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Financial lessons from my family's experience with long-term care insurance

whitecoatinvestor.com

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Re: Financial lessons from my family's experience with long-term care insurance

#91

Post by qwerpy »

SilverElfin wrote: post #69
SoftTalker wrote: post #18

Earlier quoted context omitted.

I wrote a longer response but deleted it as it was just a personal anecdote. Suffice it to say I'll never buy LTC insurance or participate in any elder care such as "assisted living" or "nursing care." It's all (IMO) engineered to drain old people of their assets before they die. Providing care is nowhere on the list of motivations of anyone involved.

Some states are forcing you to buy LTC insurance. I’ve heard Washington does this through some convoluted laws.

It’s a stealth income tax. Most high income people saw through it and opted out by buying their own LTC (which isn’t indexed to income) and then canceling it once their exemption was recorded.

Re: Financial lessons from my family's experience with long-term care insurance

#92

Post by Alive-in-2025 »

SpicyLemonZest wrote: post #82
k4shm0n3y wrote: post #73

Earlier quoted context omitted.

Who were they compromising with? The Congress had large Democrat majorities in both houses during the ACA legislative process.

The parties weren't yet ideologically sorted. The Democratic majority included dozens of members of the Blue Dog coalition, a conservative group who (among other things) didn't support healthcare reform.

Also the us Congress is blocked by the senate needing 60 votes/supporters to reach cloture on every single bill, except the once per year thing that got the bbb passed. So it's very easy to block the other side. https://en.wikipedia.org/wiki/Reconciliation_(United_States_...

Re: Financial lessons from my family's experience with long-term care insurance

#93

Post by wahern »

silisili wrote: post #74
lvl155 wrote: post #12

Healthcare in the US is broken and they won’t let you fix it because the money is too good. Think about the fact that PBMs, which is there to save and manage on pharma is incentivized to promote drug price inflation. That’s just one “small” piece of this clusterf*k. It’s layers and layers of these convoluted system of incentives. As to OP, the simplest solution is to move out of the US early enough or become “poor” e…

Healthcare is little more than a jobs program at this point. I believe it is the largest industry by employment in every single state now. That compounds the problem even further. Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant.

> I believe it is the largest industry by employment in every single state now.

This made be curious, so I looked around. FWIW, healthcare constitutes ~11% of the workforce in the US. It's ~16% in Germany, ~10% in the UK, and ~5% in France.

As a percentage of GDP healthcare is far higher in the US, of course.

Re: Financial lessons from my family's experience with long-term care insurance

#94

Post by seneca »

ta555555 wrote: post #85
thepryz wrote: post #29

Earlier quoted context omitted.

I could not agree more. My father has a neurodegenerative disorder that requires 24 hour care. He did tons of research and purchased LTC insurance decades before he was diagnosed. Experiencing first hand how difficult and predatory both the insurance company and the care facilities are has made it so I will never put my own children through it. My plan is to just euthanize myself when the time comes.

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Re: Financial lessons from my family's experience with long-term care insurance

#95

Post by elgenie »

lvl155 wrote: post #12

Healthcare in the US is broken and they won’t let you fix it because the money is too good. Think about the fact that PBMs, which is there to save and manage on pharma is incentivized to promote drug price inflation. That’s just one “small” piece of this clusterf*k. It’s layers and layers of these convoluted system of incentives. As to OP, the simplest solution is to move out of the US early enough or become “poor” e…

Like 5-10% of the US's total GDP gets wasted annually on the layers and layers and layers of healthcare middlemen… for worse outcomes.

Re: Financial lessons from my family's experience with long-term care insurance

#96

Post by emchammer »

elgenie wrote: post #95
lvl155 wrote: post #12

Healthcare in the US is broken and they won’t let you fix it because the money is too good. Think about the fact that PBMs, which is there to save and manage on pharma is incentivized to promote drug price inflation. That’s just one “small” piece of this clusterf*k. It’s layers and layers of these convoluted system of incentives. As to OP, the simplest solution is to move out of the US early enough or become “poor” e…

Like 5-10% of the US's total GDP gets wasted annually on the layers and layers and layers of healthcare middlemen… for worse outcomes.

