The Hidden Cost of Retiring Early

[BLS53]

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Originally Posted by Senator I get free VA healthcare, all I have to do is wait for it... If I was on welfare, I would get it faster, and still free. It's amazing we treat people that have never contributed a dime to society, to better health care than a veteran.

+1 Same issue with retirees and Tricare Standard and the 25% co-pays. Meanwhile, I provide transportation for a 45 year old friend, on Medicaid, for his monthly free of charge doctor visits. Followed up by a trip to the pharmacy for his monthly stash of free drugs. Deemed disabled because of a lifetime of alcohol and drug abuse.

[Alan]

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Originally Posted by Chuckanut 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

A similar thing happened to good friends of ours some years back. She had a nerve entrapment that had "experimental" surgery available that was not yet covered by their HI. ( he worked at the same company as I did). She could have the surgery done in Houston at a cost of $25,000 or travel to France (Nantes ) and have it done by the surgeon who pioneered the procedure for $5,000.

They both flew to France for the surgery and stayed for 2 weeks, and about 10 years on reckon they made a great decision.

[nun]

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Originally Posted by BLS53 +1 Same issue with retirees and Tricare Standard and the 25% co-pays. Meanwhile, I provide transportation for a 45 year old friend, on Medicaid, for his monthly free of charge doctor visits. Followed up by a trip to the pharmacy for his monthly stash of free drugs. Deemed disabled because of a lifetime of alcohol and drug abuse.

I feel good about my taxes being used to provide Medicare Medicaid for young mothers, and funding for the care of disabled veterans and children. I don't feel good about the cost of that care being twice as high as in the rest of the world.

[Alan]

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Originally Posted by nun I feel good about my taxes being used to provide Medicare for young mothers, and funding for the care of disabled veterans and children. I don't feel good about the cost of that care being twice as high as in the rest of the world.

A Medicare patient giving birth should make the news for sure.

It is possible of course....

'World's oldest mother' is dying just 18 months after giving birth at age 70 - NY Daily News

[ERhoosier]

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Originally Posted by nun 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.

Apparently not any more. Facing major cost pressures, NHS took a big step towards privatization with the Health and Social Care Act of 2012. Doc-led (general practitioners) Clinical Commissioning Groups are replacing the Primary Care Trusts.
https://en.wikipedia.org/wiki/Nation..._%28England%29
As of Apr '13 NHS instituted a 7.85 pound fee for "each drug or appliance", although certificates for on-going medications are available at reduced cost.
https://www.gov.uk/government/news/n...2013-announced
And many high cost cancer drugs are not paid for by NHS, although may (or may not) be funded the Cancer Drug Fund.
BBC NEWS | Health | Fears over NHS cancer drug costs
NHS England » The Cancer Drugs Fund
Although only if the use fits very specific preset criteria.
http://www.england.nhs.uk/wp-content...list-may14.pdf
And not just expensive cancer drugs are being denied for NHS payment. The new Hepatitis C 'cure', Sovaldi, is not covered by NHS due to its cost of US$60,000+ per course of treatment.
Sovaldi ‘cost effective but not affordable’ for NHS - News - pharmaphorum
To be fair, HC cost pressures are a huge problem for all countries, not just UK (or US). No single nation has the 'perfect' answer for HC delivery. But also in fairness, those cancer and hepatitis drugs are being provided to insured patients at MA hospitals so your $450/mo insurance premium is buying something

[Alan]

Quote:

Originally Posted by ERhoosier Apparently not any more. Facing major cost pressures, NHS took a big step towards privatization with the Health and Social Care Act of 2012. Doc-led (general practitioners) Clinical Commissioning Groups are replacing the Primary Care Trusts. https://en.wikipedia.org/wiki/Nation..._%28England%29 As of Apr '13 NHS instituted a 7.85 pound fee for "each drug or appliance", although certificates for on-going medications are available at reduced cost. https://www.gov.uk/government/news/n...2013-announced And many high cost cancer drugs are not paid for by NHS, although may (or may not) be funded the Cancer Drug Fund. BBC NEWS | Health | Fears over NHS cancer drug costs NHS England » The Cancer Drugs Fund Although only if the use fits very specific preset criteria. http://www.england.nhs.uk/wp-content...list-may14.pdf And not just expensive cancer drugs are being denied for NHS payment. The new Hepatitis C 'cure', Sovaldi, is not covered by NHS due to its cost of US$60,000+ per course of treatment. Sovaldi ‘cost effective but not affordable’ for NHS - News - pharmaphorum To be fair, HC cost pressures are a huge problem for all countries, not just UK (or US). No single nation has the 'perfect' answer for HC delivery. But also in fairness, those cancer and hepatitis drugs are being provided to insured patients at MA hospitals so your $450/mo insurance premium is buying something

Nun did say in the post you quoted that you can get better treatment for 99% of the treatments available in the USA.

We Skype with friends in the UK every week and yesterday we were chatting with some long time friends and getting an update on his latest cardio checkup. He is approaching 71 years old and 11 years ago found himself out of energy much more quickly than he should be. They are both extremely fit, cycling, hiking, swimming every week, so this was a big concern. An Echo Cardiogram showed a faulty heart valve, a congenital issue, and within a couple of months he had the valve replaced. This latest checkup showed normal blood flow but the valve was starting to fray at the edges. ( it is a hybrid, part pig part mechanical I believe). Cardiologist said it will need replacing in 18 - 24 months and since he is so fit he would recommend open heart surgery again for a full valve replacement, rather than a smaller valve inserted as a stent inside the existing valve as this would result in lower blood flow. That should allow him to keep up his vigorous exercise regime and in another 10 to 15 years they can do the less invasive stent type valve.

