How would national health plan affect ER?

David1961 · 01-08-2008, 07:34 AM

I’d like to throw a question out to the members here, particularly those planning for ER who have not ER’d yet. If and when the US goes to some sort of national health-care system, how will it affect your retirement planning? Would you be more likely to ER early? I know the devil is in the details, but in general how would such a plan affect your planning?

I read a lot about the cost of medical coverage being one reason why people need to work longer. How many folks here have intentionally delayed ER because of the inability to obtain affordable medical insurance?

**Rich_in_Tampa** · 01-08-2008, 07:36 AM

Depends on the solution. It is hard to imagine a scenario where things would get worse than now. but at the least you should be able to purchase the insurance on a competitive basis. Currently, even getting access to insurance is problematic in ER, and if you do the cost can be prohibitive.

Under almost any current proposal, universal care is likely and costs will be averaged to some extent.

**Martha** · 01-08-2008, 07:58 AM

I am already retired. What it would do for me is give me flexibility in where I live. Now when you are on an individual health plan and you have existing conditions it is about impossible to move to another state and another plan.

Trek · 01-08-2008, 08:46 AM

Quote:

Originally Posted by David1961

I’d like to throw a question out to the members here, particularly those planning for ER who have not ER’d yet. If and when the US goes to some sort of national health-care system, how will it affect your retirement planning? Would you be more likely to ER early?

I retired very early, but I had to leave the States to do so. There is no way I could have ER'd and paid for private coverage until I was 65.

Having said that, even if there was some type of affordable / universal coverage, I likely would have moved to Europe anyway for a plethora of other reasons. But if I did ever want to move back someday, I wouldn't be able to do so (before Medicare age anyway), primarily because of the cost of having to pay private medical insurance for me and my family.

DallasGuy · 01-08-2008, 09:03 AM

A national health care system in whatever form would hopefully make the availability of a health care insurance plan better (i.e. remove the pre-existing requirements, etc.) and make the cost a little more predictable. Right now health insurance coverage seems like "the great unknown" as it relates to ER. It would be nice to have a little more certainty about the availability and costs from my current age of 51 until age 65. I'll probably ER anyway, but the decision would be much easier with a national health care system. NOTE: For me a national health care system could be as simple as having health insurance companies mandated to accept everyone for insurance coverage and not throw them into a high risk, high cost plan just because they're in their 50's or 60's. Also, I understand that older people have more health care expenses so I'm not against paying a little more , within reason, as I get older.

armor99 · 01-08-2008, 09:03 AM

Interesting question David1961. First off let me start by saying that nationalized health care would be the worst thing that could possibly happen. Now before I get flammed into next week.... listen to some well thought out reasons why I believe this is true.

Any business from selling hot-dogs to practicing medicine works on the same concepts of supply and demand, quality vs. availability, etc. Competition is the only force that drives a product to get cheaper, or better. If a hot dog vendor wants to lure your business away from the guy up the block, he can lower his prices, or maybe give you free pickles (making the product better).
I believe that exactly the same principle works in medicine. Not all doctors are created equal. Some are better than others, and those that do better work, typically charge higher prices. People go to places like the Mayo Clinic because there are superior doctors there for things they might need treatment on.
So now let's say that the govt now runs health care. There is no competition, as they now control the price of medicine, services, salaries, etc. This will have some very dramatic effects immediately.
Very few doctors that I have ever met were completely altruistic. Now certainly doctors got into their profession because they want to help people. But most want to be well compansated for their time spent in medical school (8 years +), and for their personal skill as a doctor. (And I have no problem with that. Most people want to be compensated well). If doctors can no longer set their own rates, and their salaries are now set by the govt, then you will see lots of doctors fleeing the medical profession, and many fewer doctors entering medical school.
So.... when I now need a doctor, are the best and brightest doctors the ones that are going to see me? No.... the doctors left will be the most unambitious of the lot, and probably not the best in their field. That concept frightens me greatly. Now some might say that this system will yield the BEST doctors, because only the least money motivated (most altruistic) will be left. Might be right.... but I do not believe there are very many completely selfless people out there. (No one that I know likes to work for less than they can earn). And finally... I would love to hear what the medical profession folks think about nationlized heathcare. Funny that you never see interviews with the actual doctors or hospitals that will be affected by this, and hear what they think about it. I would wager that you will not be able to find many doctors that would be in favor of this at all. I doubt that lawyers would like nationalized "law services" for the same reasons.
So what would I do

Not sure..... if the govt takes away my choices, then there is not much that I can do about it.
But I will also wager that if the govt does get this one to happen, you will see many of the best and brightest doctors getting together and forming their own networks that do not accept insurance at all. They will work outside the govt system entirely. They will probably charge more, but the service would be much better. If something like this came about, I would put off retirement for a while so I could afford this route instead. I hope this made sense, and that I have presented my thoughts in a clear and logical manner.

