Obamacare = early retirement anyone?

[osirissail]

Originally Posted by tookish1

Our $3,000/month cruising budget hinged on health care costs. With pre-existing conditions, we could not have afforded to cruise and pay $1,200+/month for health care. Risking going without was not an option.

With Obamacare now a certainty, a cruising couple making less than $50,000/year from any form of income (no means testing!) will not pay more than 9.5% of income for health insurance ($395/month!). . .

It is actually better than that and has been for a year or more. My wife was refused commercial medical insurance because of a potential pre-existing condition.

Look up PCIP.gov for the ACA interim medical coverage for folks refused commercial medical insurance coverage due to "pre-existing conditons." Under PCIP.gov a standard medical insurance policy with drug coverage costs about US$250/month.

https://www.pcip.gov/

[SaucySailoress]

Originally Posted by GaryMayo

Looks through M, this has turned to a pro obamacare thread. If the voice of the people cannot be listened to, I will go back to the threads where everyone has a voice.

M? Moderation? No. We the mods don't have opinions on politics! The few posts we removed were deleted because of rule breaches, most specifically this one:

Discussions about politics, weaponry and religion are permitted only in association with the topic of this forum and will be closed or removed if they become disruptive.

We have obviously not closed the thread (yet), since it IS closely related to cruising, and IS useful for those of us who do cruise. Rather, we simply removed a few disruptive posts. Our members are welcome to post any opinion they like, as long as they do so politely

[Rakuflames]

Originally Posted by propellanttech

I hate to point this out, but my wife gave the same argument.

If the health care doesn't concern the person voting to change it, then what retribution will be served. So they didn't stay in Congress. Most Congressmen stay at least 5 years (the average is two terms or longer). They have nothing to be concerned about with regard to the health care, they are exempt from the "system".

It's just like voting themselves raises. They do it all the time. What will we do, get new ones, which are making more money, and will vote even more raises.

Where is the solution in that? I don't see it.

We are in the information age, why are we not voting for these items totally by popular vote? Are you telling me the technology is not available?

The powerful people keep the power......and the rest struggle to take it or get some.

It's just the way thing are. I don't see it changing, at least not for the better.

James L

House and senate ARE elected by popular vote. Only the President is not. We are not voting for these things ourselfves because we are a republic, not a true democracy. It would take a major revision of the Constitution to do what you suggest. It's not a technological barrier. It's a constitutional one. If we had to hold national elections to pass each law the resulting traffic jam of elections would bring government to a halt.

[Rakuflames]

Originally Posted by malbert73

Wow, I want to move to your small town. In maryland, and most other states, primary care docs earn about 30% of what you say. They also are paying back mortgage sized student loans, all while deferring all significant earnings and retirement savings until well into their 30s after residency training.

That said, there are some highly specialized fields where you can earn 500k. One is neurosurgery, and they can have it for the extra 6 years of residency training. Others may come back to earth as we approach cost certainty.

Yes, tort reform is necessary.

And this bill is far from perfect, but if Obama hadn't won reelection, what politcian would have touched healthcare reform (which is essential as we speed toward the precipice) for the next 20 yrs

I think that's why Boehner finally threw in the towel. He really thought he could just herd the "47%" off the cliff once Obama was out of office.

I didn't say anything, but you're right. Small town doctors don't make anything like $500k, and between student loans and the astronomical insurance some specialists have to pay, not to mention the demands of extra office staff to handle all the insurance paperwork ... and while neurosurgeons may MAKE lots of money, their insurance is through the roof. In many smaller towns now they no longer have OBGYN's.

I SHOULD be able to sue if something is well and truly botched. I could have sued after what happened to my body during the c-section of my first child (the second OB for my second child told me to do it and offered to testify!) -- I should have but did not. I also should have when my husband died *completely* unnecessarily, but my 14 and 16 year old daughters were completely shell shocked -- but old enough to be forced to testify. I had a friend who won a wrongful death suit, but her kids were grown. You wouldn't believe the dirty tricks the insurance lawyers went through to try to impeach her. I couldn't put my girls through that, having to testify about their parents' marriage etc.

