Am I the only one having to work until 65 just for healthcare?

[ivinsfan]

In FLA, there is no Medicaid expansion, so how much should one pay if they can't qualify for the ACA minimum?

Are you going to put me in charge of ACA, great let me start my spreadsheet. for now to be consistent 'll say a dollar a month.

 

[Dtail]

Are you going to put me in charge of ACA, great let me start my spreadsheet. for now to be consistent 'll say a dollar a month.

Okay that's sounds fair.
Interesting discussion to say the least. Tough subject......

 

[FireFool]

I, like most people, really never appreciated how much my mega-corp was subsidizing my health insurance. Each year people would complain about the increases in premium contribution and the steering towards their high deductible plans but still had no real understanding of total costs. It wasn't until I neared retirement that I educated myself on real costs. Cobra premiums represented full costs to the company. I paid $1,200/month for a $2600 overall deductible Cobra plan. I did this for the full 18 months that I could because the unsubsidized premium I'm currently paying for the two of us is $1350/month, but the deductible is now $6,500 per person. BTW I live in Ohio like the original poster. Someone in this thread referred to ACA as bankruptcy insurance and negotiated group medical rates - I think that aptly describes it. I'm thankful that our health is pretty good and since on ACA we really haven't had and medical costs above and beyond the monthly premiums. But I will add that just like we worked to establish good finances for retirement that we also work towards good health with both diet and exercise. In some ways I wish others using ACA would take more personal responsibility for their health - that would lower premiums for all of us.

 

[DeborahB]

..... Someone in this thread referred to ACA as bankruptcy insurance and negotiated group medical rates - I think that aptly describes it. I'm thankful that our health is pretty good and since on ACA we really haven't had and medical costs above and beyond the monthly premiums. But I will add that just like we worked to establish good finances for retirement that we also work towards good health with both diet and exercise. In some ways I wish others using ACA would take more personal responsibility for their health - that would lower premiums for all of us.

If you mean me, I didn’t say the ACA was bankruptcy insurance... I was talking about the state high-risk pool. ACA did not exist when I needed it. Ironically, it started about six months after I became eligible for Medicare. The $941/month was outrageously high but what if? I was lucky to have enough money to pay it.

 

[DeborahB]

COBRA cost me ~$500 for a single person. I worked for a health system and they self-insured. It could have been much more. This was in 2010, when I retired.

 

[MarieIG]

Here is a recent article by a medical professional addressing the way to "fix" the health care system. It is very interesting and makes 4 points of contention with the current system- one being that people need to have more "skin in the game".

https://www.whitecoatinvestor.com/health-care-reform/

VW

Some interesting stuff, but I'm thumbs down on the death panel.

 

[pb4uski]

Finally, someone who get it.

I understand why people are mad at the health insurance companies–the insurance companies are the ones you write the checks to. They’re the face of a health care system with runaway costs. But they’re only that. The face. The symptom, not the disease. The disease is that health care spending is way, way out of control.

Imagine going to a restaurant and ordering a meal off a menu without prices. You then walk out of the restaurant without paying any money. Six weeks later, the bill is sent to your “restaurant insurance” company. Six weeks after that, the insurance company sends you a bill for your portion of the meal. Crazy, right? You don’t even remember what you ate 3 months ago. If we’re going to have health care be a business in this country (and having worked in socialized medicine, I don’t necessarily think that’s a bad idea) you have to have a functioning market. And guess what you need for a functioning market? That’s right. Prices. You need to know the price of stuff. Both patients and doctors. You want to bring down the cost of health care? You want to see what competition and a true market can do to reduce costs? Mandate that every health care provider in the country post its prices in the waiting room and on the internet.

While I’m on this rant, let’s talk about the whole “health care is a right,” thing. What a ridiculous bit of poppycock. You can’t go to the store and get food without having to pay, no matter how hungry you are. You can’t go to a hotel and sleep in their beds without having to pay, no matter how tired you are. If we don’t have a right to food or shelter, why would we have a right to health care?

 

[Chuckanut]

An acquaintance needed bariatric surgery last year that was deemed elective by the insurance company. The cost was nearly $20,000. This person went to Mexico and had it done in a very modern hospital for less than 1/3 the price. Another person I know had a broke leg treated Europe and had no travel insurance. The cost was about $600.

It’s costs.

Note: I realize bariatric surgery is controversial but....the person who had the bariatric surgery is doing great and has their life back. BP down, joint pains gone, nearly 100 pounds lost, and can finally enjoy life. I was skeptical, but one can’t argue with success.

