Obama Health Insurance

[TromboneAl]

W2R, imagine you work three more years, get your lifetime medical benefit, and then the next day the "Free Healthcare for All Americans Act of 2012" is signed into law.

I don't think healthcare costs can go up faster than inflation for much longer, and I do see changes on the horizon.

 

[ziggy29]

W2R, imagine you work three more years, get your lifetime medical benefit, and then the next day the "Free Healthcare for All Americans Act of 2012" is signed into law.

I think she will be eligible for retiree medical late this year -- she won't need to work for three more years.

 

[youbet]

W2R, imagine you work three more years, get your lifetime medical benefit, and then the next day the "Free Healthcare for All Americans Act of 2012" is signed into law.

.

Accessible healthcare for all Amercans hopefully will come to be. But, I can guarantee you it won't be free!

 

[Independent]

Hello Group,
I plan to retire in 12 months. One of my biggest concerns is health care cost. I'm sure all of you know all about that problem. Without being to political, do you think the up coming government plans will be a knight in shinning armor for retirees and future retirees? I've tried to read the obama plans but realize we will have to wait and see if any of the promises become reality.
Thanks for your thoughts,
Steve

It seems to me that medicare in its current form is going to take up increasing chunks of taxes. I don't see congress/Obama making it any more generous for over-65 people.

I think they will focus on expanding coverage for children. They will probably do something about uninsured adults like expanded high risk pools or allowing people to buy into Medicare at "standard" cost. This can be important to a young ER, especially if you already have a health problem.

I'd look at the cost of pre-65 insurance and Med-supp after that, and just work until I can afford it.

 

[Independent]

The problem with "health insurance" in the US is that it generally isn't true insurance. Insurance is bought to cover an unanticipated and large expense. If you are young and planning to have children, then OB/gyn/perinatal costs shouldn't be categorized as "unanticipated." Likewise, checkups, the occasional small surgery, etc are neither unanticipated nor large expenses, yet we want them to be covered in a national system.

The high deductible/catastrophic care plans are closer to true insurance.

This makes sense. Most Americans hear that medical costs are 16% of GDP and don't realize that means that "on average" they will spend about 20% of their lifetime incomes on medical care. Our costs are so chopped up between employer, direct, premiums, Medicare taxes, and other taxes that we rarely think about the total cost.

If I were in the market for individual medical insurance (and I will be a couple years from now), I'm sure that I would look at high deductible plans pretty seriously.

I'd be okay with the gov't replacing Medicare and Medicaid with universal catastrphic insurance, where a "catastrophe" is defined as spending more than 20% of your gross income on medical care. But that isn't going to happen because of the first paragraph above.

 

[kyounge1956]

(snip) I do agree that, with the exception of the above, insurance should be targeted to cover the major risks. I don't think fruitless hospital care should be covered as I think this is one area where our system needs a back bone.

But who decides when it is fruitless? Three years ago my mom was on life support for more than a month after heart surgery, suffered a number of setbacks and was hospitalized all told between six and seven weeks. Medical care might have been declared "fruitless" any time during that six weeks (or before she had the bypass surgery) and she probably would never have seen her 80th birthday. Since that didn't happen, she is still with us and in fact has pretty much fully recovered. I don't say there are no problems with our current system, that would obviously not be true, but it makes me nervous that denying medical care to sick people could be perceived as getting a backbone, rather than a death sentence passed by who-knows-who, with no appeals allowed. There must be a better way than telling people, "we could treat you, but it's too expensive, so go ahead and die."

 

[Alan]

In 2007, I came into enough money to be financially independent, yet I am still working against my will until I am eligible for lifetime medical through my work. I could afford to retire now if the private health insurance situation for Americans wasn't spiralling out of control.

I will be 61 years old in June, and feel old and tired and would love to retire right now. If upcoming government plans become the knight in shining armor for retirees, I will feel like such a chump!! I guess I don't really believe this is a sure thing, and the fact that I am still working bears that out.

At least you only have had to wrestle with this decision for 1 year, and I think you are right in working the extra year. If you expect to stay healthy then that "lost" year will be well worth it if it gives you the peace of mind I expect it will. Even if UHC or guaranteed insurance for all or whatever comes into being don't fret about missing out on it. I decided long ago that being angry because others got something I didn't just isn't worth it.

 

[kyounge1956]

(snip)I worked for an employer where the largest health care expense were those associated with child bearing.

SamClem, prenatal and infant health care is the best 'investment' in health care we can make.(snip) I agree that dollars spent here have a huge payoff. But, they are not unanticipated and/or large expenses, and for that reason they would not normally be thought of as an expense to be covered by insurance.

I agree that it's not unexpected that women will get pregnant, but it is always possible that a pregnancy will not go as expected (e.g. premature birth, c-section required to save the baby, and many other possibilities). The resulting expenses can be very high indeed, especially if the child is permanently affected by problems at birth, requiring life-long medical care as a result.

