Obamacare = early retirement anyone?

[DumnMad]

JBW said sailing is his religion, he should keep religion out of this not post on sailing.

[thomm225]

Originally Posted by xymotic

Because Obamacare is the end of the American way of life and a commie plot agains capitalism that will bankrupt our children. It's be ironic if the socialists lowered costs. just guessing.

A commie plot? Who's behind it ya think? The Russians? China maybe?

There was a religious group here in Virginia against Obama for president before the election. They were specifically against Obamacare. I guess that means they were against health care for the folks including children that couldn't afford it for themselves.

In 2008, the DOW was at about 7500 or so with unemployment increasing by the minute. This was the end of 8 years of republican rule. Have we forgotten about that? About half a trillion was spent on a war in Iraq that didn't need to happen. Hello.

[xymotic]

Originally Posted by thomm225

A commie plot? Who's behind it ya think? The Russians? China maybe?

There was a religious group here in Virginia against Obama for president before the election. They were specifically against Obamacare. I guess that means they were against health care for the folks including children that couldn't afford it for themselves.

In 2008, the DOW was at about 7500 or so with unemployment increasing by the minute. This was the end of 8 years of republican rule. Have we forgotten about that? About half a trillion was spent on a war in Iraq that didn't need to happen. Hello.

We really need a sarcasm smiley. Hello.

[foolishsailor]

Last warning everybody. Keep it relevant or this thread gets closed.

No conspiracies, plots, attacks or polemics.

The thread only has value as it financially affects peoples ability to cruise.

Any more sillyness and we will zap it.

[propellanttech]

Originally Posted by foolishsailor

Last warning everybody. Keep it relevant or this thread gets closed.

No conspiracies, plots, attacks or polemics.

The thread only has value as it financially affects peoples ability to cruise.

Any more sillyness and we will zap it.

My toaster is plotting against me.....it keeps burning my toast!!

Thread hijack end.

[Christerart]

The problem with threads like this is that people who are - shall we say - fanatical in certain beliefs - will often try to derail a thread they feel is not "going their way" and hope the moderators will close it. They see it as a victory even when it shuts down the information for those who wish to find out more about these subjects.

Is it to much to ask of the moderators to simply delete those kind of posts (without warning) and let the thread evolve? There has been - and probably will be more relevant information coming.

[tomfl]

Health care is more of an individual thing than a term with meaning in and of itself, and insurance is not health care.

There is a real problem finding doctors who will accept Medicaid patients, and a problem finding doctors who will accept Medicare patients. Of course hospitals by law have to accept them, but there is no requirement about how quickly care is given. Not only is there a doctor shortage but some types of doctors are in shorter supply than others . General practitioners are the most needed, and least paid, while specialists get the glamor and big bucks.

This is not to say if you break your leg and get to a hospital you will not be treated no matter what coverage you have. Same goes for gangbangers who get hit in a drive by. The real question is for more mundane problems where waits in the emergency room can be quite long.

One of the strong points of some/many non US countries is that they are better able to control what their doctors specialize in. They concentrate on things like general practitioners and have fewer brain surgeons. This probably helps the general health of the total population, but those who need brain surgery get the short end of the stick.

Just as boats tend to be compromises the same goes for health systems. The US has a lot of bleeding edge care that saves a lives that would be lost elsewhere. A place like Cuba has very good basic health care but no one goes there for a heart, lung, or liver transplant. Same goes for lots of drugs. No where in the world develops the number of drugs the US does, and this is not cheap. Some one has to pay for the development of bleeding edge treatment and exotic drugs. On the other hand there is something to be said for providing a basic level of care and putting less emphasis the bleeding edge stuff.

Then there is the real shortage of health care professionals. Kinda like all us catamaran guys want to own a Gunboat but have to settle for a Gemini. Same goes for health care, there is not enough supply for the demand.

[Christerart]

Originally Posted by tomfl

No where in the world develops the number of drugs the US does.

Actually, of the top 10 drug companies (by revenue, 2008), only 4 are American.

This is of course a technicality as they are all world companies.

