Retirees may worry about healthcare reform

[lightwaves]

Makes one want to look at retiring in a 3rd world country with first rate and inexpensive healthcare. The estimates in this article make you want to weep

MarketWatch.com Story

[ziggy29]

All I can do at this point is keep maxing out my HSA and hope for the best.

[Ed_The_Gypsy]

I/we will be screwed no matter what. Reform is a fantasy. Washington, DC, has been ingesting too much LSD.

[Notmuchlonger]

Quote:

Originally Posted by Ed_The_Gypsy I/we will be screwed no matter what. Reform is a fantasy. Washington, DC, has been ingesting too much LSD.

That is my feeling. I think Im in the spot if they do reform it wont help me much if at all.Probably just increase my taxes. If they don't reform Ill keep paying higher costs down the road.

[huusom]

I don't know how did they come up with all the numbers in this article but I know they are way out of most retirees reach. Most americans don't have that much money saved in the first place so they are likely survive on Social Security and basic Medicare.

What this article does not say is the high cost of insurance and drugs is the direct result of un-regulated, non-competitive and wasteful insurance system we currently have.

Lets get rid of the for profit insurance companies. They are not in business to provide care. They are in business to deny care.

We need doctors, nurses and hospitals not insurance companies. What do insurance have to do with health care?

[samclem]

Quote:

Originally Posted by huusom We need doctors, nurses and hospitals not insurance companies. What do insurance have to do with health care?

That would work--getting rid of the insurance companies and having everyone pay their medical bills directly would do more than anything else to reduce medical costs. It's an extreme solution, and one I'm surprised to see you make based on the opinions you've expressed previously. Getting insurance companies (and government agencies and bureaucrats --who also provide no care) out of the system will help eliminate a lot of waste.
And to think that people say no one ever changes their minds about these things!

[Delawaredave5]

"For the time being, at least, the reality is this: Men retiring at age 65 in 2009 will need from $68,000 to $173,000 in savings to cover health-insurance premiums and out-of-pocket expenses in retirement if they want a 50/50 chance of being able to have enough money, and $134,000 to $378,000 if they prefer a 90% chance, according to a study published last week by the Employee Benefits Research Institute."

I don't understand how it can be this high - especially retiring at 65. Maybe they're assuming 20 year longevity - even then that's over $5k per year.

[Tadpole]

Quote:

Originally Posted by Delawaredave5 "For the time being, at least, the reality is this: Men retiring at age 65 in 2009 will need from $68,000 to $173,000 in savings to cover health-insurance premiums and out-of-pocket expenses in retirement if they want a 50/50 chance of being able to have enough money, and $134,000 to $378,000 if they prefer a 90% chance, according to a study published last week by the Employee Benefits Research Institute." I don't understand how it can be this high - especially retiring at 65. Maybe they're assuming 20 year longevity - even then that's over $5k per year.

One problem is the amount of money spent to die. No one seems to want to examine this and ask the hard questions. Life and death issues are something people are hesitant to place in a cost/benefit analysis, even if the benefit is to the patient. I would much rather my husband have enough money to live a long healthy life after I am gone than for the "rules of the system" to force him to expend vast resources to keep my comatose body alive for another five years just because they can. Perhaps any reform should include a requirement for living wills.

What I cannot figure out is why people complain that someone who has become unhealthy costs the system. What is health insurance insuring against? I guess I think high deductible is, ultimately, a better idea than total coverage from a cost stand point if that insurance is not subject to cancellation. (People who simply can't afford upfront costs could be subsidized for part of their routine care.) I know that the counter argument is a good one - that high deductible discourages preventative care and I acknowledge that it is a good argument. But unless we have a public plan with risks spread across all conditions of health, something unlikely to happen, I don't see how affordable insurance can provide health care, money for insurance operations and stockholder profits, especially when traded stocks are required to have large quarter over quarter increases in profit.

If we, as a society, reject measuring the value of health services as a function of probable outcome, we are stuck in our current problem of rising costs, especially as the boomers enter the aging and dieing phase. No one, no matter how healthy they are, has escaped death so far. In fact studies seem to indicate that, when viewed from total cost (includes more than health care), the healthier, longer living individual costs society more in the long run and the unhealthy, who dies earlier, costs less. But few to none are healthy at 90 because of the aging process. We have extended longevity without comparable sucess in delaying aging.

