Join Early Retirement Today
Closed Thread
 
Thread Tools Display Modes
Old 11-10-2016, 06:52 AM   #141
Full time employment: Posting here.
 
Join Date: Jan 2013
Posts: 775
Quote:
Originally Posted by scrabbler1 View Post
If the ACA disappears, I dread going back to paying a lot more for my coverage, without a subsidy, or go underinsured. All are lousy choices.
Do you think you would ever go back to work just to get health insurance?

I have found it very difficult to find work at age 50+.

I had thought that the ACA would be tweaked, but now it looks like wholesale gut.
broadway is offline  
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 11-10-2016, 06:53 AM   #142
Thinks s/he gets paid by the post
 
Join Date: Nov 2005
Posts: 1,595
Quote:
Originally Posted by travelover View Post
I don't feel that we have had an honest evaluation of how to reduce overall costs and still deliver quality care, as is done in other developed countries.
Quite a few years ago, I watched the 2008 documentary Sick Around The World. I was impressed with how backward the US healthcare system appeared compared to some other mature democracies. It would be timely for PBS to produce an update to this documentary, since the issues it brings up are still relevant.

Here's a link to the documentary: Sick Around The World
socca is offline  
Old 11-10-2016, 06:56 AM   #143
Full time employment: Posting here.
 
Join Date: Jan 2013
Posts: 775
Quote:
Originally Posted by socca View Post
Quite a few years ago, I watched the 2008 documentary Sick Around The World. I was impressed with how backward the US healthcare system appeared compared to some other mature democracies. It would be timely for PBS to produce an update to this documentary, since the issues it brings up are still relevant.

Here's a link to the documentary: Sick Around The World
Part of the problem is that we think we know best.
I doubt that is going to change with the new administration.
The mature democracies are demonized as having socialized medicine.
broadway is offline  
Old 11-10-2016, 07:01 AM   #144
Administrator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Chicagoland
Posts: 40,591
Folks, it will be helpful if we stick to the thread topic.
MichaelB is online now  
Old 11-10-2016, 07:03 AM   #145
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
NW-Bound's Avatar
 
Join Date: Jul 2008
Posts: 35,712
Quote:
Originally Posted by broadway View Post
Part of the problem is that we think we know best.
I think our problem runs deeper than that. People here want unlimited healthcare, and to extend life no matter the cost. That is not compatible with free and less expensive health care.
__________________
"Old age is the most unexpected of all things that happen to a man" -- Leon Trotsky (1879-1940)

"Those Who Can Make You Believe Absurdities Can Make You Commit Atrocities" - Voltaire (1694-1778)
NW-Bound is offline  
Old 11-10-2016, 07:16 AM   #146
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
travelover's Avatar
 
Join Date: Mar 2007
Posts: 14,328
Quote:
Originally Posted by NW-Bound View Post
I think our problem runs deeper than that. People here want unlimited healthcare, and to extend life no matter the cost. That is not compatible with free and less expensive health care.
That may or may not be the driver of high health care costs. I'd like to see a comprehensive analysis of where the money really goes. It seems like we have bits and pieces of anecdotes floating around, but no solid analysis, no common facts. With costs at $9000 a year per person, it might even be worth paying a few million dollars to have it done.
travelover is offline  
Old 11-10-2016, 07:34 AM   #147
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Nov 2009
Posts: 6,683
Quote:
Originally Posted by broadway View Post
Do you think you would ever go back to work just to get health insurance?

I have found it very difficult to find work at age 50+.

I had thought that the ACA would be tweaked, but now it looks like wholesale gut.
I would not consider going back to work just to get health insurance. If I end up paying $1,000 a month for health insurance, I will do it. At least I am only 6 years away from being able to gain unfettered access to my IRA, the first of my "reinforcements" which will supplement the dividends my taxable portfolio generates. And I did have the ACA during the time I became sick last year and ran up some big medical bills - going forward my costs are maintenance ones.

I, too, am sad and scared about the ACA disappearing and being replaced (maybe) with something far inferior, or with nothing.
__________________
Retired in late 2008 at age 45. Cashed in company stock, bought a lot of shares in a big bond fund and am living nicely off its dividends. IRA, SS, and a pension await me at age 60 and later. No kids, no debts.