That is crazy. That is more than the defense budget.

Re: Financial lessons from my family's experience with long-term care insurance

#97

Post by votepaunchy »

k4shm0n3y wrote: post #73
mike_d wrote: post #16

Earlier quoted context omitted.

In the Swiss system the private insurance companies are required to be non-profits. The government sets the standard for care and coverage and all the companies can do is compete on price. Basically what Obamacare was originally intended to be before they had to compromise to get it passed.

Who were they compromising with? The Congress had large Democrat majorities in both houses during the ACA legislative process.

The 60th vote was Ted Kennedy who died in office and a Republican was elected to fill the seat, forcing passage of an earlier bill.

https://en.m.wikipedia.org/wiki/2010_United_States_Senate_sp...

Re: Financial lessons from my family's experience with long-term care insurance

#98

Post by silisili »

wahern wrote: post #93
silisili wrote: post #74

Earlier quoted context omitted.

Healthcare is little more than a jobs program at this point. I believe it is the largest industry by employment in every single state now. That compounds the problem even further. Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant.

> I believe it is the largest industry by employment in every single state now. This made be curious, so I looked around. FWIW, healthcare constitutes ~11% of the workforce in the US. It's ~16% in Germany, ~10% in the UK, and ~5% in France. As a percentage of GDP healthcare is far higher in the US, of course.

It's actually a really hard thing to track, and BLS does a poor job of it in my opinion. That 11% covers most but not even all people at a clinic or hospital. It counts people from doctors to records specialist, but not say, janitors or IT, and nothing outside of that like insurance. And that's not necessarily wrong to do, but makes it hard to grasp the whole size.

If you add in everyone in insurance, pharma, devices, and the jobs those support, that number seems to be closer to 17% of the workforce from what I could put together.

Not sure if those in Europe do it similarly, but it just feels like a huge number of people. Maybe that is the result of demographics and a topheavy population, though.

Re: Financial lessons from my family's experience with long-term care insurance

#99

Post by esseph »

silisili wrote: post #74
lvl155 wrote: post #12

Healthcare in the US is broken and they won’t let you fix it because the money is too good. Think about the fact that PBMs, which is there to save and manage on pharma is incentivized to promote drug price inflation. That’s just one “small” piece of this clusterf*k. It’s layers and layers of these convoluted system of incentives. As to OP, the simplest solution is to move out of the US early enough or become “poor” e…

Healthcare is little more than a jobs program at this point. I believe it is the largest industry by employment in every single state now. That compounds the problem even further. Really fixing it would put a double digit percentage of people out of work. I'm all for it, but I can see why politicians are hesitant.

I'm not so sure.

If we fix healthcare costs we can spend more on hospitals. With more hospitals means more jobs and more competitive care costs.

In addition, a lot of those insurance jobs are facing pressure from "AI".

Re: Financial lessons from my family's experience with long-term care insurance

#100

Post by hawaiianbrah »

SilverElfin wrote: post #69
SoftTalker wrote: post #18

Earlier quoted context omitted.

I wrote a longer response but deleted it as it was just a personal anecdote. Suffice it to say I'll never buy LTC insurance or participate in any elder care such as "assisted living" or "nursing care." It's all (IMO) engineered to drain old people of their assets before they die. Providing care is nowhere on the list of motivations of anyone involved.

Some states are forcing you to buy LTC insurance. I’ve heard Washington does this through some convoluted laws.

Washington imposed a LTC tax where some percentage of your income is taxed and goes into a fund for LTC. At the time they implemented it, you could opt out by procuring private LTC insurance. Most tech people I know did, because it was cheaper than the tax imposed. We’re still waiting to see if it’s safe to cancel our private policies.
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