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Old 03-15-2017, 04:01 PM
 
Location: Haiku
4,056 posts, read 2,571,078 times
Reputation: 5976

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Quote:
Originally Posted by WouldLoveTo View Post
What?! I'm in my early 50s and my health insurance as been unaffordable since ACA was enacted. (keep in mind my state already had a pre-existing conditions clause and other clauses the ACA made mandatory).

Am I young then?

The people I know that are doing great on it and love it are either very young (under 30) or way underemployed.

Maybe you meant the other way around? Or is this another thing that varies by state?
I meant people who are old enough to have a family, but young enough to not be high wage earners. Obamacare takes a big bite out of that demographic, at least from what I have read. Plus a lot of young/healthy people don't want to be forced to buy insurance, which I get.

It probably does vary by state. I read recently that some states for whatever reason have extremely high rates. It seems that if we are going to have private, multiple-payer system, that insurance companies need to be able to sell nationally.
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Old 03-15-2017, 04:36 PM
 
29,775 posts, read 34,860,277 times
Reputation: 11701
Quote:
Originally Posted by shamrock4 View Post
I certainly agree with you on this (I think you and I live in the same state).

I actually laughed out loud at the idea that our current legislature would actually put any "extra" money in the pot. They have been busy cutting benefits any place they can, including making a run at Medicaid as it stands now even with no expansion.

I think LTC issues are going to be catastrophic in the next decade or two in many, many states if the bill passes with block payments to the states.
We agree. We have insurance and I hope other who don't reconsider if they still can
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Old 03-15-2017, 04:55 PM
 
Location: Midland, MI
505 posts, read 527,399 times
Reputation: 1084
Prenatal care and other aspects of plans are there just because you can't buy health care "ala carte" anymore than you can buy cable TV that way. Oh, you just want the Classic Movie channel, HGTV and the History Channel? Too bad - they can't make enough money that way.
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Old 03-15-2017, 05:08 PM
 
Location: Midland, MI
505 posts, read 527,399 times
Reputation: 1084
Medical care IS a commodity, but it doesn't really fit that category. For instance, most people agree that someone coming to the ER who has been in a traumatic accident should be treated and their life saved, regardless of their insurance coverage.

Then, when the system tries to reduce people's use of healthcare by raising co-pays, people sometimes respond by putting off healthcare, which can ultimately cost a lot more money in the long run.

As far as the cost being driven by labor costs, realize that working in the medical field requires an investment in education, which takes time and lots of money. I don't know about you but I don't want someone running my CT scan who is making minimum wage.

C. Everett Koop once said that waste and fraud are a huge chunk of the cost of healthcare. Waste could mean doctors ordering lots of extra tests to cover themselves, people making many healthcare visits that they don't need, others going to the ER for primary care, etc.

And Americans have some pretty high expectations of healthcare, especially middle and upper class folks. They want it to be cutting edge, of excellent quality, and - they want it low cost or free.
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Old 03-15-2017, 05:12 PM
 
29,775 posts, read 34,860,277 times
Reputation: 11701
Quote:
Originally Posted by hhwtm View Post
Medical care IS a commodity, but it doesn't really fit that category. For instance, most people agree that someone coming to the ER who has been in a traumatic accident should be treated and their life saved, regardless of their insurance coverage.

Then, when the system tries to reduce people's use of healthcare by raising co-pays, people sometimes respond by putting off healthcare, which can ultimately cost a lot more money in the long run.

As far as the cost being driven by labor costs, realize that working in the medical field requires an investment in education, which takes time and lots of money. I don't know about you but I don't want someone running my CT scan who is making minimum wage.

C. Everett Koop once said that waste and fraud are a huge chunk of the cost of healthcare. Waste could mean doctors ordering lots of extra tests to cover themselves, people making many healthcare visits that they don't need, others going to the ER for primary care, etc.

And Americans have some pretty high expectations of healthcare, especially middle and upper class folks. They want it to be cutting edge, of excellent quality, and - they want it low cost or free.
Not sure about that last part. I think folks buy Long Term Care Insurance and follow investment advice to have 250k-315k set aside for health care overage in retirement. Remember you said Middle and Upper class folks and that includes families making up to over 6 six figures.

http://www.cnbc.com/2017/03/13/heres...dle-class.html
Here's the breakdown of how much you have to earn each year to qualify as middle-income, depending on the size of your family:
Household of one: $24,042 to $72,126
Household of two: $34,000 to $102,001
Household of three: $41,641 to $124,925
Household of four: $48,083 to $144,251
Household of five: $53,759 to $161,277
Pew, which defines middle class as adults whose annual household income is two-thirds to double the national median ($55,775 as of 2016), details the national middle-income range for various household sizes.
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Old 03-15-2017, 06:11 PM
 
13,891 posts, read 7,395,585 times
Reputation: 25379
Quote:
Originally Posted by TuborgP View Post
Not sure about that last part. I think folks buy Long Term Care Insurance and follow investment advice to have 250k-315k set aside for health care overage in retirement. Remember you said Middle and Upper class folks and that includes families making up to over 6 six figures.
That's nonsense. 70th percentile household net worth for age 65 is about $400K. That typically includes the value of their house. The next wave of retirees don't have defined benefit pensions and are in far worse shape than people currently retired. That 70th percentile 65-year-old doesn't have the income to pay for health care or long term care insurance. As soon as they stop working, they're bumping along at something close to poverty level with nothing coming in but a Social Security check.

