Mr Money Mustache on Obamacare

[catherine]

Follow up to "So how much is insurance going up?" thread.

I know some of you read MMM. In one of his most recent posts he analyzes the impact of the ACA.

So here's the post (http://www.mrmoneymustache.com/2013/10/28/obamacare-friend-of-the-entrepreneur-and-early-retiree/), and here's a quote. He really is in favor of it, for many of the reasons I believe to be in all of our best interests--particularly, reducing the reliance on our employers to give us health benefits.


With this new law, you can now drop the decades-old tradition of great fear and dependence on your employer for health coverage. You can quit your job, switch to another one, or create your own, with no more worry about who will cover you, because cost is affordable and minimal at lower incomes.

Also, he suggests in the latest post (http://www.mrmoneymustache.com/2013/11/04/reader-case-study-should-this-man-claim-his-freedom/) (which is also a great read by the way, that if you make enough, you really don't have to get bells-and-whistles health insurance. This post is interesting because the the guy in this case study is 52, he wants to retire next year, but his wife is terrified about her financial security--and their net worth is 4.25M!!!!!! Wow, Dave Ramsey talks about women having a strong security gland, and this woman's security gland is hyperactive!!!! She needs a biopsy!

Part of the guy's expenses is in various health insurances--life, disability and critical care. For those he spends $675. I'm assuming his basic health insurance comes through his employer. MMM tells him to just cut his health insurance expenses 100%, because he can easily self-fund any issues that may arise.

Anyway, both good reads. Let me know what you think

[Florence]

Love MMM!!

[lac]

Love MMM!!
What she said!

This guy is awesome. Love his practical view of life.

[ToomuchStuff]

Part of the guy's expenses is in various health insurances--life, disability and critical care. For those he spends $675. I'm assuming his basic health insurance comes through his employer. MMM tells him to just cut his health insurance expenses 100%, because he can easily self-fund any issues that may arise.


The way it read to me, the poster is in Canada (national health care). I am not up on their system, know very, very little about it (between a few conversations and a relative that moved up there, for it decades ago). I don't know what is required (can't get out of, aka maybe disability), but the critical care insurance, I believe is a supplement insurance, to move you ahead (pay extra) to not wait in line for procedures. (private paying, rather then government) He didn't state health, but did state life (misquote on your part) and since you mentioned DR, that could be the same reason that DR uses "Sharon wants it".

[ApatheticNoMore]

In the U.S. if I was rich, I'd still get health insurance just because medical charges are completely outrageous, but Canada is another world. Disability and life he can self-fund and the other probably is some Canada thing. I wouldn't work nor worry if I had some 4 million, but I'm never going to have 4 million (short of winning the lottery and that would require me to actually play it). I don't appreciate DR's comment about women, but I am fairly security minded (but yea not if I had that kind of money), It's a viscous world with little mercy, and if I don't take care of my financial security who will?

It's a bit hard to believe the route to people being less dependent on jobs runs though continuing to empower vastly costly rentiers (hosptials, pharma, and actually insurance is probably less guilty than those two) as anything that increases the costs of living makes people more dependent on jobs just for the pay itself. And healthcare costs haven't stopped increasing. Though I guess it depends on who eats those costs, government or individuals? As it is as an individual you can only get subsidies if you fall in a very narrow sweet spot (above Medicaid, below the subsidy cut off).

[catherine]

He didn't state health, but did state life (misquote on your part)

Yes, you're right.. he did, but he also said to cancel disability and critical care insurance for the same reason--he could self-fund those also.

I do think women tend to focus, or worry, more about financial security than men, and that's probably anthropological in some sense. But how much worry is reasonable? If my DH hated his job and we had over 4M, there is NO WAY in hell I would continue to be his job-warden. I hope that MMM convinces her to let him out of the cage.

And as far as MMM point on the Obamacare article, his income is actually pretty low, and his point is, if you play your cards right, you can be free from an employers grip and have low subsidized insurance through ACA act. Yes, that is a situation for the vast minority, but it's possible.

I agree that the cost of insurance and healthcare today is nothing short of extortion. Nothing short of it. I keep hoping that Obamacare will fulfill the part of the promise that grants affordable access to those who need it. However, yes, there's a part of me that feels that in order for the lower classes/young to have MORE choice, some people in the middle class have less. The idea that breaking the connection between employer/access to affordable healthcare is theoretical from what I can see right now. It's there, but in practical terms, I'm not seeing it. I did get through the healthcare.gov site, and there is NO better alternative for me than my current policy. However, for me, by the time Obamacare gets sorted out, I'll be eligible for Medicare and will be able to dump my $1400/month policy.