Are we facing reality in the discussion of health care reform or am I just resistant to believe the massive savings that all of this is going to bring? The status quo may be too deeply ingrained in our culture to hope for anything other than a hodge-podge piece of nonsense that ultimately solves very little.

It should be obvious that I think that a single payer has a better chance of working than any other option since it spreads risk the most. A mixed insurance+public plan has only one outcome. Namely the poor and high risk end up in the public plan and insurance products continue to de-pool the young and healthy from plans carried by higher risk people, driving them to the public plan. I guess I disagree that a public plan option will drive all costs down, maining because of de-pooling, and I don't believe the cost savings of mandated insurance when the risks can be divided into pools priced by insurer's risk. The last person that can afford high year over year increases in insurance is a sick person, but the plans with the most sick people will have the highest year over year increases in premium. So, as I muse about this, I cannot see mandated insurance as solving the problem. Ultimately, if our society is not willing to make some cost/benefit life decisions, I don't think much savings will be found. And culturally, it seems from the rhetoric that that resistance to put life decisions on a risk or cost/benefit basis makes the entire subject ridiculous.

[Bestwifeever]

I love studies like that. The average 401(k) balances by age according to Bankrate.com in 2005 (who knows what they are now after the meltdown--I think most estimates show 401(k)s have actually fallen to their 2003 levels):

20s: $24,169; 30s: $50,930; 40s: $91,848; 50s: $137,766; 60s: $140,957

And only 26% of people older than 55 have more than $250,000 saved according to the 2009 Retirement Confidence Survey
(You Think That's All You'll Need to Retire?).

So good luck America on getting that separate healthcare nestegg funded too.

[suncameuptoday]

Quote:

Originally Posted by samclem having everyone pay their medical bills directly would do more than anything else to reduce medical costs.

This is the only answer - unless cost is directly tied to the consumer or the provider - everyone will merrily continue on consuming too much health care that does too little good at too much cost. I have no idea why this isn't obvious to everyone. It is how markets work.

On the other hand, it is absolutely insane to not screen everyone for Diabetes, but provide forever dialysis on the government tab once your Kidneys fail (Kidney failure being a secondary problem to the original problem, diabetes). Of course this path then opens the door to the diet police, regulators, tax incentives to modify behavior, etc.

Apparently the providers are responding to cost - more procedures equal more revenue - more procedures equal a defense case, in case of getting sued for making a human mistake.

And the consumers? More like, either you can pay (meaning someone else pays) or you can't and you live sicker and die younger.

Are there any, or many, health care consumers out there that ever dare ask - Why am I paying non generic prices for this extended release version of the same drug I can get for 1/10th less? Or asking why am I paying non generic prices, because you combined 2 generic drugs and got a new patent? Or asking why do you want to do a MRI every 6 months to watch some medical thing in which you can neither cure or treat. What good does watching it do?

Or as an earlier poster mentioned - why do people go to ICU to die? What good does that do for anyone?

Why the good provider says - but I can get you a 1% chance of a better outcome. They tell you they prevent things. How can they know whether they prevented anything, when they do not know who will or will not get something?

It is currently popular to point to fat people, as burdens to the health care system. 25% of fat people never get diabetes. They do not know who will or who won't. (my BMI is just fine thank you, so no I am not defending fat people as being people too).

In the name of prevention, the medical business world wants to treat pre-diabetes. Again, what are they treating - when they have no way of know who will or who won't.

Tie cost to the consumer, and over consumption gets reigned in.

They say if the consumer has to pay, they won't go for routine checkups. I don't know anyone personally - who had no symptoms, who ever benefited from seeing a doctor (though I am sure there are folks). Health Care is infinity expensive when they are treating people with no symptoms, and no disease, but in the absence of, begin treating for risk of such, never knowing who will or won't eventually get disease. Why look at the market - the business folks drool, it is everyone.

suncameuptoday

[Bikerdude]

Quote:

Originally Posted by Delawaredave5 "For the time being, at least, the reality is this: Men retiring at age 65 in 2009 will need from $68,000 to $173,000 in savings to cover health-insurance premiums and out-of-pocket expenses in retirement if they want a 50/50 chance of being able to have enough money, and $134,000 to $378,000 if they prefer a 90% chance, according to a study published last week by the Employee Benefits Research Institute." I don't understand how it can be this high - especially retiring at 65. Maybe they're assuming 20 year longevity - even then that's over $5k per year.

Why do you think this is high? With medicare premiums, medigap premiums and co-pays you will easily hit 5K+ per year.