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Old 28-01-2018, 19:22   #46
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Re: Early retirement and health care for boaters

The expat won't work with my wife. She is a home body and won't leave the area where the grand kids are. My plan is to upgrade to a larger boat and be a sailboat vagabond. I can be away 6-8 months if I still want to fly some and if I give that up there is no limit. I have visions of where I want to sail to while I still can. Pictures and videos aren't for me. I want to see, touch,smell,etc, areas of the world. So with this in mind I might just roll the dice on health care and pay out of pocket in foreign lands.
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Old 28-01-2018, 20:05   #47
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Re: Early retirement and health care for boaters

Going without health insurance is great... Until you need it. If you have no assets, you will be fine...if you have assets, well maybe someone will take them and then you will have no assets, then you will be fine(but without assets).
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Old 28-01-2018, 20:09   #48
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Re: Early retirement and health care for boaters

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We were in the same situation and were paying $137/mo for ACA with an enormous deductible ($3500 each) so we looked at it as catastrophic insurance "just in case" and we wouldn't lose our house to medical bills should the worst happen.
WOW, is this country full of snowflakes! Since when is $3500 an enormous deductible? One auto accident or heart attack can put you in a hospital where after two weeks the 24 hour doctor/surgeon/anesthesiologist/hospital/nurse/facility/lab/drug/personal injury insurance/janitorial fees for those taking care of you can quickly shoot past $150,000, Do Americans believe that health care is free or that health care workers work for min wage?
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Old 28-01-2018, 22:12   #49
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Re: Early retirement and health care for boaters

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WOW, is this country full of snowflakes! Since when is $3500 an enormous deductible? One auto accident or heart attack can put you in a hospital where after two weeks the 24 hour doctor/surgeon/anesthesiologist/hospital/nurse/facility/lab/drug/personal injury insurance/janitorial fees for those taking care of you can quickly shoot past $150,000, Do Americans believe that health care is free or that health care workers work for min wage?
Are you serious??? I had a bad motorcycle accident in Northern California about 6 years ago. I was in the hospital for 19 hours, that's how long it took my wife to get there and get me out of there, strapped up and skidded up the ramp on an aircraft headed for home.No operations, just a series of tests, MRI several x rays,that sort of stuff. Temporary cast and lots of morphine.
The total bill was just shy of $49,000.00 that's why Canadians are scared to ever get sick in your beautiful country.
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Old 28-01-2018, 23:43   #50
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Re: Early retirement and health care for boaters

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Are you serious??? I had a bad motorcycle accident in Northern California about 6 years ago. I was in the hospital for 19 hours, that's how long it took my wife to get there and get me out of there, strapped up and skidded up the ramp on an aircraft headed for home.No operations, just a series of tests, MRI several x rays,that sort of stuff. Temporary cast and lots of morphine.
The total bill was just shy of $49,000.00 that's why Canadians are scared to ever get sick in your beautiful country.
That just blows my mind!!! It's just crazy. A good mate of mine was cruising the caribean, they went north to florida. Wanted to get off the boat, hired a car and went to the drive in pictures. I still remember his email,

"one moment your in the car watching a movie eating fried chicken, next minute your in hospital bleeding from your ass. You wake up it the morning and are told you have irritable bowel and get handed a 12k bill, I know why my ass was bleeding he said "
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Old 29-01-2018, 00:07   #51
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Re: Early retirement and health care for boaters

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Just wondering why an early retiree with a sailboat would want to be based in the USA? After all a sailboat is the perfect escape vehicle from what sounds like a crazy political situation and extortionate health care costs. I would be nervous about spending any length of time there as a visitor let alone being based there permanently.
Reality it's not half as bad as the media would have you believe. The USA is still a great place to live. For every exorbitant expense in the USA, every other country has a similar cost for something else (not always measured in dollars)
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Old 29-01-2018, 00:08   #52
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Re: Early retirement and health care for boaters

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I'd like to see reducing the eligibility age for medicare. Say 55 instead of 65. It could be done in stages until we get to single payer. The system (medicare) is already in place. I guess it makes too much sense for it to happen.
I'd like a million dollars...are you going to pay for it?

There is no free lunch. When you hear people in other countries talk about free medical care it's always either paid for with higher taxes, lower service or some other downside.
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Old 29-01-2018, 01:01   #53
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Re: Early retirement and health care for boaters

Last year we were on a friend's boat, cruising Patagonia. My persistent cough was driving my friends and my wife nuts. I agreed to visit the military hospital in Puerto Williams where I was seen immediately. The doctor listened to my lungs, took an x-ray, diagnosed pneumonia and prescribed antibiotics and steroids. The cost for everything including the medications was about 8,500 pesos or about US$14.

We have been with Kaiser, an HMO popular here in California, for many years, despite their stratospheric costs. Currently, we pay US$1,200/month with a US$5,000 annual deductible each. According to our policy, Kaiser will pay for health care if we get sick while out of the country but I didn't bother submitting a claim for the treatment I got in Chile. We don't have too much longer before we turn 65 and I'm considering getting fake IDs so we can take advantage of the savings now (just kidding).