Again, this all gets back to my other thread about taking a path that so vastly departs from what's natural. Why have we gotten to the point where the cost of living includes high cost health insurance policies?? My permaculture teacher scoffed at health insurance. He says his "insurance" is living stress free, eating right, and exercising by planting and building outdoors. Peace Pilgrim was never sick. I know, I know, we can't all do that. But this excessive reliance on health insurance (and the need to get a job JUST to get it) just seems wrong, and it points to a much more serious flaw in our culture.

[SteveinMN]

But this excessive reliance on health insurance (and the need to get a job JUST to get it) just seems wrong, and it points to a much more serious flaw in our culture.
We rely heavily on health insurance because health care is so expensive. Health care is expensive, in part, because most of us don't believe we should regulate the profits of the companies which provide it. People are living longer and more common causes of death are being reduced while chronic diseases remain or even increase in incidence. Some of the cost of health care comes in treating illnesses which result from our more sedentary lives and a lifestyles fueled by cheap shortcuts like HFCS and coal mining -- someone else pays for the eventual cleanup. Tort law contributes, too, adding costs to health care in the price of insuring against malpractice and in legal and punitive damages.

Perhaps at the root, though, most people can't put a realistic price on good health and freedom from pain -- or, for that matter, life itself. The moral criteria we use when addressing the health and welfare of our pets and farm animals and the criteria we use for humans are quite different. Is one set of criteria better? I would suggest that we, as a society, have not yet addressed this. We are (largely) unwilling to deny very expensive (and often redundant/CYA) health care to anyone regardless of the life that person will have after treatment. We still argue about "death with dignity".

Health care is expensive because we haven't spent much time addressing the root causes.

[gimmethesimplelife]

Yes, you're right.. he did, but he also said to cancel disability and critical care insurance for the same reason--he could self-fund those also.

I do think women tend to focus, or worry, more about financial security than men, and that's probably anthropological in some sense. But how much worry is reasonable? If my DH hated his job and we had over 4M, there is NO WAY in hell I would continue to be his job-warden. I hope that MMM convinces her to let him out of the cage.

And as far as MMM point on the Obamacare article, his income is actually pretty low, and his point is, if you play your cards right, you can be free from an employers grip and have low subsidized insurance through ACA act. Yes, that is a situation for the vast minority, but it's possible.

I agree that the cost of insurance and healthcare today is nothing short of extortion. Nothing short of it. I keep hoping that Obamacare will fulfill the part of the promise that grants affordable access to those who need it. However, yes, there's a part of me that feels that in order for the lower classes/young to have MORE choice, some people in the middle class have less. The idea that breaking the connection between employer/access to affordable healthcare is theoretical from what I can see right now. It's there, but in practical terms, I'm not seeing it. I did get through the healthcare.gov site, and there is NO better alternative for me than my current policy. However, for me, by the time Obamacare gets sorted out, I'll be eligible for Medicare and will be able to dump my $1400/month policy.

Again, this all gets back to my other thread about taking a path that so vastly departs from what's natural. Why have we gotten to the point where the cost of living includes high cost health insurance policies?? My permaculture teacher scoffed at health insurance. He says his "insurance" is living stress free, eating right, and exercising by planting and building outdoors. Peace Pilgrim was never sick. I know, I know, we can't all do that. But this excessive reliance on health insurance (and the need to get a job JUST to get it) just seems wrong, and it points to a much more serious flaw in our culture.+1000 I agree with all of your points. You have stated all of this much better than I ever could. One very beautiful thing about ObamaCare is that it works on cutting the link between employment and health care - why the two have been connected in the first place baffles me. What people must endure to work for someone else to keep their health insurance strikes me as a form of modern day slavery, and I find it bizarre that people criticize the former Soviet Union for it's lack of freedoms when many lack the freedom to leave an employer due to having some kind of chronic condition and the terror of not being covered by health insurance and losing everything they have worked for. That America does not have singler payer insurance is IMHO unexcusable. Period. Rob

[ApatheticNoMore]

I do think women tend to focus, or worry, more about financial security than men, and that's probably anthropological in some sense. But how much worry is reasonable? If my DH hated his job and we had over 4M, there is NO WAY in hell I would continue to be his job-warden.

how much is talking about people who have 4M reasonable in understanding most people's finances, when they should worry or not, need for financial security or not etc.? Or do we want to generalize from 4M to 400k (still a lot) to 40k to 4k (I suppose that's a lot of money for some - if you have 4k in savings, quit your job today!)


