions. I guess my possibly flawed thinking comes from "skin in the game". I would rather pay $75 for something and the other guy pay $25, than I pay $50 and he $0 for the same service. The car issue definitely has no simple solution, though one local officer trained in dispensing on site "Singapore Caning" would maybe convince the next guy to sell his car if he can't afford the insurance!


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Insurance requires a pool of those insured to spread the risk. How we define that pool will change the risk and premiums. Being a socialist I see the pool as the entire population. I'm a single man with no current girlfriend, but I'm ok having pregnancy care in my plan because it makes the premiums for pregnant women more affordable and I feel that having healthy mothers and babies is a good thing for society as a whole and so for me too.

Also I'm in my 50s so I expect my use of health care to go up so I will be benefiting from the payments of younger healthier folks soon.

Biasing the risk pools by al a carte coverage choices or excluding the already sick is good for the insurance companies and in the short term for those lucky enough to be already "under the umbrella". But I'd argue that it leads to unnecessary social divisions and reduces the health of the country. Obamacare is a highly flawed attempt to get insurance to more people, but those flaws are largely because it works in the existing structure of US healthcare.

 

[Alan]

"US life expectancy in 2011 ranked below that of every Western European country in the study, and hovered just above Chile, the Czech Republic, Poland, Estonia, the Slovak Republic, Hungary and Turkey. It was below Greece, Portugal, South Korea and Slovenia."

Whenever I see comparisons like this, whether it is healthcare, water quality or whatever, I always feel sorry for the countries ranked just above the USA, because the report is in effect saying, "Just look at how bad we are, even xxxx is better than us"

 

[mickeyd]

Don't see it mentioned anywhere else, but the following should be noted somewhere

"For retired military couple the $51,000 is incorrect. The correct amount for 3 years coverage of Tricare Prime is about $1500."

 

[daylatedollarshort]

Whenever I see comparisons like this, whether it is healthcare, water quality or whatever, I always feel sorry for the countries ranked just above the USA, because the report is in effect saying, "Just look at how bad we are, even xxxx is better than us"

Like this one?

"America's health care system is second only to Japan... Canada, Sweden, Great Britain... well, all of Europe. But you can thank your lucky stars we don't live in Paraguay!"

Homer Simpson

 

[Mulligan]

Insurance requires a pool of those insured to spread the risk. How we define that pool will change the risk and premiums. Being a socialist I see the pool as the entire population. I'm a single man with no current girlfriend, but I'm ok having pregnancy care in my plan because it makes the premiums for pregnant women more affordable and I feel that having healthy mothers and babies is a good thing for society as a whole and so for me too.



Also I'm in my 50s so I expect my use of health care to go up so I will be benefiting from the payments of younger healthier folks soon.



Biasing the risk pools by al a carte coverage choices or excluding the already sick is good for the insurance companies and in the short term for those lucky enough to be already "under the umbrella". But I'd argue that it leads to unnecessary social divisions and reduces the health of the country. Obamacare is a highly flawed attempt to get insurance to more people, but those flaws are largely because it works in the existing structure of US healthcare.

I agree in the health insurance arena if the assumption is all should have the right to access. I will admit I am slowly coming around over the past year to your viewpoints. I was never exposed to "unisex" policies and was shocked some states had already had them for years. That is why I ultimately favor a national care system to eliminate my personal bias of needs. Because at this point I certainly would prefer ala carte and check off what I won't ever use such as mental health to save on premiums. I do not however, believe in universal auto insurance. If you can't drive correctly you deserve to pay more or not be able to drive.


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[Alan]

Like this one?

"America's health care system is second only to Japan... Canada, Sweden, Great Britain... well, all of Europe. But you can thank your lucky stars we don't live in Paraguay!"

Homer Simpson

Exactly

 

[ERhoosier]

I can't agree with this approach and belief. It goes against the Hypocratic oath.......