 

[ShokWaveRider]

I believe we all do have a right to AFFORDABLE healthcare. In the same way we have a right to affordable food and shelter. No matter what rung on the social economic ladder one is on. This is why the ACA or something like it would work if properly thought out. What I mean is if there is a decided upon National percentage of taxable income one should pay for "Basic" healthcare. And yes having a baby, covering pre-existing conditions, drug coverage, blood tests etc. are basic, the ACA got the Basic part right.

Let us say the magic number is 10% up to a ceiling of say $20k a year. No idea what this number should be but 10% seems fair. So someone with an AGI of $30k would pay $3k a year and someone with an AGI of $200k would pay $20k. If everyone paid that then the system would be adequately funded if in addition prices for service were standardized.

Again one could pay for extra services if they wanted them.

 

[DeborahB]

Some interesting stuff, but I'm thumbs down on the death panel.

The death panel is a misnomer. It goes on all the time. Physicians meet to discuss a cancer patient and what might help. They have a lot of trouble acknowledging that some patients’ quality of life will be horrible if they are treated. Doctors are trained to try to cure. But some cures are worse than the disease. And ultimately cures that make your quality of life worse don’t help. It’s usually some relative who can’t bear the thought that you’re going to die. They keep patients going through treatments that are horrible.

I wish that all conditions were treatable, but they aren’t. In our society, we like to think they are. At this point in my life, I doubt if I would do chemo for cancer. I think I’d rather just give it up and say I’ve had a good life. DNR is sometimes hard to implement. But it is definitely the way I want to be treated. The expenses of treatments are huge, and if there’s no quality-of-life at the end, why?

I had a near death experience. All I can tell you is it was very calm and gentle. I was bleeding internally and had my blood pressure go down until I was cyanotic. That, they were able to stabilize with a major surgery. And I was only 47, my feelings on it were much different at the time. But now, at 70, I really don’t want a whole lot of medical intervention in my life.

I have chronic fatigue syndrome and just had a huge blood panel work up at my request. While they were taking blood for a routine check up I asked the doctor to please check for anything else that could be causing the fatigue. I just saw the results and I’m disgustingly healthy. But that I consider a good idea because what if it was Lyme disease? I would need treatment and I would take that treatment. There’s nothing wrong with me that they can find find and so I have to take it very easy and not be very active. I find that frustrating. But I’m not afraid to die, at all. I do go see the doctor fairly often just to keep her apprised of what’s been going on with my Health. But I don’t want any unnecessary treatment, especially if it would Affect my quality of life. Negatively I mean!

 

[ivinsfan]

death panels can mean many things, hospice has grown by leaps and bounds in the last few decades as everyone has come to recognize how brutal and difficult some treatments can be especially for cancer. This is pretty much universally accepted by everyone and is basically a patient/family decision.


Now another type of death panel would be oh, you are 75 so you don't get a heart by-pass op or a new kidney because you are too old. That's a different kettle of fish entirely.

 

[ShokWaveRider]

I wish that all conditions were treatable, but they aren’t. In our society, we like to think they are. At this point in my life, I doubt if I would do chemo for cancer. I think I’d rather just give it up and say I’ve had a good life. DNR is sometimes hard to implement. But it is definitely the way I want to be treated. The expenses of treatments are huge, and if there’s no quality-of-life at the end, why?

I had a near death experience. All I can tell you is it was very calm and gentle. I was bleeding internally and had my blood pressure go down until I was cyanotic. That, they were able to stabilize with a major surgery. And I was only 47, my feelings on it were much different at the time. But now, at 70, I really don’t want a whole lot of medical intervention in my life.

I have chronic fatigue syndrome and just had a huge blood panel work up at my request. While they were taking blood for a routine check up I asked the doctor to please check for anything else that could be causing the fatigue. I just saw the results and I’m disgustingly healthy. But that I consider a good idea because what if it was Lyme disease? I would need treatment and I would take that treatment. There’s nothing wrong with me that they can find find and so I have to take it very easy and not be very active. I find that frustrating. But I’m not afraid to die, at all. I do go see the doctor fairly often just to keep her apprised of what’s been going on with my Health. But I don’t want any unnecessary treatment, especially if it would Affect my quality of life. Negatively I mean!

I agree with all of this as a philosophy, just I do not go to the doc often, even though I have a few niggly issues. I live with most of them; lower back pain, a little fatigue sometimes. The only one I keep tabs on is my Blood Pressure and anything to do with my Pacemaker. I go to the doc 2 times a year for general blood work, (Have to in order to get BP meds) and cardiologist 2 times a year, that is it. I do have a DNR also.

 

[DeborahB]

death panels can mean many things, hospice has grown by leaps and bounds in the last few decades as everyone has come to recognize how brutal and difficult some treatments can be especially for cancer. This is pretty much universally accepted by everyone and is basically a patient/family decision.


