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Old 30-01-2018, 01:38   #91
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Re: Early retirement and health care for boaters

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Except that pure capitalistic system, aka free market, can't work for health care. We agree for safety reasons to regulate who can practice medicine, who can issue degrees, who can sell drugs, who can manufacture drugs, etc. It is never going to be a free market. In addition the consumer is under duress when they need care, so rational pricing decisions won't be made.

Every other major industrialized country has been able to deliver advanced health care at per capita costs way less than the US without trying a free market system.
I probably should have said "more" or "heavily" capitalistic system. "Pure" adds some connotations not meant.

It's a common misconception that capitalism allows an unfair playing field. The basis of capitalism is put everyone on a level playing field and let the best man win. Part of that can and does include requiring minimum standards to call yourself a doctor but even here, capitalism wins out. If a doctor is going to charge $300 for an office visit but I can see a PA for $50...
- When it's under insurance, give me a real doctor because it's covered under insurance.
-If I have to hand over $20 bills at the time of the appointment...the PA is fine unless it turns out to be something unusual and then they can refer me to a doctor.

Drugs and testing tools that are under patent are very much consistent with capitalism. Again, capitalism is about a fair playing field. If you put the time and money into developing a drug, the competition shouldn't get to reverse engineer it and undercut you.

As stated in my comment, insurance for catastrophic issues does still need to be present. Obviously, if you show up at the emergency room with a bloody stump instead of a hand, you aren't going to shop around. But if the kids get the sniffles, you probably already shopped around for a doctor.

As far as other countries doing it cheaper, if you cherry pick only the direct easy to calculate costs, it looks that way. If you look at the big picture, it's not so clear that they do.
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Old 30-01-2018, 01:58   #92
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Re: Early retirement and health care for boaters

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Originally Posted by valhalla360 View Post
I probably should have said "more" or "heavily" capitalistic system. "Pure" adds some connotations not meant.

It's a common misconception that capitalism allows an unfair playing field. The basis of capitalism is put everyone on a level playing field and let the best man win. Part of that can and does include requiring minimum standards to call yourself a doctor but even here, capitalism wins out. If a doctor is going to charge $300 for an office visit but I can see a PA for $50...
- When it's under insurance, give me a real doctor because it's covered under insurance.
-If I have to hand over $20 bills at the time of the appointment...the PA is fine unless it turns out to be something unusual and then they can refer me to a doctor.

Drugs and testing tools that are under patent are very much consistent with capitalism.

Again, capitalism is about a fair playing field. If you put the time and money into developing a drug, the competition shouldn't get to reverse engineer it and undercut you.

As stated in my comment, insurance for catastrophic issues does still need to be present. Obviously, if you show up at the emergency room with a bloody stump instead of a hand, you aren't going to shop around. But if the kids get the sniffles, you probably already shopped around for a doctor.

As far as other countries doing it cheaper, if you cherry pick only the direct easy to calculate costs, it looks that way. If you look at the big picture, it's not so clear that they do.
It sounds like you have an idealistic view of capitalisic commerce. You may like patents, but understand what they are. A patent is a government mandated monopoly for a period of time. It has little to do with economic efficiency. In the drug business they are extensively used to block competion, not to protect R&D in practice.

The guy with the bloody stump not only won't bargain for a better deal, in a pure capitalistic scenario the providers could up the rates based on the sudden demand.

You may not believe the published per capita costs for health care in the US vs other countries. Do you have data that shows the US system.is actually more cost effective or even ode to competitive? If so, I.d love to see it.

OK back to sailing.
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Old 30-01-2018, 03:58   #93
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Re: Early retirement and health care for boaters

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It sounds like you have an idealistic view of capitalisic commerce.
No I understand there is no perfect system and there are situations where capitalism doesn't make sense and a more socialist approach is better. But where the playing field can be kept level, capitalism almost always beats socialism.

You may like patents, but understand what they are. A patent is a government mandated monopoly for a period of time. It has little to do with economic efficiency. In the drug business they are extensively used to block competion, not to protect R&D in practice.

We'll have to disagree on patents. While there are abuses of the system, in general it's necessary if we want development. It's basically protecting intellectual property vs physical property.
- If you own a shoe factory and I send guys in and steal truckloads of shoes, you wouldn't say, "well that's capitalism".
- In the same way if I develop a drug, if you steal the formula, that's also not capitalism.


The guy with the bloody stump not only won't bargain for a better deal, in a pure capitalistic scenario the providers could up the rates based on the sudden demand.
I think we are arguing the same side on this specific part.
For emergency and catastrophic issues, insurance makes sense because it would be too easy for providers to abuse the customer.