REWahoo · 01-08-2008, 09:17 AM

Quote:

Originally Posted by armor99

First off let me start by saying that nationalized health care would be the worst thing that could possibly happen.

Let me venture a wild guess here: You are young (under 40), healthy, and have health insurance through your employer. You have never had to look for individual health coverage on the open market, nor have you had a loved one encounter serious health problems and difficulty getting health insurance.

Not trying to be critical, just pointing out the likely frame of reference for your opinions.

And one more thing: I'm not a fan of "government health care", but I do believe we need a national health policy that grants everyone an opportunity to get health insurance, especially catastrophic coverage.

retire@40 · 01-08-2008, 09:26 AM

Quote:

Originally Posted by armor99

...First off let me start by saying that nationalized health care would be the worst thing that could possibly happen...

Very good points, but the bottom line is that competition has not stopped my health insurance rates from rising double digits every year for the past few years. This year they went up 18%, last year they went up 15%.

We will end up in a nationalized healthcare system by default since the current system is collapsing on itself.

We need a combination of more people paying into the system and more spending controls. No more free rides and no more overcharging.

**Rich_in_Tampa** · 01-08-2008, 09:32 AM

Yes - let's not confuse "national health care" along the lines of "socialized medicine" with universal health care. The latter implies (to me) guaranteed access to health insurance, elimination of most underwriting so that those who need it the most are not shut out, and a certain amount of risk sharing at a national level.

Yes, the devil is in the details, but those basic principles are what I was referring to. BTW, free market capitalism and health care make uneasy bedfellows for reasons discussed here and everywhere many times. I suggest a search on national health care or universal health care in this forum if anyone is interested.

FUEGO · 01-08-2008, 09:36 AM

Depending on increases in tax burden that I would have to pay, it would probably allow me to retire a little earlier with a feeling of more certainty in my ER plan. The fact that future costs are unknown in the current system requires me to be conservative and estimate very high future payments. And the fact that insurance at any reasonable price may become unavailable or riddled with exclusions worries me, and might cause me to keep my skills a little sharp in case I had to jump back in the labor market.

**Martha** · 01-08-2008, 10:00 AM

Quote:

Originally Posted by David1961

I'd like to hear more from the medical profession, too. Also, it be nice to hear more from people like Trek who have lived in a country where they have national health care.

It would also be nice to hear from the 46 million uninsured. I know a number of uninsured people. One is young and employed in a borderline job with no benefits. Because she has no children and is not disabled (according to the SSA), she is not eligible for medical assistance. She can't afford medical insurance and is not insurable anyway. She is in a very tough position. She needs medication and a lot of time is spent trying to find ways to get her drugs at a reasonable cost. Her medications alone would use up her entire income if she had to pay full price.

armor99 · 01-08-2008, 10:05 AM

Quote:

Originally Posted by REWahoo

Let me venture a wild guess here: You are young (under 40), healthy, and have health insurance through your employer. You have never had to look for individual health coverage on the open market, nor have you had a loved one encounter serious health problems and difficulty getting health insurance.

Not trying to be critical, just pointing out the likely frame of reference for your opinions.

And one more thing: I'm not a fan of "government health care", but I do believe we need a national health policy that grants everyone an opportunity to get health insurance, especially catastrophic coverage.

Yes... I am guilty as charged.
But in my opionion the idea of universal healthcare for everyone falls under the same heading as eliminating poverty in america. While a noble ideal, it is not really possible, and attempting to do so will wind up bankrupting everyone. But to be fair... I really need to look up more information. How many people are NOT convered in America. What are the circumstances involved? What percentage of people in America not being covered by heathcare is considered acceptable (zero is just not reality).

**Martha** · 01-08-2008, 10:37 AM

I don't see why it would bankruptcy everybody. Countries with national health care spend less than we do already.

