Month eight for a middle-aged couple on a modest boat.

[a64pilot]

Originally Posted by Exile

Sounds like an interesting guy, but then I enjoy reading about nonconformists. If he posts on CF, what's his handle?

90% sure it’s Boat Alexander, it may be one word too.
I’m under the impression that he is smarter than the average bear myself, and while I many disagree with some of his opinions, I concede that he is resourceful and smart. He has my respect.
I disagree with many opinions, don’t we all?
Last year I think it was he was coming down North Carolina I think it was and was iced in, many were worried for his well being, but I felt sure that he could use his head and at most be uncomfortable.

I believe for instance that he has tried the electric propulsion thing and come to the conclusion that sculling for him is more reliable and likely does just as well.

[a64pilot]

Originally Posted by Mike OReilly

Too keep this on the budget talk (and like I mentioned), I don’t understand how Americans of modest means can ever afford to go cruising. Not trying to be political at all, but your healthcare costs are nuts! I won’t spend $450 in a year — in many years — on basic healthcare.

They don’t like to admit it, but they do as most lower income people in the US do, they are uninsured.
They go to the Emergency room and the law says they have to be treated, so they are. I’m sure they leave with a monstrous bill that they will never pay, because they can’t. But somehow the Hospital has to be able to keep its doors open, so the unpaid costs get paid by those who have Insurence and or the means to do so.
That is a major reason the costs are so high, that so few actually pay.

That is an unpopular statement and I’m sure instant death to say on the political world, but I believe it to be true.

[Cthoops]

Originally Posted by Mike OReilly

Too keep this on the budget talk (and like I mentioned), I don’t understand how Americans of modest means can ever afford to go cruising. Not trying to be political at all, but your healthcare costs are nuts! I won’t spend $450 in a year — in many years — on basic healthcare.

Now dental … that’s another story .

In researching Obamacare in different states before we left, the cost of coverage varied widely from state to state. That’s why we’ve maintained our Connecticut residency. One year, based on our 2019 projected income, is $156 in premiums. That’s for the whole year. Co-pays are $20, and if something really bad happens the total out of pocket deductible is $10,000. We can work with that.

[Exile]

Originally Posted by Cthoops

In researching Obamacare in different states before we left, the cost of coverage varied widely from state to state. That’s why we’ve maintained our Connecticut residency. One year, based on our 2019 projected income, is $156 in premiums. That’s for the whole year. Co-pays are $20, and if something really bad happens the total out of pocket deductible is $10,000. We can work with that.

Wow! That's remarkably inexpensive (premium-wise that is), and also encouraging to hear. Part of a retirement package? Medicare? Under 40 years old? Limited to a statewide HMO?

There has also been an uptick it seems in "Urgent Care" clinics that operate on a walk-in basis like ER's, but without all the overhead that often goes unpaid as a64 (correctly) described. From what I hear some are pay-as-you-go for those w/o insurance, and are quite reasonable (there's that word again ). Could be an option for someone like Mike who can always return home if something comes up that requires more than immediate care.

[Exile]

Originally Posted by a64pilot

90% sure it’s Boat Alexander, it may be one word too.
I’m under the impression that he is smarter than the average bear myself, and while I many disagree with some of his opinions, I concede that he is resourceful and smart. He has my respect.
I disagree with many opinions, don’t we all?
Last year I think it was he was coming down North Carolina I think it was and was iced in, many were worried for his well being, but I felt sure that he could use his head and at most be uncomfortable.

I believe for instance that he has tried the electric propulsion thing and come to the conclusion that sculling for him is more reliable and likely does just as well.

I've seen his posts, but maybe in threads unrelated to what you guys are discussing. Thanks.

[Mike OReilly]

Originally Posted by Cthoops

In researching Obamacare in different states before we left, the cost of coverage varied widely from state to state. That’s why we’ve maintained our Connecticut residency. One year, based on our 2019 projected income, is $156 in premiums. That’s for the whole year. Co-pays are $20, and if something really bad happens the total out of pocket deductible is $10,000. We can work with that.

This is a reasonable premium. The deductible is pretty darn high, but at least the premium sounds good.

Originally Posted by a64pilot

They don’t like to admit it, but they do as most lower income people in the US do, they are uninsured.
They go to the Emergency room and the law says they have to be treated, so they are. I’m sure they leave with a monstrous bill that they will never pay, because they can’t. But somehow the Hospital has to be able to keep its doors open, so the unpaid costs get paid by those who have Insurence and or the means to do so.
That is a major reason the costs are so high, that so few actually pay.