Now another type of death panel would be oh, you are 75 so you don't get a heart by-pass op or a new kidney because you are too old. That's a different kettle of fish entirely.

I am totally in favor of Hospice. It’s one of the best ideas we’ve come up with. But as to the death panel example you posed, I have seen elderly people have surgery. Necessary surgery. If they’re frail to begin with, it may very well exacerbate the symptoms. I have seen elderly people who have surgery. Necessary surgery. If they’re frail to begin with, it may very well exacerbate the symptoms.

Everything has to be taken on a case by case basis, of course. But the surgery itself can be so hard on someone’s body that I can’t say I recommend it. A new kidney at 75 ? You can live with one kidney. A heart bypass is a major surgery. The discussion in cases of the elderly people has to be whether the surgery is worth the risk.

 

[HadEnuff]

just to try to take the conversation back to what I think was the OP's original question, I was faced with this scenario when I opted to retire at age 62, and DW at age 59. Once I could calculate that we had enough money to cover the premiums and deductibles for the number of years we would need to, before Medicare kicked in, I deemed our work was done.

It's another expense of life. If you can't afford to pay it, because you don't have a big enough nut, then yeah, you better keep working. However, I have known many folks who could pay for it, but somehow it was in their heads that since they never had actually written that check themselves, it just wasn't right to pencil that into their budgets. So rather than earmark the 100k out of their nut, which they could easily do and still fund their retirements, they opted to pay for it with another 4 or 5 years of their lives.

Maybe because I ran my own business, and even though I could run the premiums through the business I still wrote the checks and saw what it costs, I was more able to handle it as a business transaction. Just another thing I had to figure out how to pay for before I considered myself ready to FIRE.

As it turned out, due to some unforeseen circumstances, I was able to live off my after-tax assets, and keep income low enough to get some ACA assistance, but that turned out to be a bit of gravy, not what decided if I could or could not retire.

I think those retiring much younger than I did have a far riskier set of unpredictable variables to deal with, than someone only a few years shy of Medicare.

 

[ivinsfan]

I am totally in favor of Hospice. It’s one of the best ideas we’ve come up with. But as to the death panel example you posed, I have seen elderly people have surgery. Necessary surgery. If they’re frail to begin with, it may very well exacerbate the symptoms. I have seen elderly people who have surgery. Necessary surgery. If they’re frail to begin with, it may very well exacerbate the symptoms.

Everything has to be taken on a case by case basis, of course. But the surgery itself can be so hard on someone’s body that I can’t say I recommend it. A new kidney at 75 ? You can live with one kidney. A heart bypass is a major surgery. The discussion in cases of the elderly people has to be whether the surgery is worth the risk.

That's my point since you brought up death panels. At a certain age it wouldn't be in your hands whether you have a surgery or not. The "guidelines" would simply say you are too old, in other words they don't want to spend the money on you, it has nothing to do with possible outcomes. Certain countries with universal healthcare already practice a form of this where they just stop doing things at certain ages.

 

[ivinsfan]

just to try to take the conversation back to what I think was the OP's original question, I was faced with this scenario when I opted to retire at age 62, and DW at age 59. Once I could calculate that we had enough money to cover the premiums and deductibles for the number of years we would need to, before Medicare kicked in, I deemed our work was done.

It's another expense of life. If you can't afford to pay it, because you don't have a big enough nut, then yeah, you better keep working. However, I have known many folks who could pay for it, but somehow it was in their heads that since they never had actually written that check themselves, it just wasn't right to pencil that into their budgets. So rather than earmark the 100k out of their nut, which they could easily do and still fund their retirements, they opted to pay for it with another 4 or 5 years of their lives.

Maybe because I ran my own business, and even though I could run the premiums through the business I still wrote the checks and saw what it costs, I was more able to handle it as a business transaction. Just another thing I had to figure out how to pay for before I considered myself ready to FIRE.

As it turned out, due to some unforeseen circumstances, I was able to live off my after-tax assets, and keep income low enough to get some ACA assistance, but that turned out to be a bit of gravy, not what decided if I could or could not retire.

I think those retiring much younger than I did have a far riskier set of unpredictable variables to deal with, than someone only a few years shy of Medicare.

I do think things like death panels and who should pay what are still on topic because it all adds to the costs of health. Everything about health care should be on the table to address cost and affordability.

I agree with some people having the idea health care should be almost free or heavily discounted by their employer. As a self employed person my entire working life I find mind blowing that many don't seem to realize if their employer wasn't paying 15K a year for their gold plated HI plans they would have more cash in their pockets...Guess what... everyone pays one way or another.

 

[Gumby]

I, like most people, really never appreciated how much my mega-corp was subsidizing my health insurance.

