Happy and sad

[MurrayM]

...Sorry, contributing to thread drift.

Threads, like conversations, are not linear

*Please note signature below*

 

[rsn48]

I am active on Tik Tok. This is a platform that is open to all and you can make videos from 15 seconds to one minute. The topics are all over the place from stupid humour, doctors, nurses, police, fire, ambulances, political (lots of political), lawyers, etc commenting on what ever they want to comment on. I often find the latest breaking news shows up on Tik Tok first.

And there will be fad questions, comments, and reactions. These fads come and go. The latest fad is for Americans, usually younger asking Canadians what universal health care is like and how does it work.

The usual response goes something like this: "Our health care is funded through taxes just as you military is funded through taxes. We have free access to health care and we never (this isn't 100 percent true but 99.8) receive a bill. However when we do go to the hospital for whatever reasons, we do have to pay for parking."

 

[Scrib]

I bailed out of the corp world at 60 ... not necessarily willingly but I'd say amenable to the change in work status. Company paid a year & I used COBRA for the next 6 mos. then I had to go out and buy a policy for (at the time) 3 of us. It was a mere $1975/mos for what I'd call catastrophic coverage. Private health insurance is GD expensive and it doesn't take all that much income to push you out of the "credit" side of the Affordable Healthcare Act. I'm lucky as neither my wife or myself take any prescriptions and other than me with a chronically bad lower back and a slight bout with melanoma (stage zero, simple surgical cure) we can manage with lousy coverage. Now, 5 years later my wife went on to Medicare last fall and I move to it in Mar. All in all it provides us with a pretty significant "raise" in our monthly income or less drain on the retirement fund but that doesn't sound very much fun. The USA does not make it easy to retire early and maintain your health at the same time. We're fortunate and have been able to swing the ridiculous premiums and keep our boat!

Good Luck Wild Bill!

 

[Wildbill]

Well Quarantine is over Still no symptoms except a mild headache from time to time, and I usually don't get physical headaches, many people related , back to work tomorrow, right into the Covid swirl. Will ask HR if I'm able to get COBRA coverage, and ask financial planners about expected yearly income once I "Jump ship". That will help with health insurance decisions..Thanks for all the advice and options to all

 

[GoldenDawn]

Just re-routing this thread back to something related to boats and cruising, I am careful when in an anchorage/happy hour never to bring up the subjects of: health care and gun control. Just sayin . . .

 

[MOJO]

If you go with COBRA, read the plan carefully, especially once COBRA runs out and they shift you to another plan. After mine ran out I converted to the plan they recommended thinking I had the same insurance as I had with my employer only I had to pay for it. When my wife had to have some minor surgery, we learned that it was actually a totally separate plan, and a crappy one at that where "reasonable and customary" rates hadn't been changed in 10 years. I switched over to a high deductible plan, $2,500 out of pocket then they paid 100% of everything else. It wasn't cheap but we had good coverage. When the big C hit, I paid the $2,500 and the plan paid the remaining almost $500K in expenses. My previous plan would have left me penniless! Health care insurance was by far our largest expense post retirement and pre-Medicare! Budget accordingly...

 

[pete s]

Wildbill....
I retired from "Hospital Life " almost 2 years ago.... wasn't "burnt out" about the job, I LOVED my job, but definitely felt ZERO support from the "Corporatized Admins" who were most concerned with acquiring more hospitals and doctors practices into the system, "Press Ganey" scores, fancy additions to the hospital (in areas that were just rebuilt less than 5 years ago...), acquisition of local real estate, and EPIC, etc etc etc. No concerns about what's best for patients and hospital staff ( esp. those hardworking RN's..). So after 37 years... "Adios!"...Every nurse, tech, janitor in the Hospital came to wish me well, but the only "Admin" that came to say goodbye was the chief of Engineering, since we shared a love of boats and big diesel engines...
I cut it clean.. they wouldn't let me work part time, and when offering to come back part time to help with "the Disease", paperwork and re-staffing applications were so extensive (asked for my Med School transcripts !!), I gave up after a month or 2 of trying....
I set my last day (2 years ago)as 18 mos before 65 yo for "Cobra", which worked out fine, then went total Medicare.. have my wife on an Obama plan... not cheap, but do-able..
I DO miss taking care of patients a lot, as well as the zillions of friends I had in the staff and colleagues, but using and "putzing" with my R31-CB, along with some volunteer work... and a LOT of "free medical advice" and care.. keeps me busy and satisfied that I am still "helping" (just volunteered to give vaccinations during this mess...)
But the freedom, the "broken chain" mentioned by another healthcare person, the lack of need to "check my schedule" before saying yes to plans, no more 36 hr on-call stints, no more working all those Holidays and entire weekends... is priceless..
and I didn't really have "enough" $$ saved up according to some people, but I already had The Boat, and my wife and I just adjusted our lifestyle to fit the budget...
and I never looked back... but am happy for all the folks I did help in this world...
Wildbill...Best of luck to you... and above all..THANK YOU for YOUR SERVICE !!!
p.s. If you strongly feel the need to go back to work someday, there is always West Marine or Home Depot....

