Longterm holistic approach on health(care) without reliance on social security

Health, Fitness, Food, Insurance, Longevity, Diets,...
OutOfTheBlue
Posts: 293
Joined: Thu Mar 03, 2022 9:59 am

Longterm holistic approach on health(care) without reliance on social security

Post by OutOfTheBlue »

A quote from Scott2 ("I think access to modern healthcare effectively breaks a naive 1 eco-Jacob strategy") inspires me to create this thread, because health-related costs are an important consideration, and even more so for those that target living roughly within 1 jacob/JAFI.

This reminds me of Jim Merkel's "Radical Simplicity: Small Footprints on a Finite Earth", where one would adopt a "wiseacre" approach, reducing their living to a more sustainable/modest ecological footprint. It was quite sobering to read what some of the low footprint wiseacre scenarios would look like on this department.
Jim Merkel in Radical Simplicity wrote:Table D.4 (Goods and Services) contains some of the tough trade-offs faced by wiseacres. With sample allocations of 0.1, 0.3 and 0.8 acres, would you think to invest more in education and possibly prevent an illness, or save the money in case you faced a serious illness? As you can see in this table, the allocations are quite small by North American standards. If you were a wiseacre by choice, would you refuse medical treatment beyond a certain point? Would you spend a million dollars worth of resources to recover when this amount could relieve the worst of poverty for 25,000 children? These questions are easy to philosophize about, but when your loved one has cancer or has been in a car wreck, most wouldn’t hesitate to use whatever it takes. Still, we can do many things to prevent illness and reduce the ecological footprint associated with staying healthy.
In that D.4 table, a sample monthly budget for Medical insurance and services would be $4.4 for One Acre total EF (0.1 for Goods and services), $10 for Three Acres total (0.3 acres for Goods ans services), and $30 for a Six Acre Total EF scenario (0.8 for Goods and services) [the latter scenario still being higher than biocapacity per person if everyone were living by these standards.

What strategies/actions are you using/considering regarding health and medical care [if you don't rely on social healthcare] in your life span?

Especially if you're targeting LCOL (meaning that you also need to be more creative), although, this is not only for a those interested in a low ecological footprint.

As you see, I am limiting the scope of the discussion somewhat.

For the purposes of this thread, we're not interested in situations where one would *mostly* rely on social security/public or subsidized healthcare, although of course the costs in such a scenario are collectively paid via social security. What's your approach if you don't or can't rely (or besides relying) on that?

I'm aware this excludes many cases, but it is sometimes useful to limit the scope of a discussed topic. Healthcare systems worldwide differ and evolve, and some specifics (like those of the US healthcare system) have been discussed elsewhere.

However, because the topic itself is universal and would benefit from a holistic approach, everyone can contribute, focusing on what can be done outside of relying on social security/the healthcare system.

I'll post a few of my own thoughts later on.
Last edited by OutOfTheBlue on Sun Dec 03, 2023 10:03 am, edited 2 times in total.

DutchGirl
Posts: 1641
Joined: Tue Sep 06, 2011 1:49 pm
Location: The Netherlands

Re: Longterm holistic approach on health(care) without reliance on social security

Post by DutchGirl »

It could be vital in a strategy where you decide to pay for your own healthcare, that you know that some diseases will have treatments that you will not be able to pay. And that if you ever find yourself in such a situation, you will have to choose to go for at most palliative care. You should then also put every possible document in place to make sure your wishes will be respected. Still, of course, you can possibly find yourself in a situation where you for example collapse on the street and you're taken to the hospital because the bystanders don't know that you were planning to not have such high healthcare bills.

Then again, I'm reading this blog by a woman who was a "health healer", faithfully drinking her healing teas and dusting her healing crystals. But now that she has cancer, after long internal debates she is doing the chemo and radiation after all. To live.

So you can think about this now, but when push comes to shove... there is a chance that you'll be grasping at those expensive straws just like the next human being.

User avatar
Seppia
Posts: 1987
Joined: Tue Aug 30, 2016 9:34 am
Location: South Florida

Re: Longterm holistic approach on health(care) without reliance on social security

Post by Seppia »

Our plan is to minimize the chances of high healthcare costs by living a healthy life*.
Then we plan to move back to a country that has cheap and effective healthcare, so that in case of need our stash can cover top class institutions.