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Old 29-01-2018, 05:55   #54
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Re: Early retirement and health care for boaters

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I'd like a million dollars...are you going to pay for it?

There is no free lunch. When you hear people in other countries talk about free medical care it's always either paid for with higher taxes, lower service or some other downside.
Not really. The US already pays more per capita than.any other industrialized nation for health care, with no better and often worse outcomes while still not covering everyone.
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Old 29-01-2018, 06:53   #55
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Re: Early retirement and health care for boaters

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Not really. The US already pays more per capita than.any other industrialized nation for health care, with no better and often worse outcomes while still not covering everyone.
Every time I've dug into these comparisons, there is always flaws in the analysis. I suspect most of it is an accounting issue. It's really hard to document each and every cost in a manner that can't be disputed. So, kind of like college football teams that sell out 100,000 seat stadiums and have massive TV contracts....but never seem to turn a profit...these studies always seem to match the goals of those who commissioned them.

At the same time, real people travel to the USA for treatments and most of the new drugs and treatments are developed in the USA...but clearly the system isn't very good.
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Old 29-01-2018, 07:23   #56
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Re: Early retirement and health care for boaters

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Every time I've dug into these comparisons, there is always flaws in the analysis. I suspect most of it is an accounting issue. It's really hard to document each and every cost in a manner that can't be disputed. So, kind of like college football teams that sell out 100,000 seat stadiums and have massive TV contracts....but never seem to turn a profit...these studies always seem to match the goals of those who commissioned them.

At the same time, real people travel to the USA for treatments and most of the new drugs and treatments are developed in the USA...but clearly the system isn't very good.
You don't have to spend time digging into these comparisons as highly qualified groups have done just that and continue to do it, the numbers and comparisons are there for all to see. people with deep pockets do travel to certain highly specialized Doctors in the USA for treatment, we know that but the numbers are low. People also travel to India for specialised treatment..the numbers are high
Actually drugs are created all over the world and while the USA has always been a leader other countries are starting to really step up these days. Don't you find it interesting that your bedrock of trade policy is that other countries should not be promoting protectionist policies and yet your Big Pharma is protected by not allowing any other drug companies to compete with American companies further creating a monopoly and driving your costs and their profits sky high.
Your country has the highest cost in the world for health care ( almost double its closest rival)and currently of all the studies I have looked at the highest ranking your country has achieved is 10th in the world as far as quality of health care. Not exactly stellar results but quite predictable given the circumstances.
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Old 29-01-2018, 07:25   #57
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Re: Early retirement and health care for boaters

Medical costs in the USA are kept high because there is no free market. Supply is kept low by doctors lobby. They decide who gets to be a medical school, same with lawyers. But even lawyers are less greedy they allow more schools. Since the costs are devastatingly high you need insurance if you have any assets. Single payer does nothing to help supply and increased demand. I'm for single payer to cut out high profit of insurance company's. But without fixing supply costs will keep increasing.
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Old 29-01-2018, 10:16   #58
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Re: Early retirement and health care for boaters

Robert is correct, the USA pays nearly double per-capita what most other developed nations pay for healthcare, yet the outcomes are only ‘fair to middlin’. This is a well-researched fact.

I only have a superficial idea as to why the system down south is so costly. Seems mostly to do with the waste and avarice of all the middlemen. All I really know is that if I had to pay the healthcare insurance premiums that my southern neighbours quote here, I would not be able to go cruising. I honestly don’t know how some of you manage it.
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Old 29-01-2018, 10:52   #59
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Re: Early retirement and health care for boaters

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Robert is correct, the USA pays nearly double per-capita what most other developed nations pay for healthcare, yet the outcomes are only ‘fair to middlin’. This is a well-researched fact.

I only have a superficial idea as to why the system down south is so costly. Seems mostly to do with the waste and avarice of all the middlemen. All I really know is that if I had to pay the healthcare insurance premiums that my southern neighbours quote here, I would not be able to go cruising. I honestly don’t know how some of you manage it.
Mike there are many reasons the American system is so expensive, it's quite complex. Obviously when you run healthcare on a for profit basis and then ensure you remove competition your costs will rise. One of the other issues are that there is a stacking of overhead. Every insurance company has to employ people and systems to keep track of patients, nothing is shared so that drives the overhead up compared to a single payer system that only has one set of books to keep. Then the fact that Americans have a very litigious system, Dr.'s and hospitals pay up the nose for malpractice insurance and patients sue Dr.'s and hospitals at the drop of a hat. There are a bunch of other issues as well but you add it all up and you end up with the most inefficient health care system in the world. Many cruisers are older than 65 and are on Medicare which keeps their costs down to next to nothing.
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Old 29-01-2018, 11:10   #60
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Early retirement and health care for boaters

Those urgent care facilities are a rip off. We were steered to an urgent care facility twice last year for the same ailment. Each time we saw the doctor for maybe 10 minutes, had a few tests done and the costs came in at over $1200 each visit. Same ailment a third time we went to the real emergency room. Cost was 1/2 that. Now the hospitals are getting into the pharma business and starting up their own companies to make generics. So now the same parent company will own the general practices, the hospitals, the drug companies, and the insurance companies. I bet prices go up.
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