"I want my money working for me instead of me working for my money!"
scrabbler1 is offline  
Old 11-10-2016, 07:36 AM   #148
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
NW-Bound's Avatar
 
Join Date: Jul 2008
Posts: 35,712
Quote:
Originally Posted by travelover View Post
That may or may not be the driver of high health care costs. I'd like to see a comprehensive analysis of where the money really goes. It seems like we have bits and pieces of anecdotes floating around, but no solid analysis, no common facts. With costs at $9000 a year per person, it might even be worth paying a few million dollars to have it done.
I am all for it. And you would think somebody else would have thunk about it.

I suspect people do not want the facts known, for obfuscation.

Once you know the facts, what do you do with it? Suppose we find out a lot of costs goes into this treatment, this category of drugs.

Now, we have to ask ourselves, is it worth it? See, recognizing one thing leads us to ask more and tougher questions. So, just sweep it under the rug.
__________________
"Old age is the most unexpected of all things that happen to a man" -- Leon Trotsky (1879-1940)

"Those Who Can Make You Believe Absurdities Can Make You Commit Atrocities" - Voltaire (1694-1778)
NW-Bound is offline  
Old 11-10-2016, 07:39 AM   #149
Recycles dryer sheets
 
Join Date: Feb 2010
Posts: 429
How can an individual who is in the beginning stage of early retirement, who doesn’t have access to retiree based or other health insurance coverage, with relatively low living expenses and MAGI (modified adjusted gross income), and potentially high health care costs (previous cancer diagnosis), manage his/her financial and investment affairs to maximize benefits and minimize costs as a health care consumer with Trump/Republican likely changes to the system.

For example, managing MAGI under Obamacare was a way to maximize subsidies/credits and benefit from a more generous cost sharing plan. So, what can a FIREd person due to maximize his/her insurance coverage and minimize his/her insurance costs based on the changes that Trump will likely bring into the system? Try to keep income within Medicaid eligibility criteria? Relocate to a state that had an individual mandate prior to Obamacare (like Massachusetts)? Try to manage MAGI at a level to match the amount of health insurance premiums paid that are deductible?

I guess I am just trying to accept the current state of what “is” and maximize my benefits and minimize my costs within this new system that is evolving. Any ideas? And if possible, I would love to not have to return to the workplace solely to get access to health insurance.

For the sake of my questions, assume that the "repeal and replace" trump agenda will include the following (I am not asking about the pros and cons of these policies, I am just asking about how I can minimize my cost/maximize my gain within these changes)-

a. No mandate that requires everyone to have health insurance

b. Elimination of tax subsidies and credits.

c. Individual health insurance premiums completely deductible from income taxes.

d. Allow insurance companies to sell plans across state lines. (I would rather not relocate solely based on the need for reasonably priced health insurance).

e. The use of health savings accounts, or HSAs. Essentially, you pay for your medical expenses with your savings—if you have them. (Are these kind of a waste when you are dealing with the catastrophic cost of a cancer diagnosis?)

f. Medicaid, giving each state a block grant to divvy up as it chooses.

g. No pre-existing conditions exclusion. (I recognize that a and g are in direct conflict with one another, but that is the proposal as of today).

h. Add price transparency for drug companies and healthcare providers, and intense negotiating.

Oh, and I can't vouch for its validity or reliability, but here is a calculator that estimates how much you will pay for health insurance costs based on the system in effect before obamacare, during obamacare, based on clinton's proposals, based on sanders's proposals and based on trump's proposals. Based on my situation, the money i keep per year would be about the same for all proposals except for Sanders' where i allegedly would have kept about 25 percent more than under the other plans. https://www.taxrate.xyz/
nico08 is offline  
Old 11-10-2016, 07:42 AM   #150
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Big_Hitter's Avatar
 
Join Date: May 2013
Location: Les Bois
Posts: 5,761
Quote:
Originally Posted by nico08 View Post
How can an individual who is in the beginning stage of early retirement, who doesn’t have access to retiree based or other health insurance coverage, with relatively low living expenses and MAGI (modified adjusted gross income), and potentially high health care costs (previous cancer diagnosis), manage his/her financial and investment affairs to maximize benefits and minimize costs as a health care consumer with Trump/Republican likely changes to the system.
get catastrophic coverage - like I posted earlier, the purpose of health insurance isn't to provide inexpensive healthcare, it's to indemnify an unexpected loss
__________________
You can't be a retirement plan actuary without a retirement plan, otherwise you lose all credibility...
Big_Hitter is offline  
Old 11-10-2016, 07:44 AM   #151
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Big_Hitter's Avatar
 