As our friend says, it is wonderful to have all this available with no hit to his bank balance, and like the majority of folks in the NHS they pay nothing for prescription drugs as there are many exceptions as to who pays.

I can recount similar recent stories from our relatives, including my sister, that have received or have been receiving what would be very expensive treatment and surgery for things like cancer and a kidney transplant.

[pb4uski]

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Originally Posted by Alan ....As our friend says, it is wonderful to have all this available with no hit to the bank balance....

It hits someone's bank balance.

[Alan]

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Originally Posted by pb4uski It hits someone's bank balance.

Thanks for pointing that out, I've corrected my post above to be more accurate.

[Mulligan]

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Originally Posted by pb4uski It hits someone's bank balance.

It may still be the better way, I don't know....But I think that is why they like using that ol VAT tax, as it doesn't show on the tax returns. I imagine that is why a few posters have commented on people saying the "government is paying for it" as you never actually see the tax. I know I think that way on baked in taxes. I never think about the 35 cents a gallon tax on gas when I fill up the tank.


Sent from my iPad using Tapatalk

[Rustic23]

My opinion:

It is not about what the veteran deserves. It is about what he was promised for his service. The fact that other companies have welched on their promises to their employees is meaningless. If the government does not have the means to keep all it's promises it has to prioritize. For me the debt owed the veteran is every bit as strong as say the debt owed to treasury bond holders.

Likewise weather fireman or police are equally deserving is also meaningless. If they were promised a level of benefits by their employer, then they should be granted those benefits.

I am not an expert on bankruptcy. But, when a bond holder get paid off before the pensioner, I think it is wrong. They should share equally. Maybe they do, as I said, not my field.

[nun]

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Originally Posted by ERhoosier Apparently not any more. Facing major cost pressures, NHS took a big step towards privatization with the Health and Social Care Act of 2012. Doc-led (general practitioners) Clinical Commissioning

Unfortunately recent Governments have not been aggressive in financing or protecting the NHS and are now privatizing some services and introducing some charges. These changes are resented and resisted by many patients and doctors. It is to be hoped that they will be reversed by the next Government.

The charges and creeping privatization are only happening in England and Wales. Scotland has a a lot of autonomy on how it funds the NHS and has resisted the changes.

Even with the changes the lack of out of pocket charges and paperwork would amaze most Americans. My mother was being treated for the usual old age combos of conditions for many years and had cataract surgery, shoulder surgery, blood pressure and low grade diabetes medication, a monthly trip to the podiatrist, dietary help and home visits from her doctor and she never paid a penny out of pocket or ever saw a bill. She had a fall once and the doctor prescribed a grab bar above the step where she fell and two guys from the council came and installed it...again no charge to my mum.

Of course this is paid for by taxation, but the UK spends half as much per capita on health care as the US and gets as good or better outcomes. You can point to specific areas where the statistics aren't as good as the US and some where they are better. The UK personal tax burden is similar to the US.

[daylatedollarshort]

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Originally Posted by Rustic23 If they were promised a level of benefits by their employer, then they should be granted those benefits.

The problem is a $1 trillion gap. The money has to come from somewhere:

Buffett's Omaha Shows Pension Tapeworm Eating Funds: Muni Credit - Bloomberg

[Chuckanut]

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Originally Posted by daylatedollarshort The problem is a $1 trillion gap. The money has to come from somewhere: Buffett's Omaha Shows Pension Tapeworm Eating Funds: Muni Credit - Bloomberg

That line or reasoning would sound better if it was applies to all government expenditures in these days of lower revenues and huge Federal deficits.


Sent from somewhere in the world with whatever device I can get my hands on.

[daylatedollarshort]

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Originally Posted by Chuckanut That line or reasoning would sound better if it was applies to all government expenditures in these days of lower revenues and huge Federal deficits. Sent from somewhere in the world with whatever device I can get my hands on.

I think the issue is the Federal Government with their ability to print money, run up deficits, raise taxes or cut military spending have more options that a city like Detroit.

Residents can just move out of Detroit to avoid paying higher taxes to cover pensioners, but it is a lot harder for large segments of the population to move out of the U.S. entirely.

[nun]

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Originally Posted by ERhoosier No single nation has the 'perfect' answer for HC delivery. But also in fairness, those cancer and hepatitis drugs are being provided to insured patients at MA hospitals so your $450/mo insurance premium is buying something

The NHS won't pay for treatments or drugs until they are approved by NICE (National Institute of Healthcare Excellence). So many new treatments are not available because they have not been proven to work well. This might be seen as bad for some individual patients, but it also controls costs and prevents some dubious treatments.

[Fermion]

Gilead just reported some phase III results in Japan of their new Hep C cure. 100% of the people in the test cured in 12 weeks, half of whom had failed to get cured on other drugs.

NICE says it is unsure if the drug is effective.

LOL

(I am a bit biased as I own a good chunk of Gilead)

[nun]

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Originally Posted by Fermion Gilead just reported some phase III results in Japan of their new Hep C cure. 100% of the people in the test cured in 12 weeks, half of whom had failed to get cured on other drugs. NICE says it is unsure if the drug is effective. LOL (I am a bit biased as I own a good chunk of Gilead)

I would not trust s single study.

[aja8888]

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Originally Posted by nun I would not trust s single study.

Well, then, who or what would you trust then?

[MRG]

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Originally Posted by nun I would not trust s single study.

If I was dying of Hep-C, I would.

[MichaelB]

There's a difference between trust and hope. No drug, prescribed or over the counter, is 100% effective or free of side effects.