It is now reported on your W-2 every year -- Box 12b, code DD is the premium paid by both you and your employer for health insurance. If you know what your own paycheck deductions were, you can calculate the subsidy. The total also gives you a rough idea of how much it's going to cost after retirement, when you're doing it on your own.

 

[DeborahB]

That's my point since you brought up death panels. At a certain age it wouldn't be in your hands whether you have a surgery or not. The "guidelines" would simply say you are too old, in other words they don't want to spend the money on you, it has nothing to do with possible outcomes. Certain countries with universal healthcare already practice a form of this where they just stop doing things at certain ages.

That’s actually okay with me. People often talk of long waits for procedures in countries where they have government run healthcare. But the fact is, and I have heard this many times, if you have a life-threatening crisis that is treatable you are treated fast. I don’t know how that works in the elderly, probably depends on your general health. I’m for a single-payer medical system. It keeps costs down. A lot of physicians would prefer this model. It lets them spend more time with their patients.

 

[VanWinkle]

Some interesting stuff, but I'm thumbs down on the death panel.

Thanks for taking the time to read the article before commenting on it's contents. Sometimes comments come from those that haven't taken the time to read the article and they seem uninformed.

VW

 

[ShokWaveRider]

As a self employed person my entire working life I find mind blowing that many don't seem to realize if their employer wasn't paying 15K a year for their gold plated HI plans they would have more cash in their pockets...Guess what... everyone pays one way or another.

Being an employee type worker bee prior to my ER, in my 30 years w*rking in the USA, I chose only to work for companies with the best healthcare plans, they all happened to be small companies, all 3 of them. I would consider a lesser salary for a better HC plan and often did. Most times when we were DINKS we had double HC plans and one complimented the other.

I considered the HC plan one of the most valuable parts of my compensation. Wealth is not all about Money in your pocket. (That is my UK and Canadian heritage talking) Each person's idea of wealth is different I am sure.

 

[Gumby]

I find mind blowing that many don't seem to realize if their employer wasn't paying 15K a year for their gold plated HI plans they would have more cash in their pockets.

I wouldn't go that far. I think it much more likely that money would go to shareholders or management, not to the paychecks of ordinary workers.

 

[simple girl]

My understanding is:


Pre-ACA:

If you had a pre-existing condition, you were often refused coverage on the private market. Some could get into a high-risk pool, and pay for coverage if they could afford it. Others could not get into a high-risk pool (there were waiting lists and in some cases high risk pools were closed to new members). Many chose to continue working until age 65 for healthcare only. Some rolled the dice and went without healthcare coverage. Some moved overseas for cheaper healthcare coverage.

The lucky ones had retiree health insurance or retired before developing a pre-existing condition, and were able to purchase insurance on the private market. They hoped their insurance would not close or boot them off if they developed an expensive healthcare issue.

Post-ACA:

If you have a pre-existing condition, you cannot be refused coverage on the private market. Underwriting is no longer occurring. High risk pools no longer exist.

If you can manage your MAGI for subsidies, you pay markedly less than those who cannot. Subsequently, those who cannot lower their MAGI must pay much more for healthcare. They may have to continue working until 65 if they cannot afford unsubsidized healthcare.

So both pre and post ACA some had to/have to continue to work until age 65 for healthcare.

Pre ACA the reason typically was because coverage was denied for pre-existing conditions and/or high risk pool coverage was too expensive or the pool was closed.

Post ACA the reason is typically because one cannot afford unsubsidized ACA premiums.

I would rather have option B, post ACA, regardless of whether I received subsidies or not. I'd rather have the option of expensive healthcare than no access to healthcare at all, as in pre-ACA days.

There are inequities in ACA coverage that need to be resolved but that is a whole other issue. The preexisting issue affects EVERYONE eventually. The ACA protects us all from being denied the right to purchase healthcare coverage.

 

[pb4uski]

I believe we all do have a right to AFFORDABLE healthcare. In the same way we have a right to affordable food and shelter. No matter what rung on the social economic ladder one is on. ...

Then you need to consider moving. The only rights that you have are those set forth in the U.S. Constitution, and the U.S. Constitution doesn't include a right to health care (affordable or not) nor a right to food and shelter (affordable or not).

 

[DeborahB]

I know nothing about ACA insurance. It happened after I retired and was on Medicare. I’ve seen some people talk about free insurance though, or free healthcare. In countries where this is available, they have higher taxes to cover it. Personally, I’d be happy to pay the higher taxes and have a better health safety net for all.

 

[ivinsfan]

I wouldn't go that far. I think it much more likely that money would go to shareholders or management, not to the paychecks of ordinary workers.

Will they get a 100% of the money in their pockets? probably not, but they certainly would get some or a lot of back, what do you think has been a driving costs in holding down wages increases the last few years....it's healthcare..