I can tell you with a great deal of certainty that cats are not great workout partners. I put mine on a leash. They go outside. They then go sit in the bushes under the very same window they look out of in the apartment. LOL Now as a cuddle bug... cats do that well.
Waiting until 70 to get your SS. I did that too for the same reason - have more when I am older and less able to find other ways to earn money/I might need more due to health reasons (well I already have health reasons but figuring age + heath reasons means I'd be even more likely to need the money more when I am older). I don't look at it from the point of view of "getting back what I paid in" though. I look at it from the point of view that it is buying life long income regardless of how long I live (or don't live). As I wanted the highest possible amount, the "price" was that I had to wait. I see it as sort of like buying insurance (not a perfect analogy though since here you want to use SS for as long as possible and you don't want ot have to use your insurance - see my next paragraph). You buy it, pay the premiums, and then hope you never need to use it and are a profit center for the insurance company. BUT you have it if you need it. The sort of analogy part is not wanting to use your insurance to the point that you'd break even with premiums or come out ahead as that would mean bad things happened. That, in my opinion, isn't what you want to have happen with insurance when you decide to buy it. You buy it as a hedge against a need in future. With delaying SS that is buying a hedge against your need in the future as well. Taking it so you will break even sooner doesn't buy you that hedge. Of course if you were rich enough you wouldn't need that hedge but that is a different "story".
With respect to your first comment - not looking at your investment portfolio too often because you might make rash moves/poor decisions. When we see losses we are then far more likely to be loss framed. When you are loss framed you are far more willing to make risky choices to "gain that loss back". That is the psychological explanation for that.
I agree with you. But, in a similar vein, some do have to pay taxes on money they "don't have" that isn't "real money" in the sense they can spend it. When student loans are written off they get a 1099-C (except disabled vets whose disability was documented at the VA whether or not it was service related). Because stopping capitalization of interest is only very recent, many of those people have had (or will have) written off far more than they originally borrowed and many have paid back far more than they originally borrowed as well but still owe a small fortune. Personal example: Got cancer in grad school where I went back to school later in life (since gotten two more cancer and those were in the same year while working). Student health insurance had no out of pocket limit (this was pre ACA, and I didn't qualify for medicaid because I was a student - I continued school while being treated). Borrowed a total of 92K mostly for medical expenses and some school expenses over four years, it's been 18 years since the loan went into repayment (loan is a 25 year one because it is a grad school one, I didn't make enough to pay it back in 10 or pay more than I owed each month on the income dependent 25 year terms) have paid back 102K (and that includes some periods with forbearances). Still owe nearly 99K. Was declared permanently disabled 11/2023. With the 3 year monitoring period for discharge of student loans for me ending after the pause on getting a 1099-C ends I will be getting a 1099-C. I will owe about $31K in federal and state taxes (unless I move to avoid state taxes as most states don't tax this). That is more than I get a year in SS. Because I understand statistics I realize my problems won't be solved by putting a match to my money buying lottery tickets. For reasons I won't go into here insolvency on taxes won't work if I want to have anything beyond SS in retirement (and SS will be lower because of 11 years of employment consequences). So outside of someone willing to be very generous with no strings attached I will be screwed paying taxes on money I didn't get "paid" when my student loans were discharged. Good thing house value (which I don't have) and money in retirement, etc. isn't taxed until you actually receive money from it so you can actually cover the taxes. The only thing that will save me from that tax bomb is if I die of the 3rd cancer before that tax is due. Fortunately (for every reason but the tax one) that isn't likely as I am currently on "watch and wait" (this is a blood cancer) and it is a more indolent cancer even though it is incurable - although I am beyond the median split for living with this so who knows what will happen.
