Cruisers Forum
 


Join CruisersForum Today

Closed Thread
 
Thread Tools Rate Thread Display Modes
Old 10-11-2012, 18:22   #256
Registered User
 
avb3's Avatar

Cruisers Forum Supporter

Join Date: Jul 2010
Location: Florida/Alberta
Boat: Lippincott 30
Posts: 9,913
Images: 1
Re: Obamacare = early retirement anyone?

Quote:
Originally Posted by rebel heart View Post
..........
Until there is price competition in medicine, there is zero incentive for providers to control costs. There is no God-given standard that radiologists should get 400k a year, which is their current median salary. I'm all for folks making money, but I'd prefer it to be inside the confines of a free-ish market system. The American medical system is *far* from that.
That is about what the average radiologist makes in Canada. In fact, here in Alberta, nurses make about $45/hour, and double that for overtime. You need to understand that most nurses here work under a .6 of a FTE scenario, because that is first of all where benefits kick in (like free massages), and that everything after that .6 is overtime.

In other words everything after 4.8 hours assuming an 8 hour day 40 hour week would be doubletime.

It is not unusual for a nurse to make 6 figures.

My point is, it is not the care provider salaries that are the difference it is the huge inefficiencies and profit driven hospitals and insurance companies the determine that the US spends 1/3 more of its GDP on healthcare than Canada.
__________________

__________________
If your attitude resembles the south end of a bull heading north, it's time to turn around.
avb3 is offline  
Old 10-11-2012, 18:24   #257
Moderator
 
sailorchic34's Avatar

Cruisers Forum Supporter

Join Date: Feb 2011
Location: SF Bay Area
Boat: Islander 34
Posts: 4,815
Re: Obamacare = early retirement anyone?

Quote:
Originally Posted by Don Lucas View Post
Please quote a part of the bill/law that says this. Because so far we have seen that there is a minimum amont or percentage of your income, whichever is larger.
Gee Don, Look it up yourself. I did look it up months ago so I know its in there... It really varies by state but for me being one of those folks that lives below the poverty line (IE the $500/month cruiser), there is no cost. Those below FPL which is about $900 ish a month last time I looked, get signed up for medicare for free. But it depends on the state, For some states its for those below $5000 a year, Texas for one) Those between 100 % and 400% of the FPL get tax credits for some or most of the cost.

For those families above 400 percent of the FPL (about $3600/ month) its all out of pocket.

I've got a dollar that says I'm right BTW....
__________________

__________________
sailorchic34 is offline  
Old 10-11-2012, 18:52   #258
Senior Cruiser
 
osirissail's Avatar

Cruisers Forum Supporter

Join Date: Feb 2009
Location: A real life Zombie from FL
Boat: Gulfstar 53 - Osiris
Posts: 5,416
Images: 2
Re: Obamacare = early retirement anyone?

Quote:
Originally Posted by SunDevil View Post
. . . I will say that I hate the way the billing and cost information is though. I had no idea a CT scan cost $4,000, and that was probably cheap. I found out a few weeks after when a bill came in the mail. Except it wasn't a real bill. The health insurance company paid that, but I got something in the mail asking me to pay $1000 when it was covered by my insurance.
I don't know where you got your CT scan, but it must have been in some swanky, fur lined, gold-plated clinic. I have had a half dozen CT scans in the last 1.5 years here in Central Florida at both hospitals and dedicated imaging clinics. The "retail" price** for the CT scan was US$726 (chest) and US$800 (abdominal). The "wholesale" price** was US$218 and US$154. And with AARP supplemental coverage my out of pocket was US$0 (zero).

** For the last decade or more the U.S. medical system has instituted a dual pricing system. "Retail" is what the medical provider bills for a procedure/process and "Wholesale" is what they will accept as full payment from insurance companies for that procedure/process. With most insurance policies you pay about 20% of "wholesale" (after meeting the deductible) and the rest is paid by the insurance provider. With "Supplemental" insurance the 20% you have to pay is paid by your "Supplemental" carrier.
__________________
osirissail is offline  
Old 10-11-2012, 18:58   #259
Marine Service Provider

Join Date: May 2012
Location: New Orleans
Boat: We have a problem... A serious addiction issue.
Posts: 3,940
Re: Obamacare = early retirement anyone?

According to the experts there are a coupl of drivers of the US health care costs, as to why they are much higher than in other developed countries. Of course it depends to some extent on which study you look at, but the generally agreed drivers fall into just a few categories.

1) extremely high prices for pharmaceuticals - in large part driven by non-negotiated prices between drug manufacturers and Medicare/Medicaid.
2) over payment for specialized services and lack of primary care physicians
3) high overheated related to billing complexities
4) huge quantity of services provided to people who have no possibility of paying (either no insurance, or underinsured).
5) to many non-justified tests, and procedures.