That is an unpopular statement and I’m sure instant death to say on the political world, but I believe it to be true.

The analysis I’ve seen of your healthcare industry suggests other causes for the high costs, but I’m sure this contributes as well. It all adds up to a pretty good argument for some form of collective (socialized) health insurance. But I know … the “s” word is like waving a red cape in a bull ring — at least for some in the USA.

[a64pilot]

What could happen if there were a socialized medical care in the US, is that the top earners would continue with privatized care, taking the lion share of the money with them.
The rest of us would be subjected to lower quality care.
That is one of the issues and why so many are against it.

[Mike OReilly]

Originally Posted by a64pilot

What could happen if there were a socialized medical care in the US, is that the top earners would continue with privatized care, taking the lion share of the money with them.
The rest of us would be subjected to lower quality care.
That is one of the issues and why so many are against it.

The same argument was made here in Canada when we went to government run insurance. Didn’t happen here. But it takes some political will to set up the system right.

BTW, despite the reputation, Canada is NOT one of the best to look at. The care and service levels are OK, but the costs are the second highest in the world (although still about 1/2 of the USA). There are much better models out there.

[sailorboy1]

Sometimes I wonder why I even post “how to’s” for medical for US critzens cruising in the US and I’m not feeling like 1 finger retyping it here

A note

Went to an Urgent Care a month ago ($10 copay) and they had POSTED prices for common type stuff, and even some semi advanced stuff, and I felt they were very reasonable!!!

[Exile]

Originally Posted by sailorboy1

Went to an Urgent Care a month ago ($10 copay) and they had POSTED prices for common type stuff, and even some semi advanced stuff, and I felt they were very reasonable!!!

This is one of the latest attempts at reform, namely a number of states passing "transparency laws" requiring providers to post their pricing. The idea is to promote competition amongst different providers and thereby lower costs. Not sure how effective it's been but it's a needed reform regardless, and the example you cite is encouraging. Hey, if the dysfunctional Feds can't get anything done, then why not let the states have a wack at it?

[Mike OReilly]

Originally Posted by sailorboy1

… Went to an Urgent Care a month ago ($10 copay) and they had POSTED prices for common type stuff, and even some semi advanced stuff, and I felt they were very reasonable!!!

Good idea. Wish our Canadian facilities would do the same.

[a64pilot]

Originally Posted by Mike OReilly

The same argument was made here in Canada when we went to government run insurance. Didn’t happen here. But it takes some political will to set up the system right.



BTW, despite the reputation, Canada is NOT one of the best to look at. The care and service levels are OK, but the costs are the second highest in the world (although still about 1/2 of the USA). There are much better models out there.

A large issue with comparing one system to another is to determine the percentage of people who pay into the system as opposed to the number that collect from it.
Simply put, a lot of the European countries have a higher percentage in the work force paying into the system, so it works and works well.
If however the payees are outnumbered it’s not going to work as well.

That and big business getting into the Medical system has been what has changed from many years ago, in my opinion.
When I was a kid, many if not most Dr’s pretty much were small business owners, they owned and operated their practice, that’s not the case anymore, they are employees for rather large Corporations now.

[a64pilot]

The other elephant in the room US wise is our Military, if for example we stopped being the World’s police force and cut our Military to next to nothing, then most likely we could afford a world class free Medical system.

[Tetepare]

Originally Posted by a64pilot

The other elephant in the room US wise is our Military, if for example we stopped being the World’s police force and cut our Military to next to nothing, then most likely we could afford a world class free Medical system.

I’m struggling to think of something, anything, that government does “world class”. In theory you are correct but in practice it won’t happen, as funds are drained off for other purposes and “the system” becomes an employment scheme for the politically connected and their partisan supporters who are otherwise unemployable.

[robert sailor]

Originally Posted by a64pilot

The other elephant in the room US wise is our Military, if for example we stopped being the World’s police force and cut our Military to next to nothing, then most likely we could afford a world class free Medical system.

You wouldn't have to cut your military to next to nothing to be able to pay for a single payer health care system. In fact your current system is running at 17% of your GDP and rising every year faster than inflation and it is not sustainable so something has to happen.
Keep one thing in mind, the USA is the only developed country with health care being run by a for profit system. When happiness,quality of life, longevity or life expectancy, infant mortality etc. are measured the USA scores quite low compared to other western nations and most observers believe it's your medical system. There is no question that high income earners do quite well on your current system but the lower middle class not so much.