I think one issue that gets over looked is demography. The boomers are a big population bubble and we tend to "break" things in every stage of life we move though due to no fault of our own, often coupled with the baby bust generation after us, etc. Over half of the stock market is "owned" by funds in retirement accounts. The required minimum distributions will force withdrawals. There are not enough younger people, accounting for their stage in life and how much people contribute to retirement accounts in each stage to make up for the required withdrawals. This is going to mean that eventually the stock market will drop (supply and demand), followed in threeish years by the bond market. While some folks say 3rd world investors will make up the difference, so far, last I saw not one third world country on the list of the top 20 countries with investors in our stock market. A related issue, that is going to increase, for some, spending retirement money rather than reinvest is is that when people sell their McMansions they are not going to get what they expect (except in a few housing areas). That is due to fewer people in the demographic groups who buy big houses (again supply and demand - the price of ranch and master on the first floor prices have been driven up faster than than any other "kind" of house - as both retirees and new home buyers are competing for the same homes). Not only that but the life span of many of the materials used to build those houses is about 50 years and so their repair needs will be higher. As a result those retirees will not get what they expected and will be more dependent upon what they take out of the market or their retirement accounts. That will also help drive the stock market down. I rarely see discussions about the future include those variables/issues.
I'd like to echo to please tell someone what your wishes are! Near the end you may not be in a position to do so or may have family members who can't/won't fulfil them due to their own emotional pain. Here are 2 situations that happened in my family. Neither had anything in writing 1) My father had been part of the Hemlock Society for years (polio and then post polio syndrome where you lose all the function you gain back). He sat us down to talk about it about 2 years before he died (we, as young adult kids, did not want to hear about that as it was emotionally really hard - he died 28 years ago). But when he was bed bound with respirator assisted breathing, in a nursing home and with 2 major infections (one was pneumonia) that were antibiotic resistant and he'd eventually die from he finally was ready to die. I finally, as I saw him deteriorate, asked him if he was ready to die (he had trouble talking and mostly had to write out what he wanted) and he said yes. He chose to died 8 days later. Had he not let us know what his wishes were, even though we didn't want die and this caused us a lot of emotional pain, he would have suffered who knows how much longer as he was not going to get any better and only get worse. We were already grieving in advance, nothing stops the grief regardless of how you die, but it helps to know that you had the kind of death you wanted and aren't suffering anymore even as we are in pain over your death - pain we'd have whenever you died. 2) One of my aunts (dad's sister) had ovarian cancer that came back and spread. She talked with me about her last wishes when I saw her 5 months before she died (she said she talked to me because of dad's means of death and because I've had 3 cancers, 1 with no cure a longer life span so I'd understand without getting upset - regardless I found it upsetting but didn't let her know) but told me not to tell her kids (she didn't want to upset them - umm they are already upset). I told her she needed to tell her doctor as well as her kids because if no one knew but me her wishes may well not be followed. It turns out she didn't tell anyone. When I got the call from my cousin that my aunt was dying (she stopped treatment) I asked if she was at home and was told no. I told her what my aunt had told me (she was no longer really able to tell he wishes at this point). Her daughter was really upset her mom hadn't told her her wishes and I tried to help her understand why she didn't. She was brought home about 8 hours later and died 2.5 days later. Don't upset your family by only telling someone else who, when they let you know your wishes, then your family is additionally upset you didn't let them know (of course there are reasons why you might not tell a young child in advance, etc. but I am speaking here in general). My aunt and dad took two different approaches and one almost didn't have the outcome she wanted. It's a good thing dad had told all of us as when I asked he was relieved as he didn't want to have mom ask because of the pain he felt it would cause her and didn't want to upset us by asking himself or asking one of us to ask... so he was relieved I asked him if he was ready to die and then contacted the doctor to let him know so the two of them could "talk".. As a result realize that even if someone knows your wishes you may well still need to take the initiative if one of your love ones will not/can not act if you have nothing in writing (neither my dad nor his sister did). You will not upset us - we are already upset. When we know your wishes in advance it is less of a shock when you stop treatment, pull breathing tubes, whatever and we have had some time to grieve in advance and prepare ourselves (although nothing will stop the grief when you actually die). When you are at this point we are not taken by surprise you are going to stop treatment, commit assisted suicide, whatever. We are sort of prepared. As much as we don't want you to die we don't want you to live like this either. As much as we are in emotional pain about your impending death we know what your wishes are and can act (or someone can act if you put this in writing) if you can't.