I agree that the cost of insurance and healthcare today is nothing short of extortion. Nothing short of it.

sure seems so


However, yes, there's a part of me that feels that in order for the lower classes/young to have MORE choice, some people in the middle class have less.

that pretty much does seem whose hide it was taken out of. People in lower cases get slightly better access (it's not *good* access, not with plans that won't cover out of network, you can still go medically bankrupt for hospitalization etc., but it's better than no access). And the middle class seems insurance companies and employers dropping existing plans and rates increasing. Whose hide it was *not* taking out of the profiteers. The bill to allow the reimportation of pharmaceuticals went nowhere. Now yes the middle class will have to have less so the poor can have more and oh yea so pharmaceutical companies making profits hand over fist aka the superrich can have more (but you working people fight among yourself ok? that's the kind of class war we don't mind ....). Whether it's a net benefit to the young, it depends on whether they even sign up for insurance! Remains to be seen. Many might figure their odds of getting sick are low (likely true), and insurance still quite costly with high deductibles etc. and will gamble it. Depends on how much they need security I guess :~) If they are all risk takers forget it.


The idea that breaking the connection between employer/access to affordable healthcare is theoretical from what I can see right now. It's there, but in practical terms, I'm not seeing it.

Well what is the data from MA on this? They've had it for years. Of course there's a major confounding factor of a recession in there, when people can't get jobs they do tend to try more to start businesses.


I did get through the healthcare.gov site, and there is NO better alternative for me than my current policy. However, for me, by the time Obamacare gets sorted out, I'll be eligible for Medicare and will be able to dump my $1400/month policy.

lucky you. I've got awhile.


Again, this all gets back to my other thread about taking a path that so vastly departs from what's natural. Why have we gotten to the point where the cost of living includes high cost health insurance policies??

Rental extraction I guess. Although I might ask why other costs of living are so high as well (though not petroleum and other energy sources or even water, considering what that does, and the environmental costs, I think those are likely under priced) - but all the rental extraction stuff where there shouldn't be that much natural scarcity. So way back in the day wasn't it, classical economists like Ricardo thought the entire of a workers surplus (beyond you know feeding themselves) would go to rent. Of course that hasn't entirely manifested, but an aweful lot is going to a form of rent known as health insurance (housing proper isn't cheap either of course, not to mention other rental extraction schemes). It is taking much of the surplus.


My permaculture teacher scoffed at health insurance. He says his "insurance" is living stress free, eating right, and exercising by planting and building outdoors. Peace Pilgrim was never sick. I know, I know, we can't all do that. But this excessive reliance on health insurance (and the need to get a job JUST to get it) just seems wrong, and it points to a much more serious flaw in our culture.

People aren't very healthy true. But just living a perfectly healthy lifestyle assuming you will never get sick is a bit much. It's not like I USE my health insurance really, nope still too young, nope not on pharma garbage, etc.. It's there as insurance, in part to prevent medical bankruptcy, to insure against the worst case scenario yea. I do often suspect that with the U.S. medical system your permaculture's teachers plan is the only REAL health coverage anyone will have to soon (what with narrow networks with few hospitals or doctors in them, etc.). So the U.S. healthcare system does make it important to have that kind of insurance (eat healthy, exercise etc.) :~)

I think at this point pharma is MAKING people sick. Now it's not all bad of course, sometimes it's necessary, people who really need meds should be able to get them, even I take antibiotics when prescribed etc., blah blah. But the most profitable drugs ever are statins! Statins CAUSE diabetes! This should be a post of it's own. I'm absolutely convinced some of the increase in diabetes is due to statins! It's causing a major disease that will shorten the lifespan of everyone who gets it and cause all sorts of complications. Statins mess up blood sugar regulation (sure an overly sugery carby bad diet, overeating, being overweight, not getting any exercise, maybe genetic susceptibility etc. can also cause diabetes even with no statins), but statins by themselves push people into a diabetic state! Even the FDA recognizes that now.

[catherine]

Rob, I agree about single payer insurance. We can get there, but it's going to take a LONG time.

ANM, just want to say that it's always fun to discuss with you.

Re the confounding aspect of pharmaceuticals in healthcare.. I have such a love/hate relationship with Pharma. Obviously I'm grateful because they pay my bills, and I do see many, many cases where people have benefited from all the R&D Pharma has done. Look at oncology--there has been so much progress in making cancer survivable. Look at HIV--it has stabilized thanks to antiretrovirals. I speak to PCPs and they say they hardly ever get called to the ER at night with patients' heart attacks thanks to antihypertensives and other drugs.

At the same time, I see how the marketing of drugs is a factor, probably a major one, in the rise in healthcare costs, and in people's belief they need drugs that they may not need.

It's complicated...

