The Hidden Cost of Retiring Early

[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]

Quote:

Originally Posted by Alan 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]

Quote:

Originally Posted by nun 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]

Quote:

Originally Posted by daylatedollarshort 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]

Quote:

Originally Posted by nun 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]

Quote:

Originally Posted by 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.

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]

Quote:

Originally Posted by 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.

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]

Quote:

Originally Posted by nun 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--r...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]

Quote:

Originally Posted by 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?

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]

Quote:

Originally Posted by 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?

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]

Quote:

Originally Posted by 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?

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.

[Chuckanut]

Quote:

Originally Posted by MRG 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.

Rich people have many more choices that the rest of us. No surprise there.

[daylatedollarshort]

Quote:

Originally Posted by 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?

The health care system metrics do not just measure health care for those who can afford it or have great insurance. It is not a comparison of which country can the top 20% of the population in terms of net worth get the best care.

The benchmark studies compare metrics like percent of population uninsured, cost per capita for health care, infant mortality and life expectancy. If you look at Chart 1 on this link, it graphs where the U.S. rates spending per capita compared to life expectancy:

Why Are U.S. Health Care Costs So High? - Forbes

This graph shows U.S. health care costs compared to the same procedures in other OECD countries:

21 graphs that show America’s health-care prices are ludicrous - The Washington Post

From the British Medical Journal -

http://www.bmj.com/content/329/7467/644.1?etoc=

"The most thorough investigation ever into individual surgeons' performance at the operating table has found that the United Kingdom's cardiac surgeons are among the best in the world, with more adults surviving surgery despite patients being sicker and older than elsewhere."

[marko]

Quote:

Originally Posted by nun 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.

....and retired at 55.

God, I wish I had listened to my buddies 40 years ago and "got on the State (of MA)". Most of 'em retired around 45 due to uhhhh.....disability and the checks go to Florida now.

If I had to do it over again......!

[Chuckanut]

Quote:

Originally Posted by daylatedollarshort T Why Are U.S. Health Care Costs So High? - Forbes This graph shows U.S. health care costs compared to the same procedures in other OECD countries: 21 graphs that show America’s health-care prices are ludicrous - The Washington Post

When a US citizen can fly to Belgium for a hip replacement, stay about two weeks, return home, and save tens of thousands of dollars over having it done in the USA, there is something wrong.

http://www.nytimes.com/2013/08/04/he...gewanted%3Dall

[nun]

Quote:

Originally Posted by marko ....and retired at 55. God, I wish I had listened to my buddies 40 years ago and "got on the State (of MA)". Most of 'em retired around 45 due to uhhhh.....disability and the checks go to Florida now. If I had to do it over again......!

I'm 53 and paying full premium because I'm not 55 yet...I'm a "deferred retiree". As it stands at 55 my premium should go down to $100/month. Then, at 65 I go on Medicare. But who knows what the healthcare landscape will be by then. I might well end up moving to Scotland as the NHS in the rest of the UK is having funding difficulties. The Scottish National Party strongly supports the original single payer and funding from general taxation principles of the NHS and as a UK passport holder I can move there even if Scotland becomes independent.