A useful reminder - get rid of junk so someone else doesn't have to... Had that reminder when my mom moved from a house to an apartment and again from there to assisted living and now in a nursing home... I started and then stalled out. Need to get started on that again. Long covid doesn't help that...ironically caught covid Dec 2023 at a major cancer center while I was there despite wearing a mask and being vaccinated - I too have a cancer with no cure, although mine, my 3rd cancer, is a blood cancer so typically has a longer lifespan even though it is incurable... Be aware that MD Anderson Cancer Center found, following people prospectively that about 60% of cancer patients who caught covid get long covid whether or not they are in active treatment. Of course cancer diagnoses (and other major, serious, won't go away health issues) throw a wrench in our lives in so many ways - financial, physical, emotional, and that of our families. It's never easy and some of us have more work to do than others to pull the aspects of our lives together that you talk about. Like anything else it is easier to do things a little at a time rather than all at once when we have to. Most of us only realize that when we hit the "when we have to" stage of life. For me I have found that a cancer diagnosis is an emotional earthquake with plenty of aftershocks. And I found there is a qualitative difference between a cancer with a potential cure (my first two) and one that currently doesn't have one (my 3rd). In some respects it is like grief - initially intense emotions most of the time. I remember being at work (I was diagnosed with my 3rd day one of a new job, got the call in the middle of the day at work) and the one day early on I suddenly realized I hadn't thought about cancer for nearly 4 hours I was so involved in what I was doing. And like grief, you eventually mostly get a grip and just like when grieving the emotions, over time when they hit, are nearly as intense, but last shorter periods of time and are further and further apart. Of course out of the blue you can be unexpectedly triggered, and like grief it can be months or even years later. It's the uncertainty about time left that I struggle with. I procrastinate and then sometimes feel guilty as I know if I don't get some things done it will make things harder for others. As my finances were wrecked (I live in a state with no medicaid expansion) by having to pay full price for health care once I lost my job over chemo side effects, the tension of doing things I had always planned on doing that cost money, vs worrying I won't have enough to live until I die (social security doesn't even begin to meet basic needs but I make just a smidge too much to be dual eligible for to add medicaid to medicare) so I don't do the things I had always planned on. That has meant finding other, free things to do that bring pleasure into my life. Those of you reading his journey through a terminal illness and have waded through my zillion words I just wrote, think about balancing, in a rational way, saving for your unknown future and doing things you love now that cost money. Later it may be too late. None of us can plan when or how we actually will die until we are caught in the middle of that last part of our lives. For some of us we will be dumped on that path suddenly and earlier than planned/expected. But we can plan and do things now that enrich our lives and do it is a way that still allows us to plan for the future. We can also make that last part of our journey easier if we do at least some of the things he suggests above in his article before we are forced to.
Enriching investors - and that is part of the problem of for profit health care. Instead of only paying salaries and patient expenses, they have to pay the investors with some of the money they get from premiums (or with medicare, the government). That leaves less for patient care and drives up costs. It is even worse when venture capital buys health care. They make their money when they sell at a profit (they don't buy to hold). So they cut costs, trim out fat, sell at a higher rate and then the company that buys what they sold has more debt that has to be serviced (so the new owner company has higher costs too to pay down the debt and some health care money has to go for that).
You need to compare apples t apples and a true comparison would include adding in all the deductibles and maximum out of pocket for everything, I have original medicare, G and D. On G my 2025 deductible is $185 - Just B's deductible/out of pocket (and because I have G that is also my maximum out of pocket). For me premiums (B, G, D) plus B's deductible is $5182 a year or (averaging the out of pocket over 12 months and rounding up) $432/mo. You can now, in 2025 ignore the out of pocket for D in the calculations as D is run exactly the same between for advantage plans as D (It's $2000). Advantage plans also require one to pay B premiums as they are required to have B so if you remove that then I pay $2688 (or 224/mo) - way less than the max on any advantage plan available in this state. D is more complicated in how things work as drugs have tiers and the price in some tiers for some drugs is $0, and tiers between D's vary along with their prices (in most 2025 plans now there is a % of the drug cost for your copay in each higher tier and not a flat fee anymore), as does with medicare advantage (same rules now apply to both which didn't used to be the case). What is now the same now in D is the out of pocket is identical. It is prudent to check your drug prices each year and switch D or switch your advantage plan (you can switch those without passing medical underwriting, unlike with original medicare switching medigap plans) based on projected drug costs (and the big unknown is what will you be prescribed later in the year that you don't know about yet). Of course if you switch your advantage plan usually that means switching who is in network which may or may not be practical. In my case my work premiums were lower, but if I used the entire work out of pocket I'd be roughly where I am now with original medicare and G costs. A good chunk of my income, but I am grateful to have it as like the author, I have cancer. Mine has no cure but a longer life span (indolent non-hodgkin's lymphoma) so I fail medical underwriting so good thing I chose original medicare to begin with as my total costs each year are thousands less than with an advantage plan and I can go to MD Anderson Cancer Center, the number one cancer center in the USA. Most advantage plans are not accepted by them. Unlike advantage plans, with original medicare I can go anywhere in the country that accepts medicare.