If you want to know more about the uninsured in the US (about 46 million) here is a link which shows some of the demographics:
Facts and Research on the Uninsured: Fact Sheets

There are a number of disturbing trends. For example, nearly all large employers offer health insurance to full time workers. But the number of small employers offering health insurance has been on the decline for a while.

maddythebeagle · 01-08-2008, 10:41 AM

Quote:

Originally Posted by armor99

Interesting question David1961. First off let me start by saying that nationalized health care would be the worst thing that could possibly happen. Now before I get flammed into next week.... listen to some well thought out reasons why I believe this is true.

Any business from selling hot-dogs to practicing medicine works on the same concepts of supply and demand, quality vs. availability, etc. Competition is the only force that drives a product to get cheaper, or better. If a hot dog vendor wants to lure your business away from the guy up the block, he can lower his prices, or maybe give you free pickles (making the product better).
I believe that exactly the same principle works in medicine. Not all doctors are created equal. Some are better than others, and those that do better work, typically charge higher prices. People go to places like the Mayo Clinic because there are superior doctors there for things they might need treatment on.
So now let's say that the govt now runs health care. There is no competition, as they now control the price of medicine, services, salaries, etc. This will have some very dramatic effects immediately.
Very few doctors that I have ever met were completely altruistic. Now certainly doctors got into their profession because they want to help people. But most want to be well compansated for their time spent in medical school (8 years +), and for their personal skill as a doctor. (And I have no problem with that. Most people want to be compensated well). If doctors can no longer set their own rates, and their salaries are now set by the govt, then you will see lots of doctors fleeing the medical profession, and many fewer doctors entering medical school.
So.... when I now need a doctor, are the best and brightest doctors the ones that are going to see me? No.... the doctors left will be the most unambitious of the lot, and probably not the best in their field. That concept frightens me greatly. Now some might say that this system will yield the BEST doctors, because only the least money motivated (most altruistic) will be left. Might be right.... but I do not believe there are very many completely selfless people out there. (No one that I know likes to work for less than they can earn). And finally... I would love to hear what the medical profession folks think about nationlized heathcare. Funny that you never see interviews with the actual doctors or hospitals that will be affected by this, and hear what they think about it. I would wager that you will not be able to find many doctors that would be in favor of this at all. I doubt that lawyers would like nationalized "law services" for the same reasons.
So what would I do

Not sure..... if the govt takes away my choices, then there is not much that I can do about it.
But I will also wager that if the govt does get this one to happen, you will see many of the best and brightest doctors getting together and forming their own networks that do not accept insurance at all. They will work outside the govt system entirely. They will probably charge more, but the service would be much better. If something like this came about, I would put off retirement for a while so I could afford this route instead. I hope this made sense, and that I have presented my thoughts in a clear and logical manner.

The space bar is the longer key towards bottom middle of your keyboard

Mayo Clinic is "a place of last resort" for most people currently and probably wouldnt change under any health care reform...

**Rich_in_Tampa** · 01-08-2008, 10:53 AM

Armor, if you are open-minded on the issue you might find the link in this recent post to be helpful. It's a pretty complex issue and even many conservatives now recognize what a mess we are in with our health care system, and spiraling down every year.

FWIW, I am a practicing physician and assure you that few of my colleagues oppose a major overhaul. But if you are young, healthy, and employed with good benefits, the current system may work well for you for now, so it is easy to understand why you might not have much exposure to the catastrophic problems in the larger scheme of things.

**Want2retire** · 01-08-2008, 10:55 AM

Quote:

Originally Posted by David1961

I’d like to throw a question out to the members here, particularly those planning for ER who have not ER’d yet. If and when the US goes to some sort of national health-care system, how will it affect your retirement planning? Would you be more likely to ER early? I know the devil is in the details, but in general how would such a plan affect your planning?

I read a lot about the cost of medical coverage being one reason why people need to work longer. How many folks here have intentionally delayed ER because of the inability to obtain affordable medical insurance?

In answer to your questions, this will not affect my ER planning. I have been delaying ER until I qualify for lifetime medical as a federal employee. Since ER will be in about 22 months, I don't think things will progress fast enough to personally help me to retire sooner. Since I will already have lifetime medical, it won't help my situation in retirement, either.

On the other hand, increased taxes would hit me hard after ER! I will have to manage with less than I had planned.

I earned (and I am still earning) a lower salary as a federal worker than I could have in industry, for many years. I deliberately chose to do so, because I felt that this job offered the greater total compensation package when considering the small pension and lifetime medical offered to federal employees.

