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A) The even lesser known secret is this is largely BS. I have known several people confident in their knowledge of the above and in their ability to negotiate. Then the Doctors and hospitals they attempted to engage essentially told them to stuff it. Give me the money or get lost. You can give me your personal stories of someone who managed to get a discount by dickering but they mean nothing unless it is true in every single case without exception. It's just another roll of the dice. get lucky=Good. Not Lucky= *********
B) So even with dickering how much was the savings from the "listed" (ie secret) price? For many medical procedures a 90% discount would still bankrupt most people. OS saying Joe Blow got a discount means nothing.
C) This is proof positive that there is no free market. For any of this to be a free market transaction it would have to be known to all everywhere and always that:
1) Negotiating is permitted. Not something some would have to guess at and "give it a try"
2) Part of this would necessarily have to be that the customer knows exactly how the merchant is going to defraud them and by how much. Caveat Emptor is there to protect a criminal mentality. It is not there for free trade.
3) Unless negotiating is known by all to always work and work to the extent needed it is just another roll of the dice and even when it works if it doesn't work sufficiently.... it doesn't work
What hospitals and that jeweler do is no different than what the masked gunman does when he sticks a gun in their face and says "Give me the money/jewely/medical attention"
You can keep believing otherwise and keep being wrong
I honestly can't make heads or tails of all this. This post is just all over the place.
Why would my experience "mean nothing" if it's not true for everyone, everywhere? My experience is just that, MY experience. Sometimes, often in fact, you can get a discount if you ask for it. The vendor is still going to make a profit, just a smaller one on that particular sale. Just like a vendor with a product that's not selling, they cut the price. Negotiating (which is nothing more than asking a question) is ALWAYS permitted. Sometimes the answer is "no". No harm in asking. No offense taken if the answer is "no". I also don't have to make a purchase if the answer is "no". I might if I am willing to pay the higher price, or I can shop elsewhere. No one said any vendor is defrauding anyone, it's just that the markup is great on some items and they can afford to forgo some of their profit margin to make a sale, especially when business is slow, or at the end of a reporting period when they need to show more sales. How is that the same as a gunman threatening someone's life??
Medical/dental care is a commodity, just like eggs or orange juice. Prices are all over the place for any given procedure. A particular doctor or dentist may be willing to work with you or give you a cash discount. Another one, especially a large corporate office, might say no. It saves the doctor money if his staff doesn't have to spend time billing insurance, and then waiting for reimbursement, and then billing you for the balance, and then waiting for you to pay, maybe even having to give up a portion to an agency if it goes into collections, etc. Large insurance companies negotiate lower prices for their client groups, why shouldn't you?
Last edited by TheShadow; 06-02-2017 at 02:30 PM..
A) The even lesser known secret is this is largely BS. I have known several people confident in their knowledge of the above and in their ability to negotiate. Then the Doctors and hospitals they attempted to engage essentially told them to stuff it. Give me the money or get lost. You can give me your personal stories of someone who managed to get a discount by dickering but they mean nothing unless it is true in every single case without exception. It's just another roll of the dice. get lucky=Good. Not Lucky= *********
B) So even with dickering how much was the savings from the "listed" (ie secret) price? For many medical procedures a 90% discount would still bankrupt most people. OS saying Joe Blow got a discount means nothing.
C) This is proof positive that there is no free market. For any of this to be a free market transaction it would have to be known to all everywhere and always that:
1) Negotiating is permitted. Not something some would have to guess at and "give it a try"
2) Part of this would necessarily have to be that the customer knows exactly how the merchant is going to defraud them and by how much. Caveat Emptor is there to protect a criminal mentality. It is not there for free trade.
3) Unless negotiating is known by all to always work and work to the extent needed it is just another roll of the dice and even when it works if it doesn't work sufficiently.... it doesn't work
What hospitals and that jeweler do is no different than what the masked gunman does when he sticks a gun in their face and says "Give me the money/jewely/medical attention"
You can keep believing otherwise and keep being wrong
I grew up around the car business and virtually no one came in and wrote a check for the full asking price... of course there are exceptions but definitely not the norm...
One of the salesmen would negotiate everything in his personal life to the point his family would be embarrassed... buying a suit negotiate several pairs of socks or underwear... going out for dinnner... use the coupon book... going to the doc... ask up front for the cash discount which always got him at least 10%...
Has anyone heard of some negotiating for Long Term Care?