What blows my mind is how so many insurance agents view Medicare Advantage plans vs Original Medicare + Medigap + D (OM) have the same misunderstanding. They view what people should get based on their current medical costs. The auto/health insurance comparison I see is you haven't had an accident yet so you buy, with your brand new expensive car, only the state minimum liability insurance. Oops you have an accident that you are at fault or are hit by someone without enough insurance to cover your costs and it costs you an arm and a leg. So then you decide to get better insurance. Oops again. now it costs you a fortune because of the accident. Between the two you are out a lot of money that could have been saved had you bought good insurance to begin with. But people don't think ot it like that. With car insurance insurance you pay for good insurance hoping you will never use it and hope yourare a profit center for the insurance company... BUT if you ever need to use it you are glad you have good insurance because it is there and that is what you need when you need to use it. But many people don't seem to view health insurance or original medicare vs medicare advantage plans in that same light. They see zero premiums, they aren't sick, they ignore the frequently $5000 to 14,000 maximum out of pocket, the limited network issues (try going to MD Anderson Cancer Center or the Mayo with an advantage plan - good luck with that) and frequent denials those don't affect them. Yet. And then they do they often can't pass medical underwriting to get a medigap plan (G only has the medicare deductible, which is less than $300. the cost of D - both pay B) where the combined premiums and other costs (including the limited dental, vision and hearing that MA's include - although some medigaps have that included too) on OM are far, far less when you actually use your insurance to the extent you use it if you have an expensive illness or expensive chronic condition. What I read on one agent forum where they justify the MA choice over OM is that the people are healthy when they sign up and don't need OM because the high maximum out of pocket on MA (often $5000-14,000) isn't being paid by them and they save a lot of money with zero to low premiums. Okay so what happens when they then get sick with an expensive condition and actually need to use their insurance? Oops. Their cost is then way more than OM, G and D combined. AND they have major network limits and more denials. So then when they want to change to OM as that will now be cheaper now that they are actually using their insurance they find they can't as they fail medical underwriting. As a result they are stuck paying a lot more for life. Of course the kicker is that independent agents get paid typically double to sign someone up for MA plans and the renewal is also typically double vs medigap and D (some D's aren't even paying a commission). They earn their entire income from commissions so we have the folly of rewarding for A (paying them a lot more for one of the choices, in this case MA plans) while expecting B (giving unbiased help to help people choose the plan best for them). And we wonder why MA plans are growing in popularity. At 65 to 70, when most people sign up, typically they are far healthier than at 75, 80 or 90 or beyond. If people viewed the MA vs OM choice like car insurance likely many would make a different choice. Side note - I am ignoring those who qualify for medicare and medicaid (called dual eligible) as health care is free or close to it for those people regardless of their choices. I am also ignoring who qualify for medicare premium assistance (and some for drug assistance) as well as the care/costs they have with their choices isn't the same as those who are enough over the poverty line they don't qualify for help.
Comments:
I can tell you with a great deal of certainty that cats are not great workout partners. I put mine on a leash. They go outside. They then go sit in the bushes under the very same window they look out of in the apartment. LOL Now as a cuddle bug... cats do that well.
