Happy and sad

[Wildbill]

Hi All, I usually lurk except when my medical training allows to offer an educated opinion. 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. I grew up on purse seiner SS and lobster boat TS from 12 yo after father died to 18 when I went away to first college. Since then owned many small boats (fished semipro Bass circuit till felt like a job). Since my time on the ocean Fought the big C x 3 and had right ear resected into labyrinths causes vertigo if cool air blows into R ear. Needed to evaluate my response to wave action as well as admirals tolerance of being on boat for extended time before we purchase a vessel for retiring and exploring the Loop. We both tolerated well, I had NO symptoms , and admiral did great except decided NO sundeck (too many ladders, afraid she'd fall into water off back )..Navigation is WAY easier from a guy who learned with Loran C...Old skills came back quick, I was ready to come home and start the buying process (admiral more sensible keeps applying brakes). As if to end 2020 properly when I returned we quarintined and to return to work I needed a covid test..Not worried, I had vaccine #1 15 days before we left, wore N95 masks, crazy careful, Test was + OH CRAP!! No Symptoms so were good, she's still negative..Problem is I want to retire in 1 year and join the trawler life, financially we should be good, but what about health insurance, how do early retires manage this, I have DM so pre-exhisting condition along with C follow-ups. Don't want to wait for Medicare, feeling burnt out in ER and new medical model is all about metrics and volume and nothing like I was trained where the patient comes first and "Do what's right". Enough whining...We are looking at cockpit MY and Hatteras LRC as we'd like to do the NE loop later, having fun looking at boats in Yachtworld, Boattrader, Boats, (driving admiral crazy), setting up speadsheet, trying to be logical Sticky problem is insurance, figured I'd ask here so I can leverage the Admiral Thanks Guys

 

[Brooksie]

City = Lincoln
You know there is a Lincoln or two in every state, right.

 

[Wildbill]

Maine....In the great north woods

 

[MurrayM]

You may not post often, but you really unloaded on this one!

Not much to offer insurance wise being Canadian, only that after retiring early we chose to keep paying into my old workplaces extended health and dental plans until our daughter gets out of college.

That'll give us some time to research and rethink things later. Lots to consider when retiring early, so punting things downfield for later helps.

I saw Covid coming, noted that the Spanish Flu epidemic was about 7 times worse in its second year, applied for early retirement last June, and stopped working at the end of October, 2020.

If you don't mind me asking (ignore question if you want) how far along are you with your Covid infection? Hopefully the first vaccination will have buttressed your immune system somewhat and you'll skate through unscathed.

Sounds like you more than deserve quiet mornings at anchor where the only pressing issue is whether to make a second cup of coffee or not.

Sending profound wishes of peaceful calmness your way!

 

[Wildbill]

Ya I'm seeing if I can COBRA for 1 1/2 years from the medical center and retire at 63 1/2 then that gets me to the magic 65. Willing to listen to any other viable options. Maybe it was the mornings and evenings onboard in the 70's in southern Florida that really got my blood boiling to retire, or it was as you say, the only question was ? 2nd cup coffee, Where do we want to go, NO life and death decisions....
We've been quarintined since 1/1, our return, and have no symptoms at all, I return to the ED on 1/15 per the CDC, to a understaffed team in a state where we are seeing record numbers of Covid daily.

 

[MurrayM]

I left 5 years early with a reduced pension, but my job was far from what anyone would call 'a calling' and while essential to the smooth running of society, was easily replaced.

Lots on your plate right now...hope the system is backstopping you and all your coworkers on an emotional level, and that those rippling effects quieten quickly.

