I do shop for medical care. The incentive is that, with a HSA, I am paying the 1st $5000. I agree with you that at times, shopping isn't an option, but for most things it is.
Two years ago I had to have an operation on my shoulder (that getting-older problem). Now, even though I pay the first $5,000 out of pocket, I'm supposed to pay at the agreed upon Blue Cross Rate. That is, if I go to a doctor or facility on the plan. The doctor assured me the Outpatient Facility he wanted me to go to would accept the same rate.
I hate doctors, hospitals or anything related - at least when it comes to me! The operation, a short one about an hour and half - was a success. I awoke as they wheeled me out to recovery on the gurney. Needless to say, I dressed and wobbled out of the place.
Then the bill arrived. For the less than 3 hours it took, they billed $28,550! I protested. They said, oh that's retail, and took it down. I kicked, screamed and generally made a scene. Finally, the bill was $3000. That's as much as a few day stay at a resort, I said. And, besides, my plan said it would cost much less.
Fine. At least I could apply this $3000 towards my very high yearly deductible of $5000.
No dice, said the insurance company, I had gone to a facility off the plan so nothing would apply to the deductible.
No, no, no!
To shorten this up: I complained to the doc who call the facility and said, hey, what gives. They agreed to accept what my plan would pay for (if they actually paid for it).
Ended up costing me $600. Big drop from that first figure.
I understand most people don't have the drive or determination to see this through. And, granted, the system is far from perfect, but what system isn't.
If you want to see imperfection personified, let the federal government get their hands on health care.
My point is still if you give people more responsibility for their own health, it will inevitably drive costs down.
Everyone wants insurance, no one wants to pay for it.
By the way, there's no insurance against death - the final destination. People should really get over it.
I love it when people chime in from all over! (For future reference, the reason I pick on Canadians is that my family is entirely Canadian, and I like getting a rise out of them when they read my blog).
I'm glad that the point about health care not being totally "cheap" in Canada was raised - because taxes are very high there, and jobs, frankly, don't pay as well as they do here. I occasionally consider using my citizenship to move up to BC and work as a tech writer, but the pay is much lower than it is in Seattle - I don't know if I could afford to buy a home in Canada.
There are many reasons why healthcare costs so much in the US, and I don't think that irresponsible people are the main cause. I think doctors make too much money and drug companies spend too much on advertising (and pass the costs along to consumers). Are these the main problems with the system? No. Would changing them drastically reduce the cost of healthcare? I believe so.
I don't think that's it. At any rate, I don't have any problem with the level of care I get, on those rare occasions that I actually need to see a doctor. (I'm really quite healthy.) My problem is the very small risk that simple bad luck will bankrupt me.
You can buy insurance against most of other kinds of bad luck that might bankrupt you. (You can even buy insurance against a market downturn that might wipe out your portfolio, in the form of an annuity.)
I just want to be able to buy health insurance on similar terms. Right now, you can't. (Or rather, you can--unless you've ever been sick.)
There are plenty of people who have lifestyles that lead to illness, but there are plenty of other people--more than you seem to think--who fall into the bad genes/bad luck category.
Have you ever tried to shop around for medical care? My wife and I have had health savings account-style insurance for awhile now--the sort with the high deductible that's supposed to encourage people to shop around for their medical care. Our experience is that it doesn't work.
For the most common stuff--getting a throat culture, perhaps, or a course of antibiotics--it's kind of possible. But for anything even slightly less ordinary, it really isn't.
There are plenty of places around here with an MRI machine, but your doctor isn't going to want you to go to another one--and not just because profits from his MRI place help pay his salary. He wants you go to to his MRI place because he knows the radiologist there and trusts him (and knows his weak spots and how to allow for them). He wants you to go to his MRI place because he knows what equipment they've got; he's seen the pictures it produces, and he knows that it's good enough for his needs. (And, if it isn't, he knows which research hospital has a better machine and will send you there.)
And that's assuming that you're basically healthy (although, if you are, it's not clear why you need an MRI). If you're sick--if you've got a brain tumor or you've had a stroke, or were in a bad accident--then how are you supposed to shop around? Going to wake up from your coma and quick hire an ambulance to take you across town to the cheap MRI place?
If you've ever actually tried to shop around for medical care, you'll have run into this again and again.