Post: What I Watch
Link to comment from January 18, 2025
Waiting until 70 to get your SS. I did that too for the same reason - have more when I am older and less able to find other ways to earn money/I might need more due to health reasons (well I already have health reasons but figuring age + heath reasons means I'd be even more likely to need the money more when I am older). I don't look at it from the point of view of "getting back what I paid in" though. I look at it from the point of view that it is buying life long income regardless of how long I live (or don't live). As I wanted the highest possible amount, the "price" was that I had to wait. I see it as sort of like buying insurance (not a perfect analogy though since here you want to use SS for as long as possible and you don't want ot have to use your insurance - see my next paragraph). You buy it, pay the premiums, and then hope you never need to use it and are a profit center for the insurance company. BUT you have it if you need it. The sort of analogy part is not wanting to use your insurance to the point that you'd break even with premiums or come out ahead as that would mean bad things happened. That, in my opinion, isn't what you want to have happen with insurance when you decide to buy it. You buy it as a hedge against a need in future. With delaying SS that is buying a hedge against your need in the future as well. Taking it so you will break even sooner doesn't buy you that hedge. Of course if you were rich enough you wouldn't need that hedge but that is a different "story".
Post: What I Watch
Link to comment from January 18, 2025
With respect to your first comment - not looking at your investment portfolio too often because you might make rash moves/poor decisions. When we see losses we are then far more likely to be loss framed. When you are loss framed you are far more willing to make risky choices to "gain that loss back". That is the psychological explanation for that.
Post: What I Watch
Link to comment from January 18, 2025
I agree with you. But, in a similar vein, some do have to pay taxes on money they "don't have" that isn't "real money" in the sense they can spend it. When student loans are written off they get a 1099-C (except disabled vets whose disability was documented at the VA whether or not it was service related). Because stopping capitalization of interest is only very recent, many of those people have had (or will have) written off far more than they originally borrowed and many have paid back far more than they originally borrowed as well but still owe a small fortune. Personal example: Got cancer in grad school where I went back to school later in life (since gotten two more cancer and those were in the same year while working). Student health insurance had no out of pocket limit (this was pre ACA, and I didn't qualify for medicaid because I was a student - I continued school while being treated). Borrowed a total of 92K mostly for medical expenses and some school expenses over four years, it's been 18 years since the loan went into repayment (loan is a 25 year one because it is a grad school one, I didn't make enough to pay it back in 10 or pay more than I owed each month on the income dependent 25 year terms) have paid back 102K (and that includes some periods with forbearances). Still owe nearly 99K. Was declared permanently disabled 11/2023. With the 3 year monitoring period for discharge of student loans for me ending after the pause on getting a 1099-C ends I will be getting a 1099-C. I will owe about $31K in federal and state taxes (unless I move to avoid state taxes as most states don't tax this). That is more than I get a year in SS. Because I understand statistics I realize my problems won't be solved by putting a match to my money buying lottery tickets. For reasons I won't go into here insolvency on taxes won't work if I want to have anything beyond SS in retirement (and SS will be lower because of 11 years of employment consequences). So outside of someone willing to be very generous with no strings attached I will be screwed paying taxes on money I didn't get "paid" when my student loans were discharged. Good thing house value (which I don't have) and money in retirement, etc. isn't taxed until you actually receive money from it so you can actually cover the taxes. The only thing that will save me from that tax bomb is if I die of the 3rd cancer before that tax is due. Fortunately (for every reason but the tax one) that isn't likely as I am currently on "watch and wait" (this is a blood cancer) and it is a more indolent cancer even though it is incurable - although I am beyond the median split for living with this so who knows what will happen.
Post: Money Grows Up
Link to comment from January 18, 2025
I think one issue that gets over looked is demography. The boomers are a big population bubble and we tend to "break" things in every stage of life we move though due to no fault of our own, often coupled with the baby bust generation after us, etc. Over half of the stock market is "owned" by funds in retirement accounts. The required minimum distributions will force withdrawals. There are not enough younger people, accounting for their stage in life and how much people contribute to retirement accounts in each stage to make up for the required withdrawals. This is going to mean that eventually the stock market will drop (supply and demand), followed in threeish years by the bond market. While some folks say 3rd world investors will make up the difference, so far, last I saw not one third world country on the list of the top 20 countries with investors in our stock market. A related issue, that is going to increase, for some, spending retirement money rather than reinvest is is that when people sell their McMansions they are not going to get what they expect (except in a few housing areas). That is due to fewer people in the demographic groups who buy big houses (again supply and demand - the price of ranch and master on the first floor prices have been driven up faster than than any other "kind" of house - as both retirees and new home buyers are competing for the same homes). Not only that but the life span of many of the materials used to build those houses is about 50 years and so their repair needs will be higher. As a result those retirees will not get what they expected and will be more dependent upon what they take out of the market or their retirement accounts. That will also help drive the stock market down. I rarely see discussions about the future include those variables/issues.
