Cruisers Forum
 


Join CruisersForum Today

Reply
 
Thread Tools Search this Thread Rate Thread Display Modes
Old 10-07-2018, 21:54   #226
Registered User
 
Mike OReilly's Avatar

Join Date: Sep 2011
Location: Good question
Boat: Rafiki 37
Posts: 5,262
Re: Early retirement and health care for boaters

Quote:
Originally Posted by HBWT View Post
AND TIME! Yep, it took a whole 64 minutes for another Anecdotal reference as if fact. Thanks for supplying us with endless information that has no relevence in reality. OECD and WHO rank countries based on a wide spectrum of analysis from morbidity, mortality and equity to comparative treatment outcomes. The U.S. is ranked #2 for emergency medicine, Panama is 78th. Where would you rather be with stroke or heat attack. Ö

Full report: http://apps.who.int/iris/bitstream/h...5-eng.pdf?ua=1
Thanks for the report link. As it clearly states, the USAís healthcare system is far more expensive than almost every other country (no matter what measure you use). And the results on most parameters put the country somewhere near the middle as far as population health outcomes ó just as has been stated.

Iím not trying to bash the USAís system. Thatís not the point of this thread. The point is that high health insurance costs, which are related to this expensive system, and are borne by the individual in the USA, all make it difficult for Americans to retire early and go cruising.

It sounds like youíve got some useful advice or direction about how Americans can navigate the system to achieve low cost coverage. That seems great to me. I hope my American friends benefit from this.
__________________

__________________
Why go fast, when you can go slow.
BLOG: www.helplink.com/CLAFC
Mike OReilly is online now   Reply With Quote
Old 11-07-2018, 09:46   #227
Senior Cruiser

Cruisers Forum Supporter

Join Date: Jul 2005
Location: Bellingham
Boat: Outbound 44
Posts: 5,988
Re: Early retirement and health care for boaters

Quote:
Originally Posted by HBWT View Post
AND TIME! Yep, it took a whole 64 minutes for another Anecdotal reference as if fact. Thanks for supplying us with endless information that has no relevence in reality. OECD and WHO rank countries based on a wide spectrum of analysis from morbidity, mortality and equity to comparative treatment outcomes. The U.S. is ranked #2 for emergency medicine, Panama is 78th. Where would you rather be with stroke or heat attack.

Lastly, that meaningless $1,500 is an actuarial value based on actuarial tables. Im gonna let you in on a little secret, Actuaries use this information to price insurance based on risk. If you know the risk, you can understand the price. To understand the likelihood of loss.

Full report: http://apps.who.int/iris/bitstream/h...5-eng.pdf?ua=1

Thanks for playing the game.
What a meaningless statement. Like most people, I plan to have a stroke or heart attack where ever I happen to be T the time. I do not plan it based on health care available. Obviously large city hospitals in the US have excellent emergency care and life-flight is available from many smaller population areas. Totally irrelevant to a discussion of cruising health care, asbut the point of cruising is to go somewhere else.

If you can select your location for care for non-emergency care then there are many places aound the world that offer high quality medicine, at costs much lower than the US. Panama City is one of them. You are the one who brought up Panama, apparently without knowledge of what's there.
__________________

Paul L is online now   Reply With Quote
Old 11-07-2018, 11:03   #228
Registered User

Join Date: Jan 2013
Posts: 112
Re: Early retirement and health care for boaters

Quote:
Originally Posted by Paul L View Post
What a meaningless statement. Like most people, I plan to have a stroke or heart attack where ever I happen to be T the time. I do not plan it based on health care available. Obviously large city hospitals in the US have excellent emergency care and life-flight is available from many smaller population areas. Totally irrelevant to a discussion of cruising health care, asbut the point of cruising is to go somewhere else.

If you can select your location for care for non-emergency care then there are many places aound the world that offer high quality medicine, at costs much lower than the US. Panama City is one of them. You are the one who brought up Panama, apparently without knowledge of what's there.
Yep, meaningless in facts but okay. You are right, wherever you have a heart heartattack or stroke is where you are going to have your initial type 1/class 1 treatment. You don't get to decide your initial location (my fault here is I forget to understand that you have very little basic knowledge of healthcare delivery) BUT... as soon as you are stable, this is when the real treatment and cost start because this is often where a major surgery/procedure (s) is involved. I don't doubt that Panama has the ability to do a bypass effectively, I don't doubt that that can manage a Ischemic stroke, but again as someone who has a career studying insurance markets and risk, would you rather place your trust in a facility that has a 60% chance of success or a 90% chance of success. Yes, I understand Panama is a beautiful country with many beautiful things, but a emergency evacuation policy that will bring you back to the US for less than $20 a month to access superior care is a perfectly smart RISK HEDGE. Jesus Christ, I can't believe I am arguing over the validity of a $20 a month insurance plan.

