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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

#131

Post by Yeul »

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.

That is not exclusively an American thing. In my country currently 17% of the workforce is in healthcare. Probably need to start exporting more old folks to 3rd world countries where they can live out their days in resorts.

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

#132

Post by BobbyTables2 »

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 find the real problem is not the doctors, but the hospitals.

For a simple outpatient procedure, the fee from the hospital dwarfs that of the anesthesiologist and surgeon.

For an inpatient stay, the hospital charges thousands of dollars per night for a room! Makes the Ritz Carlton look cheap!

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

#133

Post by rawgabbit »

tsoukase wrote: post #126

From the European POV this is awful and marginally scary. A commenter down the article writes that she is gonna sell her mother's house in order to serve her and even that will not last long. The way US health care functions is an argument that the nation's principles (all free capitalism and no public intervention) are problematic. If I were POTUS for a season, I would make a volcanic erruption in the health system.…

I don't know about LTC insurance. I can tell you though; how it works in Texas where I live. If you want to go into a reputable facility, meaning one that is actually staffed and pays their staff a livable wage, it is very expensive; you pay out of your own pocket and after you had exhausted your savings etc. then they will apply for Medicaid on your behalf and use those government funds to continue your care.

As for me, when it is my turn, I plan to do "home attendant services". My understanding is that Medicare will pay, after a doctor has declared I am home bound, medical services at my home. I will have to arrange for meals, bathing, etc. out of my own pocket. When that time comes, I hope to find people at my church who are willing to do this. When it comes close to my time, I would need the doctor to say I need "at home hospice". Then an attendant will stay with me 24 hours a day and give me painkillers etc. until I pass in my own home.

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

#134

Post by bell-cot »

casenmgreen wrote: post #122
Avicebron wrote: post #79

Earlier quoted context omitted.

> 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'd love to hear what you think "really fixing it" is, please share. I can report that all (almost all?) of the hospitals and their networks both big and small in the area I am in have had layoffs this year of admin staff and healthcare professionals (nurses, doctors, etc). They ha…

In the UK, with the NHS, it seems the focus of the NHS became management, rather than clinical care. One example I read of stuck with me; a superb nurse, who ran her ward extremely well, had to leave clinical nursing because as a career path, it was a dead end. She had to move into management, and her former ward descended into chaos. NHS budget has last I knew increased many times over since 1948, but the bed count…

This problem is far broader than health care. Doesn't matter whether your actual "product" is hospital wards, sheet steel, romance novels, or mowed lawns - if your sector of the economy is not structured to have draconian penalties for bloated management/bureaucracy/overhead, then it will quickly develop ever-worsening bloat. Because it's always quicker & easier to scale up the desks & paperwork. And guess who makes the decisions about where to allocate resources?

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

#135

Post by jrs235 »

llbbdd wrote: post #111
A_D_E_P_T wrote: post #109

Earlier quoted context omitted.

> I'd love to hear what you think "really fixing it" is, please share. I'm not that poster, but there's a really easy fix: Just model the system after Hong Kong's. There's a tax-funded public system available to every citizen, so that everybody gets treatment. In practice, this is mostly utilized by the poor, and for emergencies like broken bones. You can see specialists via the public system, but there can be a wait…

Aside from the prescription part, this is exactly 1:1 how it works in the US. I say this having myself and my family utilize all of it extensively, public tax-funded emergency treatment, inpatient coverage, private doctors and specialists.

What free health services are available to me that I am unaware of?

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

#136

Post by bluGill »

vjvjvjvjghv wrote: post #59
bluGill wrote: post #11

You need to get this long before you need it, but also ensure it is good plan that will take care of you. The person in the article is lucky to have kids doing that, if you don't have kids who care who will care for you.

"ensure it is good plan that will take care of you. " That's basically impossible. You will only know if you made the right choice once you are actually starting to use the insurance.

not exactly - you can check on the experience of those who have it. Though of course things can change.

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

#137

Post by bluGill »

reactordev wrote: post #28
bluGill wrote: post #9

Earlier quoted context omitted.

Government does not have to run it. Gokernment needs to ensure it is run well but there is no reason they have to run it.

Oversight doesn’t work, look at the finance markets.

works very well there - don't confuse imperfection for not working.

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

#138

Post by Yeul »

victorbjorklund wrote: post #112
silisili wrote: post #98

Earlier quoted context omitted.

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…

Doubt european numbers count insurance (public or private) pharmacy etc or all the jobs that support healhcare in general (powerplants, construction workers, restaurants, etc)

Well when you get really down to it what is the most important thing in the world? Your health. Not much point being rich if you're in chronic pain.

And thanks to technology and science our first world society's got really good at keeping people alive and relatively comfortable.

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

#139

Post by WalterBright »

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…

Is it a coincidence that the industries with the most heavy government involvement - health care, education, and housing - are the most messed up with perverse incentives?

Whereas the software industry, with near zero government involvement, has had enormous improvements in function and has pushed the cost to literally zero.

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

#140

Post by hcknwscommenter »

silisili wrote: post #86
Avicebron wrote: post #79

Earlier quoted context omitted.

> 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'd love to hear what you think "really fixing it" is, please share. I can report that all (almost all?) of the hospitals and their networks both big and small in the area I am in have had layoffs this year of admin staff and healthcare professionals (nurses, doctors, etc). They ha…

I don't know all the answers, but I can tell you that cutting doctors and services is not what I had in mind. Mainly the behemoth that is everything tangential to that, namely insurance and pharma, for two. I worked on the insurance side(in tech), and most people wouldn't believe the number of people involved between the doctor getting money from the patient. On the contrary of your statement, I would also do everyth…

Get rid of Pharma and there will be zero new drugs or treatments ever again. Have fun with that.
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