Something close to 1/3 of the Medicaid budget is spent on long term care. If the Paul Ryan dream of blowing up Medicaid happens, seniors who run out of money and need long term care are out of luck. There's no Medicaid money to pay nursing homes. It's not like a nursing home is going to take someone with no Medicaid money and a sub-$20K per year Social Security income.
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Old 03-15-2017, 06:36 PM
 
30,073 posts, read 47,320,143 times
Reputation: 16023
Quote:
Originally Posted by TuborgP View Post
Wouldn't bet on that in states that didn't expand Medicaid when the government was giving them money to. This will probably become part of the best states to retire to discussion as folks down the road may want to weigh Medicaid benefits in possible retirement locations. On the other hand it may for future retirees drive up the percentage buying LTCi.
If this reform is implemented I want to see how future LTCi threads go.
Just do the math--
Most people complain that LTCI rates are too expensive now--for people who have had policies and get older and see increases from their carriers...
Many people might pay for 10+ yrs and then large increases because carriers didn't run their numbers correctly and price higher initially...
Frankly I think they do that deliberately because most people who start with LTCI policy in their 50s rarely need it until they get into later 70s maybe--so they pay and pay and get priced out and drop the policy before the clients can't actually USE the policy...

What do you think will happen once these new insurance costs/coverages are factored into LTCI coverage???
People will see even higher rates for LTCI because insurance is going to be covering less and people will get basic care policies and are likely to have more serious issues develop that are not treated correctly...so likely to NEED LTCI sooner rather than later...

We have had LTCI for about 10 yrs--John Hancock--which stopped selling new coverage this year...mainly to get it while we were healthier, and in case of so something unexpected/catastrophic--like car accident or stroke
We have had small increases a couple of times because we chose a moderate--not Cadillac--type of coverage--
More to offset the costs than totally cover any nursing home costs

People won't have the money to pay the 4K a year for two people to carry LTCI if they are paying heavier premiums for health care coverage....
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Old 03-15-2017, 06:44 PM
 
2,630 posts, read 1,934,527 times
Reputation: 4597
Just work until you can clearly afford $1200/month for an insurance policy and any deductible, until you are Medicare age. You're not 35 anymore. Lots can happen no matter how health conscious you are/were. One bad aspect in your stars affecting your bodily functions; or just one bad gene, and Boom! underinsured? you're done. It happens a lot. Stents, bypasses, orthopedic surgery are real expensive - and I mean the hospital costs. They can wipe your savings out overnight. Tough it out until you've stashed enough away - just like any other aspect of retirement, actually. Inflation is another one. Calculate your living costs ....then double it.


O'care ain't going nowhere in the near future. That you can safely assume. And, at least, these days, you know what to expect.

Last edited by TwinbrookNine; 03-15-2017 at 06:53 PM..
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Old 03-15-2017, 06:47 PM
 
13,891 posts, read 7,395,585 times
Reputation: 25379
Quote:
Originally Posted by TuborgP View Post
Are you suggesting increasing the number of folks working in the field by expanding training and cutting salaries and benefits?

Remember there is no such thing as a free lunch and somebody is going to pay somehow for the training.
That's what every other first world country does. It doesn't cost $300K to go to medical school.

Cost for the Curie med school in Paris: 150 Euro enrollment fee.
Cost at Oxford med school: The Brit NHS pays the whole bill

You sign a contract that you'll work in-country for some period of time or you owe them a huge pile of money. That's the way it works everywhere else in the first world.
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Old 03-15-2017, 07:06 PM
 
29,775 posts, read 34,860,277 times
Reputation: 11701
Quote:
Originally Posted by GeoffD View Post
That's nonsense. 70th percentile household net worth for age 65 is about $400K. That typically includes the value of their house. The next wave of retirees don't have defined benefit pensions and are in far worse shape than people currently retired. That 70th percentile 65-year-old doesn't have the income to pay for health care or long term care insurance. As soon as they stop working, they're bumping along at something close to poverty level with nothing coming in but a Social Security check.

Something close to 1/3 of the Medicaid budget is spent on long term care. If the Paul Ryan dream of blowing up Medicaid happens, seniors who run out of money and need long term care are out of luck. There's no Medicaid money to pay nursing homes. It's not like a nursing home is going to take someone with no Medicaid money and a sub-$20K per year Social Security income.
Don't argue with me argue with the link. Which is CNBC and Pew Research. Did you actually read the link and their methodology? If so you and Pew Research are on different pages and that happens. Readers will just have to read the link and your post and decide for themselves.

http://www.cnbc.com/2017/03/13/heres...dle-class.html

Quote:
Pew, which defines middle class as adults whose annual household income is two-thirds to double the national median ($55,775 as of 2016), details the national middle-income range for various household sizes.

"The income it takes to be middle-income varies by household size, with smaller households requiring less to support the same lifestyle as larger households," Pew explains.
A point for lurkers to consider. The link is talking annual income and its conclusions are be challenged by a reference to net worth. Many with six figure incomes have limited net worth because of debt and that include the mortgage on their home. Some might call it Apples and Oranges comparison. Net worth v income. The link is about income and how that translates to middle class not net worth. There are sixty year olds who have had high lifetime income and little net worth.

Last edited by TuborgP; 03-15-2017 at 07:30 PM..
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