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

whitecoatinvestor.com

141–150 of 210 posts

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

#141
post #111

Earlier quoted context omitted.

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.

The public system in Hong Kong doesn't really cost anything. It's not that you get costs "waived" if you whine hard enough that you ought to be a charity case (which, by the way, is degrading,) and it's not that costs are passed on to a middleman. Medical treatment is transparently priced and simply inexpensive -- so it's simply not a cause of bankruptcy in Hong Kong, whereas, in the US... > https://worldpopulationre…

Nearly identical with a coat of paint. Every "horror story" I've heard about having to beg with the health system here is tellingly parroted by people who do not have experience with the system. It is the default to get itemized bills when you are insured and the outcome is the same. And again, there is nothing unusual about private care in the US - I pay cash, direct, a small amount monthly, for excellent private care. The ghost people claim to haunt US healthcare is mostly propaganda that for some reason is consumed wholesale by people outside the US who have no stake in it.

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

#142
post #135
post #111

Earlier quoted context omitted.

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?

How free do you want it? Emergency healthcare is free at point of service in the US. Most other healthcare is covered partially or entirely if you're employed, which you should be. I've had hundreds of thousands of dollars of inpatient medical care for my family that I paid nothing for. Every other metric just starts to deal with the impact of taxes on the definition of free. I'm sure there are countries with systems that are fuzzier feeling to use, but this one works just fine until someone invents infinite unlimited free doctors to replace it.

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

#143
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.

Most other advanced nations have nationalized health care which works much better.

The US health care system is broken because health care is a natural monopoly that US free-market ideology dictates be run with (fake) "free markets" with result being a variety of companies profiting by abusing the system.

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

#144
post #141

Earlier quoted context omitted.

The public system in Hong Kong doesn't really cost anything. It's not that you get costs "waived" if you whine hard enough that you ought to be a charity case (which, by the way, is degrading,) and it's not that costs are passed on to a middleman. Medical treatment is transparently priced and simply inexpensive -- so it's simply not a cause of bankruptcy in Hong Kong, whereas, in the US... > https://worldpopulationre…

Nearly identical with a coat of paint. Every "horror story" I've heard about having to beg with the health system here is tellingly parroted by people who do not have experience with the system. It is the default to get itemized bills when you are insured and the outcome is the same. And again, there is nothing unusual about private care in the US - I pay cash, direct, a small amount monthly, for excellent private ca…

On reread: worth noting that the link you provided for some reason includes "missed more than 2 weeks of work" under "medical bankruptcy". I won't dismiss that out of hand without knowing more but that smells bad.

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

#145

> they each paid about $14,000 in annual premiums for 10 years, and the daily benefit started at $200 per day. Insurance companies have to make money, but that's not that good of a deal, and the payout isn't that high ($73k annually) considering you won't be doing much else.

A lot of people think of insurance like a savings account rather than something like a sequence of options being rolled over so when they experience the reality of what they've been spending money on they tend to get very upset.

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

#146
The best way to do long-term care for a loved one is to hire the nurses they like at a facility they stay at for a short while to treat the sick person at home. This is vastly cheaper than doing so in a facility, and the nurses earn more and are incentivized to keep the person as healthy as possible because the job pays very well since there is no facility extracting enormous overhead and executive salary costs from their salary.

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

#147

Earlier quoted context omitted.

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.

Most other advanced nations have nationalized health care which works much better. The US health care system is broken because health care is a natural monopoly that US free-market ideology dictates be run with (fake) "free markets" with result being a variety of companies profiting by abusing the system.

other nations get benefits from 1. US subsidizing pharma startups and 2. less people with chronic diseases 3. offer lower quality of care at lower price point 4. import doctors vs solely rely on homegrown

USA is very very good at complicated, cutting edge medical care but not efficient at delivering routine care.

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

#148
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.

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

What's most frustrating about this-- just take the poultry industry. To bring the cost to zero, all it would take is a single hacker to steal one government-regulated chicken and click "Copy" in its elusive little context menu[1].

Try telling that to a young person today. If you're like me you'll get the so-called "Gen Z Stare" in response.

1: Assume a 2d chicken.

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

#149
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…

The fun part is that government intervention has driven a lot of the messed up things about US healthcare.

Super inflated prices nobody pays? - law on “U&C prices”

Consolidation of small oncology clinics into huge hospital systems? - law on 340B prices

All of these laws were put into place in an attempt at regulating prices, and as a result, entities exploited the law to give themselves even more profit than if the laws never existed.

Now that’s not to argue the government is solely at fault, but it’s remarkable how much government intervention had made the US system worse, not better.

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

#150

Earlier quoted context omitted.

Yea, just like the country forces you to buy Medicare, except convoluted because people hate social safety nets.

Medicare provides a long term benefit as well, anyways the LTC is insolvent and is mostly a ploy to get everyone to pay for expensive unhoused neighbor care (well, the homeless industrial complex gets most of the money, it probably isn’t being used to help many). It doesn’t transfer if you ever leave the state, and doesn’t pay out very much if you ever need it.

As has been planned and legislated for years, it does transfer out of state as of 2030, which is such well advertised information that people who don’t know it are clearly operating entirely on curated propaganda, not their own thoughts.

You were right in one thing: that yes, it’s going to be insolvent. Why? Because the idiots in legislature were convinced by the anti-safety-net bastards to add an exemption carve-out that fucked the entire financial plan. If you let anyone opt out of Medicare it wouldn’t have existed for six weeks. And now those bastards have the nerve to turn around and say oohhhhh noooooo it’s not even fiscally stable!

But, homeless industrial complex? Ridiculous conspiracy theory nonsense.

For anyone not blinded by that nonsense - the WA LTC benefit would fill in the gaps for people who do not qualify for Medicare long term care, which is basically everyone who is going to need the Medicare benefit, and keep them from going bankrupt, destroying their family or simply dying for lack of care in that year it takes before Medicare kicks in for them.

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