Post: Is There a Change Coming in the Direction of the Markets’ Winds?
Link to comment from January 17, 2025
I'd like to echo to please tell someone what your wishes are! Near the end you may not be in a position to do so or may have family members who can't/won't fulfil them due to their own emotional pain. Here are 2 situations that happened in my family. Neither had anything in writing 1) My father had been part of the Hemlock Society for years (polio and then post polio syndrome where you lose all the function you gain back). He sat us down to talk about it about 2 years before he died (we, as young adult kids, did not want to hear about that as it was emotionally really hard - he died 28 years ago). But when he was bed bound with respirator assisted breathing, in a nursing home and with 2 major infections (one was pneumonia) that were antibiotic resistant and he'd eventually die from he finally was ready to die. I finally, as I saw him deteriorate, asked him if he was ready to die (he had trouble talking and mostly had to write out what he wanted) and he said yes. He chose to died 8 days later. Had he not let us know what his wishes were, even though we didn't want die and this caused us a lot of emotional pain, he would have suffered who knows how much longer as he was not going to get any better and only get worse. We were already grieving in advance, nothing stops the grief regardless of how you die, but it helps to know that you had the kind of death you wanted and aren't suffering anymore even as we are in pain over your death - pain we'd have whenever you died. 2) One of my aunts (dad's sister) had ovarian cancer that came back and spread. She talked with me about her last wishes when I saw her 5 months before she died (she said she talked to me because of dad's means of death and because I've had 3 cancers, 1 with no cure a longer life span so I'd understand without getting upset - regardless I found it upsetting but didn't let her know) but told me not to tell her kids (she didn't want to upset them - umm they are already upset). I told her she needed to tell her doctor as well as her kids because if no one knew but me her wishes may well not be followed. It turns out she didn't tell anyone. When I got the call from my cousin that my aunt was dying (she stopped treatment) I asked if she was at home and was told no. I told her what my aunt had told me (she was no longer really able to tell he wishes at this point). Her daughter was really upset her mom hadn't told her her wishes and I tried to help her understand why she didn't. She was brought home about 8 hours later and died 2.5 days later. Don't upset your family by only telling someone else who, when they let you know your wishes, then your family is additionally upset you didn't let them know (of course there are reasons why you might not tell a young child in advance, etc. but I am speaking here in general). My aunt and dad took two different approaches and one almost didn't have the outcome she wanted. It's a good thing dad had told all of us as when I asked he was relieved as he didn't want to have mom ask because of the pain he felt it would cause her and didn't want to upset us by asking himself or asking one of us to ask... so he was relieved I asked him if he was ready to die and then contacted the doctor to let him know so the two of them could "talk".. As a result realize that even if someone knows your wishes you may well still need to take the initiative if one of your love ones will not/can not act if you have nothing in writing (neither my dad nor his sister did). You will not upset us - we are already upset. When we know your wishes in advance it is less of a shock when you stop treatment, pull breathing tubes, whatever and we have had some time to grieve in advance and prepare ourselves (although nothing will stop the grief when you actually die). When you are at this point we are not taken by surprise you are going to stop treatment, commit assisted suicide, whatever. We are sort of prepared. As much as we don't want you to die we don't want you to live like this either. As much as we are in emotional pain about your impending death we know what your wishes are and can act (or someone can act if you put this in writing) if you can't.