The real (original) Hippocratic Oath, or at least best evidence of it, says nothing about a patient's ability to pay. Only for the physician to share their goods with their mentor. The oath states the physician should PRESCRIBE regimens for the good of the patient, but says nothing about the actual delivery of that care prescription. It is likely Galen a few hundred yrs later who 1st wrote of treating all patients for free.
The HO swears to the Greek gods Apollo, Asclepius, Hygieia, and Panacea, which is hardly a tenet followed by modern physicians.
It proscibes against performing abortion and likens it to euthanasia, or prescribing deadly medicine (at least in the most common historical versions of the Oath).
It also proscribes against performing surgery for renal/bladder stones. It is generally believed that Hippocrates, like most in that era, did not view surgeons as physicians.

The actual HO is no longer in common use.

Just sayin'

 

[athena53]

While the article stated the obvious (it costs money to bridge the gap between leaving an employer plan and qualifying for Medicare if you retire early), it should have noted the sheer headaches of dealing with the insurance maze. My last day at work was 5/9. We got COBRA through 5/30. DH is 75, so Medicare-eligible, and I'm 61. DH did all the right things to get himself Medicare A and B as of 6/1. (That included documenting creditable coverage for the past 10 years- fortunately, I had responsive people in HR at both previous employers even though one had been acquired). His Medicare card arrived last week.

We met with insurance agents on 5/23. I thought that, between my familiarity with the insurance business (although it's property-casualty) and their expertise, we'd wrap it all up easily. Nope. I couldn't get into a high deductible plan till 7/1 (another month of COBRA) then the agent told me I couldn't get it till the Open Enrollment Period in November because I'd already signed up for COBRA. Then the insurance company told me I DID have coverage. Turns out that I had applied in the 60 days following termination of employment so they could write me.

DH's was worse. In early June the wife (H/W team, she handles Medicare supplements) was back here with papers for DH to fill out for his application but said that it would still be effective 6/1. She was wrong. So, we'll have to pick up co-pays on some tests DH has to have done this month (we leave on vacation 7/1 and don't want to postpone). DH got a note telling him we have to pay a steep surcharge for Medicare B premiums based on our 2012 income. The earliest appointment I can get for a phone conference to get that changed based on the decrease in our income is 7/18.

Yesterday DH got a letter from the Medicare supplement carrier asking the same questions about creditable coverage we'd already supplied to the SSA.

I can see that the ACA has solved some genuine problems in the healthcare system (I'm relieved that no company can retroactively cancel a policy as soon as you develop an expensive condition just because you forgot to tell them you were treated for acne when you were 14), but this has been an endless, infuriating, confusing process. I keep thinking that soon we'll have insurance cards in hand and everything running smoothly and then there's another piece of paper and something not done.

 

[urn2bfree]

Dirty little secret is that the VA is primarily a jobs program - congressmen build VA facilities in their districts to create jobs there. The VA is also a training ground for interns residents, fellows and students. Poor vets get to serve all over as "subjects" for medical folk in training. The VA is not and never has been the best way to take care of our servicemen and women's healthcare needs.

 

[jollystomper]

One reason I went OMY was to build up additional cash reserves for medical expenses. Even though we are in mostly good health for now, I'm estimating $250K for medical premiums and expenses before Medicare eligibility (9 years). We still had a child that may be on our health insurance for up to another 6 years.

Megacorp no longer provides retiree health care as a benefit, but instead provided us with "Megacorp dollars" that can be applied towards Megacorp employee health plans but not ACA plans. But that would only cover about 15% of the total premiums before Medicare.

ACA plans are cheaper but I haven't seen any in our state (or states we are considering retiring to) that are as good as the Megacorp employee plans. But, I am still doing the analysis.

Now, if Megacorp would just lay me off... the severance would more than cover that $51K amount.

 

[ERhoosier]

Dirty little secret is that the VA is primarily a jobs program - congressmen build VA facilities in their districts to create jobs there. The VA is also a training ground for interns residents, fellows and students. Poor vets get to serve all over as "subjects" for medical folk in training. The VA is not and never has been the best way to take care of our servicemen and women's healthcare needs.