If I now have to pay for lifetime medical for everybody else through my taxes as a retiree, that would NOT make me happy.

I have no idea what taxes would increase or how much in order to pay for all this, but I am thinking it can't be good for my personal financial position after ER.

Notmuchlonger · 01-08-2008, 10:57 AM

Quote:

Originally Posted by Want2retire

I will already have lifetime medical since I am a federal employee, so I don't think it will personally help my situation in retirement.

On the other hand, increased taxes would hit me hard after ER!

I earned (and I am still earning) a lower salary as a federal worker than I could have in industry, for many years. I deliberately chose to do so, because I felt that this job offered the greater total compensation package when considering the small pension and lifetime medical offered to federal employees.

If I now have to pay for lifetime medical for everybody else through my taxes as a retiree, that would NOT make me happy.

I have no idea what taxes would increase or how much in order to pay for all this, but I am thinking it can't be good for my personal financial position after ER.

Maybe you would get a reimbursement or tax credit. Or be excluded. Im sure something would be worked out for people in your situation.

01-08-2008, 07:34 AM	#1
David1961 Recycles dryer sheets Join Date: Jul 2007 Posts: 73	How would national health plan affect ER? I’d like to throw a question out to the members here, particularly those planning for ER who have not ER’d yet. If and when the US goes to some sort of national health-care system, how will it affect your retirement planning? Would you be more likely to ER early? I know the devil is in the details, but in general how would such a plan affect your planning? I read a lot about the cost of medical coverage being one reason why people need to work longer. How many folks here have intentionally delayed ER because of the inability to obtain affordable medical insurance?

01-08-2008, 07:36 AM	#2
Rich_in_Tampa Moderator Join Date: Feb 2006 Location: Tampa Posts: 5,882	Depends on the solution. It is hard to imagine a scenario where things would get worse than now. but at the least you should be able to purchase the insurance on a competitive basis. Currently, even getting access to insurance is problematic in ER, and if you do the cost can be prohibitive. Under almost any current proposal, universal care is likely and costs will be averaged to some extent. __________________ Rich Tampa, FL (10% retired) As if you didn't know..If the above message happens to contain medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any medical purpose whatsoever. Consult your own doctor for all medical advice.

01-08-2008, 07:58 AM	#3
Martha Moderator Join Date: Feb 2004 Location: minnesota Posts: 9,794	I am already retired. What it would do for me is give me flexibility in where I live. Now when you are on an individual health plan and you have existing conditions it is about impossible to move to another state and another plan. __________________ . Do not rely on the information provided--my posts are not to be taken as legal advice. Needless to say you must consult with your legal representative. I am not responsible for errors. If I offended you with cya I apologize. If I did not, I tried.

01-08-2008, 09:32 AM	#9
Rich_in_Tampa Moderator Join Date: Feb 2006 Location: Tampa Posts: 5,882	Yes - let's not confuse "national health care" along the lines of "socialized medicine" with universal health care. The latter implies (to me) guaranteed access to health insurance, elimination of most underwriting so that those who need it the most are not shut out, and a certain amount of risk sharing at a national level. Yes, the devil is in the details, but those basic principles are what I was referring to. BTW, free market capitalism and health care make uneasy bedfellows for reasons discussed here and everywhere many times. I suggest a search on national health care or universal health care in this forum if anyone is interested. __________________ Rich Tampa, FL (10% retired) As if you didn't know..If the above message happens to contain medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any medical purpose whatsoever. Consult your own doctor for all medical advice.

01-08-2008, 10:37 AM	#13
Martha Moderator Join Date: Feb 2004 Location: minnesota Posts: 9,794	I don't see why it would bankruptcy everybody. Countries with national health care spend less than we do already. If you want to know more about the uninsured in the US (about 46 million) here is a link which shows some of the demographics: Facts and Research on the Uninsured: Fact Sheets There are a number of disturbing trends. For example, nearly all large employers offer health insurance to full time workers. But the number of small employers offering health insurance has been on the decline for a while. __________________ . Do not rely on the information provided--my posts are not to be taken as legal advice. Needless to say you must consult with your legal representative. I am not responsible for errors. If I offended you with cya I apologize. If I did not, I tried.