Pharmaceutical industry - Wikipedia, the free encyclopedia


1 Pfizer USA
2 Novartis Switzerland
3 Merck & Co. USA
4 Bayer Germany
5 GlaxoSmithKline United Kingdom
6 Johnson and Johnson USA
7 Sanofi France
8 Hoffmann–La Roche Switzerland
9 AstraZeneca United Kingdom
10 Abbott Laboratories USA


And terms of sales, of the top 5, only one is American:


1 Pfizer United States
2 GlaxoSmithKline United Kingdom
3 Novartis Switzerland
4 Sanofi-Aventis France
5 AstraZeneca United Kingdom

And as some have reported in this thread, the exact same drugs are much cheaper outside the US - bad for American residents but good for cruisers.

[LauderBoy]

Okay, I'll bite. How this will affect me. I'm 41, in very good health, no kids or wife, can get insurance on my own for maybe 180 a month.

My rates may go up. I really don't mind if it means more people out there are getting proper health care. I'm mostly looking forward to the health exchanges. I'm very very tired of my health plan choices being locked into what my employer picks as options.

Ideally I'd like to be able to switch over to a HSA account type plan and I hope one of those makes it onto an exchange. That'll let me ferret pre-tax money into that which I can use for any health expense. Possibly I could even use that money for health care out of the US, which would be a plus. Would be interested to know if anyone does this today. Ideally I could put money into that over the next 20 years(max it out each year) and then use that as a means to pay for health care expenses down the road.

As a cruiser that'd give me the best of both worlds. 100% critical care in the US and being able to spend pre-tax money on cheaper minor health care abroad. But again, I don't know if you can use a HSA out of country.

Long term I've been pretty scared crapless about what happens if my health goes downhill and I want to not be locked into employer-only group plan options. Personally I'd like to just self employ, go freelance, and not be locked into a 40 hours a week job. But the exchanges should help me with finding competitive insurance for that.

So all in all I'm interested to see how this plays out, I'm really looking forward to getting away from employer-based healthcare and hoping we see some serious looking at health care cost issues down the road.

[Paul L]

Originally Posted by LauderBoy

..... Ideally I could put money into that over the next 20 years(max it out each year) and then use that as a means to pay for health care expenses down the road.

As a cruiser that'd give me the best of both worlds. 100% critical care in the US and being able to spend pre-tax money on cheaper minor health care abroad. But again, I don't know if you can use a HSA out of country.
.....

Not sure what items you plan to pay with the built up reserves in your HSA after 20 years. Many people seem to treat insurance as pre-paid health care, as opposed to insurance. You need the insurance to cover the unlikely event that you get hit with a serious illness that might easily cost $500k to $2mil US. So an HSA isn't likely to cover this. You still need catastrophic health insurance if you wish to ensure that you don't become one of the health care bankruptcies.

[KJB]

Originally Posted by roverhi

Are you saying thank you for us paying so that you can go cruising???

Well said!

[osirissail]

Originally Posted by tomfl

. . . There is a real problem finding doctors who will accept Medicaid patients, and a problem finding doctors who will accept Medicare patients. Of course hospitals by law have to accept them, but there is no requirement about how quickly care is given. . . .

Again, I think these types of impressions are driven by politics or by the medical profession trying to bargain up the pitiful payments they get from insurance companies and medicare/medicaid.

The numbers I found by Google'ing around the subject tell a different story. As does my personal experience as a Medicare user here in Central Florida.

Personal experience shows that over the last 1.5 years I have had access and used upwards of 50 doctors and never had any refuse to take my Medicare business.

Within 15 miles of my primary zipcode near Orlando there are 113 oncologists in the Medicare program. Within 15nm of my Cape Canaveral (rural/suburban area) there are 93 oncologists. I only need one or two at most.

Looking at the entire USA according to various sources from the US Census Bureau to the AMA the total number of physicians numbers from 661,400 to 954,224 practicing medicine.

Looking at claims in the news media, the high end financial magazines/newspapers claim 1/3 to 1/2 of those doctors are limiting or refusing Medicare/medicaid patients. However, USA Today puts the number at 13% to 17% not dealing with Medicare/Medicaid. The Centers for Medicare and Medicaid Services says 97% of doctors accept Medicare.

So these numbers are all over the place which leads me to the conclusion that the news releases about access to Medicare doctors is being "spun" as a bargaining tactic and is not actually a problem.

I can see why the medical profession is doing this as according to US Bureau of Labor Statistics the average physician earns about $166K per year. That doesn't even put them in the bracket to have their Bush era tax cut taken away. In order words, they are in the upper middle income bracket with significant amounts of CEO's and others out earning them.