It's a semantic issue. When people want the majority of health care expenses to be paid by others, it may be best to just call it "public health care" rather than "insurance."

I am not sure anyone here is talking about having the majority of one's health care expenses "paid by others", which to me implies that one is not paying anything oneself, but rather some form of a pool into which everyone pays and out of which everyone's health care expenses come. I would describe that as "all pay for all" rather than "my cost paid by others". But if you want to call it "public health care", I don't have a problem. After all, we call the schools "public education", and they are also (more or less) an "all pay for all" system.

 

[Stevewc]

I read an article a few days ago where some of the obama team mentioned they did not want to make the same mistakes on the health care plan that passed administrations (clinton) had made. Number one thing was move quickly during their honey moon phase in office. Not sure if we will all like what they do but it did give me hope that they might make progress during the first year. Like others posted, I just need something more affordable. Another bright side to retireing early, I would help create a job opening for someone else. Its all how you look at it.
Thanks to everyone,
Steve

 

[samclem]

I read an article a few days ago where some of the obama team mentioned they did not want to make the same mistakes on the health care plan that passed administrations (clinton) had made.

The Clinton healthcare initiative failed primarily because the planning was not open to the public and because it looked like the government was going to control the type and level of care provided. I think President Obama will likely avoid the first problem (he says he favors openness when building policy, and I have no reason to believe otherwise), but I don't know how his team can avoid the second problem if government is to be the payor and we are trying to control costs. Little improvements around the margin (e.g. electronic medical records) are not going to make a big diference. Someone in the government is going to have to tell Granny that she can't have her new hip because she's 70.

 

[Alan]

Like others posted, I just need something more affordable. Another bright side to retireing early, I would help create a job opening for someone else. Its all how you look at it.

Good point. If I could have affordable life insurance when I left my job I would leave today and reduce the unemployment ranks also

 

[ziggy29]

Another bright side to retireing early, I would help create a job opening for someone else. Its all how you look at it.

This tends to be my response to folks who say people who retire early are shiftless, lazy and selfish people who are parasites on the economy. But what could be more selfless than someone who no longer NEEDS a job voluntarily giving it up for someone who needs it?

 

[Alan]

Someone in the government is going to have to tell Granny that she can't have her new hip because she's 70.

Unless private health insurance is still there - like in the UK, Australia and others. The Queen's mother had 3 hip replacements that weren't on the National Health.

Lady Thatcher (even when she was Mrs Thatcher and Prime Minister) always went private and justified this went questioned by saying she was not putting an additional burden on the National Health System (yeah, right, nothing to do with waiting lists).

I always had private health insurance through work when I lived in the UK

 

[Alan]

This tends to be my response to folks who say people who retire early are shiftless, lazy and selfish people who are parasites on the economy.

You must move in different circles - everyone I know are envious of early retirees and appreciate what it takes to be able to RE.

 

[ziggy29]

You must move in different circles - everyone I know are envious of early retirees and appreciate what it takes to be able to RE.

Oh, most people I know probably would be envious as well. But for some people, envy means tearing others down because they don't have to be as miserable as you.

People who say things like I mentioned earlier aren't the norm, but they are out there, and it's to them I say: "isn't it MORE selfish to keep a job you no longer need financially than it is to give it to someone who *does* need it financially?"

 

[Alan]

People who say things like I mentioned earlier aren't the norm, but they are out there, and it's to them I say: "isn't it MORE selfish to keep a job you no longer need financially than it is to give it to someone who *does* need it financially?"

I couldn't agree more, and you are correct that are going to be some who are ticked off at early retirees. No one I personally know has ever stated that view to me. (thankfully)

 

[W2R]

Thanks, T-Al, Gotadimple, Ziggy, and others for your perspective on this.

At least you only have had to wrestle with this decision for 1 year, and I think you are right in working the extra year. If you expect to stay healthy then that "lost" year will be well worth it if it gives you the peace of mind I expect it will. Even if UHC or guaranteed insurance for all or whatever comes into being don't fret about missing out on it. I decided long ago that being angry because others got something I didn't just isn't worth it.

It was originally two years and one month, but I only have about ten months left to wait. Might as well finish it out. You are SO RIGHT that being angry because others got something I didn't just isn't worth it. I need to remind myself of that more often.

Gotadimple mentioned free lifetime medical, and I should clarify... for me it isn't free, but will cost very little - - currently $152/month for BCBS Standard, the best BCBS Uncle Sam offers me.

And yes, T-Al, if Obama announces the "Free Healthcare For All Americans" health act, I will feel like such a chump. On the other hand, if I quit work and then he announces the "Healthcare For All Americans up to $5000/year Max" health act, or some such thing, I would be kicking myself around the block.

Ten more months won't kill me (probably). I plan to use up all my vacation time, about 8 weeks after this week, during these 10 months before I leave rather than choosing reimbursement. And I suppose I should be glad that I am working during this economic downturn, but (shhh!) I'm NOT...

