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What $600 (month?/year?) drug are you talking about? Have you explored all the alternatives (there are usually alternatives - sometimes not)?
Why are you so surprised that drugs can cost a significant amount of money? And if you thought $600 was a lot, wait until you read my story:
Several years ago while I was still fighting ulcerative colitis, I was given several infusions of Remicade, which is dosed based on body weight. The more you weigh, the higher your cost. Well, I'm 6'4" & 250. The cost of each of my three infusions over a six-month period was $11,000.
That was not a typo.
$11,000 (and change) for each infusion. And no, there are/were no alternatives.
Fortunately, my Blue Cross plan paid 90% of that, but that still left me with an $1100+ bill for each infusion. (This would have been an ongoing cost, but the drug stopped working for me after a year or so.)
As Keeper pointed out, just because you and your husband have been fortunate enough not to have had to pay for very expensive drugs, that doesn't mean that everyone else is in the same situation.
Well...my wife has been on a medication for years (transplant recipient) that costs $500 per month. That's certainly not the only med she takes. We have good insurance and only pay a portion of this. But for someone without good insurance and a smaller annuity, it would be a problem. By the way, the only reason my wife ever got any health insurance was because of my career. No one would insure her even when she was a child because of the pre-existing conditions she was born with.
Why are you so surprised that drugs can cost a significant amount of money? And if you thought $600 was a lot, wait until you read my story:
Several years ago while I was still fighting ulcerative colitis, I was given several infusions of Remicade, which is dosed based on body weight. The more you weigh, the higher your cost. Well, I'm 6'4" & 250. The cost of each of my three infusions over a six-month period was $11,000.
That was not a typo.
$11,000 (and change) for each infusion. And no, there are/were no alternatives.
Fortunately, my Blue Cross plan paid 90% of that, but that still left me with an $1100+ bill for each infusion. (This would have been an ongoing cost, but the drug stopped working for me after a year or so.)
As Keeper pointed out, just because you and your husband have been fortunate enough not to have had to pay for very expensive drugs, that doesn't mean that everyone else is in the same situation.
My husband has MS. I think we're pretty up to date on how expensive drugs can be. Sometimes there are alternatives to expensive drugs - sometimes there aren't. Never hurts to ask. Robyn
I would like to ask Moderator cut: snip why according to my morning newspaper, why there will be no raise in benefits for most seniors.
It seems there is money for nonsense in the Middle East - billions of dollars and supports illegal immigrants getting free health care, and other benefits!
What about WE THE PEOPLE!!!
If you really want to make a difference on these things then contact your local representative REGARDLESS OF PARTY and let then know your feelings.
People that are slaves to a particular political party allow this type of stuff to happen since they will do as they are told and they feel it's their party looking out for them rather than hold them accountable on the issues.
Look at the middle east and immigration? Neither party has done anything the other hasn't done.
There's no bright line - but I think most of us can identify people in our lives who would fall into the first group - and people who would fall into the second.
And - my thinking is that with any medical care system that might be set up - we have to ensure that people aren't allowed to be irresponsible (e.g., they can't not pay into any system when they're healthy - sign up when they're sick - and only pay a small fine). Do you agree with that? Robyn
Robyn, Despite what you may think, I agree with much of what you write. The problem with these issues pertaining to boomers, is that most of the problems are past tense, and irreversible by the time a person reaches retirement age. And to include a subjective term such as "irresponsible" to describe a class of people, in the writing of government legislation, opens up all kinds of issues.
As I said before, I think such a program would have to revolve around a form of reverse means testing. Which is the opposite of every entitlement program enacted since The New Deal. It would involve people getting entitlements, who don't need them, and people who need them, not getting them.
I don't think the results of such a policy would be as positive as you think. I would rather see seniors living modestly on Social Security, than living in the streets. Then again, maybe Gen X and Y will gain power, and just throw everyone over 60 into an incinerator. Senior boomer entitlement problem solved. Maybe there will be a provision to buy your way out by surrendering your IRA. Like the old Jack Benny sketch with the robber, "Your money or your life?" Benny: "I'll have to think about it."
Really the bottom rung of the ladder? What is the magic bridge between only social security and staying afloat that the rest of society walks on?
