How important is the quality of medical care in your retirement decision?

[Orchidflower]

1. Very important (as in the top 3 items I consider important). I may not need it now or ever, but I want great medical care very nearby just in case (as in 30 minutes away at most).
2. Just one of the equations I look at. Not of primary importance. In fact, I am happy living an hour or more away from a good hospital figuring they can always transfer me to another hospital if needed.
3. Not very important at all. I don't even give it much thought, because if I get sick then I get sick.

After discussing this issue with friends, I am really surprised at the variety of responses I've received. It's amazing to me that many of my retired friends just give very little thought to what type of medical care they receive, trust in whatever physician they have and don't question anything. Maybe it's just me...so, I am asking what your opinion is of this.

 

[dex]

I don't understand the issue you are raising or questioning.

Does it have to do to where you retire?

 

[HFWR]

I expect to continue living either in or near a major metro area, so I expect to have access to reasonably good health services. Just back up the Brink's truck...

 

[audreyh1]

3.

I'm retired young. I expect to live in many places (hopefully) before I kick the bucket. I'm only 48. Right now anticipation of medical needs it is very low on the totem pole. Maybe when I'm 68 my attitude will be different.

I don't like to live or invest according to the worst case scenario. If something bad happens to my health (or investments), I'll make the changes then. In the meantime I'm too busy having fun.

BTW - location has nothing to do with not questioning your physician or medical care. It takes quite a bit of work to do your own "second opinion", but I've done it before - fired one doc and "interviewed" three others before making major health decisions. I imagine this is why many people don't question their physicians - doing otherwise takes a great deal of work. I watched my father-in-law guard my MIL's health care like a bulldog when she was undergoing cancer treatment, and you wouldn't believe how many things he caught! He used the internet a lot and asked a great deal of questions in spite of knowing very little. It takes that kind of tenacity. It seems like many folks don't want to do that?

Audrey

 

[bow-tie]

Despite being a young dreamer, it is something that has crossed my mind. Moving is a PITA so the proximity to medical was a small part, but a part nonetheless, of where we moved to.

 

[FUEGO]

Not very important to me, but I'm young. However it isn't an issue right now because I live within 30 minutes of two of the best med schools and teaching hospitals in the nation. One of those has an affiliated branch hospital within a mile of my house. Most of the local docs are trained at one of these two hospitals, so I feel good about the average quality of care here.

I guess I take this all for granted. If I were older, I might be less inclined to move away from here due to access to good medicine. At this point though, I wouldn't mind moving to Thailand/Mexico and dealing with a medical system that may provide a lower quality of care. If I get really sick I could always return stateside for treatment.

 

[unclemick]

Hmmm - zero or all important depending on how you look at it.

1993 - single, age 49 No health insurance for the next 12 yrs. Had I bought the cheapest availible to me in New Orleans, LA at that time - I couldn't have afforded ER.

Not recommended - unless perhaps you head overseas ala Billy and Akaisha.

heh heh heh - no house insurance(over water), LA swamp, 12k my lowest expense year, took in women boarders with their own 401k'srolleyes:, ).

Tongue in cheek - and with time I'm less of an outlier(polite term) in greater Kansas City, higher expenses, health insurance(BC/BS), house in the burbs, lawn, dogs, cat, girlfriend, etc, etc. And a Chevy SUV - ho hum.

P.S. 65 and reasonably healthy - big and good medical stuff in KC. Forty minutes - could move closer if something develops.

 

[Notmuchlonger]

3

 

[W2R]

I guess 1?

I am working while hating it and FI, just to get lifetime medical. That's got to count for something.

I would like to live no more than a couple of miles from a decent emergency room, hospital, and doctors' offices. In fact, my chosen/probable retirement neighborhood is no more than a mile or two from a street nicknamed "The Medical Mile", which has two large hospitals and many, many clinics for various specialties, doctors' offices, two class one trauma centers, and so on. The hospitals ought to be good enough to take care of most things, though as you point out, M.D. Anderson in Houston is known worldwide for cancer treatment and the hospitals in Springfield are not of that caliber. I guess if I get a form of cancer that is difficult to diagnose or treat, I would have to fly there. But I think most problems could be easily handled in Springfield.