01-08-2008, 09:03 AM	#5
DallasGuy Recycles dryer sheets Join Date: Aug 2007 Posts: 199	A national health care system in whatever form would hopefully make the availability of a health care insurance plan better (i.e. remove the pre-existing requirements, etc.) and make the cost a little more predictable. Right now health insurance coverage seems like "the great unknown" as it relates to ER. It would be nice to have a little more certainty about the availability and costs from my current age of 51 until age 65. I'll probably ER anyway, but the decision would be much easier with a national health care system. NOTE: For me a national health care system could be as simple as having health insurance companies mandated to accept everyone for insurance coverage and not throw them into a high risk, high cost plan just because they're in their 50's or 60's. Also, I understand that older people have more health care expenses so I'm not against paying a little more , within reason, as I get older.

01-08-2008, 09:03 AM	#6
armor99 Recycles dryer sheets Join Date: Feb 2007 Posts: 442	Interesting question David1961. First off let me start by saying that nationalized health care would be the worst thing that could possibly happen. Now before I get flammed into next week.... listen to some well thought out reasons why I believe this is true. Any business from selling hot-dogs to practicing medicine works on the same concepts of supply and demand, quality vs. availability, etc. Competition is the only force that drives a product to get cheaper, or better. If a hot dog vendor wants to lure your business away from the guy up the block, he can lower his prices, or maybe give you free pickles (making the product better). I believe that exactly the same principle works in medicine. Not all doctors are created equal. Some are better than others, and those that do better work, typically charge higher prices. People go to places like the Mayo Clinic because there are superior doctors there for things they might need treatment on. So now let's say that the govt now runs health care. There is no competition, as they now control the price of medicine, services, salaries, etc. This will have some very dramatic effects immediately. Very few doctors that I have ever met were completely altruistic. Now certainly doctors got into their profession because they want to help people. But most want to be well compansated for their time spent in medical school (8 years +), and for their personal skill as a doctor. (And I have no problem with that. Most people want to be compensated well). If doctors can no longer set their own rates, and their salaries are now set by the govt, then you will see lots of doctors fleeing the medical profession, and many fewer doctors entering medical school. So.... when I now need a doctor, are the best and brightest doctors the ones that are going to see me? No.... the doctors left will be the most unambitious of the lot, and probably not the best in their field. That concept frightens me greatly. Now some might say that this system will yield the BEST doctors, because only the least money motivated (most altruistic) will be left. Might be right.... but I do not believe there are very many completely selfless people out there. (No one that I know likes to work for less than they can earn). And finally... I would love to hear what the medical profession folks think about nationlized heathcare. Funny that you never see interviews with the actual doctors or hospitals that will be affected by this, and hear what they think about it. I would wager that you will not be able to find many doctors that would be in favor of this at all. I doubt that lawyers would like nationalized "law services" for the same reasons. So what would I do Not sure..... if the govt takes away my choices, then there is not much that I can do about it. But I will also wager that if the govt does get this one to happen, you will see many of the best and brightest doctors getting together and forming their own networks that do not accept insurance at all. They will work outside the govt system entirely. They will probably charge more, but the service would be much better. If something like this came about, I would put off retirement for a while so I could afford this route instead. I hope this made sense, and that I have presented my thoughts in a clear and logical manner.

01-08-2008, 09:36 AM	#10
FUEGO Full time employment: Posting here. Join Date: Nov 2007 Posts: 670	Depending on increases in tax burden that I would have to pay, it would probably allow me to retire a little earlier with a feeling of more certainty in my ER plan. The fact that future costs are unknown in the current system requires me to be conservative and estimate very high future payments. And the fact that insurance at any reasonable price may become unavailable or riddled with exclusions worries me, and might cause me to keep my skills a little sharp in case I had to jump back in the labor market.

01-08-2008, 10:53 AM	#15
Rich_in_Tampa Moderator Join Date: Feb 2006 Location: Tampa Posts: 5,882	Armor, if you are open-minded on the issue you might find the link in this recent post to be helpful. It's a pretty complex issue and even many conservatives now recognize what a mess we are in with our health care system, and spiraling down every year. FWIW, I am a practicing physician and assure you that few of my colleagues oppose a major overhaul. But if you are young, healthy, and employed with good benefits, the current system may work well for you for now, so it is easy to understand why you might not have much exposure to the catastrophic problems in the larger scheme of things. __________________ Rich Tampa, FL (10% retired) As if you didn't know..If the above message happens to contain medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any medical purpose whatsoever. Consult your own doctor for all medical advice.