But at the same time, I see LAWYERS (or people acting for them) on cancer support forums trying to drum up support for lawsuits because a drug saved their lives -- literally -- but had some side effect. I know *i* was told about all those risks -- ALL of them mentioned in those posts. I chose life with side effects over death, and I'm not going to sue the people who saved me.

[Rakuflames]

Originally Posted by jongleur

Rakuflames posted:

No matter how hard psychologists, nutritionists and MD's have tried, they haven't yet found an effective way for people to lose AND keep off weight. 95% of those who lose weight gain some or all of it back.


Not quite true. Check out: Dietdoctor.com

ABSOLUTELY true. Watch those people over ten years and see what happens.

Our bodies' function have not kept up with our improved nutrition. 50,000 years ago when we lived in caves, fat saved lives. Fat people had a survival advantage over skinny ones when food was scarce. There's so much we don't know about how to change that.

[Rakuflames]

Originally Posted by oldragbaggers

I have to say this is one of the most interesting threads I have seen so far and has presented a lot of things to consider on both sides of this issue. I have not been a fan of Obamacare up to this point but I am not knowledgeable enough to be bullheaded, so I am trying to keep an open mind and consider points made by both sides. This thread has given me plenty to think about.

The only thing to do now is watch it play out and pray that those responsible for implementing it will do so wisely and with the best interests of the people and the country at heart.

Thanks to all who have tried to contribute in a constructive way.

Your honesty is refreshing. I'm sitting with you. I'm not a lawyer, and legal documents don't say what most of us think they do. In addition, there are all the court judgments that affect how they are interpreted, the latitude beaurocrats will have when implementing, etc. '

The more someone tries to tell me exactly how we're going to go over the cliff on this and why, the less I listen, because even the senators and reps can't read and digest every page of every version of every bill that's past. Most of what we read on such hot topics are written by idealogues, another example of free speech in action.

[Rakuflames]

Originally Posted by avb3

I suppose there are different experiences. When I needed to have care and ended up in hospital for 3.5 months, it was there in spades. When my mother needed it, it was there now and in spades. A friend of mine just got diagnosed with cancer, he was in surgery 3 days later.

Overall, we do live longer. As far as survival rates on serious illnesses, perhaps factcheck.org is as good a reference as any. They dispute your suggestion. In part they say:

For one thing, survival rates in Canada, Japan, Australia and Cuba were all comparable to or higher than U.S. survival rates on all types of cancer that the Lancet study examined, except for prostate cancer. Those countries all have some form of government-provided health care coverage. Prostate cancer often doesn’t require treatment, so the aggressive screening common in the U.S. turns up both early cases and cases that would never need intervention. This leads to an inflated survival rate in the U.S., where asymptomatic patients are more likely to be diagnosed.

I disagree about the "aggressive screening" often turning up cases that don't need to be treated. One example is the claim that much prostate cancer doesn't need to be treated.

Know what that claim is based on? *Some* prostate cancer progresses slowly. However, they ALL progress. To not treat is to gamble that you will simply die of something else first. However, while you are waiting to have that heart attack, stroke, or whatever, if that prostate cancer spreads to your liver, or bones, as it did in my dad, you'll be very sorry you didn't have it treated, and a heart attack may actually be wecome.

That is the ULTIMATE "let the 47% fall off the cliff" mentality.

AND, most screening doesn't cost all that much. Which is cheaper -- removing a very small breast lump, or having to do a mastectomy, followed by three rounds of chemotherapy, Herceptin, readiation, and AI's, only to find that none of that worked, it came back and either has to be done all over again for the other breast, or even worse,has spread, requiring far more expensive drugs and other interventions? Just to give an example from one disease I've learned a lot about.