Yes... one of my friends did just that... she had failing health and owned a home near Loma Linda Medical University... she negotiated care by offering accommodations for medical students... it really worked very well and she saved a bundle and had medical versed boarders.
Originally Posted by eastcoastguyz
More importantly, people live in different cost of living areas.
Originally Posted by matisse12
I don't really believe that this is a big factor in retirement - although it is sometimes touted as one in this Retirement Forum
hi nightbird47, my comment was directed toward the well-to-do posters who want a million dollars or over a million or many hundreds of thousands of dollars for their retirement - and somehow think it is crucial to accumulate - even when they have their house or condo fully paid for which is usually the greatest expense in one's bills when not yet paid for, and having it fully paid for free's up lots of money in their expenses.....and they live in 'high cost of living' cities - where housing is high, but their housing is fully paid for already! (on top of it, they often have nice or hefty pensions) (no need to mention paying one's children's college tuition, some do, some don't) (and mathjak107, we know that you pay $10,000 per year or whatever for your Long Term Care insurance, and also other insurance before turning 65)
My comment was not directed at people like yourself, nightbird47 (^:
Another point is that people of all incomes and many different levels of income do happen to live in 'high cost of living' cities and areas.
A lot of that depends on the sort of place you're comfortable. I'd hate to be stuck in the middle of a big city. But know friends who have chosen that as ideal. We're all different people and it depends on what you need.
It also pays to look into your options before its time to decide, any and all, as some might be ideal but you might have a wait to get in. And if its a place you've never been, maybe a visit is a good idea.
I have a friend who's six years behind me, meaning he's just on disabiltiy. He would be miserable in a place like where I live, since there is nothing of interest to him here. The kind of things he needs are what I miss, too, but I like the quiet and calm and its good for me. But I fully understand why he needs to stay out in Los Angeles where his friends and life are.
He did a very important thing, though, about the time he was diagnosed and working toward disability. He looked at long term rental buildings subidized for low income. They also provide some services which housing a bit. He doesn't need that, but its located in an area he can easily get by bus or rail to where he would be going. He's active in the local science fiction club, something I do miss very much. He can get to his mom's, in her 80's to check on his mom and often spends the weekend with her. It works very well for him and he's lived there for years, and will until he doesn't need the apartment.
He only could have done this by planning. They had a waiting list and when he decided on that area, he applied. It took a couple of years to get the apartment. With it, he got a kind of support he hadn't had before. Some people can live with mom or dad. Some both parties get driven to a bad place. He didn't fall on this place by accident, but by planning and looking at the money. It's not the answer for everyone, but all of them require a standing back and looking at the situation, and the dollars and allowing for the stuff which might not be as good, if they are worth it. And it takes honesty.
I'd vaguely wanted to get away from overpopulated socal. But I had no target. When I made a visit to a friend in OK, and discovered the prices of housing like my little house, I started considering, and when it looked good and possible, even family liked the idea, I ran with it.
If there is a place you'd like to live, don't cross it off the list automatically if its more high cost. Look at how you get around that. Are there any situations like my friend getting the apartment, which might pay off? Do they have transportation to where you need to go? Look at all the factors and see what they say. Check out all the options, and ask what you really want. I'd had it with city, traffic, smog, noise and the rest. It's quiet here, no smog, luckily not a high chance of tornados, but stores close enough you can get your daily needs. And online all that stuff you hunt for the best price. So this is good for me. For others it would be miserable.
There is no one kind of 'good' for retirement. It all depends on what you want and need. And it should not be a quick decision, or just 'assumed'. Know what you want, know what your resources are and what you'll need. And go looking. And don't sign on the dotted line until you can say you're sure.
Last edited by nightbird47; 06-02-2017 at 04:35 PM..
Then the value of the house is a lot more and a person can sell and relocate.
Not necessarily true. Looking at homes in NJ where the taxes are real high, the property values for similar houses in other states with lower taxes are higher. The high taxes are causing people to move away and there aren't enough buyers to keep the prices where they should be.
Until that roof needs to be replaced. Or some other major repair is needed.
That's true, but if the cost of living is low enough it can at least fufill your normal needs, get food, pay your utilities, etc. In high col areas, those things all cost more too. The cost of living may be the difference between being able to afford your bills or not. At least it means you can eat and have a roof over your head even if its leaky.
If your income is low, everything is a balancing act where the fact the roof may need work someday with the other fact that it was fixed a few years ago and the likelyhood isn't high you'll need to for some time. And if you have the money, getting insurence so they'll fix the roof is the best option.