 

[Captain DJ]

Cobra is your only choice but it really isn't that much more expensive than mediocre with a supplement plan and a part "D". I think Medicare is about $165 a month, my supplement just went up to about $300 and part "D" is about $50. Cobra, depending on the policy is probably about $800, maybe $1,000 for both you and the Admiral. Cobra with the supplements is half way there.

Just bite the bullet.

pete

Pete,

I sure hope your numbers are right.
I am 55 and wife 54, we are being forced to self insure (living in Mexico) or pay Cobra to extend our BCBS policy. It is $3k a month with HUGE deductibles and copays. Absolutely worthless insurance in my opinion. God what if we were sick?
We both are healthy with No preexisting problems/conditions. So how can they charge us youngsters (that never had jobs offering pensions) so much more than the older folks more likely to use the benefits?
What am I missing?
Got until Feb 1st to figure this out or we start wasting $3k/month on crappy healthcare insurance. Yikes, talk about biting into savings.

Thanks for giving me hope...

DJ

 

[Kintala]

Trawler School

Well over Christmas week we finally got to attend Trawler school (after 2 previous reschedules due to Covid). We (Admiral and I) had multiple reasons for attending besides the knowledge and experience which was OUTSTANDING...Navigation is WAY easier from a guy who learned with Loran C...Old skills came back quick

We took the same Trawler School last year and were actually on his boat when the reports started to come in about Covid on the news. Glad we got it in before lockdown. We did learn a lot about ourselves and the type of boat that will work for us through the school. It was worth the money. Oh and the laughs over the MOB drill...

 

[Kintala]

High Deductible Plan

Look at High Deductible Healthcare Plans (HDHP) with an Health Savings Account (HSA). NOT AN HRA!!.

The name "High Deductible" scares lots of folks away. But with the reduced premiums, pass through money, and portable HSA it is often cheaper that a traditional plan. The tax benefits are great too. No tax on what goes into the HSA on the front end and no tax on what comes out of the HSA on the back end (as long as it is used for health care). Like having an IRA going in and a Roth IRA coming out.

I was going to suggest the same thing. We got a high deductible plan for both of us together that was in the low $400s. One caveat - if you need a procedure close to the end of December, wait till January to have it done. I had some breast biopsies done late in Dec and then surgery in January and they charged me two deductibles, both of which were $11K. We paid on that bill for 4 years...

 

[EatSleepBoat]

I retired at age 57, and for healthcare tried various "faith-based" plans as the premiums seemed low, but you get what you pay for - refusal to pay claims, really useless customer service, poor recognition by doctors, etc. We switched to a BlueCrossBlueShield HMO a couple years ago, virtually the only half decent plan available in this part of Texas for individual buyers. We don't qualify for Obamacare subsidies. We've been happy with the plan, but it costs $1740 a month (for two) and still has a high deductible. By far our largest cost in retirement. Watching Cruising Sea Venture on YouTube last week, they are in a similar age and retirement position, and they mentioned paying $1900 a month for a similar policy, which made me feel a tiny bit better. Can't wait to qualify for Medicare.

 

[Maryboo]

Insurance

We also felt it was important to get insurance through DAN. Divers network. Covers airlift to he nearest US hospital from outside the country, like Bahamas or Bermuda. Worth it in case you every need it for a fracture, or a coronary event. Most of the little islands have a medical person, sometimes a nurse, only a few days a week. And not usually at night. And only the biggest islands have airstrips and ferry services. So the first evacuation will be on a boat, ferry, etc.
We lived aboard for almost 10 years and when we moved aboard we continued with BCBS, which, by the way, does not cover medical expenses outside the US. HMO were useless because of the travel.
So figure out where you are going to go and fashion your coverage around that. Maybe confining your voyages to within the us till you get to Medicare would make the transition easier. Then consider sitting down with an insurance broker to get current facts. Not the time for hearsay or outdated coverage rules.
And lastly, I know as a medical person you know what to do. But be prepared to be the one sick and unable to give directions to your wife. We also had a procedure if we were underway to secure the boat, call for help - write this down and leave at the helm- and written sheet to assess the medical situation from a non medical person’s perspective. I kept a well stocked Med kit, as I’m sure you will have, and our most used items were otc pain meds, seasickness pills, lots of bandaids, ace wraps, instant ice packs. But we were fortunate to have stuff others needed and we could help out. I guess I’m a live in the emergency mode person, and then I’m prepared for anything. Good luck, it’s a great life aboard.