[Rakuflames]

Originally Posted by DumnMad

Can't believe so many people have been fooled into thinking change of diet can't change things. Even more importantly, lots of sailing will bring down your weight and the hospital bills. I'm told cruisers experience "reverse aging" because even when asleep they are exercising- (bracing themselves against the movement.) Cruisers should have tax discounts on health care!

But MUCH sailing PLUS living on the boat (that's a LOT more physical working than living in a condo) hasn't taken a pound off me. I certainly eat better. With limited refrigeration (that stuff called "ice") I go to the store every couple of days and eat virtually no processed food. I never was much of a late night snacker, but potato chips take up so much room in a (very) small pantry and are so hard to keep from crumbling into dust that such a habit probably would have gone by the wayside anyway. I climb all the time -- in and out of the cabin (those aren't stairs -- it's a ladder), on and off the boat (pull those 11,000 lb. to the dock each time, etc., etc., etc. How many people have to scrub their roof every two days because it's berry season?

My body WANTS to be this weight, and has since I had children -- pregnant women are the ultimate example of humans with a little extra fat having a better survival chance 50,000 years ago. And, by the way, the things we thought were caused by excess weight in pregnancy, such as eclampsia/toxemia? They're actually caused by poor nutrition, which can be tied to pregnancy in a number of ways. The original research was terribly flawed by not considering why the women in it *were* overweight (very poor diets in post-war Europe with weight gain as a side effect).

The overweight children we have today, that's a different story, but a child does not have to gorge himself to eat 91 more calories a day than he's using, and 10 extra pounds on a child is more extra weight than it is on a 6 ft man.

We've figured out not to target people for race, religion or disabilities, but fat is left. It's as if we have to have someone to feel superior to.

[chuckr]

Just a couple of thoughts --
first - way to many lawyers adversting for clients who may have been hurt by such and such a drug - we will sue - tort reform may not mean capping damage but everyone pays their own way and if you lose you have to pay the other person legal expense and lawyers are capped at a minimum of the reward - (the most famous is hot coffee in your lap while driving and get $1m - foolish)

NOW #2 our experience in the carib - i have a slight skin issue and used a doc in mexco for a couple of exams - $50-60 and i was a walk in and a gringo - medicine was at any large pharmacy and very inexpensive - by the way we also picked up some antibiotics across the counter there
the admiral had hand surgery in colombia by a hand surgeon - she has a congential issue where the fingers curl - on day 1 saw an otho doc who had a hand surgeon eatiing lunch with him at a local hospital, after exam they did one blood test but no xray, ekg, full physical ect required in the usa to keep the lawyers away - then 2 days later surgery and back to the boat - doc cost was $1,500 usa and hosp and drugs were about $500 usa and physical therpy was $25 usa a session - she had a quote from a usa doc when she had insurance and just the surgeron was $7k not including everything else -
in usa a lot of unnessary tests are done to try and keep the lawyers at bay

broke a tooth just as we left panama and got it fixed in the DR for $50 usa - in trinidad admiral got a double root canal, xrays, and tooth cleaning over 4 office visits for about $500 usa -
went to dermatologist in trinidad and cost $50 usa not sure of medicine cost yet as had same stuff mexican doc recommended but will have to refill soon -

i also agree that being out here makes you healthier as we are more accurate, probably eat better and have to keep our mind alter and active - i am 67 and admiral is 65 -

our biggest concern is when we get back can we get a doc who will take medicare patients -- with the cut on payments to docs something has to give somewhere

just our experiences thoughts and opinions
chuck patty and svsoulmates
in trinidad for hurricane season

but our biggest conc

[Skipper65]

Originally Posted by malbert73

Wow, I want to move to your small town. In maryland, and most other states, primary care docs earn about 30% of what you say. They also are paying back mortgage sized student loans, all while deferring all significant earnings and retirement savings until well into their 30s after residency training.

That said, there are some highly specialized fields where you can earn 500k. One is neurosurgery, and they can have it for the extra 6 years of residency training. Others may come back to earth as we approach cost certainty.

Yes, tort reform is necessary.