This is not a simple problem, and even trying to discuss it is fraught with difficulty since the issues are very complicated, and there are too many people that are emotionally invested in issues with little to no empirical basis.

To me this is part of the problem with a lot of political issues. The problems and answers are very complicated and cannot reasonably be understood by the average person. But because they are emotional issues poor or misinformation is easily digested by both sides.
__________________
Greg

- If animals weren't meant to be eaten then they wouldn't be made of food.
Stumble is offline  
Old 10-11-2012, 19:22   #260
Moderator
 
sailorchic34's Avatar

Cruisers Forum Supporter

Join Date: Feb 2011
Location: SF Bay Area
Boat: Islander 34
Posts: 4,815
Re: Obamacare = early retirement anyone?

BTW the reason that the fine folks that live on LESS then 100% of the federal poverty limit (FPL) get signed up for medicare, is it actually saves the government money to do so. It saves $100 BILLION to sign the folks up for medicaid then to do the tax credit for the Sub FPL people. That's why its set up that way.

Or so I read on the internet. Its got to be true if its on the internet....

I knew I was a cheap date ;-)
__________________
sailorchic34 is offline  
Old 10-11-2012, 19:45   #261
Registered User

Join Date: Dec 2009
Posts: 46
Re: Obamacare = early retirement anyone?

The bottem line is who will pay for Obamacare when I and many others stop working as hard or stop working all together like I plan to do next year? The superintendent on the job I'm on now plans to quit first of the year, I quit running work 5 years ago. I plan on sailing away and sucking up the easy life with everyone else while it last. Rick
__________________
rberrey is offline  
Old 10-11-2012, 20:08   #262
Registered User
 
Doodles's Avatar

Join Date: Nov 2009
Location: Virginia, USA & Krabi, Thailand
Boat: Wauquiez Pretorien 35; Nordica 16
Posts: 2,810
Images: 1
Re: Obamacare = early retirement anyone?

Quote:
Originally Posted by Stumble View Post
According to the experts there are a coupl of drivers of the US health care costs, as to why they are much higher than in other developed countries. Of course it depends to some extent on which study you look at, but the generally agreed drivers fall into just a few categories.

1) extremely high prices for pharmaceuticals - in large part driven by non-negotiated prices between drug manufacturers and Medicare/Medicaid.
2) over payment for specialized services and lack of primary care physicians
3) high overheated related to billing complexities
4) huge quantity of services provided to people who have no possibility of paying (either no insurance, or underinsured).
5) to many non-justified tests, and procedures.

This is not a simple problem, and even trying to discuss it is fraught with difficulty since the issues are very complicated, and there are too many people that are emotionally invested in issues with little to no empirical basis.

To me this is part of the problem with a lot of political issues. The problems and answers are very complicated and cannot reasonably be understood by the average person. But because they are emotional issues poor or misinformation is easily digested by both sides.
Thanks! A very intelligent observation .... and I was being to believe Obama did it all to us!
__________________
Mundis Ex Igne Factus Est
Doodles is offline  
Old 10-11-2012, 22:07   #263
Registered User
 
dochueb's Avatar

Join Date: Jul 2011
Location: Kearney, Nebraska
Boat: Fountaine Pajot Helia 44
Posts: 61
Quote:
Originally Posted by Pete7
Dave, thank god for the NHS (National Health Service). It would worry me cruising the US if something went wrong.

What happens in the US if you don't have insurance and something serious goes wrong like a badly broken leg?

Pete
You get it fixed in the hospital of your choice by the doctor of your choice as neither is legally allowed to turn you away based on your ability to pay.

The hospital & doctor may or (more likely) may not get paid.
__________________
dochueb is offline  
Old 10-11-2012, 22:59   #264
Registered User

Join Date: May 2008
Location: daytona beach florida
Boat: csy 37
Posts: 2,844
Images: 1
Re: Obamacare = early retirement anyone?

not true, dochueb.

states, (usually at the county level), have 'county' hospitals. years ago they were dubbed 'charity' hospitals but that seems to be politically incorrect today. in any case, an indigent or uninsured patient will be transported to the county hospital where they will get cared for - but not the hospital or doctor of their choice.

the taxpayer then picks up the tab - but not the whole tab. states maintain funds to reimburse hospitals/doctors for a portion of their unpaid services, usually at about the same level that insurance companies reimburse them - about 30 to 50% of their 'usual and customary fee' (the retail price).