You may not believe the published per capita costs for health care in the US vs other countries. Do you have data that shows the US system.is actually more cost effective or even ode to competitive? If so, I.d love to see it.
I did provide some information. The USA has a drastically higher per capita GDP compared to the EU. I readily admit teasing out the exact amount of that difference that relates to health care costs is difficult but there is no doubt at least some of it is related.
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Old 30-01-2018, 04:43   #94
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Re: Early retirement and health care for boaters

Raise your deductible and consider your health insurance as a catastrophic policy only. That should lower your monthly premium. For simple out-patient procedure like MRI, call the clinic and see what discount they will cut you for paying cash at time of service. I've been shocked at discounts as Dr's know they won't have to fight for payment.

Some of the dentists in our area are in co-ops that don't take insurance, but their charges are lower. Stay away from the emergency clinics as they charge inflated prices. Basically spend as much time on research, shopping prices, negotiating your care as you do on boat equipment purchases.
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Old 30-01-2018, 04:52   #95
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Re: Early retirement and health care for boaters

Oh, and while you are working and have taxable income, fund your HSA to the max. Which I think you can only do if you have an HDHP plan. Your HSA contribution will be tax deductible, and the interest growth is not taxed either, although most account administrators charge a small fee. And when you do have to deal with a large medical event that falls short of your high deductible, you can pay it with your socked away HSA funds.
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Old 30-01-2018, 05:36   #96
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Re: Early retirement and health care for boaters

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I did provide some information. The USA has a drastically higher per capita GDP compared to the EU. I readily admit teasing out the exact amount of that difference that relates to health care costs is difficult but there is no doubt at least some of it is related.
Norway per capita GDP: $70,600 (2017 est.)
U.S. per capita GDP: $59,500 (2017 est.)
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Old 30-01-2018, 06:06   #97
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Re: Early retirement and health care for boaters

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Norway per capita GDP: $70,600 (2017 est.)
U.S. per capita GDP: $59,500 (2017 est.)

Already mentioned the Norway poster child and that's why I highlighted the USA vs Europe rather than individual European states.

Soon as we find per capita oil reserves equal to Norway, we're golden.
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Old 30-01-2018, 06:15   #98
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Re: Early retirement and health care for boaters

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Already mentioned the Norway poster child and that's why I highlighted the USA vs Europe rather than individual European states.

Soon as we find per capita oil reserves equal to Norway, we're golden.
OK, how about:
Massachusetts (aka Taxachusets) per capita GDP: $74,564
Texas per capita GDP: $58,028
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Old 30-01-2018, 06:22   #99
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Re: Early retirement and health care for boaters

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OK, how about:
Massachusetts (aka Taxachusets) per capita GDP: $74,564
Texas per capita GDP: $58,028
How about that...just like I said, when comparing small states to large, it's easy to cherry pick data and get the answer you want.
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Old 30-01-2018, 07:10   #100
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Re: Early retirement and health care for boaters

OK, unsubscribe from this one. Thread drift. Think I will go find a fun thread.
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Old 30-01-2018, 07:11   #101
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Re: Early retirement and health care for boaters

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OK, unsubscribe from this one. Thread drift. Think I will go find a fun thread.
"GUN" thread. Oh, never mind.
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Old 30-01-2018, 08:06   #102
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Re: Early retirement and health care for boaters

This is a boating forum, all we need to discuss is how can boaters get health care. There is no need to discuss health systems various countries etc. as I bet there are forums for that.

I got my statement the other day and I got $13k of assistance on my ACA plan last year. So my method is worth considering for cruisers and early retirees in the USA. It is interesting how hard it was for me to find this method as even early retiree forums didn't know. My wife was an HR manager and went to seminars on health insurance, including ones just about the ACA, and even the people giving those seminars didn't know.
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Old 30-01-2018, 09:59   #103
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Re: Early retirement and health care for boaters

OK, I was about to post a tirade in response to certain “alternative facts” being presented here. But Don’s post shamed me into stepping away from the keyboard. Thanks Don. You are completely correct.

From all I’ve read here, outside of actually just paying as you go, or moving to another country with normal healthcare, Don’s approach seems incredibly innovative.
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Old 30-01-2018, 10:34   #104
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Re: Early retirement and health care for boaters

One man's subsidy is another man's tax burden.

There is no free lunch. Someone always pays.

But, yes, there are ways to game the system so that it is not you.
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Old 30-01-2018, 10:59   #105
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Re: Early retirement and health care for boaters

[derail alert]

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Keeping your income low can reap other peoples taxes to subsidize your lifestyle. Canada appears to let everyone do this if they choose, without manipulating income level to stay below a cutoff. Definitely something I'm considering.
Beg pardon? As with the US, we don't get much of a lifestyle in Canada if we have low or no income. We do get decent healthcare, regardless of income.

Quote:
I'm all for tax payer provided health insurance in the USA. 65+ have to be astronomically more expensive to insure than those under 65, so why not everyone? Just like dozens of other successful countries? I personally think there is a lot of entrepreneurial spirit that could be unleashed by letting people leave their jobs that they only have for the 'benefits'.
It is indeed true that Canada has a fairly mobile workforce, and few are trapped in a job simply out of fear of losing health benefits.

[ok, I'm about 5 pages late with this. Ignore if no longer timely]
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