Early retirement and health care for boaters

[Mike OReilly]

Originally Posted by HBWT

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. …

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

Thanks for the report link. As it clearly states, the USA’s 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 — just as has been stated.

I’m not trying to bash the USA’s system. That’s 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 you’ve 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.

[Paul L]

Originally Posted by HBWT

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.

[HBWT]

Originally Posted by Paul L

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...

[Paul L]

Originally Posted by HBWT

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.

[HBWT]

Originally Posted by Paul L

What a meaningless statement.

Originally Posted by Paul L

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.

[DotDun]

Originally Posted by Mike OReilly

Thanks for the report link. As it clearly states, the USA’s 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 — just as has been stated.

I’m not trying to bash the USA’s system. That’s 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 you’ve 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.

[Paul L]

Originally Posted by HBWT

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.

[hpeer]

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.

[DotDun]

Originally Posted by hpeer

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.

[hpeer]

Originally Posted by DotDun

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?

[Mike OReilly]

Originally Posted by DotDun

High is relative. Planning is the key to retirement without difficulties.

Right … 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.

[DotDun]

Originally Posted by hpeer

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?

Originally Posted by Mike OReilly

Right … 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!

[svlamorocha]

Originally Posted by sailorboy1

I think health care costs are the same in all first world countries. All that’s 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....

[sailorboy1]

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.

[DotDun]

Originally Posted by sailorboy1

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.