 

[Hippocampus]

At time of retirement was a solo practice physician after having been both the senior partner in a group practice and having simultaneously worked for salary or consulting fees in various settings. Like you just got totally fed up being punished for doing my job to the best of my ability rather than at the rewarded level of mediocrity. Yes they have definitely raised the floor but at the expense of lowering the ceiling. I was several years too young for Medicare and just bit the bullet on cobra. Fortunately care and medications are orders of magnitude less expensive once you leave the US. So between my own knowledge and communication with the colleagues with whom I was friendly had little concern receiving care outside the US. First year the bride continued to work at a tertiary center in Boston (MGH) so could go on her plan ( she had enough comp days to carry us for 1/2 a year as well) and defer cobra. Throughout it all we both have had medivac insurance. In my view that’s a necessary expense to add into your budget.
Best thing we every did was to go cruising when we did. Makes no sense to work part time. Between med mal, CMEs, taxes and all the rest in my speciality I’d be working 6 months before the first dollar entered my pocket. Should be a clean cut when you walk out the door. Psychologically it was like chains being broken. Thought I’d miss the joy you get from successfully caring for people but was so burnt out that feeling was delayed by years. Wife is delighted she doesn’t have to answer to nurse managers who typically care more about hospital politics than patient care. My friends all tell me their variations of the same story. Constant frustration with administration, Epic, and inability to provide care at the level they want. Go for it. You won’t regret it.

 

[Wildbill]

Hippocampus, Thank you so much for your reply. I'm very appreciative of your insight, Yes frustration for years with administration, I don't really remember when the care of patients switched from provider to admin and insurance. Now it's all metrics and volume, working lean, constant running out of supplies long before Covid. As I sit here unable to return to work, my younger colleagues text telling me that they're feeling overwhelmed and rushed but because we have a sight decrease in census due to the Covid flair, Admin is talking about decreasing provider hours to save money, no concept of the increased time treatment takes due to donning and doffing PPEs. I was glad to do my job when Covid hit, I am the very frontline, but it's my duty, just like when Mers and Ebola where a risk. I think I crossed the burnout line when we lost a 30 yo colleague to Covid, devastated the ED, Admin barely blinked. So striving to Cruise, before my Give a damn is busted!! All my nurses say I'm never allowed to retire...Won't they be surprised when I return with a purpose

 

[Pete Meisinger]

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

 

[Wildbill]

Thanks for all the replies, Wasn't singling out, and thanks for the Covid concerns...Doing well, fingers crossed.

 

[JCM-Houston]

I retired at 61 and got a policy through the health care exchange (Obamacare). It was cheaper than cobra and had better coverage.

 

[Peter B]

'scuse me, but WHAT IS COBRA..? Sorry I shouted, but folk who just put up abbreviations/acronyms without spelling it out at least once, get my goat, as the saying goes. Especially when the assumption is clear that everyone on here is American, (possibly Canadian), and will know exactly what you mean. I remind all, this is an international forum. Many of us are not of the US - or Canada - and quite glad we are not frankly, right now in this epoch of Covid. Sorry...just sayin'...

 

[BruceK]

Could be a new British TV series. Or a very nasty snake that needs charming. Google wasn`t much help either.

 

[Bradenvlp]

You guys don’t know the Consolidated Omnibus Budget Reconciliation Act in Auz? You are missing out.

 

[Bradenvlp]

When you leave (or get sacked from) a job in the US you can stay on your previous employer’s health plan but pay the whole $ premium amount out of your pocket for 18-36 months depending on the plan. This is referred to as a COBRA plan.

 

[Peter B]

Thank you. I'd have never worked that out.

 

[IronZebra]

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.

Private practice attorney can get a group rate through the Bar Association. I would think that with number of Docs in private practice there would be an equivalent to get a group rate though.

Also, if you start young enough (20-40s) you can build a large enough HSA balance to be self-insured by using the interest on investments in the HSA to pay the HDHP premiums.

 

[Wildbill]

THANKS ALL...Sorry I forgot that this is a world wide forum, and that anyone not faced with or recent job loss would know COBRA. I started way too late to build up an HSA, and yes you'd expect a professional group to have insight and start a group plan at a discount, I'll have to check on that. Because we're an educated group in one area in my experience ONLY doesn't translate to good common sense

 

[rsn48]

Canadians don't have a clue what COBRA is, we just think the health care system in the states is crazy. I have a close friend, spent her life nursing, but she made the mistake of moving around, translation: not the best pension. She didn't worry as she knew she would inherit her mother's house in Chicago. Mom got sick, had to go into long term care, my friend had to sign mom's house over to the hospital, this is crazy.