Post: Share the Power
Link to comment from January 4, 2025
A useful reminder - get rid of junk so someone else doesn't have to... Had that reminder when my mom moved from a house to an apartment and again from there to assisted living and now in a nursing home... I started and then stalled out. Need to get started on that again. Long covid doesn't help that...ironically caught covid Dec 2023 at a major cancer center while I was there despite wearing a mask and being vaccinated - I too have a cancer with no cure, although mine, my 3rd cancer, is a blood cancer so typically has a longer lifespan even though it is incurable... Be aware that MD Anderson Cancer Center found, following people prospectively that about 60% of cancer patients who caught covid get long covid whether or not they are in active treatment. Of course cancer diagnoses (and other major, serious, won't go away health issues) throw a wrench in our lives in so many ways - financial, physical, emotional, and that of our families. It's never easy and some of us have more work to do than others to pull the aspects of our lives together that you talk about. Like anything else it is easier to do things a little at a time rather than all at once when we have to. Most of us only realize that when we hit the "when we have to" stage of life. For me I have found that a cancer diagnosis is an emotional earthquake with plenty of aftershocks. And I found there is a qualitative difference between a cancer with a potential cure (my first two) and one that currently doesn't have one (my 3rd). In some respects it is like grief - initially intense emotions most of the time. I remember being at work (I was diagnosed with my 3rd day one of a new job, got the call in the middle of the day at work) and the one day early on I suddenly realized I hadn't thought about cancer for nearly 4 hours I was so involved in what I was doing. And like grief, you eventually mostly get a grip and just like when grieving the emotions, over time when they hit, are nearly as intense, but last shorter periods of time and are further and further apart. Of course out of the blue you can be unexpectedly triggered, and like grief it can be months or even years later. It's the uncertainty about time left that I struggle with. I procrastinate and then sometimes feel guilty as I know if I don't get some things done it will make things harder for others. As my finances were wrecked (I live in a state with no medicaid expansion) by having to pay full price for health care once I lost my job over chemo side effects, the tension of doing things I had always planned on doing that cost money, vs worrying I won't have enough to live until I die (social security doesn't even begin to meet basic needs but I make just a smidge too much to be dual eligible for to add medicaid to medicare) so I don't do the things I had always planned on. That has meant finding other, free things to do that bring pleasure into my life. Those of you reading his journey through a terminal illness and have waded through my zillion words I just wrote, think about balancing, in a rational way, saving for your unknown future and doing things you love now that cost money. Later it may be too late. None of us can plan when or how we actually will die until we are caught in the middle of that last part of our lives. For some of us we will be dumped on that path suddenly and earlier than planned/expected. But we can plan and do things now that enrich our lives and do it is a way that still allows us to plan for the future. We can also make that last part of our journey easier if we do at least some of the things he suggests above in his article before we are forced to.
Post: Four Questions
Link to comment from December 28, 2024
Enriching investors - and that is part of the problem of for profit health care. Instead of only paying salaries and patient expenses, they have to pay the investors with some of the money they get from premiums (or with medicare, the government). That leaves less for patient care and drives up costs. It is even worse when venture capital buys health care. They make their money when they sell at a profit (they don't buy to hold). So they cut costs, trim out fat, sell at a higher rate and then the company that buys what they sold has more debt that has to be serviced (so the new owner company has higher costs too to pay down the debt and some health care money has to go for that).
Post: Quinn’s last rant for 2024. Misinformation is frustrating. No, your wife is not a car!