It's true that part of the reason that medical care in the US is so expensive is that most patients don't care how much something costs. But it's false that they can "shop around" for cheaper care. Even if you're paying for the care out of your own pocket, it's simply not practical, once you're beyond the sort of care that you can get at a doc-in-the-box.
If you've never been seriously ill, $1000 a month will buy you great health insurance in the US. If, however, you have any sort of health problem--if you've ever had heart disease, cancer, stroke, diabetes, or a dozen other illnesses or conditions--then you simply can't buy insurance at all. (Sometimes, depending on the state you live in, you can buy insurance, but it doesn't cover anything--no coverage for heart attacks or strokes or cancer, for example.)
As long as someone's there for you when you fail, most people won't take personal responsibility.
I should clear something up. I have a HSA (health savings account) which means that I pay the 1st $5000 medical expenses out of pocket , then I pay $7000 a year for catastrophic insurance coverage for anything over that - with co-pays, naturally. I have to work extra hard to pay for that coverage, but I'm concerned about my family's health.
Canadagirl: you say, what about the families not financially advantaged? What about those who don't work hard enough to provide the coverage for their families. Or, what about those who'd rather spend their money on other things than insurance. If a person decides they want to live a 'frugal' existence, let's say they manage to live on less than $15,000 a year, I say fine. That's great. But why do I have to pay for what they won't work hard enough to pay for?
It's really basic. Some are for wealth redistribution. I'm not.
Kejla asked why she should pay someone else's medical expenses when she works hard to keep her family healthy and other people are careless.
I've often wondered the same thing. My country's government health care covers people who do stupid things -- people who drive drunk, have a poor diet, and smoke (among other things). It's a drain on our system, to be sure.
Yes, I think people need to smarten up and take accountability for their actions, but I don't think that's a good argument for getting rid of (or not having) universal health care. It's good that some people can afford several thousand dollars for their family's insurance, but what about families who aren't as financially advantaged? Are their children worth less than others?
Should a child who is ill suffer and maybe die because they can't afford care? Seems to that shouldn't happen in a developed country. It's in everyone's best interests that the members of a community and country have health care available. It's time to lose the "it's all about me and my family" attitude and see that even people who don't have money deserve care and respect.
Perhaps 3% of Medicare's budget goes to administrative costs, but it wouldn't matter if it was .05%. The trend is clear, the growth of Medicare is outstriping incoming revenue.
Don't you realize, eventually entitlement programs will make up more than 100% of the budget? Simple Math.
Well Stated, I wish more people would get it. I do think your time frame is a bit hastened but still some good advice. China is very secretive about any long term plans. But they have successfully duplicated our middle class which is/was the fuel of America.
Being totally debt free is great burden lifted from anyone's shoulders.
Cash reserves are smart no matter what the economy does.
To some it may seem like 6-12 months cash is a lot but if your debt free, it really isn't.
The outlook is not good based on the belief that people can get something for nothing, this November's outcome could hasten our peril. Back to your point, returning to the times of Romans...
There really is no reason to have private health insurance companies that make a profit. Health insurance is a relatively simple accounting function that is most efficient and fair with the largest pool of people possible (like everyone in the county) so that risk is dispersed. Medicare operates at very high efficiency, with about 3 percent of its budget going to operating costs. Private insurance spends about 15% by comparison. I'd like to see us move to a form of Medicare for all, with a Medicare card issued the day you are born.
I think the main problem is that health care is treated as a commodity nowadays, much like college degrees. People are so used to buying things that they expect that health (and education) can be bought too when those things actually comes down to particular behavioral problems and all they're buying is a doctor visit or a "degree". A doctor can fix a broken bone but he can't fix most problems which aside from the unlucky cases of poor genetics basically comes down to crappy lifestyle choices of poor diet, poor exercise routines, bad sleep patterns, etc.
When there is increasingly less connection between price and results, that is, between cost of benefits and actual "benefits"=health, the price can be whatever people are willing to pay. And some people are willing to pay a lot merely because they have a lot of money.
Already I notice that people are increasing their medical tourism, though. Our desire to spend money is driving up global prices, but for now foreign doctors are inexpensive.
'Not Free to be Poor' - what an incredibly stupid, even absurd, statement.