Meaningless... okay. I wonder, I don't know what you do or did for a living. But for example, if you were a contractor building a house in the US and someone said, but in Panama they build houses out of bamboo and palm fronds, why can't we build that here? Wouldn't your answer be, I get it, palm fronds are beautiful and certainly work for houses in Panama but 2X4 construction is far superior. I bet there answer would be, oh 2X4 is meaningless...
HBWT is offline   Reply With Quote
Old 11-07-2018, 11:50   #229
Senior Cruiser

Cruisers Forum Supporter

Join Date: Jul 2005
Location: Bellingham
Boat: Outbound 44
Posts: 5,988
Re: Early retirement and health care for boaters

Quote:
Originally Posted by HBWT View Post
Yep, meaningless in facts but okay. You are right, wherever you have a heart heartattack or stroke is where you are going to have your initial type 1/class 1 treatment. You don't get to decide your initial location (my fault here is I forget to understand that you have very little basic knowledge of healthcare delivery) BUT... as soon as you are stable, this is when the real treatment and cost start because this is often where a major surgery/procedure (s) is involved. I don't doubt that Panama has the ability to do a bypass effectively, I don't doubt that that can manage a Ischemic stroke, but again as someone who has a career studying insurance markets and risk, would you rather place your trust in a facility that has a 60% chance of success or a 90% chance of success. Yes, I understand Panama is a beautiful country with many beautiful things, but a emergency evacuation policy that will bring you back to the US for less than $20 a month to access superior care is a perfectly smart RISK HEDGE. Jesus Christ, I can't believe I am arguing over the validity of a $20 a month insurance plan.

Meaningless... okay. I wonder, I don't know what you do or did for a living. But for example, if you were a contractor building a house in the US and someone said, but in Panama they build houses out of bamboo and palm fronds, why can't we build that here? Wouldn't your answer be, I get it, palm fronds are beautiful and certainly work for houses in Panama but 2X4 construction is far superior. I bet there answer would be, oh 2X4 is meaningless...
Sounds like you are arguing for the sake of arguing. The issue at hand in this thread is how a US based cruiser can cover medical financial risks. You have advised cruisers that if they are out of the US for extended time they don't need or require insurance, but they should have an evacuation plan to get them back to the US for the superior care. This advice doesn't make sense to me. Who pays for the bill once you get back.

I maintain both an evacuation insurance plan, DAN, plus a US based health insurance plan. The insurance is to protect our assets, so in the case of an excessively large bill we won't leave the other partner bankrupt or broke. It is not to cover the more minor care that often is done in the local country with excellent care at costs often less than US copays. Has worked for the last 8 years cruising.
Paul L is online now   Reply With Quote
Old 11-07-2018, 12:59   #230
Registered User

Join Date: Jan 2013
Posts: 112
Re: Early retirement and health care for boaters

Quote:
Originally Posted by Paul L View Post
What a meaningless statement.
Quote:
Originally Posted by Paul L View Post
That's some conflicting advice.
Pot meet kettle.

I am arguing because your assertions are wrong. Notice I also recommended 2 other options for health coverage.

Even your statement of:

[QUOTE=Paul L;The insurance is to protect our assets, so in the case of an excessively large bill we won't leave the other partner bankrupt or broke. [/QUOTE]

is factually inaccurate. Medical debt is unsecured specialized and has strict control, they cannot garnish wages, drain your bank account, draft from qualified accounts, or repossess your house if you cannot/will not pay. The most they can do is put a judgement lien on your assets and at time of sale, collect on the lien.
For more information, please review the Fair Credit Reporting Act (FCRA) and Fair Debt Collections Practices Act (FDCPA).

If you are someone with significant assets that you want to protect in case of loss, of course your should purchase a health insurance plan. Self Insuring was relative to what options does the OP have.

But again, keep arguing with me.
HBWT is offline   Reply With Quote
Old 11-07-2018, 13:09   #231
Registered User

Join Date: Jun 2007
Location: SW Florida
Boat: FP Belize, 43' - Dot Dun
Posts: 3,834
Re: Early retirement and health care for boaters

Quote:
Originally Posted by Mike OReilly View Post
Thanks for the report link. As it clearly states, the USAís healthcare system is far more expensive than almost every other country (no matter what measure you use). And the results on most parameters put the country somewhere near the middle as far as population health outcomes ó just as has been stated.

Iím not trying to bash the USAís system. Thatís not the point of this thread. The point is that high health insurance costs, which are related to this expensive system, and are borne by the individual in the USA, all make it difficult for Americans to retire early and go cruising.