Clearly overall care delivery at the VA needs to improve, and VA must improve its system of finding & terminating bad employees. Whether or not the VA is the "best way" to care for vets is open to debate.
But vets are no more or less "subjects for medical folk in training" than civilians at civilian teaching hospitals. In fact, data show that VA teaching hospitals are consistently among the best in that system. Almost all of the "interns, residents, and fellows" serve at the VA under affiliation agreements. They serve on scheduled rotations from their civilian teaching programs (e.g. May at their University hospital, June at VA). They must follow all (sometimes stricter) rules regarding their involvement in patient care. Their VA physician staff must maintain credentials for a joint appointment with their civilian (mostly university) medical centers.

https://www.va.gov/oaa/GME_default.asp

FWIW- Except for the shameful wait times & delays, I would feel more comfortable being cared for at a major 'academic' VA hospital than a typical non-academic civilian facility.

 

[pb4uski]

Dirty little secret is that the VA is primarily a jobs program - congressmen build VA facilities in their districts to create jobs there. The VA is also a training ground for interns residents, fellows and students. Poor vets get to serve all over as "subjects" for medical folk in training. The VA is not and never has been the best way to take care of our servicemen and women's healthcare needs.

I strongly disagree and believe it may vary geographically. I have a number of friends/acquaintances who are vets and use our local VA are are quite happy with the service they receive. At least three who I can think of right of the bat. While it is true that our local VA is close to a top-notch teaching hospital, IIRC the vets I talk to tend to get the teachers rather than the students.

 

[daylatedollarshort]

I can't agree with this approach and belief. It goes against the Hypocratic oath and the way I believe we should treat our fellow man.

I just read another article on this topic today. Not only does the UK provide health insurance for all, they do it at half the cost per capita as the U.S. for a higher ranked health care system:

"The UK, which was ranked highest, blew the U.S. out of the water, despite the fact that the country spends less than half as much on health care per capita ($3,406 on average, compared to $8,508 in the U.S.). The U.S. also spends the most on health care as a percentage of GDP (17%) than any other other nation. "

http://finance.yahoo.com/news/u-s--...untries-in-health-care-quality-162331309.html

 

[pb4uski]

So DLDS, if someone in another country gets seriously sick, do you think they will go to the UK or the US for their care?

 

[MRG]

So DLDS, if someone in another country gets seriously sick, do you think they will go to the UK or the US for their care?

I know what I believe based on past observations. I used to travel to Rochester MN. frequently, and many lenghty stays. You would see people from all around the world staying there to get treated at the Mayo. Many were obviously wealthy with an entourage, privite limos etc......They could have gone anywhere in the world, but choose the US.

 

[nun]

So DLDS, if someone in another country gets seriously sick, do you think they will go to the UK or the US for their care?

Many people go to Europe for treatment....many go to the US. The excellence of US acute care is well known, but the problem is people in the US have to pay twice as much as the rest of the world for treatment that, arguably, produces poorer outcomes.

I have cadillac US health insurance that costs me $450/month, I basically have zero deductible and get to go to the best hospitals in MA..so Mass General etc which have fantastic care. Whether the expensive care of MGH actually produces better outcomes is, again, arguable. I like my plan, my US doctor and have received excellent care in the US, but I would have no problem in moving back to the UK and using the NHS and paying nothing. I would also have no problem in moving to any European country and using the health systems there as I would get treatment as good as I could get in the US for 99% of possible issues.

 

[marko]

So DLDS, if someone in another country gets seriously sick, do you think they will go to the UK or the US for their care?

I had a discussion with a (supposedly) very well educated woman not long ago.

We were talking HC and she said: "Well, my friend was travelling in the UK and she got sick and spent a week in the hospital and it didn't cost her a thing!!"

I said: "Well, somebody paid for it"

She said: "Yes, the government!"

I couldn't continue and let it drop at that point.