Life isn't certain and it certainly not easy. Never has been. You can live the way you want but there are CONSEQUENCES for any action! Your health and the costs associated with keeping it are your business - not mine. You want another bloated, wasteful, unaccountable governmental program destined to grow uncontrolled into the future to take care of you and your family? You want government to be your supermommy? Why should I pay for for someone else's med expense anyway? I work extra hard to pay for my family's health insurance - $7,000 yearly. In addition, I make sure we eat healthy and exercise regularly.
Right now, More than 50% of the U.S. medical expense is already borne by government and mainly through unfunded entitlement programs. These entitlement programs will - without a doubt - bankrupt the nation. This is a fact, a mathmatical certainty, that people refuse to address.
The root cause for the incredible inflation in medical expenses is the lack of personal responsibility. Most medical expense is paid by a 3rd party - either insurance or government. Because the consumer isn't looking at cost, a bureacracy is, price is not the concern it should be. What do you think would happen if people HAD to pay for their medical expenses out of pocket.
Right, prices WOULD HAVE to come down.
Yes, you can decide to live on less than (name an amount) and by doing so not have to endure the stresses of the modern rat race. By doing this you can follow your 'creative' muses - enjoy life and have more fun. Yes, but don't expect society to pay for your play!
I know - I'm p***ing into the wind. Too many expect someone else to take care of them. This is a hugh change even from 30 years ago. Nothing will stop the trend until the whole thing collapses on itself because it's not affordable.
@ Post 17 (and 20), I'd just like to point out that the National Insurance contributions you make cover not only health care but disability allowance, state pensions, bereavement and maternity allowances etc.
Also it's not linked to how much you have contributed, so if you were to become a stay at home spouse, your family's combined contribution total would drop but you be entitled to the same treatment- pretty much the point of socialised care.
The retirement plan for the poor is to die. From this perspective the issue of health insurance is moot.
To live cheaply I would suggest retiring abroad. There are a few countries that still have a lower standard of living than US.
I'm still confused about what this post is proposing. Retiring at 40? What do you want to retire for? You couldn't have had children and couldn't travel like the typical idle elderly. I think what you want is to live comfortably without working. Can't do both without slavery.
I am pleasantly surprised at the number of places that accommodate golf carts. I hope that cities and towns will become more friendly to alternative means of transportation.
As a young investor myself, this is very disconcerning. I am starting to save for my retirement, and I am living frugally. Unfortunately I do realize that there are unexpected expenses that arise. I say unfortunately because it depresses me to find that there are so many expenses involved with just living out your everyday life. I realize that behind the facade of credit, mortgages, and more you still have payments that will need to be repaid. This is why I try to live by the age old philosophy of "don't spend beyond your means." Even with this philosophy I find it hard to just get by let alone save for future expenses.
Anyways sorry about the rant, I it just helps me realize what kind of problems there are with our society and what to look forward to in the future.
I am American and live in the UK with my British husband. My husband and I pay a combined average $1000 per month for National Insurance. I used to resent the amount of my salary that's paid, but actually now I am quite happy with it. I've realised that it reduces one of the huge stresses of life.
We would like to move to the States one day, but given the high cost of medical coverage I'm not sure it's a viable option for us. I'm not sure we would even be able to get coverage. At least here, if there's a problem, we can get it taken care of. Granted, it usually takes a bit longer than things do in the States, but things are prioritized based on medical requirements as much as possible. We do pay for prescriptions and eye exams (you don't if you're either a child or on benefits [welfare]) but these things can be budgeted for. We also pay for the dentist (unless you're a child or on benefits or a pregnant woman) but if you go to an NHS dentist there is a very clear fee structure that is quite reasonable.
One worry I have now as a resident of the UK and NOT an EU citizen is that there is some talk in the government of reducing the medical benefits to non-citizens. Not sure what I'll do then, especially if I am still required to have the National Insurance deducted from my paychecks.
Dangerman, I am your nemesis. I have lived without medical insurance intentionally for nine years--not one penny spent on thousands of dollars of premiums for which I would have received zero benefit (and I received zero benefit during the previous 14 years that I did pay for medical insurance). I spend that money instead on ways that promote health. As a result, I have not been in a physician's office in 15 years. A side benefit to my healthy living is that I look 10 years younger--truly, I've been told this many times.
Thanks, Canadian girl! I think a lot of Americans are under the impression that universal health care would solve all of our problems. The problem is that we hear all the good things about Canada's health care system, and none of the negative aspects.