One big statement you see in the news is that Doctors are restricting the number of Medicare/medicaid patients they are seeing. If you have been in both the "outside the USA" and "inside the USA" medical system, currently the USA doctor's daily schedules are totally saturated. They are having to see dozens of patients per day to get enough payments from the "system" to pay for their practices. In other words, they just don't have time to see any increased numbers of patients.

This is driven by the reimbursement/payment rates set by the political system overseeing Medicare/medicaid. And non-Medicare insurance plans (young folk) are piggy-backing the Medicare payment rates as they don't see any sense in paying more for the same product.

Bottom line, there is no shortage of available doctors for Medicare patients but there is a problem of squeezing you into an already fully booked doctor's schedule. However, in places like Central Florida we have more medical facilities and doctors offices than we have T-shirt/souvenir shops and convenience stores. It seems every block of every city has one or more medical facilities/ doctor's offices. I suspect this is because the region is thick with retirees and an "easy market" for doctors to find patients.

[terminalcitygrl]

Originally Posted by eliems

Health Care premiums combined for my wife and I are $130/month. I have needed serious med attention twice in the last five years and both times I give the system top marks for looking after me!

I can not understand why the debate down south so often points to Canada as a what not to do system, I think our system does very well in providing universal health care at excellent quality and reasonable wait

That said our demographics are going to stretch budgets in the years to come as the Baby Boomers move through old age.

I think where ALL medical care fails in the current age is for fuzzy and chronic issues which seeme to be on the increase. If you break a bone or have a heart attack or cancer, generally your problem will be quickly defined and a proven course of treatment will follow. If you have rheumatoid arthritis, ms, lupus, lou gherings, alzheimers, fibromyalgia, chronic pain, neurological deterioration, mental health issues, thyroid or adrenal dysfunction, your care will likely be hit and miss. Managing the symptoms is time consuming and expensive and everyone responds differently to treatments. As baby boomers age they will likely deal with more of these types of problems which will result in many complaints, expensive tests and imaging, no clear answers, and a lifetime of drug prescriptions. If more research could be done to actually cure some of these chronic issues, the cost savings and quality of life could be greatly improved for sufferers. Oh well, at least drugs for cruisers can be purchased for less outside country.

[tomfl]

Originally Posted by Christerart

Actually, of the top 10 drug companies (by revenue, 2008), only 4 are American.

This is of course a technicality as they are all world companies.

Pharmaceutical industry - Wikipedia, the free encyclopedia


1 Pfizer USA
2 Novartis Switzerland
3 Merck & Co. USA
4 Bayer Germany
5 GlaxoSmithKline United Kingdom
6 Johnson and Johnson USA
7 Sanofi France
8 Hoffmann–La Roche Switzerland
9 AstraZeneca United Kingdom
10 Abbott Laboratories USA


And terms of sales, of the top 5, only one is American:


1 Pfizer United States
2 GlaxoSmithKline United Kingdom
3 Novartis Switzerland
4 Sanofi-Aventis France
5 AstraZeneca United Kingdom

And as some have reported in this thread, the exact same drugs are much cheaper outside the US - bad for American residents but good for cruisers.

I am not sure what point you are trying to make with this post.

Your lists have to do with revenue, not R&D. Not to mention the revenue is not broken out by country. To make matters worse you go to post prices for the same drugs are higher in the US than elsewhere implying foreign drug companies may be making more revenue in the US than outside.

The issue is not the companies revenue, but how much revenue is spent on R&D to develop new drugs; and to a lesser extent where the R&D is taking place.

Think of it this way, most folks in the US have bought Bayer aspirin (at higher prices than it would cost in Europe). While this inflates Bayer's revenue stream it does not preclude Bayer from using part of its revenue to develop drugs in the world leading research labs in the US; or perhaps more realistically in the up and coming labs in China where there is far less regulation and a govt that goes to great lengths to encourage R&D.

[Pat Ross]

Originally Posted by Christerart

The problem with threads like this is that people who are - shall we say - fanatical in certain beliefs - will often try to derail a thread they feel is not "going their way" and hope the moderators will close it. They see it as a victory even when it shuts down the information for those who wish to find out more about these subjects.

Is it to much to ask of the moderators to simply delete those kind of posts (without warning) and let the thread evolve? There has been - and probably will be more relevant information coming.

Bravo, well said