ways of dealing with ER health care costs

[wanderer69]

X-posted at raddr- pages. Any additional suggestions?

1. overseas treatment in Thailand/India/other low cost medical tourism place.

2. get Rx meds overseas or via internet.

3. MSAs set up before entering retirement (have to confess ignorance - has to paid for with earned income, non?).

4. work a bit longer build up nest egg reduce time spent in retirement.

5. maintain health - exercise, diet, etc.

6. high deductible, catastrophic policy.

7. uninsurable pool run by states (e.g. Washington state).

8. save and invest like a banshee.

9. 'unretire' for a few weeks a year - some companies give health insurance if you work over Christmas holidays

10. work a job that older folks can do. maintain the job and get yourself closer to the time when Medicare kicks in: e.g. academia, teach at community college, etc.

11. shortage of younger workers means more of the brief stints that could include health care (Wal Mart doesn't provide health care, I think).

12. Access to overseas health care either by a) living there or b) visiting (Just to clarify one above).

13. Become a student and get coverage thru clinic on campus - work towards a series of degrees. May be cheaper than actual health insurance and co-pays.

14. get COBRA coverage

15. Meet the requirements of HIPAA and be willing to pay for what may be very expensive individual coverage (6 requirements per Martha)

16. Meet, befriend, marry a spouse from a nationalized health care country (say, Canada, Western Europe, etc.). Obvious HUGE risk to sanity and assets.

17. Hedge cost of health care by investing in VGHCX, individual health care-related equities whose appreciation may equal or exceed the increase in retiree medical costs/premia.


http://www.raddr-pages.com/forums/vi...hp?p=9732#9732

[Martha]

Hi wanderer. I commented on your list at Raddr's board, but I had another thought this morning based on some advice by Sailaway in another thread. He suggested that you negotiate with providers for discounts on health care, which in his experience can be pretty generous. See http://early-retirement.org/cgi-bin/...26474;start=30

[P.S.]

Quote:

X-posted at raddr- pages. *Any additional suggestions? 5. maintain health - exercise, diet, etc. http://www.raddr-pages.com/forums/vi...hp?p=9732#9732

Yes, I honestly don't think this is beat in enough. Would rewite the list as such....

1. maintain health

2. maintain health

3. maintain health

4. maintain health

5. maintain health

6. preventative health maintenance

7. preventative health maintenance....

kind of a medical corollary to the Two Income Trap...

[Martha]

But don't forget that sometimes it just doesn't matter. My very best friend never was a bit overweight, got plenty of exercise, and was a vegetarian for years. She got breast cancer at about 46 years old, which resulted in a double masectomy, chemo for 6 months and radiation. She has been clean for three years now. No one is exempt.

[P.S.]

Right, I am actually (day in day out) reminded that genes plays a role, but for the vaaaaaassst majority of people, preventative health maintenance is most effective. *Good to hear that your friend has been doing well. *Breast cancer is estimated to hit 1/9 women born and raised in the U.S. (highest in the world). *Rates much lower for other countries, phenomenally lower for "undeveloped" countries, which implies that there are many factors to an American lifestyle which predispose someone to developing not just breast cancer, but many cancers, not including chance (as in your friend's case?).

[Ginger]

I am an 8 year cancer survivor. So ladies do get a mammogram every year! I was the one in my office who never took a sick day and felt perfectly fine when diagnosed. I eat vegetarian (mostly), walk every day, etc. I had skilled doctors, great cancer cancer and am very grateful for all the nurses and doctors and their professionalism.
Men, do get a yearly physical too. Prevention is the way to go. Don't put it off.
With my health care situation, health insurance is priority and health insurance a must. Right now, my company pays 100% of the premium, when my husband retires in October, I will go on his government health care insurance. No complaints about paying, it is a must.

[wanderer69]

From lazyday, raddr-pages.com:

Get on working spouse's plan

-Find a great dr&hospital in Mexico near border, and live near there, in US

-Volunteer for experimental treatments

-Obtain citizenship in a country which is (or might in future) be in EU.

When I was considering teaching English in Europe or South America, it was becoming hard for Americans to get jobs in Europe legally in EU countries. If a job could be done by an EU citizen, was illegal to hire not citizen, IIRC.
Read somewhere that it might be possible to pay some "fees" and get a dual citizenship. Maybe even in Ireland, but not sure about that. And opportunity may be gone now, at least in countries already in the EU.

[ShokWaveRider]

Quote: " -Obtain citizenship in a country which is (or might in future) be in EU."



But that would mean you would have to go LIVE there? I have 3 Citenships, USA, Canada and UK, but I do not get the UK national health unless I visit there. You can't say "Hmm.. I think I will move back to the EU" just before your heart attack. Or can you?