Link to comment from December 22, 2024
You need to compare apples t apples and a true comparison would include adding in all the deductibles and maximum out of pocket for everything, I have original medicare, G and D. On G my 2025 deductible is $185 - Just B's deductible/out of pocket (and because I have G that is also my maximum out of pocket). For me premiums (B, G, D) plus B's deductible is $5182 a year or (averaging the out of pocket over 12 months and rounding up) $432/mo. You can now, in 2025 ignore the out of pocket for D in the calculations as D is run exactly the same between for advantage plans as D (It's $2000). Advantage plans also require one to pay B premiums as they are required to have B so if you remove that then I pay $2688 (or 224/mo) - way less than the max on any advantage plan available in this state. D is more complicated in how things work as drugs have tiers and the price in some tiers for some drugs is $0, and tiers between D's vary along with their prices (in most 2025 plans now there is a % of the drug cost for your copay in each higher tier and not a flat fee anymore), as does with medicare advantage (same rules now apply to both which didn't used to be the case). What is now the same now in D is the out of pocket is identical. It is prudent to check your drug prices each year and switch D or switch your advantage plan (you can switch those without passing medical underwriting, unlike with original medicare switching medigap plans) based on projected drug costs (and the big unknown is what will you be prescribed later in the year that you don't know about yet). Of course if you switch your advantage plan usually that means switching who is in network which may or may not be practical. In my case my work premiums were lower, but if I used the entire work out of pocket I'd be roughly where I am now with original medicare and G costs. A good chunk of my income, but I am grateful to have it as like the author, I have cancer. Mine has no cure but a longer life span (indolent non-hodgkin's lymphoma) so I fail medical underwriting so good thing I chose original medicare to begin with as my total costs each year are thousands less than with an advantage plan and I can go to MD Anderson Cancer Center, the number one cancer center in the USA. Most advantage plans are not accepted by them. Unlike advantage plans, with original medicare I can go anywhere in the country that accepts medicare.
Post: Quinn’s last rant for 2024. Misinformation is frustrating. No, your wife is not a car!
Link to comment from December 21, 2024
What blows my mind is how so many insurance agents view Medicare Advantage plans vs Original Medicare + Medigap + D (OM) have the same misunderstanding. They view what people should get based on their current medical costs. The auto/health insurance comparison I see is you haven't had an accident yet so you buy, with your brand new expensive car, only the state minimum liability insurance. Oops you have an accident that you are at fault or are hit by someone without enough insurance to cover your costs and it costs you an arm and a leg. So then you decide to get better insurance. Oops again. now it costs you a fortune because of the accident. Between the two you are out a lot of money that could have been saved had you bought good insurance to begin with. But people don't think ot it like that. With car insurance insurance you pay for good insurance hoping you will never use it and hope yourare a profit center for the insurance company... BUT if you ever need to use it you are glad you have good insurance because it is there and that is what you need when you need to use it. But many people don't seem to view health insurance or original medicare vs medicare advantage plans in that same light. They see zero premiums, they aren't sick, they ignore the frequently $5000 to 14,000 maximum out of pocket, the limited network issues (try going to MD Anderson Cancer Center or the Mayo with an advantage plan - good luck with that) and frequent denials those don't affect them. Yet. And then they do they often can't pass medical underwriting to get a medigap plan (G only has the medicare deductible, which is less than $300. the cost of D - both pay B) where the combined premiums and other costs (including the limited dental, vision and hearing that MA's include - although some medigaps have that included too) on OM are far, far less when you actually use your insurance to the extent you use it if you have an expensive illness or expensive chronic condition. What I read on one agent forum where they justify the MA choice over OM is that the people are healthy when they sign up and don't need OM because the high maximum out of pocket on MA (often $5000-14,000) isn't being paid by them and they save a lot of money with zero to low premiums. Okay so what happens when they then get sick with an expensive condition and actually need to use their insurance? Oops. Their cost is then way more than OM, G and D combined. AND they have major network limits and more denials. So then when they want to change to OM as that will now be cheaper now that they are actually using their insurance they find they can't as they fail medical underwriting. As a result they are stuck paying a lot more for life. Of course the kicker is that independent agents get paid typically double to sign someone up for MA plans and the renewal is also typically double vs medigap and D (some D's aren't even paying a commission). They earn their entire income from commissions so we have the folly of rewarding for A (paying them a lot more for one of the choices, in this case MA plans) while expecting B (giving unbiased help to help people choose the plan best for them). And we wonder why MA plans are growing in popularity. At 65 to 70, when most people sign up, typically they are far healthier than at 75, 80 or 90 or beyond. If people viewed the MA vs OM choice like car insurance likely many would make a different choice. Side note - I am ignoring those who qualify for medicare and medicaid (called dual eligible) as health care is free or close to it for those people regardless of their choices. I am also ignoring who qualify for medicare premium assistance (and some for drug assistance) as well as the care/costs they have with their choices isn't the same as those who are enough over the poverty line they don't qualify for help.
Post: Quinn’s last rant for 2024. Misinformation is frustrating. No, your wife is not a car!
Link to comment from December 21, 2024