I've been lucky in that I found a decent plan through ehealthinsurance.com. I'm self-employed. It's not "cheap" ($150 per month), but it does save a bit on taxes (premiums are tax deductable) and I strongly feel everyone should have insurance.
For the healthy diabetic - have you looked into a high deductable policy? If you rarely utilize a doctor other than preventative needs, you "may" be able to find a policy that works for you. These plans stress prevention, not curing ailments, and may be a bit more forgiving if you rarly need expensive emergency treatments. I do feel your pain - diabetes runs in my family, and my worst financial nightmare would be to develop a chronic illness this early in life. Best of luck!
Still, your greater point is well taken. You can't just add up your expenses from last year and assume that you'll be able to get by if you can earn that much this year. You need to do some planning, so that you know you can cover your less-than-annual expenses. And you need to have a cushion against some small amount of unexpected expenses.
Sometimes, though, the unexpected expenses aren't small--they're huge. That's when you need insurance.
As I glare at all you Americas with my beady eyes and flap my head in your general direction, I can't help but think you're over-simplifying about how cheap it is to live here.
I'm very grateful that basic health care is covered, even if wait times are long and services could use a lot of improvement. However, there is also a lot that isn't covered that can get quite expensive when you're self-employed or your company doesn't have a good benefits plan.
For example, in Ontario dental care and eye care (exams are only free for those under 18 or over 65) are extra costs. Physiotherapy is no longer covered, and no one will pay a cent if you choose to see an alternative health care practitioner. Prescription medications aren't covered either until you are a senior.
Just because our health care is "free", doesn't mean we still aren't tied to our jobs -- many of us need that benefit plan.
I certainly don't hate Americans, but I don't understand why a country as wealthy as the U.S. doesn't take better care of its people.
I would have to recommend http://www.pricealerter.co.uk as a great way to save money with Amazon. Their prices change all the time, so this site will email you when something your interested in goes down in price.
Philip,
I do shop for medical care. The incentive is that, with a HSA, I am paying the 1st $5000. I agree with you that at times, shopping isn't an option, but for most things it is.
Two years ago I had to have an operation on my shoulder (that getting-older problem). Now, even though I pay the first $5,000 out of pocket, I'm supposed to pay at the agreed upon Blue Cross Rate. That is, if I go to a doctor or facility on the plan. The doctor assured me the Outpatient Facility he wanted me to go to would accept the same rate.
I hate doctors, hospitals or anything related - at least when it comes to me! The operation, a short one about an hour and half - was a success. I awoke as they wheeled me out to recovery on the gurney. Needless to say, I dressed and wobbled out of the place.
Then the bill arrived. For the less than 3 hours it took, they billed $28,550! I protested. They said, oh that's retail, and took it down. I kicked, screamed and generally made a scene. Finally, the bill was $3000. That's as much as a few day stay at a resort, I said. And, besides, my plan said it would cost much less.
Fine. At least I could apply this $3000 towards my very high yearly deductible of $5000.
No dice, said the insurance company, I had gone to a facility off the plan so nothing would apply to the deductible.
No, no, no!
To shorten this up: I complained to the doc who call the facility and said, hey, what gives. They agreed to accept what my plan would pay for (if they actually paid for it).
Ended up costing me $600. Big drop from that first figure.
I understand most people don't have the drive or determination to see this through. And, granted, the system is far from perfect, but what system isn't.
If you want to see imperfection personified, let the federal government get their hands on health care.
My point is still if you give people more responsibility for their own health, it will inevitably drive costs down.
Everyone wants insurance, no one wants to pay for it.
By the way, there's no insurance against death - the final destination. People should really get over it.
I love it when people chime in from all over! (For future reference, the reason I pick on Canadians is that my family is entirely Canadian, and I like getting a rise out of them when they read my blog).
I'm glad that the point about health care not being totally "cheap" in Canada was raised - because taxes are very high there, and jobs, frankly, don't pay as well as they do here. I occasionally consider using my citizenship to move up to BC and work as a tech writer, but the pay is much lower than it is in Seattle - I don't know if I could afford to buy a home in Canada.
There are many reasons why healthcare costs so much in the US, and I don't think that irresponsible people are the main cause. I think doctors make too much money and drug companies spend too much on advertising (and pass the costs along to consumers). Are these the main problems with the system? No. Would changing them drastically reduce the cost of healthcare? I believe so.
It seems like a lot of people are reading this book. Here's a picture of Barack Obama with the book.