If you worked at least 30 of the 48 years between ages 18 and 66, your Social Security check should be at least $1500 a month. The food stamp threshold varies among states, but usually for a single person, it's about $1000 a month. The $1500 in Social Security, disqualifies one from getting food stamps.
Public housing is based on 30% of income, and comparative market prices. For $1500, that gives you $450. Lots of places in America where a single person can rent a decent place for $450. Therefore, in many cases public housing is not available to the senior with a median range Social Security check.
I've never understood how someone on Medicare, qualifies for Medicaid. Maybe someone has an anecdote for that one.
In conclusion, the majority of seniors who qualify for these additional programs, have not been gainfully employed for much of their working years. I'm sure there's exceptions, and stories of misfortune, but generally yes, they are at the bottom rung of society. And it's not anything new to them in their senior years. They've been there for a long time.
Your first paragraph isn't true. I know many middle class people who are the parents of boomers - people with hundreds of thousands of dollars - who spend a lot of time scheming about - for example - how to get Medicaid care in skilled nursing facilities. Some of them - unfortunately - are in my own family.
Ever hear of elder care law? About 75% of it consists of figuring out how your kids will wind up with your money while the taxpayers pay for you. Medicaid eligibility rules are stricter today than they used to be. But the government rarely chases after or catches cheats. In any event - this is a problem that is probably getting smaller - not larger. Because many decent or better skilled nursing facilities are shutting down Medicaid beds or eliminating them entirely. And those that accept Medicaid patients make them fill out about a 50 page financial form if they're looking for a Medicaid bed.
Like I said - I've seen this in my own family - and it makes me sick. Why put Dad in a nice place? He has Alzheimer's and won't notice. And when he dies - we can go to Europe or get new granite kitchen counters.
The crazy part of this is that people who are really poor frequently don't know about Medicaid paying for SNFs - or that many good SNFs have Medicaid beds. It's the middle class people who are gaming the system. The SNF my late FIL lived in is the "Jewish" SNF in JAX. Very liberal people. They are always trying to get some poor diverse residents. And usually can't. Because really poor diverse potential residents usually aren't aware of these programs.
And there's more. I had a housekeeper. Legal immigrant from Peru. Very hard working (she used to be a teacher in Peru - but was a housekeeper here due to poor language skills - probably good for her - teachers don't make much where I live). Lower middle class. When her husband needed Plavix - she threw up her hands. They couldn't afford it. She didn't know about drug subsidy programs offered by drug companies for people with limited means. I told her about the program the Plavix company offered - and her husband was able to get Plavix for about 90% off list price.
IOW - it's people with some or more than some money - people who know how to play the subsidy game for the most part - that wind up with the most subsidy chips - not the poor who don't have any money. I don't think it's ethical to play those games - but I am - best I've observed - in a distinct minority.
In terms of tax deals. Many communities offer tax deals to seniors to get them to stay put when they retire - instead of moving to lower tax places. Because they don't have kids. No matter what seniors pay - they almost always pay more in taxes than they consume in services. Unlike people with children. Here where I live - if you have 1 kid in the public school system - your house to be worth over $400-500k for the county to break even in terms of tax receipts and education costs.
There are also tax breaks for seniors who are house rich and cash poor (payment plans). I never liked them - because I thought they allowed seniors to hold onto bigger older places they didn't need and could no longer afford - to the detriment of younger people. With the huge housing bust we've had in Florida - I think the tax breaks we have here are kind of beside the point in terms of my original objection.
I actually agree with the anti-unemployment insurance crowd to some extent. Wouldn't make people pick up litter along the side of the road (here - they'd be competing with prison labor doing that job). But what's wrong with working at a place like the local library 20 hours a week - so we don't have to cut back hours at libraries or close them? Work giving out parking tickets - especially to people who park illegally in handicap spaces (the latter where I live is pretty much a volunteer job). Do 20 hours a week community service - look for a job 10-20 hours a week. What's wrong with that?
As a lawyer - I actually handled a death row case. And the one thing I know for sure here in Florida (where there are a lot of people on death row) - is that it is much more expensive trying to fry someone than to give that person a life sentence. So whatever you think or don't think about the death penalty in general - it cannot be justified as cost-effective.
