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

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

#181

Post by nobodyandproud »

2OEH8eoCRo0 wrote: post #80
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.

My father's doctor says she doesn't want healthcare reform or more doctors because then their salaries will tank.

We now have noctors, and the physician role is now in danger of becoming supplanted by incompetent mid-levels with better people skills.

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

#182

Post by nobodyandproud »

Avicebron wrote: post #79
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.

> 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 have a perspective shift that may help: Physicians are the peak of blue-collar work.

Yes, a lot of physician work involves diagnoses; but it also involves getting one’s hand dirty. Hospitals are the peak of shop and factory work.

My wife, who worked as an RN in the OR is far handier with shop tools than I am as it’s time-sensitive physical labor!

Meanwhile the jobs program are all of the white collar variety; jobs that purport to support our healthcare workers includes 100% of the health insurance companies and programs.

Thanks to a generational messaging since the 1980s and 1990s, we white collar workers have wormed our way into all aspects of industry.

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

#183

Post by hirvi74 »

b112 wrote: post #169
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…

Beyond it being normally weird, that's a very weird thing to do. With the aging population, we'll need more and more health care professionals. I'm not just referring to people over 60, even people 40 upwards require more care.

I am not trying to start any sort of political discussion. However, I do not think many of the layoffs that have hit healthcare workers are due to maximizing profits for hospitals nor due to the lack of demand for healthcare.

If I am not mistaken, the current administration has enacted changes that have caused a significant reduction in federal grant funding for hospitals. So, many of the layoffs, as I understand it, are to make up for the coming losses in funding.

I live in a state with plenty of rural areas. There are growing fears of some rural hospitals being forced to completely shut down due to funding cuts.

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

#184

Post by const_cast »

WalterBright wrote: post #139
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.

When it comes to healthcare, we didn't used to have so much regulation.

And, well, it sucked. People died, black people got injected with radiation, and we experimented on humans.

Ultimately, I don't want poor people to just... die. Because that's bad. So we need some sort of guarantees.

Or, we don't: in which case, I hope you're content scraping bodies off the freeway for free. Someone has to do it if we're not paying for their healthcare and disposal costs. Hope you're not busy next weekend!

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

#185

Post by const_cast »

kasey_junk wrote: post #89
wredcoll wrote: post #49

Earlier quoted context omitted.

Something I've run into in similar situations is the "moral necessity of punishment", sort of a reverse just-world fallacy. "There are people not good enough for health care and helping them would violate this natural order".

It’s absolutely the case that public health coverage will benefit some people who make bad health decisions at the cost to some of those who make good decisions (or the decisions themselves must be made by a central authority). That doesn’t make it the wrong policy decision. Lots of systems we happily manage with similar dynamics. But I don’t think denying that basic fact is the right path forward. The moral hazard i…

The problem is we're already doing that, just worse.

Insurance is just risk-pooling. The most effective risk-pooling requires a bigger pool. That's why we have big insurance companies and bigger companies offer better employer healthcare plans.

Well, the biggest pool is the entire US population. So, we should just do that.

We already have socialized medicine. If my coworker smokes, I pay for that. If we're going to do socialized medicine, we should do it right.

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

#186

Post by [deleted] »

wat10000 wrote: post #129
SoftTalker wrote: post #65

Earlier quoted context omitted.

Consider also that by the time you need a nursing home or some other form of continual skilled care you are probably going to die within that year. "Long-Term" is sort of a scare tactic that is used to get you imagining that you're going to be needing expensive skilled care for years. That can happen, but isn't normal.

“That can happen but isn’t normal” is exactly the kind of thing that insurance should be for. Unfortunately, US health insurance is more oriented towards covering everything rather than spreading out the risk of rare high-cost events.

[deleted]

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

#187

Post by dehrmann »

wat10000 wrote: post #129
SoftTalker wrote: post #65

Earlier quoted context omitted.

Consider also that by the time you need a nursing home or some other form of continual skilled care you are probably going to die within that year. "Long-Term" is sort of a scare tactic that is used to get you imagining that you're going to be needing expensive skilled care for years. That can happen, but isn't normal.

“That can happen but isn’t normal” is exactly the kind of thing that insurance should be for. Unfortunately, US health insurance is more oriented towards covering everything rather than spreading out the risk of rare high-cost events.

My person pet peeve for insurance is dental insurance. Here's what Delta Dental offers for its own employees:

https://www1.deltadentalins.com/content/dam/ddins/en/pdf/car...

If you get the PPO, you have an in-network annual benefit cap of $2,500. So you're paying your insurance company to pay your dentist for you? And as soon as the bill gets large enough that you'd actually need insurance, they tap out?

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

#188

Post by apwell23 »

conception wrote: post #158
apwell23 wrote: post #147

Earlier quoted context omitted.

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.

“USA is very very good at complicated, cutting edge medical care” - i hear this but haven’t seen it in practice or in statistics. Everyone I know that has needed such things has had the same poor quality of care that primary care providers have - long waits, insurance issues and mediocre outcomes.

> i hear this but haven’t seen it in practice or in statistics

curious. what kind of statistics would that show up?

When i was looking into clinical trials for prostate cancer. almost 80% of experimental cutting edge medicine was in usa. They even have spl k2 visa for International patients to participate.

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

#189

Post by novok »

mjevans wrote: post #113
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…

It also doesn't count family members providing care for loved ones 'unpaid'. Nor does it count any of the people who really should have more or better care but don't get it.

I don't think unpaid people would mind if they were 'put of an unpaid job' in this case.

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

#190

Post by FloatArtifact »

For those in the US, In some states like Minnesota, if you have long-term care insurance, assets can be sheltered equal to the amount of the LTC policy. This allows you qualify for Medicare with significant assets beyond the House, Vehicle and traditional qualifying assets. The sheltered assets could be used for legacy or personal needs.
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