I grew up around the car business and virtually no one came in and wrote a check for the full asking price... of course there are exceptions but definitely not the norm...
One of the salesmen would negotiate everything in his personal life to the point his family would be embarrassed... buying a suit negotiate several pairs of socks or underwear... going out for dinnner... use the coupon book... going to the doc... ask up front for the cash discount which always got him at least 10%...
So what? means nothing. And on top is the quintessence of inefficient marketplace. So now we all have to be some obsessive/compulsive salesman? Even with the essentials of life? The real answer is "no" and everyone who understands life and the marketplace knows it.
Goodie for that salesguy who has the time and resources to make a Hand-down-his-pants game of simply getting through life but there is no reason in that story to advocate it as a way to do any kind of business especially medical business. In fact the story itself speaks against its own right to exist as any kid of business model
So what? means nothing. And on top is the quintessence of inefficient marketplace. So now we all have to be some obsessive/compulsive salesman? Even with the essentials of life? The real answer is "no" and everyone who understands life and the marketplace knows it.
Goodie for that salesguy who has the time and resources to make a Hand-down-his-pants game of simply getting through life but there is no reason in that story to advocate it as a way to do any kind of business especially medical business. In fact the story itself speaks against its own right to exist as any kid of business model
To each there own... anyone can pay full price and many do.
Many cultures the price given is merely the starting price.
I'm in the medical business and negotiations are very much alive and well...
I just bought all new top line Anesthesia Machines for our Hospital... the price paid was NO WHERE near the "List" price... in fact it was about half when it was all said and done.
Food, Shelter and Clothing are the essentials of life by legal definition....
Home Buying embodies the art of negotiation... and so does my local Farmer's market and my example shows it happens buying clothes.
So you think moving to a particular county somehow changes my life expectancy?? It doesn't change my eating habits, or my genetics, or my exercise habits, or my weight, or any other relevant thing. This is a case of correlation vs. causation. Living in the county doesn't automatically change anything about you.
I lived in CA for 54 years, but that doesn't matter because then I moved to a poor county in TN. I suppose I could live in Tennessee just until I'm 65, and then move to Aspen and I'll live to 87.
And SS checks I don't receive because I'm dead? Why would I care? In my grave I'll be tossing and turning about all those checks I missed out on! Stop, I'm laughing so hard milk came out my nose.
I can give you one little example of how living in a wealthier county does make a difference for health. I was living in Del Norte County, which is one of the poorest counties in CA. I have Denta-Cal (part of Medi-Cal, which is basically Medicaid in CA). But, even though there is a Denta-Cal clinic in Crescent City, where I was living, they were not taking new adult patients and didn't expect to ever do so.
The nearest clinic I could go to for dental care was in Redding. A four hour drive each way, and the gas to get there and a hotel room, unless I was up to doing it in one day.
Next option was to go sign in at the local clinic at 8:00 a.m. and hope they could squeeze you in, if there was a cancellation. I needed a tooth pulled that was killing me, and I was able to get it pulled - after waiting 5 hours in the waiting room. So, forget about getting cleanings or check-ups or anything that wasn't dire.
So, needless to say, my dental care has seriously suffered for the last 3 1/2 years. I'll be able to now make an appointment locally, because I'm in a county that can afford to pay enough dentists. So, I'll be getting check-ups and cleanings and some new crowns, etc., that have been sorely needed for a few years.
In Del Norte County, you regularly see people missing front teeth. I'm talking the clerks at the Walgreens or at Home Depot, etc. And that's mainly due to a lack of resources. They probably qualify for the local clinic, but can't be seen, can't afford to drive 4 hours each way to get their teeth taken care of, etc.
I guess if you could afford to fly wherever you needed to go, that would work. Or if you just wouldn't take care of your teeth anyway...
But, there are lots of other resources in a wealthy county, too, that are not available in poor counties, in all different segments of health care. It does make a difference in my personal health to have these resources where I live.
I can give you one little example of how living in a wealthier county does make a difference for health.
I live across the water from one of the top neurological hospitals in the US and the head of neurology there operated on me when I had an aneurysm. I don't doubt that if I hadn't lived in this area and not gone to that hospital, I would have had far more problems recovering from the aneurysm. By all rights, I should have died from it.
Money = good health, all down the line. The more money you make, the healthier you'll be, and the closer you live to a well off medical center, the better and faster you'll recover if you do get sick.
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