It sounds like youíve got some useful advice or direction about how Americans can navigate the system to achieve low cost coverage. That seems great to me. I hope my American friends benefit from this.
High is relative. Planning is the key to retirement without difficulties.
DotDun is offline   Reply With Quote
Old 11-07-2018, 13:37   #232
Senior Cruiser

Cruisers Forum Supporter

Join Date: Jul 2005
Location: Bellingham
Boat: Outbound 44
Posts: 5,988
Re: Early retirement and health care for boaters

Quote:
Originally Posted by HBWT View Post
Pot meet kettle.

I am arguing because your assertions are wrong. Notice I also recommended 2 other options for health coverage.

Even your statement of:



is factually inaccurate. Medical debt is unsecured specialized and has strict control, they cannot garnish wages, drain your bank account, draft from qualified accounts, or repossess your house if you cannot/will not pay. The most they can do is put a judgement lien on your assets and at time of sale, collect on the lien.
For more information, please review the Fair Credit Reporting Act (FCRA) and Fair Debt Collections Practices Act (FDCPA).

If you are someone with significant assets that you want to protect in case of loss, of course your should purchase a health insurance plan. Self Insuring was relative to what options does the OP have.

But again, keep arguing with me.
No thanks, you aren't adding enough to make me care. Telling people that debt from medical bills is not an issue in the US is silly. And backing it up with its only a lien and they can't come after your IRA doesn't make the debt go away.
Paul L is online now   Reply With Quote
Old 11-07-2018, 14:49   #233
Senior Cruiser
 
hpeer's Avatar

Cruisers Forum Supporter

Join Date: Dec 2008
Location: Philadelphia
Boat: Murray 33-Chouette & Pape Steelmaid-44-Safara-both steel cutters
Posts: 4,599
Re: Early retirement and health care for boaters

When I went on sabatical we had to pay the USA health insurance premium out of pocket $2,500 / MONTH.

Now 8 years older (67 and 65) we buy comparable insurance on the free market for $3,000 / YEAR - Provided we stay out of the USA 10 months a year.

Somehow I think that speaks volumes.
hpeer is offline   Reply With Quote
Old 11-07-2018, 14:57   #234
Registered User

Join Date: Jun 2007
Location: SW Florida
Boat: FP Belize, 43' - Dot Dun
Posts: 3,834
Re: Early retirement and health care for boaters

Quote:
Originally Posted by hpeer View Post
When I went on sabatical we had to pay the USA health insurance premium out of pocket $2,500 / MONTH.

Now 8 years older (67 and 65) we buy comparable insurance on the free market for $3,000 / YEAR - Provided we stay out of the USA 10 months a year.

Somehow I think that speaks volumes.


To me that speaks that you either had 10 dependents when you were on sabbatical or you got screwed. First rate coverage, ~$700/month per adult.
DotDun is offline   Reply With Quote
Old 11-07-2018, 15:28   #235
Senior Cruiser
 
hpeer's Avatar

Cruisers Forum Supporter

Join Date: Dec 2008
Location: Philadelphia
Boat: Murray 33-Chouette & Pape Steelmaid-44-Safara-both steel cutters
Posts: 4,599
Re: Early retirement and health care for boaters

Quote:
Originally Posted by DotDun View Post
To me that speaks that you either had 10 dependents when you were on sabbatical or you got screwed. First rate coverage, ~$700/month per adult.
2 dependents, the other 40,000 people in the company had the same plan. It is a typical plan for consulting/engineering firms. Several hundred thousand professionals are covered by very similar plans.

But even using your number of $700/month that would be $8,400/year/adult or for 3 it would be $2,100/month (not so far from my $2,500 huh) which is $25,200/year.

Or $16,800/year vs $3,000/year for two.

Now that I’ve demonstrated your numbers are pretty close to mine does it make sense in a different and more meaningful way?
hpeer is offline   Reply With Quote
Old 11-07-2018, 15:42   #236
Registered User
 
Mike OReilly's Avatar

Join Date: Sep 2011
Location: Good question
Boat: Rafiki 37
Posts: 5,262
Re: Early retirement and health care for boaters

Quote:
Originally Posted by DotDun View Post
High is relative. Planning is the key to retirement without difficulties.
Right Ö high relative to every other developed nation. It just means it is harder for American cruisers, or for those of us who would like to cruise the USA.
__________________
Why go fast, when you can go slow.
BLOG: www.helplink.com/CLAFC
Mike OReilly is online now   Reply With Quote
Old 11-07-2018, 15:51   #237
Registered User

Join Date: Jun 2007
Location: SW Florida
Boat: FP Belize, 43' - Dot Dun
Posts: 3,834
Re: Early retirement and health care for boaters

Quote:
Originally Posted by hpeer View Post
2 dependents, the other 40,000 people in the company had the same plan. It is a typical plan for consulting/engineering firms. Several hundred thousand professionals are covered by very similar plans.