I was listening to a program out of the states, the biggest reason for bankruptcies in the States is medical - this is crazy.

Look at these statistics for nine countries - America, Costa Rica, Austria, Germany, Japan, South Korea, Sweden, United Kingdom:

https://healthsystemsfacts.org/?gcl...69PlfkjAjtz52DyYvS3DQfckEz0xdBHYaAjiDEALw_wcB

By the way, this isn't me being political, this is me posting fact. I did graduate work in health care planning.

 

[MurrayM]

...Mom got sick, had to go into long term care, my friend had to sign mom's house over to the hospital, this is crazy...

A coworker gave me two pieces of advice when I moved from part-time to full-time and my wife & I started looking for a house;

1) Don't let the bank lend you so much that you become mortgage poor, and,

2) don't 100% count on your house as part of your retirement plan.

Good advice, no matter where you live.

 

[psneeld]

Thinking anything in the USA is crazy nowadays I get....the principles on which the country may have been founded...not so crazy..but as we evolve, there are too many people in the USA who see the old world as the "easy" world, certainly not the best.


I admit no one should go bankrupt from a medical bill...but that doesn't mean any current form of medical care on the planet is the best one.

 

[Nomad Willy]

City = Lincoln
You know there is a Lincoln or two in every state, right.

They should require us to list what state or country we mostly reside in.

Would be nice to know if one lived in Florida or N. Dakota. So. Africa or China.

But no. We’re asked what city or town and most of the towns and many cities are unknown to most. So in a way we haven’t got a clue who we’re talk’in to.

 

[Art]

Maine....In the great north woods

You are in the willy boons!

I know town of Lincolnville Center and Lincolnville [beach]. Late 60's thru mid 70's I lived in that area. Built and owned "The Hunter" - tavern, restaurant in Camden ME.

Good Luck! Stay safe. Stay healthy!

 

[TBill36]

If you can keep your income under about $65K a year, a couple will qualify for a considerable subsidy for your medical insurance if acquired through the Marketplace (Obamacare).

 

[Wildbill]

Yes Art...You were down south on the coast, We're 50 miles from Canada as the crow flies...But as they say around here "You can't get theya from heeya".
I'll have to check with our financial people to see what our yearly income would be, not being overly trusting we split our retirement years ago between TD ameritrade and Fidelity and the hospital pension, which now makes it a pain. The admiral has a state pension when it comes time. I appreciate all the answers, been drooling over boat porn on Yachtworld, Boat trader and boats...planning on maybe a bare boat charter to make sure we know what we want before making the leap, thinking we'd like to spend next winter or the next down south

 

[rsn48]

I think news just broke today that Biden wants to bring in some form of universal (?) health care quickly.

 

[Peter B]

I think news just broke today that Biden wants to bring in some form of universal (?) health care quickly.

That should be good news. For many anyway. After all, ObamaCare was always imperfect - a work in progress - sadly obstructed at nearly every turn. It ended up better than nothing, but left with huge room for improvement, is my understanding.

 

[Wildbill]

Universal health care liked by many, hated by some

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. As a future retiree I'd welcome universal healthcare but that's me being selfish. Before the border closing from Covid for example we'd see our friends north of the border come down and present with chest pain, they'd had CP at home, and had a work-up and waited for a stress test which was abnormal, scheduled for cardiac cath or bypass in 6 months ...Come to US and say CP, 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. That's what Americans expect, that's why our healthcare is expensive, I'M NOT saying right or wrong, but Universal Healthcare will require a change in expectations. I've dealt with the public that feel entitled and demanding of instant fix...Never the Canadians who are appreciative and thankful. Just saying.

 

[MurrayM]

Sure, a few people can afford to jump the line or go to another country for faster medical procedures. For the other 90% of Canadians, who won't go bankrupt or homeless after needing hospitalization for any reason, the system works.

According to a life expectancy chart in the link a few posts ago, Canadians live to 83 while those in the US live to 79. On average our system appears to be more than adequate, for the majority.

 

[Wildbill]

Preventative healthcare and having your own Primary provider at early age (at no cost) likely significant factor to longer life. Sorry, contributing to thread drift.