 

[Captain DJ]

I retired at age 57, and for healthcare tried various "faith-based" plans as the premiums seemed low, but you get what you pay for - refusal to pay claims, really useless customer service, poor recognition by doctors, etc. We switched to a BlueCrossBlueShield HMO a couple years ago, virtually the only half decent plan available in this part of Texas for individual buyers. We don't qualify for Obamacare subsidies. We've been happy with the plan, but it costs $1740 a month (for two) and still has a high deductible. By far our largest cost in retirement. Watching Cruising Sea Venture on YouTube last week, they are in a similar age and retirement position, and they mentioned paying $1900 a month for a similar policy, which made me feel a tiny bit better. Can't wait to qualify for Medicare.

I would easily stomach $1700-1900/month for two of us, but I am staring at $3k plus. Not sure why...But I will keep searching. Maybe Michigan has something to do with it? I work for a company 13 years, in Michigan and live in AZ and Sonora, Mexico. I can afford the best upper tier healthcare here for less than the co-pays and deductibles with BCBS Preferred Care for lesser quality care in the US. Doctors here do the work themselves and spend a lot of time with you.
For example, my annual physical has ten times the tests and analysis, the doctor spends 2-3 hours with me and all in costs me under $200.
Had kidney stones, the Radiologists himself did the Ultrasound scan and gave me readings and results immediately, no wait, no scheduling issue. And he did not even charge me at all. My wife had Carpal Tunnel Syndrome fixed surgically on her right hand, and again, anesthesiologist, surgeon and tech did it No Charge because she works as a nurse/office manager for a doctor friend of theirs. Amazing quality care and dirt cheap. A friend had a quadruple bypass, four nights at hospital and total bill for Top Shelf facility, $18k and that included all the imaging and even the ambulance ride when he had a heart attack that precipitated the surgery. My Dad had that at UAB and it costed over $1.2million with six months of torture at the end, with death as a result. My friend is fine with his penny on the dollar Mexican experience. I know that is anecdotal but I have other similar cases that I will not bore you with.
Thanks for the tips and I will keep looking or we will just stay here in Mexico. The Sea of Cortez (Gulfo de California) and the entire West Coast of Mexico is a pretty nice cruising ground for now...
Adios

 

[thataway]

The admiral has a state pension when it comes time

Is there any possibility you can link to your's wife's state pension for health insurance for the both of you before medicare and as a supplement? I am an MD who retired at age 56, but we had already spent 4 years cruising World wide in our late 40's. We accidentally self insured--I had to have back surgery--but that is a chance you take. I thought my medical group was covering my COBRA--a clerical error didn't make the payments..--we didn't pick up on it because we left the USA shortly after retirement and friends were paying bills..

..I had contributed to state pension for XX years when in training and full time academic medicine--drafted to Army--then Private Practice. Last of career went back to a state university..and for total 20 year (2 years service credit, plus 2 year golden handshake. ), mostly to get medical coverage (bridge between 56 and 65, plus supplement. As you know the Medicare Advantage plans may have stipulations which limit your travel...

Another issue is if you decide to leave the USA when cruising, the Medicare will not pay for care outside of USA. But organizations like Seven Seas Cruising Association do have access to medical insurance when outside of the USA, which is much less expensive --but does not give in USA coverage. (In some cases you have to be outside of the USA for over 6 months year)---you would have to investigate the various policies. There are other policies which cover emergency care and evacuation to the States, if you elect to cruise abroad.

I am an advocate of do it now while your health is good. In my case at age 65, we could no longer go offshore because of heart and back disease...We still boated, but went to smaller boats and in the US and Canada...

By the way, don't rule out sundeck MY with cockpits..gets away from the high aft deck ladder, if you have an exit thru the aft stateroom, or like the Defever 44 + 5 with the 5' cockpit. There are only 3 steps down to cockpit, and stairway to Flying Bridge. One of the most "livable" loop boats, plus 1100 gallons of fuel gets you anywhere in the Caribbean East or West.

Good on beating the C and COVID!!