And this bill is far from perfect, but if Obama hadn't won reelection, what politcian would have touched healthcare reform (which is essential as we speed toward the precipice) for the next 20 yrs

There are certainly young doctors in competitive markets, with a lot of student debt, that start out making less and netting less. But I actually know what doctors generally make.....I'm not guessing. Obviously some do better than others. But I've never met a doctor on food stamps. For that matter, I've also never met an attorney, hospital adminstrator, insurance executive or politician that was on food stamps either. Is medical education expensive.....you bet. And when it becomes a bad investment, the free market will fix it. Incomes will rise, education cost will go down.....or we'll have less doctors.

My point is there's too much money in the medical system. Outlandish jury awards in the millions.....DO....impact malpractice insurance costs and care. We absolutely need tort reforms and limits imposed. Hospitals make millions in profits.....even non-profits. We need more competition and have the patient put some skin in the game (based on ability) so they refuse to take that $12 Tylenol.

I'm not a fan of Obamacare. I think it's a disaster. Will kill jobs, the economy and ultimately the federal govt will screw it up by being involved. But with that said, it is a real problem that the other side has not tried to fix either. The right answer is probably somewhere in the middle, like most solutions. I'd use the Canadian system as a good starting point. Not that I'm not a small govt, free market guy....I absolutely am. But this is one area, like social security, that the federal government could play a valuable role....if they would do it RIGHT. Unfortunately they probably won't, and try to over-manage it....and screw it up and corrupt the process for political reasons.....just like Social Security.

But since we now have legalized marijuana in Colorado.....my guess is they'll push that legalization thru to the rest of the country. The strategy is, we'll all get stoned and not really complain. Stoners rarely complain about anything and "Stoner's never riot". So we won't have the Greece type riots to deal with. We've got that going for us. Doritos and Twinkie's stocks will quadruple....need to buy them....LOL

[svBeBe]

Frankly, I am not going to waste time reading this entire thread. The original posting was enough. Cruising to me does not mean staying on the coast of the USA. And ObamaCare is not (will not) cover any medical care or expenses outside the USA. So, how having ObamaCare coverage will benefit any American cruiser is beyond my limited grasp. Unless one plans to fly 'home' every time one gets sick. Sure; that'll save you a lot of money.

Judy

[sabray]

I heard a great story about a practice who's rates were cut and cut. So he gave up direct coverage. This means you can apply to your insurance for some coverage but the office won't. Fair enough if you want this doctor you will deal with the paper work and pay. Hard to feel bad when this practice has offices in the highest value property in the USA. Try getting an appointment.
That is basic supply and demand. The USA needs more medical care practitioners. Less at fault lawyers and more small towns.
I

[Doodles]

Originally Posted by svBeBe

Frankly, I am not going to waste time reading this entire thread. The original posting was enough. Cruising to me does not mean staying on the coast of the USA. And ObamaCare is not (will not) cover any medical care or expenses outside the USA. So, how having ObamaCare coverage will benefit any American cruiser is beyond my limited grasp. Unless one plans to fly 'home' every time one gets sick. Sure; that'll save you a lot of money.

Judy

Funny, I was wondering the same thing but too lazy to read the whole thread. Maybe it all just ranting.

[Dave52]

yup mine went from $5000 to $500 a month and allowed me retire, buy a boat and now cruising to Bahamas

[mbianka]

Originally Posted by Doodles

Funny, I was wondering the same thing but too lazy to read the whole thread. Maybe it all just ranting.

Heres the deal Obamacare won't cover U.S. cruisers after they leave the U.S. waters but, they will still be required to pay for an Obamacare policy even if they will never be able to use it or they will pay a fine. The Internal Revenue Service will be hiring auditors to make sure one of those two things happen. So U.S. cruisers will be required to pay for an Obamacare insurance policy even though they can't use it and they will also pay for local health care coverage in their cruising grounds if they become ill out of pocket. If you remain a U.S. citizen you can't "opt out" of Obamacare you will pay whether you like it or not one way or the other.