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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

#171

Post by Scoundreller »

llbbdd wrote: post #142
jrs235 wrote: post #135

Earlier quoted context omitted.

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…

> Emergency healthcare is free at point of service in the US.

The same as any fancy restaurant meal is free: They gonna bill ya later

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

#172

Post by Scoundreller »

squigz wrote: post #87
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.

Given that my only experience with such homes is indeed long-term, I'd be curious to see actual statistics on this

The studies I’ve seen that say months or a small number of years specially look at older adult admissions, so may exclude a lot of dementia patients.

US study:

> The mean age of decedents was 83.3 (SD 9.0) and the majority were female (59.12%), and White (81.5%). Median and mean length of stay prior to death were 5 months (IQR 1-20) and 13.7 months (SD 18.4), respectively. Fifty-three percent died within 6 months of placement. Large differences in median length of stay were observed by gender (men, 3 months vs. women, 8 months) and net worth (highest quartile, 3 months vs. lowest quartile, 9 months) (all phttps://pmc.ncbi.nlm.nih.gov/articles/PMC2945440/

Danish Study:

> The median survival after nursing home admission was 25.8 months, with the 3-year survival being 37%.

https://academic.oup.com/ageing/article/49/1/67/5639744

Tbh, there’s a lot of data on this because it’s easy to measure.

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

#173

Post by Scoundreller »

dehrmann wrote: post #110
getnormality wrote: post #106

Earlier quoted context omitted.

It has been a terrible deal. These policies have been a disaster for the industry. They're very expensive and they've raised premiums to cover rising costs, which causes people to drop the policy unless they're sure they'll need it. And then those people often require care for many years, generating massive losses. Insurance is wonderful when it works, but the conditions for it to work can be quite fragile.

Certain types of insurance can be funny because of how much information asymmetry there is.

Or perfect pricing. When insurance pricing is perfect, it’s never worth it.

“It appears you’re slipping on ice and about to hit a tree with your automobile, to continue your insurance, please deposit $27k within the next 6 seconds”

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

#174

Post by BadCookie »

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.

No, it’s not. Yes, we have Medicaid in the U.S., which makes everything free for the poor, but GP is saying that effectively everybody (including the not-so-poor) can get this level of care in Hong Kong. Definitely not true in the U.S.!

Pricing transparency also does not exist here as GP is claiming it does in Hong Kong. I am supposed to get certain imaging tests done every year, and I never know how much those will cost me until after I have already done them (in the U.S.). Maybe there is some way to get a non-binding estimate ahead of time, but I have never received such a thing and am not even sure it is possible. So I can’t easily “shop around”—or if can, tell me how because I (and I think most people) don’t know how.

I most certainly cannot pay $300 to see a specialist the same day in the U.S. I would have to pay that much to see my GP after waiting 6 weeks despite my employer paying more than $20k/year to insure my family. To see a specialist, I would have to wait a few months and probably pay $1-2k for one visit, not counting any tests or imaging that is ordered.

The description of Hong Kong’s system sounds amazing if true.

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

#175

Post by getnormality »

Scoundreller wrote: post #173
dehrmann wrote: post #110

Earlier quoted context omitted.

Certain types of insurance can be funny because of how much information asymmetry there is.

Or perfect pricing. When insurance pricing is perfect, it’s never worth it. “It appears you’re slipping on ice and about to hit a tree with your automobile, to continue your insurance, please deposit $27k within the next 6 seconds”

The basic bargain of insurance is supposed to be: the insured buys it before they foresee needing it, and the insurance company keeps premiums level. If either side defects from this protocol, things fall apart.

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

#176

Post by Spooky23 »

esseph wrote: post #107
gosub100 wrote: post #47

Earlier quoted context omitted.

So government (my congressman) IS the problem! Thanks for reinforcing what Reagan said 40 years ago.

This cult of personality in American politics is such a curse.

It really is. I’m not a fan of Reagan’s politics, but I respect his point of view.

But the weird deification of him, now displaced by the new guy’s cult of personality is so awful and toxic. He’s either a giant among men or a demon, and both positions are wrong.

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

#177

Post by WalterBright »

throw-the-towel wrote: post #167
Dilettante_ wrote: post #160

Earlier quoted context omitted.

Sorry, but I'm completely lost on the chicken point. Would you mind expanding on that just a little more? Is the gov't keeping secret vat-grown super-chickens?

I think they're implying that software is completely unlike healthcare or chickens. One can be multiplied for free but the others cannot, no matter if regulated or not.

[flagged]

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

#178

Post by WalterBright »

Yeul wrote: post #166
WalterBright wrote: post #155

Earlier quoted context omitted.

If they're fake free markets then free market ideology doesn't apply. > health care is a natural monopoly It obviously isn't, because it wasn't a monopoly before the 1960s when the government got involved in it.

You cannot free market healthcare because quite frankly there is no real profit in this industry. Yeah even your high net worth client that pays 50k in premiums every year wipes you out when they get some complicated form of cancer. Edit this actually came up in a videogame called Cyberpunk. A lot of people here on HN consider themselves code wizards indispensable to their employer. Google will replace your multiple…

[flagged]

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

#179

Post by wredcoll »

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…

What moral hazard? Is there someone out there smoking 16 packs a day on the basis that their lung cancer will be treated for free??

I think bad health is usually its own punishment.

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

#180

Post by gosub100 »

Spooky23 wrote: post #176
esseph wrote: post #107

Earlier quoted context omitted.

This cult of personality in American politics is such a curse.

It really is. I’m not a fan of Reagan’s politics, but I respect his point of view. But the weird deification of him, now displaced by the new guy’s cult of personality is so awful and toxic. He’s either a giant among men or a demon, and both positions are wrong.

I think the weirdness is the recent condemnation of him by the far-left. They are shitting on a guy who has been dead for 20 years. It's absolutely bizarre. It seemed to start about 2020 out of the blue.
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