before being state reimbursed, hospitals/doctors are REQUIRED to pursue the patient for payment, right up to using collection agencies. only when they demonstrate to the state that there is no possibility of being paid by the patient can they apply to the state.

so in effect we already have 'social' medicine for the indigent. but only for emergencies. getting regular checkups and other forms of non-essential care is not paid for by the state, leading to ill health for americans at the lower income levels.

so, do i think that americans are grossly overcharged for medical care? of course i do, for the very simple reason that hospitals/doctors are perfectly willing to accept 30 to 50% of their 'usual and customary' fees from insurance companies.
__________________
onestepcsy37 is offline  
Old 10-11-2012, 23:15   #265
Registered User
 
Aussiesuede's Avatar

Join Date: May 2008
Location: Vancouver, BC & Seattle, WA
Posts: 641
Re: Obamacare = early retirement anyone?

Quote:
Originally Posted by dochueb View Post
You get it fixed in the hospital of your choice by the doctor of your choice as neither is legally allowed to turn you away based on your ability to pay.

The hospital & doctor may or (more likely) may not get paid.
Actually when you present at the emergency room, you do not get to choose your doctor. You are attended to by whatever random doctor on rotation at the time. And hospitals CAN and DO turn away patients who present at an emergency room if it's determined that the patient is sufficiently stabilised enough to be transferred to the mandatory county facility of record. Present at an emergecy room at a private hospital with a broken arm and either insufficient, or no insurance coverage, and you'll get a quick exam- often in the waiting are- to determine that you are sufficiently stable; then you'll be given directions to the nearest facility in the county that is mandated to fix ya up.
__________________
I'm On point, On task, On message, and Off drugs. A Streetwise Smart Bomb, Out of rehab and In denial. Over the Top, On the edge, Under the Radar, and In Control. Behind the 8 ball, Ahead of the Curve and I've got a Love Child who sends me Hate mail. - (George Carlin)
Aussiesuede is offline  
Old 11-11-2012, 00:02   #266
Senior Cruiser

Cruisers Forum Supporter

Join Date: Mar 2006
Location: Whangaparaoa,NZ
Boat: 63 ft John Spencer Schooner
Posts: 956
Re: Obamacare = early retirement anyone?

I started reading at page 1 and got as far as page 8 before giving up.

One thing became glaringly obviouseople in the USA need to get over their irrational fear of anything vaguely "socialist", sack the insurance companies and hospitals for profit and institute a sensible taxpayer funded health system. For advice look to your neighbours to the north (or just about any other OECD country). People - you are all getting screwed.
__________________

dana-tenacity is offline  
Old 11-11-2012, 00:31   #267
Registered User

Join Date: Nov 2012
Posts: 4
Re: Obamacare = early retirement anyone?

This is an excellent discussion for those of us who are (1) retired and (2) dreaming of casting off from our big mortgages and taking up the cruising life. It's something I never considered in my cruising life fantasy planning. I won't go into a political rant that will cause the moderators to close this thread, but I do have to agree with roverhi: "Are you saying thank you for us paying so that you can go cruising?" The lesson I take from all the excellent posts on this thread is that those of us who DO have pre-existing conditions really need to plan for health care costs. Thanks for all the excellent posts from those who are dealing with this issue.
__________________
Scofvb is offline  
Old 11-11-2012, 00:50   #268
Senior Cruiser
 
osirissail's Avatar

Cruisers Forum Supporter

Join Date: Feb 2009
Location: A real life Zombie from FL
Boat: Gulfstar 53 - Osiris
Posts: 5,416
Images: 2
Re: Obamacare = early retirement anyone?

Quote:
Originally Posted by Stumble View Post
. . . To me this is part of the problem with a lot of political issues. The problems and answers are very complicated and cannot reasonably be understood by the average person. But because they are emotional issues poor or misinformation is easily digested by both sides.
I would suggest using the word "regurgitated" instead of "digested" - seems to have a closer "smell & taste" to the issue at hand. . .
__________________
osirissail is offline  
Old 11-11-2012, 04:26   #269
Registered User
 
dochueb's Avatar

Join Date: Jul 2011
Location: Kearney, Nebraska
Boat: Fountaine Pajot Helia 44
Posts: 61
Quote:
Originally Posted by onestepcsy37
not true, dochueb.

states, (usually at the county level), have 'county' hospitals. years ago they were dubbed 'charity' hospitals but that seems to be politically incorrect today. in any case, an indigent or uninsured patient will be transported to the county hospital where they will get cared for - but not the hospital or doctor of their choice.

the taxpayer then picks up the tab - but not the whole tab. states maintain funds to reimburse hospitals/doctors for a portion of their unpaid services, usually at about the same level that insurance companies reimburse them - about 30 to 50% of their 'usual and customary fee' (the retail price).

before being state reimbursed, hospitals/doctors are REQUIRED to pursue the patient for payment, right up to using collection agencies. only when they demonstrate to the state that there is no possibility of being paid by the patient can they apply to the state.

so in effect we already have 'social' medicine for the indigent. but only for emergencies. getting regular checkups and other forms of non-essential care is not paid for by the state, leading to ill health for americans at the lower income levels.

so, do i think that americans are grossly overcharged for medical care? of course i do, for the very simple reason that hospitals/doctors are perfectly willing to accept 30 to 50% of their 'usual and customary' fees from insurance companies.
Also not quite true.