But even using your number of $700/month that would be $8,400/year/adult or for 3 it would be $2,100/month (not so far from my $2,500 huh) which is $25,200/year.

Or $16,800/year vs $3,000/year for two.

Now that Iíve demonstrated your numbers are pretty close to mine does it make sense in a different and more meaningful way?


Quote:
Originally Posted by Mike OReilly View Post
Right Ö high relative to every other developed nation. It just means it is harder for American cruisers, or for those of us who would like to cruise the USA.
Like I said, planning is key....income went up 50% after retirement, don't care what health insurance costs. Others, YMMV!
DotDun is offline   Reply With Quote
Old 11-07-2018, 16:24   #238
Registered User

Join Date: Jun 2009
Location: still in a roll of fiberglass around Cape Town
Boat: Leopard 40 (new model)
Posts: 1,293
Re: Early retirement and health care for boaters

Quote:
Originally Posted by sailorboy1 View Post
I think health care costs are the same in all first world countries. All thatís different is how it gets paid for. It other words how the payments get structured and spread around.
Your statement is far from reality. A good approximation is that healthcare expenditure in $ per head per year roughly double that of non-Mediterranean Western Europe countries, and treble that of Mediterranean Western Europe countries. Life expectancy in the US is shorter than in most of those countries. There is plenty of data to back up those statements.

Even a free-marketeer like myself can undestand that healthcare is a "public good' as in one of the four cases of market failure. If you move to the UK I am sure you will hate the NHS, but you will get the care the doctors thing you need (not the one you want) at no direct cost to you and half the total cost of the US.

Example from my time in the UK: Most British men over a certain age used to get their prostate examined by their GP with a method that only costed one disposable glove... Not enjoyable but cheap enough to give to everyone at a total cost that is lower than asking who wants it,etc and effective! At the same time our British employer would spend fortunes on the annual medical exams for US workers that would include full-body scans just because they were covered by the health plan.

Compare what the whole NHS spends in prescription drugs (centrally purchased from a short vademecum without letting people tell the doctor what drug they want and with high barriers to add on-patent drugs that are not clearly better than existing off-patent stuff.) per person per year to Medicare or Medicaid and you will be surprised. Ask a UK doctor to give you azitromicine instead of amoxicilline because it is more "convenient" to take just a pill a day and he will probably send you packing....
svlamorocha is offline   Reply With Quote
Old 11-07-2018, 16:47   #239
Don't ask if you can't handle it
 
sailorboy1's Avatar

Cruisers Forum Supporter

Join Date: Jul 2007
Location: On the boat somewhere
Boat: Hunter 410
Posts: 13,610
Re: Early retirement and health care for boaters

I bet no matter good or bad your health care is you still are going to die. The important thing is whether you win the CF health care thread first because that’s the real goal of many or the thread posters.

Of course like in many things I could be wrong and posters are really interested it helping people find low cost insurance/coverage and not in who has the “best” health care system.
__________________
jobless, houseless, clueless, living on a boat and cruising around somewhere
sailorboy1 is offline   Reply With Quote
Old 11-07-2018, 17:23   #240
Registered User

Join Date: Jun 2007
Location: SW Florida
Boat: FP Belize, 43' - Dot Dun
Posts: 3,834
Re: Early retirement and health care for boaters

Quote:
Originally Posted by sailorboy1 View Post
I bet no matter good or bad your health care is you still are going to die. The important thing is whether you win the CF health care thread first because thatís the real goal of many or the thread posters.

Of course like in many things I could be wrong and posters are really interested it helping people find low cost insurance/coverage and not in who has the ďbestĒ health care system.
__________________

DotDun is offline   Reply With Quote
Reply

Tags
boat, health, health care, men, retirement

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes Rate This Thread
Rate This Thread:

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
Working Through Retirement - AKA Working Retirement CNC-Charters Boat Ownership & Making a Living 21 01-09-2012 20:58
How to Take Care of the Oceans Which Take Care of Us . . . SarasotaYacht Seamanship & Boat Handling 1 04-11-2011 11:31
Retirement in My Early 40s ? ZuiQuan Dollars & Cents 89 27-08-2010 05:31
US Health Care Bill and Cruising Stevens 47 Health, Safety & Related Gear 20 16-05-2010 07:11
Six Years to Early Retirement, then Live Aboard DocSailor Meets & Greets 39 11-11-2009 10:34



Copyright 2002- Social Knowledge, LLC All Rights Reserved.

All times are GMT -7. The time now is 15:24.


Google+
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2018, vBulletin Solutions, Inc.
Social Knowledge Networks
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2018, vBulletin Solutions, Inc.

ShowCase vBulletin Plugins by Drive Thru Online, Inc.