I live in one of the reddest zip codes in the US - and I have never heard anyone trying to marginalize government employees. But quite a few of us think there are too many government employees in certain areas (and not enough in others for that matter). And that certain areas are more efficient if privatized. For example - are the people who pick up your garbage private - or government employees. If the latter - what do you pay for garbage pick-up? We have a private company - and I think people who use government employee systems would be amazed at what we pay. Robyn
I wasn't thinking about nursing homes, but you have a point. I would say the wrangling to protect assets is common for most families. I think long term care policies have come to the forefront in recent years.
It's a good point about "'Dad" not caring. I think most families care about extending their parent's life, more than the parent does. This kind of carries over into the Medicare cost arena too, but is obviously a sensitive subject.
As for receiving unemployment, I believe in earned dignity. If for whatever reason, attorney positions became unavailable, would you like the government forcing you to work as a maid?
The death penalty view, is often expressed by the uneducated. Cost Accounting is not their strong point.
I wasn't thinking rednecks as it pertains to government employees. The attitude is more prevalent among the moderately rich. My background's in aviation, with some of it with government agencies. Nothing's worse than these guys who buy expensive airplanes, and think they don't have to take orders from lowly government workers, because the taxes they pay puts them above the law.
Robyn, Despite what you may think, I agree with much of what you write. The problem with these issues pertaining to boomers, is that most of the problems are past tense, and irreversible by the time a person reaches retirement age. And to include a subjective term such as "irresponsible" to describe a class of people, in the writing of government legislation, opens up all kinds of issues.
As I said before, I think such a program would have to revolve around a form of reverse means testing. Which is the opposite of every entitlement program enacted since The New Deal. It would involve people getting entitlements, who don't need them, and people who need them, not getting them.
I don't think the results of such a policy would be as positive as you think. I would rather see seniors living modestly on Social Security, than living in the streets. Then again, maybe Gen X and Y will gain power, and just throw everyone over 60 into an incinerator. Senior boomer entitlement problem solved. Maybe there will be a provision to buy your way out by surrendering your IRA. Like the old Jack Benny sketch with the robber, "Your money or your life?" Benny: "I'll have to think about it."
Well I'm not talking about changing the whole system for everyone tomorrow. You have to give people enough time to plan for changes (and perhaps consider a transitional period). The youngest boomers were born in 1964 - they won't even be 50 for 3 years - and they won't qualify for regular Medicare for 18 years. I think it's possible to change things over the course of 18 years.
Although I get mad at people who are irresponsible - that shouldn't be a part of any health care system we come up with in the future (so we can put that one to bed). But I would design a system where people couldn't be irresponsible - at least in terms of basic medical care. A single payer kind of system where everyone has to pay in - period - no small fines as if not paying in was an overtime parking ticket. And not the kind of vouchers Rep. Ryan is talking about - which I don't think would work at all.*
I would even do away with all the Medicaid nursing home nonsense (you either pay $75k a year or nothing) - and bring skilled nursing home care under the general insurance/Medicare umbrella. Perhaps the most interesting economic analysis I ever heard about nursing homes is that they cost X (depending on where you live) - about half of all people wind up in one - and the average resident lives for a little more than 2 years. It is much easier to figure out how much money an average person in a large pool will need for a nursing home than to figure out other medical costs.
I do think we will see some stirrings in Gen X and Y along the lines you mention in the future. Younger people who are probably already paying through the nose for their own medical expenses may well resent paying a lot for seniors (many of whom have more money and fewer expenses than they do). It's kind of opposite the situation many seniors are enjoying today (they paid in a little - are getting a lot).
Along with getting more money into the system - hard choices have to be made about what any system would cover. We're going to start to see some of this in the next year or so - as regulators struggle to come up with guidelines about what the Obamacare plans will and will not cover. There is a *lot* of lobbying going on now on behalf of various types of providers to cover this - cover that - cover everything. But I think it's obvious to anyone except a total dunce that everyone can't have everything at a reasonable cost.