The last time I worked in such a setting was in St. Louis. Since then, (17 years & 4 cities ago...), I haven't seen the county / charity system. Patients come to ER and are treated. One can only be transferred to a higher level of care (eg. Trauma center) if medically necessary. Otherwise, the hospital & physician are dealing with an EMTALA violation.

I've never worked in a state were physicians were reimbursed for indigent care. I also don't believe that's true for hospitals in my state.

As for preventive care, I agree. I wasn't proposing that our system as A-OK, just answering the broken leg hypothetical.

DH
__________________
dochueb is offline  
Old 11-11-2012, 07:55   #270
Registered User
 
svHyLyte's Avatar

Join Date: Mar 2006
Location: Tampa Bay area, USA
Boat: Beneteau First 42
Posts: 3,434
Images: 25
Whats the Point of the Debate?

I don't see what the point of this debate is. Obamacare in its current incarnation is the law of the land and those choosing to reside here (USA) will have no choice but to endure it. One's options then are to simply maximize one's own benefit while minimizing ones own losses in the regime.

The essential problem is that in this issue, as others, there are more takers than givers and, as made clear hereinbefore (earlier posts), because if its implementation, there will be even fewer givers as many, such as we, finally say "The heck with it. If I can't make a reasonable return on my investment and labor, why bother?" Do not put one's money at risk in a business (when "government" never share the losses but greadily steps up for a share of the profits) and skip the 60-70 hour work weeks.

Folks do not provide for themselves and their needs when they are confident others will pick up their burdens. They suffer no consequences for such an approach. Frankly, it's not the fault of the majority of people at this point as they have been raised with, nearly, every want provided for by someone even before many of these wants become manifest. My own daughter, who I love quite dearly, was a perfect illustration in her time. As she approached the age when she would be permitted to obtain a driver's license, she came into the garage one day to ask me what kind of car Mommy and I planned to buy for her and to let me know which ones she didn't want. She was quite stunned to hear that we had no plans to buy her a car at all. "But why not?" she protested, "..all the other kids' moms and dads are getting cars for them!" Having had virtually every wish/need/demand fulfilled for her entire 15+ years of life (although this despite some rather heated debates between the parents in the events), from her perspective her expectations were entirely reasonable. The idea that if she wanted a car, she would have to earn the money to buy one and pay for its maintenance, upkeep and insurance, never occured to her. And so the body politic. "It's not my fault!" is invariably the cry, closely followed by "There should be a Law!".

N'any case, arguing between ourselves and berating one another and creating ill-will for one or another's choices serves no useful purpose. The election is over and folks have made their choices. If the consequences are painful enough, they will make different choices next time around, or not--because, of course, there a more now that will not suffer the consequences then will. The only way to change that calculus is to reverse the balances--one person at a time. So, for those of you that have the resources to say the heck with it and go cruising, do so, please. There are many places that one can cruise within the limits of the USA that are quite lovely and often unvisited and yet still avail one of all of the free advantages of Obamacare (e.g. Puerto Rico, the USVI, Hawaii, American Samoa et al.) And maybe, at some point, when folks realize that there simply aren't enough givers at any tax rate, that they have gutted the Golden Goose and there are no more golden eggs to be had, and foreign investors will no long buy US debt then things will change. Or not. In the mean time, I shall go sailing as I will in a few minutes (here it will be in the 80's today with 10-15 knt winds from the NNE which will make for a nice reach out to Egmont Key for lunch, a nap and a good book to read for an hour or so).

Here Home Nods...
__________________

__________________
"It is not so much for its beauty that the Sea makes a claim upon men's hearts, as for that subtle something, that quality of air, that emanation from the waves, that so wonderfully renews a weary spirit."
svHyLyte is offline  
Closed Thread

Tags
retirement

Thread Tools
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




Copyright 2002- Social Knowledge, LLC All Rights Reserved.

All times are GMT -7. The time now is 12:59.


Google+
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.
Social Knowledge Networks
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.

ShowCase vBulletin Plugins by Drive Thru Online, Inc.