Join Date: May 2013
Location: Les Bois
Posts: 5,761
Quote:
Originally Posted by travelover View Post
That may or may not be the driver of high health care costs. I'd like to see a comprehensive analysis of where the money really goes. It seems like we have bits and pieces of anecdotes floating around, but no solid analysis, no common facts. With costs at $9000 a year per person, it might even be worth paying a few million dollars to have it done.
$9K a year? what gender/age band?
__________________
You can't be a retirement plan actuary without a retirement plan, otherwise you lose all credibility...
Big_Hitter is offline  
Old 11-10-2016, 07:46 AM   #152
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Nov 2009
Posts: 6,683
MBSC, great read. Thanks for posting it.
__________________
Retired in late 2008 at age 45. Cashed in company stock, bought a lot of shares in a big bond fund and am living nicely off its dividends. IRA, SS, and a pension await me at age 60 and later. No kids, no debts.

"I want my money working for me instead of me working for my money!"
scrabbler1 is offline  
Old 11-10-2016, 07:46 AM   #153
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Big_Hitter's Avatar
 
Join Date: May 2013
Location: Les Bois
Posts: 5,761
Quote:
Originally Posted by broadway View Post
Do you think you would ever go back to work just to get health insurance?

I have found it very difficult to find work at age 50+.

I had thought that the ACA would be tweaked, but now it looks like wholesale gut.
I'm going to wait and see how the dust settles on this.
__________________
You can't be a retirement plan actuary without a retirement plan, otherwise you lose all credibility...
Big_Hitter is offline  
Old 11-10-2016, 08:24 AM   #154
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
audreyh1's Avatar
 
Join Date: Jan 2006
Location: Rio Grande Valley
Posts: 38,012
I'm glad that I have let a cash buffer build up over the past few years. If there is repeal, and then a couple of years pass before some relief, who knows what we will have to pay out of pocket.
__________________
Retired since summer 1999.
audreyh1 is online now  
Old 11-10-2016, 08:43 AM   #155
Recycles dryer sheets
bamsphd's Avatar
 
Join Date: Nov 2005
Posts: 337
Quote:
Originally Posted by pb4uski View Post
He didn't HAVE to sell because the depreciation rules changed.. he chose to. Big difference.
If he was going to pay his unexpected tax bill he had to raise cash. He sold the apartments as his best (only?) practical way to pay that tax.

Observing that drove home to me the difference between tax deferral and tax credit. As a hypothetical example, currently we can defer taxes on capital gains until we sell the asset. Suppose the tax law changed so that we could no longer defer realizing capital gains? Every year we had to mark-to-market and pay that year's capital gains. As a longtime buy-and-hold investor, I know I would have to sell something to pay my tax bill that first year!

While usually the feds are reasonable about their tax changes, sometimes a minority gets bitten. I can easily see congress planning to pass two bills, REPEAL and REPLACE. The REPEAL bill causes tax issues they plan to fix in the REPLACE bill, but then for some reason the REPLACE bill gets delayed, so people getting ACA subsidies get bitten. I'm not saying it is the most likely scenario, nor that anyone would want it, just that it is a believable scenario.
bamsphd is offline  
Old 11-10-2016, 08:54 AM   #156
Recycles dryer sheets
 
Join Date: Sep 2015
Posts: 161
Quote:
Originally Posted by Big_Hitter View Post
get catastrophic coverage - like I posted earlier, the purpose of health insurance isn't to provide inexpensive healthcare, it's to indemnify an unexpected loss
Agreed. I would gladly pay a low premium for a catastrophic plan. Problem is that I am currently paying what I consider a high premium of around $350.00 for a $5,000 deductible.
Youngster is offline  
Old 11-10-2016, 08:57 AM   #157
Thinks s/he gets paid by the post
photoguy's Avatar
 
Join Date: Jun 2010
Posts: 2,301
Quote:
Originally Posted by nico08 View Post
How can an individual who is in the beginning stage of early retirement, who doesn’t have access to retiree based or other health insurance coverage, with relatively low living expenses and MAGI (modified adjusted gross income), and potentially high health care costs (previous cancer diagnosis), manage his/her financial and investment affairs to maximize benefits and minimize costs as a health care consumer with Trump/Republican likely changes to the system.
Personally, I think trying to minimize costs is not the right strategy with all of the uncertainty. I would try to maintain flexibility and just the basic ability to obtain insurance.