 

[Alan]

I plan to use up all my vacation time, about 8 weeks after this week, during these 10 months before I leave rather than choosing reimbursement. And I suppose I should be glad that I am working during this economic downturn, but (shhh!) I'm NOT...

I plan on doing the same thing. End of this year (2009) I'll have 6 weeks owing in 2010, so I plan to only work the first 2 weeks in January and be on vacation until retirement on March 1st.

I had noticed how many posts you manage to get in during your "workday", but don't worry, I won't tell anyone

 

[W2R]

I had noticed how many posts you manage to get in during your "workday", but don't worry, I won't tell anyone

I hope you are the only one who has noticed all my multitasking! Shhhh! At work I am gradually sliding into the RIP (Retired In Place) category, and so far I have not felt any repercussions since I am getting the job done. Sometimes I have to focus just on the job, though, when workload demands. My job either avalanches me with work or just the opposite, rather than providing a steady stream of work. That probably sounds familiar to a lot of people as I suppose most jobs are like that.

I am so envious of your March ER date! Mine will be in November. (sigh)

 

[Alan]

I hope you are the only one who has noticed all my multitasking! Shhhh! At work I am gradually sliding into RIP (Retired In Place) category, and so far I have not felt any repercussions since I am getting the job done. Sometimes I have to focus just on the job, though, when workload demands.

I am so envious of your March ER date! Mine will be in November. (sigh)

March 2010 !!!!

It is I who am envious of you

 

[W2R]

March 2010 !!!!

It is I who am envious of you

OH!!! I missed that part. Yes, I will be glad to be done by the second week in November, 2009, assuming all goes as planned.

 

[Brat]

But who decides when it is fruitless? Three years ago my mom was on life support for more than a month after heart surgery, suffered a number of setbacks and was hospitalized all told between six and seven weeks. Medical care might have been declared "fruitless" any time during that six weeks (or before she had the bypass surgery) and she probably would never have seen her 80th birthday. Since that didn't happen, she is still with us and in fact has pretty much fully recovered. I don't say there are no problems with our current system, that would obviously not be true, but it makes me nervous that denying medical care to sick people could be perceived as getting a backbone, rather than a death sentence passed by who-knows-who, with no appeals allowed. There must be a better way than telling people, "we could treat you, but it's too expensive, so go ahead and die."

It is not a question of denial of care, it is a question of who pays for it.

 

[kyounge1956]

It is not a question of denial of care, it is a question of who pays for it.

Then please elaborate on what you meant when you wrote earlier: "I don't think fruitless hospital care should be covered as I think this is one area where our system needs a back bone." If treatment which is determined to be "fruitless" is "not covered", how is this not "denial of care"?

 

[Brat]

Ah, there are many many sick people who do not have the resources to pay for care today, even that which will restore them to essentially the level of function they had before becoming ill. How is that different than a health insurance program that pays for care that is not likely to be fruitless and not other care?

IMHO individuals should have the option of purchasing a private policy that insures against the risk of being denied payment because a treatment is not likely to be fruitful. A program that is all things to all people will be affordable for only a few.

 

[kyounge1956]

Ah, there are many many sick people who do not have the resources to pay for care today, even that which will restore them to essentially the level of function they had before becoming ill.

I agree. There are many people in the U.S. who have no medical insurance, and as a result don't get treatment.

How is that different than a health insurance program that pays for care that is not likely to be fruitless and not other care?

If I understand your question, the U.S. health care situation today is different in that the selection of which patients get care and which do not is made on the basis of whether they have insurance, not on the basis of whether the care is likely to be fruitful. I think this could and should be improved. In both the current system and what I think you are suggesting, some people are allowed to go without treatment for strictly financial reasons. Either way we are making money more important than peoples' lives, which IMO means our priorities are wrong.

Would I be correct to conclude that to you, "fruitful care" means care which is likely to return the person to their original level of function? In that case, what of people who have incurable conditions such as brain or spinal injury or genetic illnesses? There is no treatment that will restore them to their original level of function. Should they receive care, or not? What about people with birth defects, whose original level of function is subnormal in some way? Should they be treated?

IMHO individuals should have the option of purchasing a private policy that insures against the risk of being denied payment because a treatment is not likely to be fruitful. A program that is all things to all people will be affordable for only a few.

It sounds like to me like you are advocating a system under which people would pay for insurance (whether via premiums or a paying into a public pool via taxes), but if they suffer a catastrophic injury or illness from which full recovery is unlikely even with treatment, they would not be eligible for coverage, unless they also had a fail-safe private policy. It hardly seems fair to cut off treatment to someone who has been contributing to the system all along, just when they need it most and due to injury or illness are least able to pay out of pocket. But perhaps I misunderstand you?

I think a system which paid for the devastating injuries and illnesses, while leaving the smaller, preventive expenses to be paid for on an individual basis, would be preferable.

I think your suggestion of supplemental policies, which an individual would have the option of buying to increase their coverage, would be a good addition to just about any universal system.