Can't wait to get my copy this week.
@Early Retirement Extreme:
I don't think that's it. At any rate, I don't have any problem with the level of care I get, on those rare occasions that I actually need to see a doctor. (I'm really quite healthy.) My problem is the very small risk that simple bad luck will bankrupt me.
You can buy insurance against most of other kinds of bad luck that might bankrupt you. (You can even buy insurance against a market downturn that might wipe out your portfolio, in the form of an annuity.)
I just want to be able to buy health insurance on similar terms. Right now, you can't. (Or rather, you can--unless you've ever been sick.)
There are plenty of people who have lifestyles that lead to illness, but there are plenty of other people--more than you seem to think--who fall into the bad genes/bad luck category.
@Kelja:
Have you ever tried to shop around for medical care? My wife and I have had health savings account-style insurance for awhile now--the sort with the high deductible that's supposed to encourage people to shop around for their medical care. Our experience is that it doesn't work.
For the most common stuff--getting a throat culture, perhaps, or a course of antibiotics--it's kind of possible. But for anything even slightly less ordinary, it really isn't.
There are plenty of places around here with an MRI machine, but your doctor isn't going to want you to go to another one--and not just because profits from his MRI place help pay his salary. He wants you go to to his MRI place because he knows the radiologist there and trusts him (and knows his weak spots and how to allow for them). He wants you to go to his MRI place because he knows what equipment they've got; he's seen the pictures it produces, and he knows that it's good enough for his needs. (And, if it isn't, he knows which research hospital has a better machine and will send you there.)
And that's assuming that you're basically healthy (although, if you are, it's not clear why you need an MRI). If you're sick--if you've got a brain tumor or you've had a stroke, or were in a bad accident--then how are you supposed to shop around? Going to wake up from your coma and quick hire an ambulance to take you across town to the cheap MRI place?
If you've ever actually tried to shop around for medical care, you'll have run into this again and again.
It's true that part of the reason that medical care in the US is so expensive is that most patients don't care how much something costs. But it's false that they can "shop around" for cheaper care. Even if you're paying for the care out of your own pocket, it's simply not practical, once you're beyond the sort of care that you can get at a doc-in-the-box.
@Wilson:
If you've never been seriously ill, $1000 a month will buy you great health insurance in the US. If, however, you have any sort of health problem--if you've ever had heart disease, cancer, stroke, diabetes, or a dozen other illnesses or conditions--then you simply can't buy insurance at all. (Sometimes, depending on the state you live in, you can buy insurance, but it doesn't cover anything--no coverage for heart attacks or strokes or cancer, for example.)
As long as someone's there for you when you fail, most people won't take personal responsibility.
I should clear something up. I have a HSA (health savings account) which means that I pay the 1st $5000 medical expenses out of pocket , then I pay $7000 a year for catastrophic insurance coverage for anything over that - with co-pays, naturally. I have to work extra hard to pay for that coverage, but I'm concerned about my family's health.
Canadagirl: you say, what about the families not financially advantaged? What about those who don't work hard enough to provide the coverage for their families. Or, what about those who'd rather spend their money on other things than insurance. If a person decides they want to live a 'frugal' existence, let's say they manage to live on less than $15,000 a year, I say fine. That's great. But why do I have to pay for what they won't work hard enough to pay for?
It's really basic. Some are for wealth redistribution. I'm not.
Kejla asked why she should pay someone else's medical expenses when she works hard to keep her family healthy and other people are careless.
I've often wondered the same thing. My country's government health care covers people who do stupid things -- people who drive drunk, have a poor diet, and smoke (among other things). It's a drain on our system, to be sure.
Yes, I think people need to smarten up and take accountability for their actions, but I don't think that's a good argument for getting rid of (or not having) universal health care. It's good that some people can afford several thousand dollars for their family's insurance, but what about families who aren't as financially advantaged? Are their children worth less than others?
Should a child who is ill suffer and maybe die because they can't afford care? Seems to that shouldn't happen in a developed country. It's in everyone's best interests that the members of a community and country have health care available. It's time to lose the "it's all about me and my family" attitude and see that even people who don't have money deserve care and respect.
John Krumm,
Perhaps 3% of Medicare's budget goes to administrative costs, but it wouldn't matter if it was .05%. The trend is clear, the growth of Medicare is outstriping incoming revenue.
Don't you realize, eventually entitlement programs will make up more than 100% of the budget? Simple Math.