[Rogar]

I hope it all has a happy ending. I am glad people like MMM have more freedom in his lifestyle, but it isn't exactly a free ride. The subsidy that lowers his insurance costs come from a variety of places that include tax increases and money from middle class people who had individual policies and now have to pay for coverage they will never use. For example a single male who previously had an individual policy specific for his status will now have to be in a pool that requires maternity coverage and pediatric dental care. Unless he qualifies for a subsidy, his rates will go up. I am not going to judge if this is right or wrong, but MMM's subsidies do not just magically appear.

I don't necessarily consider insurance and healthcare costs extortion. It is an inefficient system that has higher administrative costs than most other countries. My impression as I've tried to keep up with the issues is that no one is exactly soaking the public, but there are too many levels of bureaucracy, and opportunities for law suits. My personal physician claims that for every dollar he bills, he and his office staff only receive about nineteen cents. The rest goes for overhead and administrative fees. I think that even if the ACA is hugely successful, the rising costs for healthcare and healthcare for our aging population are going to be a major drain on our economy and possibly personal welfare. We already spend something like 18% of our GDP on health costs. That seems huge to me. Imagine a future economy based on healthcare as it's primary product?

The ACA has good intentions and will benefit a lot of people, but throwing money at insurance without fixing the system seems like putting the cart before the horse.

I thought this was a good article on healthcare costs.
http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-compares-with-other-countries.html

[Lainey]

We rely heavily on health insurance because health care is so expensive. . .
Health care is expensive because we haven't spent much time addressing the root causes.

Amen. Plus we haven't mentioned the sad fact of so many of those WITH INSURANCE having to declare bankruptcy due to uninsured medical bills. An event unknown in other first world countries.
A while back our local newspaper had a front page story on a retired man who spent his live savings on his wife's Alzheimer's care. His house was under foreclosure, and he was wondering where he was going to live. And even worse, the story is so commonplace that it barely got any response.

[gimmethesimplelife]

Amen. Plus we haven't mentioned the sad fact of so many of those WITH INSURANCE having to declare bankruptcy due to uninsured medical bills. An event unknown in other first world countries.
A while back our local newspaper had a front page story on a retired man who spent his live savings on his wife's Alzheimer's care. His house was under foreclosure, and he was wondering where he was going to live. And even worse, the story is so commonplace that it barely got any response.This is a big reason I'm so glad I live in Arizona and one reason I probably won't be leaving it. If I had any long term deteriorating condition, I personally would seriously consider taking up residence somewhere south of the border to flee US health care costs - to stay under the conditions of outrageous costs would not be showing myself love and respect for myself. So I'd be running south probably as fast as many draft dodgers ran North during the Vietnam war - which was a totally different situation, I bring up that war only to illustrate how fast I'd run.

I understand under ObamaCare and once I make enough to be ineligible for Medicaid there would be an annual cap on what I would be accountable for - but I would read the fine print big time to see if there were any cracks. I'd have no problems taking up residence somewhere like Mexicali if there were and if I had a long term costly condition that would run into megadollars. Case in point - last September I went to Mexicali for a series of ultrasounds - cost $58.50 US and from the hospital entrance I was maybe 1/8 mile from the US border. I understand in Phoenix without insurance this would have priced out at $900 or so.....Makes me think we should all learn some Spanish as insurance against US health care - instead of criticizing the spread of the Spanish language in the US. Knowing Spanish can really cut down on outrageous US costs if nothing else. Rob

[Spartana]

Follow up to "So how much is insurance going up?" thread.

I know some of you read MMM. In one of his most recent posts he analyzes the impact of the ACA.

So here's the post (http://www.mrmoneymustache.com/2013/10/28/obamacare-friend-of-the-entrepreneur-and-early-retiree/), and here's a quote. He really is in favor of it, for many of the reasons I believe to be in all of our best interests--particularly, reducing the reliance on our employers to give us health benefits.



Also, he suggests in the latest post (http://www.mrmoneymustache.com/2013/11/04/reader-case-study-should-this-man-claim-his-freedom/) (which is also a great read by the way, that if you make enough, you really don't have to get bells-and-whistles health insurance. This post is interesting because the the guy in this case study is 52, he wants to retire next year, but his wife is terrified about her financial security--and their net worth is 4.25M!!!!!! Wow, Dave Ramsey talks about women having a strong security gland, and this woman's security gland is hyperactive!!!! She needs a biopsy!

Part of the guy's expenses is in various health insurances--life, disability and critical care. For those he spends $675. I'm assuming his basic health insurance comes through his employer. MMM tells him to just cut his health insurance expenses 100%, because he can easily self-fund any issues that may arise.

Anyway, both good reads. Let me know what you think

Also in various threads on his forum there has been a lot of discussion about the ACA. Some go back fairly far - I only looked back as far as Sept just before the ACA sign ups could start. So there is a lot of info and personal experience trying to sign up, etc... from some of the members.