 

[Mark Laurnen]

Wildbill and Hippocampus, I’m right there with you. Feeling pretty burned out after my 30 year Anesthesia private practice was confiscated, without remuneration, by a national company. Hard to enthusiastically climb out of bed at 04:30 to go grind it out on behalf of market investors while getting paid pennies on the dollar. Pondering the same dilemma, maybe IronZebra gave us a valid lead ... I’m wondering if the AMA might have a program. I’m not a fan of the AMA but would possibly join just for health insurance.

 

[IWAB]

Mark, I have been reading, with interest, this entire thread, and pretty much have experienced and seen all discussed. Am aware of the “corporatitizing” of medicine, but don’t understand your statement about having your practice taken from you by a national corporation. Would you be willing to share that, or you could private message me?

 

[Peter B]

As a medical provider in northern Maine we see our neighbors (Canada) universal healthcare in action. Usually works very well, but to work, they have to ration advanced procedures...Come to US and say CP, (chest pain) and get fast tracked, get immediate EKG , abnormal EKG = stress test, that's done that day or next morning (not 6 weeks), ?abnormal = cardiac cath in morning, if abnormal = Stents, or Cardiac Bypass within next 1-2 days, in American model, not 6 mo-1 yr, in Universal healthcare.

Not all universal healthcare systems are as overloaded as the Canadian system. Like the UK's NHS, this is largely because of the embargo on charging any private fees. So the public system is overloaded.

Here in Australia, in most places, the above description of speedy attention to coronary disease would be similar to the US experience as described. However that's because we also have a private alternative that folk can elect to also be in, but can also access our Medicare, so the public system is not so over-loaded, and emergencies are treated very well in public as a consequence.

Point being, maybe somewhere in the middle between the two extremes is the right place to aim for, health system wise..?

 

[Crankyank]

Not all universal healthcare systems are as overloaded as the Canadian system. Like the UK's NHS, this is largely because of the embargo on charging any private fees. So the public system is overloaded.

Here in Australia, in most places, the above description of speedy attention to coronary disease would be similar to the US experience as described. However that's because we also have a private alternative that folk can elect to also be in, but can also access our Medicare, so the public system is not so over-loaded, and emergencies are treated very well in public as a consequence.

Point being, maybe somewhere in the middle between the two extremes is the right place to aim for, health system wise..?

As a native American/permanent resident Australian I can vouch for the above. I think the Australian system would be perfect for the US, as those who worry about being on a "gubmint" system can keep their private policy, but are still covered on the public system. We paid a small monthly fee (about $250 IIRC) for our private policy, but 99% of the time just used the regular public system (Medicare). Works fine.

 

[AZ2Loop]

I have studied this healthcare situation a lot. Wilbill, Crankyyank and others are hitting some of the nails in this hopefully avoidable coffin on the head. It is actually not a complex problem to solve, but that is for another thread, and it takes a few paragraphs to explain it so I'll save the lengthy typing. I lack the discipline not to add this simple statement, though:
The fact that COBRA is discussed as the "best" alternative says it all. That really shows just how much the ACA/Obamacare screwed up our health insurance system in just a few short years. That statement alone shows just how messed up this is. COBRA was a last resort, a costly resort, a short-term solution between jobs one would only consider short of another option just a few short years ago. Now it is routinely accepted as the best option, and not because COBRA got better, but because all other options were either taken off the table or made worse.

It is so so sad what has happened to health insurance here. The ripple effect of lives destroyed or negatively impacted is huge. The solution is incredibly simple, and it is not single payer.... but that is where we are headed sadly.

 

[seighlor]

For this old guy, this has been an immensely interesting and enlightening discussion. My only connection with the medical profession has been as a recipient of my doctor's services. And how those services have changed. And not for the better.

I've used the same family doctor for generations. Now middle aged, he was a young man at the time of our first association. And I thought he was great.

Recently he moved his practice to a hospital grouping and, WOW, what a difference.

I'll be ninety this month and my memory is not the greatest so prior to my recent six-month checkup I made a list... three or four issues about which I had concerns. My doctor barely glanced at the list, checked me over with his stethoscope, told me I was fine and WHAM-BAM, I was outta there.

This is a doctor who used to take pride in his patient care.

 

[Art]

Kaiser Permanente - I need say no more.

 

[Mark Laurnen]

IWAB, I am happy to elucidate privately. I’m not sure how to shift to a private conversation, another clue that I’m old school. Can you direct me?

 

[IWAB]

I think you can private message me, I don’t think I am allowed to give my email. I’ll dig around the site and see how to do that.