UNSUSTAINABLE.
Well Stated, I wish more people would get it. I do think your time frame is a bit hastened but still some good advice. China is very secretive about any long term plans. But they have successfully duplicated our middle class which is/was the fuel of America.
Being totally debt free is great burden lifted from anyone's shoulders.
Cash reserves are smart no matter what the economy does.
To some it may seem like 6-12 months cash is a lot but if your debt free, it really isn't.
The outlook is not good based on the belief that people can get something for nothing, this November's outcome could hasten our peril. Back to your point, returning to the times of Romans...
There really is no reason to have private health insurance companies that make a profit. Health insurance is a relatively simple accounting function that is most efficient and fair with the largest pool of people possible (like everyone in the county) so that risk is dispersed. Medicare operates at very high efficiency, with about 3 percent of its budget going to operating costs. Private insurance spends about 15% by comparison. I'd like to see us move to a form of Medicare for all, with a Medicare card issued the day you are born.
It's a political problem, not an economic one.
I think the main problem is that health care is treated as a commodity nowadays, much like college degrees. People are so used to buying things that they expect that health (and education) can be bought too when those things actually comes down to particular behavioral problems and all they're buying is a doctor visit or a "degree". A doctor can fix a broken bone but he can't fix most problems which aside from the unlucky cases of poor genetics basically comes down to crappy lifestyle choices of poor diet, poor exercise routines, bad sleep patterns, etc.
When there is increasingly less connection between price and results, that is, between cost of benefits and actual "benefits"=health, the price can be whatever people are willing to pay. And some people are willing to pay a lot merely because they have a lot of money.
Already I notice that people are increasing their medical tourism, though. Our desire to spend money is driving up global prices, but for now foreign doctors are inexpensive.
'Not Free to be Poor' - what an incredibly stupid, even absurd, statement.
Life isn't certain and it certainly not easy. Never has been. You can live the way you want but there are CONSEQUENCES for any action! Your health and the costs associated with keeping it are your business - not mine. You want another bloated, wasteful, unaccountable governmental program destined to grow uncontrolled into the future to take care of you and your family? You want government to be your supermommy? Why should I pay for for someone else's med expense anyway? I work extra hard to pay for my family's health insurance - $7,000 yearly. In addition, I make sure we eat healthy and exercise regularly.
Right now, More than 50% of the U.S. medical expense is already borne by government and mainly through unfunded entitlement programs. These entitlement programs will - without a doubt - bankrupt the nation. This is a fact, a mathmatical certainty, that people refuse to address.
The root cause for the incredible inflation in medical expenses is the lack of personal responsibility. Most medical expense is paid by a 3rd party - either insurance or government. Because the consumer isn't looking at cost, a bureacracy is, price is not the concern it should be. What do you think would happen if people HAD to pay for their medical expenses out of pocket.
Right, prices WOULD HAVE to come down.
Yes, you can decide to live on less than (name an amount) and by doing so not have to endure the stresses of the modern rat race. By doing this you can follow your 'creative' muses - enjoy life and have more fun. Yes, but don't expect society to pay for your play!
I know - I'm p***ing into the wind. Too many expect someone else to take care of them. This is a hugh change even from 30 years ago. Nothing will stop the trend until the whole thing collapses on itself because it's not affordable.
@ Post 17 (and 20), I'd just like to point out that the National Insurance contributions you make cover not only health care but disability allowance, state pensions, bereavement and maternity allowances etc.
Also it's not linked to how much you have contributed, so if you were to become a stay at home spouse, your family's combined contribution total would drop but you be entitled to the same treatment- pretty much the point of socialised care.
"I am American and live in the UK with my British husband. My husband and I pay a combined average $1000 per month for National Insurance."
This would get you coverage in the US to, wouldn't it? (Guess universal health care is neither cheap nor efficient...another illusion crushed)
The retirement plan for the poor is to die. From this perspective the issue of health insurance is moot.
To live cheaply I would suggest retiring abroad. There are a few countries that still have a lower standard of living than US.
I'm still confused about what this post is proposing. Retiring at 40? What do you want to retire for? You couldn't have had children and couldn't travel like the typical idle elderly. I think what you want is to live comfortably without working. Can't do both without slavery.
I am pleasantly surprised at the number of places that accommodate golf carts. I hope that cities and towns will become more friendly to alternative means of transportation.