FWIW - I think 2 areas that are underrated in terms of cutting costs are going after Medicare fraud (which is enormous - perhaps I am very sensitive to it because Florida is the Medicare fraud capital of the US). And using the government's negotiating power to bring down the costs of some things for which it overpays a ton. Not doctors - the usual target. But things like durable medical equipment. To give you a for example. My husband needs a leg brace for his MS. Same leg brace a college or professional linebacker might wear - an ACL brace. If he or the linebacker buys directly from the company - they pay X. If Medicare pays for the thing - it pays about 50% more. Crazy. Which is not to say my husband won't get his one brace from Medicare (only 1 allowed every 5 years) - but he needs a backup - and so we buy any others he needs ourselves. Again - perhaps I am sensitive about a particular area - but my brother (a nephrologist) left the clinical practice of medicine last year after being nickled and dimed to death by Medicare. And if a brace company will sell braces to professional football teams (they're not exactly poor) for X - why should Medicare pay more? I think there is a lot of low hanging fruit out there. Picking it won't solve the whole problem by a long shot - but you have to start somewhere. Robyn
* - My husband and I have been been uninsurable in the private market since we were in our 30's (MS will do that to you - and I had some stuff going on too). We were *very* lucky to have a state high risk health plan available to us back then. It wasn't cheap - still isn't (like many state high risk plans). But my husband was in it until he went on Medicare last year - and I will be out next year when I go on Medicare. This plan closed to new enrollment almost 20 years ago because - even with high premiums - it always lost money (and the losses were passed on to carriers doing business in Florida - the main champion in terms of getting it closed was the Chamber of Commerce - which has consistently opposed it being reopened). Today - there are about 250 people left in the program - in the whole State of Florida!
FWIW - my premium is based on a % of what a person in Florida my age would pay for an individual health insurance policy (125% - lowest risk category). This year - it is about $550/month - with a $10k deductible - and a 20% co-pay up to an additional $3k a year - for excellent catastrophic coverage. Isn't cheap - but I will take it.
To me - by definition - all seniors are high risk - high - higher - highest. And I don't know how 100 different insurance companies in 50 different states will come up with anything reasonable that these vouchers will pay for. Unless the companies cherry pick younger and healthier seniors - and then we're back to square one again. Coverage will always be expensive for older people - but the larger and more random the pool of insured people in any particular plan - the lower the average cost of participating. So we need bigger plans - not smaller chopped up markets IMO. What do you think?
I just found this.. I thought it was prevalent to our discussion here.
The Medicare Rights Center noted in a fact sheet that nearly half of all Medicare consumers have annual incomes of $20,000 or less and that 80 percent of Medicare beneficiaries older than 65 depend on Social Security for at least half of their incomes. Even with Medicare, it said, median out-of-pocket healthcare spending rose from 11.9 percent of income in 1997 to 16.2 percent in 2006.
I think we can all agree that some ppl do take advantage of the benefits and it isn't usually the 'little' ppl.
If you worked at least 30 of the 48 years between ages 18 and 66, your Social Security check should be at least $1500 a month. The food stamp threshold varies among states, but usually for a single person, it's about $1000 a month. The $1500 in Social Security, disqualifies one from getting food stamps.
Public housing is based on 30% of income, and comparative market prices. For $1500, that gives you $450. Lots of places in America where a single person can rent a decent place for $450. Therefore, in many cases public housing is not available to the senior with a median range Social Security check.
I've never understood how someone on Medicare, qualifies for Medicaid. Maybe someone has an anecdote for that one.
In conclusion, the majority of seniors who qualify for these additional programs, have not been gainfully employed for much of their working years. I'm sure there's exceptions, and stories of misfortune, but generally yes, they are at the bottom rung of society. And it's not anything new to them in their senior years. They've been there for a long time.
There's a crazy quilt of state and federal programs - with different eligibility requirements state by state. I have often sent people to this website to figure out what they might be able to get in terms of benefits:
With Medicaid versus Medicare - the most obvious possible benefit of the former in most states is payment for care in skilled nursing facilities - which Medicare doesn't cover for the most part. And this is where you get most of your "elder care planning". Although - again - the Medicaid benefits are different state to state. My late grandmother in New York (she died at 103) had a 24/7 full time home health aide paid by New York Medicaid for years. This is something that doesn't exist in Florida (we'd go broke faster with that than we would if hit by 5 cat 5 hurricanes this year).
I know Ryan's proposals are supposed to turn whatever Medicaid is now at the federal level to block grants (whatever they are). I don't know a lot about Medicaid - except that it is a black hole in terms of Florida's budget - and is sucking money out of the education part of the budget:
The one thing I know for sure. I wouldn't want to have to rely on Medicaid as my insurance source (more and more providers are refusing to accept Medicaid patients). Robyn
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