Healthcare insurance and retirement - again!

[REWahoo]

Some folks are determined to get this thread closed down. A shame, really.

+1

Apparently more interested in getting in their two cents than allowing the discussion to continue.

 

[MichaelB]

Some folks are determined to get this thread closed down. A shame, really.

+1

Samclem, thanks. There's not that much left to talk about until we have some hard activity in Congress, but even so, I think we'd all like to keep the thread open. So, once again, a reminder to keep the partisan comments, and especially the snark, out of the conversation. And if some members feel this is a bit like third grade, big red letters and all, well, this is the reason.

 

[Senator]

I was not suggesting Medicare be opened up to everyone under 65 aka the Public Option. I suggested it as a potential alternative to kicking 10 million people to the curb who would be negatively financially impacted if the subsidies were pulled away.

I would think that the federal healthcare plan could be opened up to everyone under Medicare age. There are millions of people already on it, and it seems to work. Adding a bunch more people to the plan would make sense.

It would not crowd the medical facilities more, as the people are getting care already.

 

[aja8888]

I would think that the federal healthcare plan could be opened up to everyone under Medicare age. There are millions of people already on it, and it seems to work. Adding a bunch more people to the plan would make sense.

It would not crowd the medical facilities more, as the people are getting care already.

DW and I are on Medicare and have very good Medigap Policies. We also have Part D drug plans. Our "insurance" cost part of that is about $8,000 per year. Add in our drug costs (out of pocket) of about $5000 per year and we are at $13K. It's not cheap if you want the "best" under Medicare. Our drug cost OOP is high as DW is on 9 prescriptions and I just take one script.

it could work for all, but remember; many doctors and doctor PC's are dropping out of accepting Medicare patients.

DW typically has a one to two month wait to see her pulmonologist. It's kind of like "Canada Lite" coverage in some instances.

 

[Youngster]

Yeah, good luck with that. How big a deductible do you have in mind for a $200/month premium?

I'd be good with $10,000; but, would prefer the $6,000 mine is going to be next January for almost $350.00 per month.

 

[Just_Steve]

Right, but it might have to be some tax on all income, not just earned income. And as NW-Bound kept saying, we need ways to control and hopefully reduce the cost of healthcare as well.

Maybe it would be better if it were a national sales tax and a means test so everybody would share the cost, especially those that are managing their income to get subsidies.

 

[Youngster]

Anyone familiar with how Canada does it's health care funding?

Maybe some ideas can be gleened concerning funding. Please note. I am not taking any position on whether US should have socialized medicine; just wondering how medical insurance can be made reasonably affordable.

 

[ivinsfan]

DW and I are on Medicare and have very good Medigap Policies. We also have Part D drug plans. Our "insurance" cost part of that is about $8,000 per year. Add in our drug costs (out of pocket) of about $5000 per year and we are at $13K. It's not cheap if you want the "best" under Medicare. Our drug cost OOP is high as DW is on 9 prescriptions and I just take one script.

it could work for all, but remember; many doctors and doctor PC's are dropping out of accepting Medicare patients.

DW typically has a one to two month wait to see her pulmonologist. It's kind of like "Canada Lite" coverage in some instances.

Now I understood it's "Medicaid" patients that docs are declining to see not "Medicare" ......do you have hard evidence of this....

 

[Youngster]

Now I understood it's "Medicaid" patients that docs are declining to see not "Medicare" ......do you have hard evidence of this....

I know your question is not directed at me. However, in my community there are doctors that don't take "Medicare" patients.

 

[Just_Steve]

Anyone familiar with how Canada does it's health care funding?

Maybe some ideas can be gleened concerning funding. Please note. I am not taking any position on whether US should have socialized medicine; just wondering how medical insurance can be made reasonably affordable.

Sales and income tax.

 

[bclover]

It just occurs to me that most posters here are or used to be workers at megacorps or the public sector. When talking about ER, they talk about leaving a secure health policy with their employers.

We tend to forget that not every worker in the US has this benefit from work. Many work for small mom-and-pop businesses, or for themselves. They never have what you and I take for granted.

Now, I understand what the average person has to deal with. I will look for that statistics again, but recall seeing the number of workers outside of megacorps and the government. The number of the self-employed and employees of small businesses is huge. It's something like 50% of all workers.

Not only that many of the big mega corps are doing away with retiree health care.
My big chemical company did so in 2012. they actually stopped pensions back in 2008.
I am simply lucky that I was grandfathered in.

Sadly I take just that fact into consideration with my 20 something sons. I have them take all city service test, whether they want a career as a fireman, bus or train conductor or something else or not. the reality is around here they are the pretty much the only jobs with decent benefits.

Septa (our transportation system) just went on strike for 6 days for that very reason. to shore up their retirement benefits.

 

[Youngster]

Sales tax.

Thanks. Is it a national sales tax, and what is the percentage designated for health care?

 

[Fermion]

Maybe it would be better if it were a national sales tax and a means test so everybody would share the cost, especially those that are managing their income to get subsidies.

That might work, along with taxing employer provided health care benefits (currently a tax break given to people who are lucky enough to have employer provided insurance).

 

[Just_Steve]

That might work, along with taxing employer provided health care benefits (currently a tax break given to people who are lucky enough to have employer provided insurance).

I agree.

 

[Just_Steve]

Thanks. Is it a national sales tax, and what is the percentage designated for health care?

I'm sure our Canadian members can enlighten us on the funding, from what I have read it's different per providence.

 

[zinger1457]

I would think that the federal healthcare plan could be opened up to everyone under Medicare age. There are millions of people already on it, and it seems to work. Adding a bunch more people to the plan would make sense.