Hi Dr. Liu, thanks for visiting and adding the caveat about free drugs. I enjoyed the book!
As a young investor myself, this is very disconcerning. I am starting to save for my retirement, and I am living frugally. Unfortunately I do realize that there are unexpected expenses that arise. I say unfortunately because it depresses me to find that there are so many expenses involved with just living out your everyday life. I realize that behind the facade of credit, mortgages, and more you still have payments that will need to be repaid. This is why I try to live by the age old philosophy of "don't spend beyond your means." Even with this philosophy I find it hard to just get by let alone save for future expenses.
Anyways sorry about the rant, I it just helps me realize what kind of problems there are with our society and what to look forward to in the future.
I am American and live in the UK with my British husband. My husband and I pay a combined average $1000 per month for National Insurance. I used to resent the amount of my salary that's paid, but actually now I am quite happy with it. I've realised that it reduces one of the huge stresses of life.
We would like to move to the States one day, but given the high cost of medical coverage I'm not sure it's a viable option for us. I'm not sure we would even be able to get coverage. At least here, if there's a problem, we can get it taken care of. Granted, it usually takes a bit longer than things do in the States, but things are prioritized based on medical requirements as much as possible. We do pay for prescriptions and eye exams (you don't if you're either a child or on benefits [welfare]) but these things can be budgeted for. We also pay for the dentist (unless you're a child or on benefits or a pregnant woman) but if you go to an NHS dentist there is a very clear fee structure that is quite reasonable.
One worry I have now as a resident of the UK and NOT an EU citizen is that there is some talk in the government of reducing the medical benefits to non-citizens. Not sure what I'll do then, especially if I am still required to have the National Insurance deducted from my paychecks.
Dangerman, I am your nemesis. I have lived without medical insurance intentionally for nine years--not one penny spent on thousands of dollars of premiums for which I would have received zero benefit (and I received zero benefit during the previous 14 years that I did pay for medical insurance). I spend that money instead on ways that promote health. As a result, I have not been in a physician's office in 15 years. A side benefit to my healthy living is that I look 10 years younger--truly, I've been told this many times.
Thanks, Canadian girl! I think a lot of Americans are under the impression that universal health care would solve all of our problems. The problem is that we hear all the good things about Canada's health care system, and none of the negative aspects.
I've been lucky in that I found a decent plan through ehealthinsurance.com. I'm self-employed. It's not "cheap" ($150 per month), but it does save a bit on taxes (premiums are tax deductable) and I strongly feel everyone should have insurance.
For the healthy diabetic - have you looked into a high deductable policy? If you rarely utilize a doctor other than preventative needs, you "may" be able to find a policy that works for you. These plans stress prevention, not curing ailments, and may be a bit more forgiving if you rarly need expensive emergency treatments. I do feel your pain - diabetes runs in my family, and my worst financial nightmare would be to develop a chronic illness this early in life. Best of luck!
I actually wrote a bit just recently about dental and vision care as things that generally don't need to be insured against.
Still, your greater point is well taken. You can't just add up your expenses from last year and assume that you'll be able to get by if you can earn that much this year. You need to do some planning, so that you know you can cover your less-than-annual expenses. And you need to have a cushion against some small amount of unexpected expenses.
Sometimes, though, the unexpected expenses aren't small--they're huge. That's when you need insurance.
As I glare at all you Americas with my beady eyes and flap my head in your general direction, I can't help but think you're over-simplifying about how cheap it is to live here.
I'm very grateful that basic health care is covered, even if wait times are long and services could use a lot of improvement. However, there is also a lot that isn't covered that can get quite expensive when you're self-employed or your company doesn't have a good benefits plan.
For example, in Ontario dental care and eye care (exams are only free for those under 18 or over 65) are extra costs. Physiotherapy is no longer covered, and no one will pay a cent if you choose to see an alternative health care practitioner. Prescription medications aren't covered either until you are a senior.
Just because our health care is "free", doesn't mean we still aren't tied to our jobs -- many of us need that benefit plan.
I certainly don't hate Americans, but I don't understand why a country as wealthy as the U.S. doesn't take better care of its people.
Oh wait... I know! It wouldn't be profitable!
I would have to recommend http://www.pricealerter.co.uk as a great way to save money with Amazon. Their prices change all the time, so this site will email you when something your interested in goes down in price.
The US version is here.