SWR

[JWV]

Re: preventative health care as posted by P.S. and Martha

S**t does happen but according to the CDC, the leading causes of death are:

Deaths-Leading Causes

(Data are for U.S. in 2001)

Number of deaths for leading causes of death

Heart Disease: 696,947

Cancer: 557,271

Stroke: 162,672

Chronic lower respiratory diseases: 124,816

Accidents (unintentional injuries): 106,742

Diabetes: 73,249

5 of these are directly related to lifestyle (diet, exercise, smoking, alcohol consumption, stress). By making better choices, many diseases can be ameliorated, especially if diagnosed early. Lifestyle is also a contributing factor in many cancers. Along with the usual suspects (diet, exercise...) sex (STDs) can also be related to cancer. (Why is all the good stuff bad?)Genetics can play a small, but not insignificant, role in cancer. Anyone with a strong family history of breast, ovarian, prostate and/or colorectal cancer should seek genetic counseling and develop a plan to minimize risk/maximize surveillance.

Even tho people who have apparently led a very healthy life do get ill, they usually withstand the treatment better and have a better longterm prognosis. It's hard to work with PPP (med term for piss-poor protoplasm).

As with investing, the majority of our healthcare is up to us.

To your health,
Judy

[Martha]

Judy, and P.S. too, you are absolutely right about preventive health care. And that includes checkups as Ginger says. I probably lean too far towards the fatalistic on health because my father spent 10 years in a TB sanitarium and died too young. Bad Habits? None. Thin, never smoked, never drank (maybe he should have). My mom died suddenly at 39 of a heart attack. No smoking or drinking and plenty of exercise (we were a farm family). They ate a typical 1950s/60s diet.

My only point was even if you have good health, anything can happen any time.

But, point taken that the best thing you can do is care of yourself.

[MRGALT2U]

Hello Martha. I agree and could do a better job of taking care. I don't smoke, but probably drink
too much. My diet could be better and I certainly
need to get more exercise. OTOH, my parents
are 85 and 87, in pretty good shape. I have one friend with both parents still alive. His mother smokes 2
packs of Viceroys a day. It's all a big crap shoot IMHO.

JG

[JWV]

I agree, with JG (what, I agree with JG? Quick someone slap me, I must be delirious ) and Martha, it is oftentimes a crap shoot (just like investing) but ya gotta play the percentages and play the hand dealt ya (excuse my mixed metaphors)

Judy

[MRGALT2U]

Hi Judy. I love mixed metaphors; or any metaphors.
In 'As Good as it Gets', Jack Nicholson says "People
who speak in metaphors ought to shampoo my crotch!"
But, I digress. Supposedly, Nixon said. "You don't know
your ass from Shinola!". Anyway, a good metaphor makes my day.

JG

[VoyT]

Quote:

5. maintain health 6. preventative health maintenance

*Can't -- and won't -- argue with that part, but should your car be hit by a drunken driver, or some other accident befall you, health insurance would be a good thing to have...

* As for going to other countries, a few years ago, we visited Bisbee, AZ, which is close to the Mexican border. *Got to talking with the woman who took care of cleaning at the B&B. She said she went to Mexican doctors and dentists -- she had no insurance and couldn't afford to pay the costs in AZ.

[lazyday]

On lifestyle vs genetics... So, lets say that X% of your health is based on a combination of luck&genes, which you can't control.
Then, 100-X is the % that is dependant on your behavoir, such as diet,exercise,driving speed,sex partners.

So, you can have control over that 100-X portion, however big it is.

Even though I suspect that 100-X is low, perhaps 20%, I put great efforts and sacrifice into diet and exercise. Even 20% is very important to me.

SWR--yes, that's a problem with the using multiple citz. as a solution. I just meant it as a partial-solution idea for some. For example, it can provide a safety net in case of chronic disease or losing insurance. (Live in US until can't afford care here, because of failing health or medical inflation.)

[JWV]

Quote:

Hi Judy. *I love mixed metaphors; or any metaphors. In 'As Good as it Gets', Jack Nicholson says "People who speak in metaphors ought to shampoo my crotch!" But, I digress. *Supposedly, Nixon said. "You don't know your ass from Shinola!". *Anyway, a good metaphor makes my day. JG

JG,

Sometimes you crack me up!

Judy

[BUM]

We dealt with health care costs in ER by NOT folding the corporation. Instead I'm "awarding" DW 50% of the stock. There will be no payroll, therefore no payroll taxes. In NY a group must have a minimum of 2 employees. There are other conditions but when compared to individual rates : its a no-brainer.

BUM

[MJ]

BUM,

I asked one of the independent consultants in my company if he would consider hiring me for a buck so we could get the group rate insurance but he think the cost for individual or a group of 2 may not be that different.

What has been your experience?

MJ

[MRGALT2U]

I agree with BUM on the way he handled this issue.
I had EXACTLY this scenario worked out with my little company. Could still do it someday, but I have to deal with a few other issues. If I did not, as BUM says, it's
a real no-brainer.

JG

[P.S.]

Quote:

Even though I suspect that 100-X is low, perhaps 20%

In medicine, we (generically) say 90% is prevention, 90% is preventable. But there are billions of people in the US, so the odds ratio is that **** happens. Okay, last post on this, EOR (I've been waiting to use that one )