Anyway, I would not consider most towns under 100,000 population because most of them do not have much in the way of medical facilities. (They also do not have the shopping I would like).

I may not NEED much in the way of medical facilities right now, since I am pretty healthy, but I don't want to have to move when I am 80 just because there are no hospitals nearby. It just seems prudent to look at a community's medical facilities at my age (60).

Edited to add: When my parents retired, I remember that they were all excited because there was a small hospital on the windward side of Oahu about 5-10 minutes away. But when they grew older and were actually sick and in need of a hospital, did they go there? NO - - they went to Queens (a big hospital on the other side of the island, about 30-60 minutes away depending on traffic). I guess when you are sick and want the best, it is worth the drive.

 

[Billy]

orchidflower

1. Very important
2. Just one of the equations I look at. Not of primary importance. In fact, I am happy living an hour or more away from a good hospital figuring they can always transfer me to another hospital if needed.
3. Not very important at all.

Hi Orchidflower,

Perhaps I look at the management of healthcare somewhat differently due to my (worldwide) exposure.

In foreign countries the pharmacies are the first line of defence when it comes to one's health. Pharmacists know what the 'current bug' is that's going around and they also have medical training (somewhat). It is quite common to go to one's pharmacist first with any questions, aches and pains, or day-to-day, run of the mill problems.

Hospitals and clinics are often on a walk-in basis, although the ones that cater to foreigners have adopted the 'get an appointment' mentality and those can be done by phone.

But mostly, my point is that Western medicine is only one arrow in the quiver. Usually, when we suffer from one thing or another, we personally utilize western medicine, accupuncture, detoxifying spas and massage therapists. We have yet to utilize a chiropractor, but that just shows our lack of experience with them. Some people swear by them.

I think it depends on what one's needs are. If you need surgery or emergency care Western medicine is excellent at that. If you want to be 'cured' of something there are other approaches that can be satisfying and yield results. How does one decide? Being near a hospital isn't the only answer by any means.

Audrey

BTW - location has nothing to do with not questioning your physician or medical care. It takes quite a bit of work to do your own "second opinion", but I've done it before - fired one doc and "interviewed" three others before making major health decisions. I imagine this is why many people don't question their physicians - doing otherwise takes a great deal of work. I watched my father-in-law guard my MIL's health care like a bulldog when she was undergoing cancer treatment, and you wouldn't believe how many things he caught! He used the internet a lot and asked a great deal of questions in spite of knowing very little. It takes that kind of tenacity. It seems like many folks don't want to do that?

I agree. couldn't have said it better. Even with the best of medical care, one must still be actively involved.

Akaisha
Author, The Adventurer's Guide to Early Retirement

 

[CuppaJoe]

1. Very important (as in the top 3 items I consider important). I may not need it now or ever, but I want great medical care very nearby just in case (as in 30 minutes away at most).

--

How are your knees doing, Orchid?

Your first sentence here applies although the second does not. So my answer is that health insurance and the nearness of care is #1 for me. Since I am uninsurable outside my current plan, I cannot move away from my HMO insurance areas. If I consider moving before age 65 (I'm 61 now), I would be very restricted as to where I can go. I may start looking into how MediCare will affect those choices; even so, a lot can change in four years. On another thread recently someone said that $1,000/mo. for medical expenses (insurance plus out-of-pocket expenses) is worth paying in order to RE; I ditto that sentiment! And will leap for joy when I write those monthly insurance checks. Maybe.

 

[Moemg]

Medical care is #1 for me . I would not even consider an area without a great hospital . Sarasota is about 45,000 people but it has Sarasota Memorial and it's an easy drive to Tampa for great Cancer care .