It would not crowd the medical facilities more, as the people are getting care already.

I don't see how it would work without the FEHB rates going up significantly. There are maybe ~3M federal employees and ~12M people signed up for ACA. I checked my state and the total FEHB monthly premium for an individual is about half of what it would cost on ACA. Not sure of the reasons for the price differences, one might assume the ACA is a much riskier pool.

 

[aja8888]

Now I understood it's "Medicaid" patients that docs are declining to see not "Medicare" ......do you have hard evidence of this....

Actually both!

As an example, last year we got a letter from Kelsey-Seybold, a medical provider where we live, that their office would not be accepting traditional Medicare coverage any longer. If you care to review:

Doctors The Woodlands Texas | The Woodlands Clinic | Kelsey-Seybold Clinic

Many doctors have dropped out of Medicare in this area and I could list them, but I don't want to waste the bandwidth.

 

[SteveNU]

Not only that many of the big mega corps are doing away with retiree health care.

My company is sort of doing this starting in 2017. Instead of the company providing retiree health insurance we will have to purchase our own health insurance next year. Thankfully they are providing a generous subsidy which will actually make our cost for insurance stay about the same next year.

If we were to hit our max out of pocket limit next year like we did this year we would be looking at over $28,000 for health insurance costs without the company subsidy. That is the cheapest plan available.

The big question is what happens later since we are no longer on an employer plan. Changes in the ACA could possibly have a substantial impact on our ability to obtain affordable insurance.

 

[NW-Bound]

I'm sure our Canadian members can enlighten us on the funding, from what I have read it's different per providence.

Each Canada province has its own rules and benefits. And as each has to fund its own healthplan, one can imagine that there's a difference in service level.

When I was RV'ing in Nova Scotia, the owner of the RV campground where I stayed said his wife was just diagnosed with cancer, and went back to Alberta for treatment because it was better there. He said they maintained a domicile in Alberta to keep the coverage.

Out of curiosity, I looked up the per-capita income of both provinces, and indeed Alberta was a more prosperous province, probably due to revenues from oil.

 

[Sue J]

Actually both!

As an example, last year we got a letter from Kelsey-Seybold, a medical provider where we live, that their office would not be accepting traditional Medicare coverage any longer. If you care to review:

Doctors The Woodlands Texas | The Woodlands Clinic | Kelsey-Seybold Clinic

Many doctors have dropped out of Medicare in this area and I could list them, but I don't want to waste the bandwidth.

I clicked on it just to see what it says. They do accept some Medicare Advantage plans. One is called KelseyCare, did they create their own Medicare Advantage plan?

Is this common? Is this a large provider in the area?

 

[daylatedollarshort]

We went over our retirement spreadsheets today decided if our premiums go to $25K (5X younger premiums instead of 3X), we lose our subsidies and reach $14K out of pocket max as long as we are insurable we will just absorb the cost since moving is also expensive and a lot of work. Higher premiums than that and maybe moving would look more attractive. We're happy with the retirement life we have where we live now and we have a number of clubs and activities that happen on weekdays so neither one of us really wants to go back to an 8 - 5 job at this point. I don't think I can count on getting a part-time job with healthcare benefits though that would be great. We have some hobby income we could increase to help cover the extra costs.

A year or two of transition time puts us a couple of years closer to Medicare. If we are uninsurable at any price or premiums are much higher than $25K we will likely move and come back at age 65. So that's our current hope for the best but plan for the worst plan.

 

[Calgary_Girl]

Thanks. Is it a national sales tax, and what is the percentage designated for health care?

It varies from province to province.

http://healthcarefunding.ca/key-issues/current-funding/

 

[eta2020]

A year or two of transition time puts us a couple of years closer to Medicare. If we are uninsurable at any price or premiums are much higher than $25K we will likely move and come back at age 65. So that's our current hope for the best but plan for the worst plan.

I am quite flexible in my mind about moving. I grew up in Communist country. Then I spend my working years in great place for my profession. Moving to another country after FIRE date does not look strange to me a bit.

I can obtain high quality insurance in Spain for 70 bucks a month. All 401k and IRA accounts are shielded from Wealth Tax plus we will get 2 000 000 euros Wealth tax free allowance and Spain will benefit from us spending money in their economy. Looks like win win to me.

That EU passport will come handy in few years.

 

[jabbahop]

The other thing we need to all think about is Medicare viability. Based on a Kaiser foundation report, Medicare premiums only cover 13% of costs.

Total medicare expenditures were estimated @ $618B in '14 covering 55M users or roughly $11K/participant. As the number of participants and cost/participant rise, this could become a problem.

 

[NW-Bound]

Anyone familiar with how Canada does it's health care funding?

Maybe some ideas can be gleened concerning funding. Please note. I am not taking any position on whether US should have socialized medicine; just wondering how medical insurance can be made reasonably affordable.

Thanks to the posts by eta2020, I searched the Web for info on Spain healthcare, a country suffering from economic problems, and found the following Web site that shows the country ranking by WHO (World Health Organization). It starts with the following excerpt:

Some people fancy all health care debates to be a case of Canadian Health Care vs. American. Not so. According to the World Health Organization’s ranking of the world’s health systems, neither Canada nor the USA ranks in the top 25.​

Indeed Spain is rated #7. Canada: #30. USA: #37.

See: World Health Organization’s Ranking of the World’s Health Systems | thepatientfactor.com.

I do not know how WHO grades each country, but looking at the list makes you wonder how other countries solve the problem. There's a lot of things one can learn.