For someone with low expenses and MAGI -- I don't think there's much actionable other than retain flexibility in living location (be willing to move states and/or zip codes within a state), build up taxable reserves (in case healthcare costs more), maintain continuous coverage, and don't undergo any financial transactions that are difficult to reverse.
photoguy is offline  
Old 11-10-2016, 09:01 AM   #158
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
donheff's Avatar
 
Join Date: Feb 2006
Location: Washington, DC
Posts: 11,318
Quote:
Originally Posted by Senator View Post
I think it had to do with amounts the Government would pay for health services.

Certainly insurance companies make money on Medicare, they offer many plans, but they did not want to be part of the ACA. The ACA was severely flawed, and that needs to be changed. Even Medicaid patients have issues finding doctors.

I hope they add an additional payroll tax to help it, and stay away from any income tax increases. It would be funded more like medicare, which seems to work. Then offer Medicare to everyone in the USA. I suspect that any new plan would be closer to Medicare,
Under the ACA marketplace plans the government does not set rates -- the insurance companies negotiate them with the providers. For Medicare/Medicaid the government does negotiate the rates. But the Medicare supplements are, once again, handled by the insurance companies, not single government payer like Medicare.
__________________
Idleness is fatal only to the mediocre -- Albert Camus
donheff is offline  
Old 11-10-2016, 09:10 AM   #159
Thinks s/he gets paid by the post
Senator's Avatar
 
Join Date: Feb 2014
Location: Williston, FL
Posts: 3,925
Quote:
Originally Posted by Big_Hitter View Post
I'm going to wait and see how the dust settles on this.
I predict, that it will not be as bad as the doom and gloom here predict...

There are many options. Going with medicaid, stiffing the hospital, gong back to work, declaring bankruptcy, etc.

No politician is going to sacrifice votes to make a change most people do not want.

I would suspect this.

Healthcare will get cheaper, not more expensive. The new administration will make sure of that. Can you imagine their fate if it got worse?

Whether the cost is deferred, or paid through another means, it's hard to tell. It may be a payroll tax, made more efficient, or paid with printing money. There may be asset tests for subsidies, or not, like medicare.

It's hard to tell at this point, but it will be at least a year out.
__________________
FIRE no later than 7/5/2016 at 56 (done), securing '16 401K match (done), getting '15 401K match (done), LTI Bonus (done), Perf bonus (done), maxing out 401K (done), picking up 1,000 hours to get another year of pension (done), July 1st benefits (vacation day, healthcare) (done), July 4th holiday. 0 days left. (done) OFFICIALLY RETIRED 7/5/2016!!
Senator is offline  
Old 11-10-2016, 09:16 AM   #160
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Big_Hitter's Avatar
 
Join Date: May 2013
Location: Les Bois
Posts: 5,761
Quote:
Originally Posted by Senator View Post
I predict, that it will not be as bad as the doom and gloom here predict...

There are many options. Going with medicaid, stiffing the hospital, gong back to work, declaring bankruptcy, etc.
without the 3 to 1 rule, it will get much more expensive for early retirees - remember the actual cost for a 60 year old is something like 5 to 8 times the cost of a 25 year old

so I'm looking forward to a productive 2017 on the j*b....
__________________
You can't be a retirement plan actuary without a retirement plan, otherwise you lose all credibility...
Big_Hitter is offline  
Closed Thread


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Obamacare and Employee retirement healthcare azauthor Life after FIRE 27 07-04-2012 01:35 PM
Healthcare Insurance Costs in Texas and the 2010 Law eytonxav FIRE Related Public Policy 14 01-18-2012 11:25 AM
Social Security Again Again??? greg Other topics 60 11-13-2006 04:06 PM
Simplecare no-insurance healthcare cute fuzzy bunny FIRE and Money 2 04-05-2004 08:28 AM

» Quick Links

 
All times are GMT -6. The time now is 08:59 AM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2024, vBulletin Solutions, Inc.