 

[Orchidflower]

OK, granted I am a geezer of 63 now; but, I have ALWAYS been conscious of choosing a city that would have great medical care available. Never been sick in all these years--unless you count having my tonsils out at 6; being thrown over a car completely and ending up with a broken wrist and (6 mos. later) a calcium deposit in my leg that had to be cut out bad (it wasn't really); and a C-section from having a 10 lb. breech whopper baby bad. Pretty good track record for an old babe. No other medical problems worth speaking about other than that.
I'm horrible about going to Drs., too. I just never go hardly (of which I should be ashamed, but am not).
However, I always have lived in major cities (Chicago, DC, Houston) and always considered my good health as a wonderful gift that I wanted to keep. So, to me, being near a great medical area is important. Outdated techniques and lack of medical services in an area, frankly, creeps me out if I am living there--and it DOES exists as you have read from other responses.
But I do find that I am somewhat unique--even among the other geezers I swim with weekly. So, I thought I would ask the population on this board and see what they had to say, and the answers were pretty similar to my pool buddies. They just seem to accept that whatever happens, happens....go figure?

(CuppaJoe: Thanks for asking about the torn tendons/muscles in my knee. Friday is the end of the 6th week after the Chiro pulling the leg back in place. I think I get why football and basketball players get all that moola$$$ now. This was painful...really painful...and am still icing it down daily; however, hope to be walking upright like a human by next week. Not fun times.)

 

[Leonidas]

Option 2 fits the bill for me. I'm young, doing well and live close to some great hospitals. But if I move at some point, the quality of relatively close medical care will be something that is fairly high on my list.

 

[kcowan]

We chose PV in Mexico because of their excellent and inexpensive medical services. Being Canadian, we avoided the long arm of Uncle Sam, especially all the required avoidance measures for estate taxes on resident aliens.

 

[shoe]

Top-notch medical care is #1 in importance to Dh and me. Both of us have several medical issues that could flair up and cause problems and being at the doorstep of the Cleveland Clinic is oh so reassuring.

 

[A854321]

The lack of decent medical care outside of Oahu has certainly changed my mind about a Hawaiian retirement.

 

[friar1610]

Just a thought...I've often heard people say things like "I don't worry about medical insurance; I've always been healthy and I take care of myself, work out regularly, etc." That might be a shortsighted way of looking at things. What happens if you fall off a ladder, are in a serious auto accident or all of a sudden learn that the lump you've had for a month is more than a swollen muscle?

 

[Dawg52]

I probably fall in the third category. Having said that, I live in area that has above average health care for a small town. I guess that is because the hospitals here service many small rural towns in a 60 mile radius. So I am fortunate. If I can't get what I need here, Univ of AL Birmingham hospital is only 2 hours away.

 

[Billy]

Friar

Just a thought...I've often heard people say things like "I don't worry about medical insurance; I've always been healthy and I take care of myself, work out regularly, etc." That might be a shortsighted way of looking at things. What happens if you fall off a ladder, are in a serious auto accident or all of a sudden learn that the lump you've had for a month is more than a swollen muscle?

That's an excellent point, Friar. Access to good emergency care is a serious consideration. That being said, When one travels in remote areas that access to decent emergency care is compromised.

For instance, taking a two week cruise to the Galapagos islands, visiting the Amazon jungle, or going to distant villages in Nepal, Cambodia, Laos, Vietnam or Ecuador. Anything can happen at any time to anyone.

This is a question that Billy and I ask each other: Do we not go because we could trip or fall or crash or maybe there will be a hurricane or...?? Wasn't it Helen Keller who said Life is an adventure or nothing at all? something like that?

Now granted, choosing a place to live in retirement is different than a two week vacation destination... but we travel constantly. It's our lifestyle. So we are up against this question often.

It can be scary to be 'out of network' but in our case, at this time in our lives, we are opting for the adventure.

Again, good point, Friar.

Be well,
Akaisha
Author, The Adventurer's Guide to Early Retirement

 

[Rich_by_the_Bay]

I agree with Akaisha. Sitting home all the time for fear of accident or illness that might occur if you travel is not a winning strategy, IMHO.

Of course a little extra prevention could minimize the risk. Strenuous climbing at altitude might warrant a preparatory exercise stress test if you are at risk by age or other illnesses and risks. Fitness training in advance can minimize strains and blisters. Still, the small risk of a problem would not hold us back from extended or remote travel.

And don't forget specific travel measures like immunizations and malaria pills, extra prescription meds in case of delays, and legitimate pharmacy packaging and even a copy of the prescription if you get searched by security or immigration.