*eat healthy, move enough, get plenty of sleep

7Wannabe5
Posts: 9285
Joined: Fri Oct 18, 2013 9:03 am

Re: Longterm holistic approach on health(care) without reliance on social security

Post by 7Wannabe5 »

Well, absent the ability to rationally or functionally maintain the socialist perspective to any degree whatsoever, I would tend towards inhabiting the anarchist perspective entirely. IOW, I would hack a solution without respect for law, custom, or whatever Priesthood is currently held in respect. For instance, I would try to set up an underground lab to produce asthma medication for the poor cute deserving kids living in the filthy, increasingly hot city who can't afford to pay $200/month for the product as "market" priced by the clinging remnants of the dominant oligarchy. And I would do the same for some filthy "undeserving" grouchy, fat, old alcoholic bum who needs some insulin.

Unfortunately, when I read "The Knowledge: How to Rebuild Civilization in the Aftermath of a Cataclysm", I realized that chemistry was one of my weakest suits. I passed the AP exam in 11th grade and never took another course. So, I would have to hit the books pretty hard. Since a lot of humans are currently inclined to give all their money to the Priesthood/Oligarchical-Structure simply to avoid pain rather than death, I would first focus on synthesis of morphine from opium poppies.

loutfard
Posts: 302
Joined: Fri Jan 13, 2023 6:14 pm

Re: Longterm holistic approach on health(care) without reliance on social security

Post by loutfard »

Two observations before reading the Merkel book:

- Any insurance system, whether private or public, inflates the price paid for healthcare. Think of how access to subprime mortgages and historically low interest rates inflated residential real estate pricing.

- Taleb's observations in his book "Anti-fragile" on consumption of medical services might be a good heuristic for deciding whether to pay for a certain medical treatment or not. He has a fairly holistic approach to medical overconsumption.

Now, on to your question...
What strategies/actions are you using/considering regarding health and medical care [if you don't rely on social healthcare] in your life span?
I do happen to rely on socialised healthcare for avoiding financial ruin in case of a black swan health event. If not, I might try and move to/geo-arbitrage with a socialised healthcare area. I understand that that is not in scope of your question. That makes things extremely hypothetical. I would probably move to/geo-arbitrage with a low cost area with decent quality healthcare.

I would put a lot of stress on Taleb style risk management: prevention, avoidance of medical treatment with very low/questionable/probably negative ("iatrogenesis") medical benefits.

Also, a thought regarding ecological footprint. Responsibility without agency is a recipe for depression. And I have extremely limited means of influencing other humans' problematic consumption patterns. An extremely worded example. Should I really muster the intrisic motivation to forego cancer treatment to stay within my ecological means? Even while fellow humans are rolling coal or would be doing so if they had the means?

7Wannabe5
Posts: 9285
Joined: Fri Oct 18, 2013 9:03 am

Re: Longterm holistic approach on health(care) without reliance on social security

Post by 7Wannabe5 »

Generic drugs outside of patent are generally 85% less expensive than drugs currently under patent. Pharmaceutical companies are hugely profitable, and research debunks the notion that R&D costs are in alignment with drug prices.

https://www.wired.com/story/drug-research-pricing/
An example of this is the hepatitis C drug Sovaldi, which was put on the market in 2013 for a steep $84,000 per 12-week course. In 2015, an 18-month-long US government investigation that reviewed some 20,000 pages of internal company documents revealed that Gilead, the company who owned the drug, had set the high price as a way “to ensure its drugs had the greatest share of the market, for the highest price, for the longest period of time”—in essence, that it was prioritizing profit.

Scott 2
Posts: 2805
Joined: Sun Feb 12, 2012 10:34 pm

Re: Longterm holistic approach on health(care) without reliance on social security

Post by Scott 2 »

To clarify - my point is to look beyond an "eco-Jacob," and consider one's systemic ecological impact. Above average output could warrant above average inputs. Or perhaps the marginal impact of foregoing care is negligible, due to inelastic resource allocations.

I think "don't be sick" is a weak strategy. I advocate for both lifestyle factors and regular preventive care. One of the bigger mistakes I made during accumulation, was minimizing medical appointments. I didn't want to go or pay for it. Now I'm playing catch-up. Coming from behind at 40 sucks.

Dream of Freedom
Posts: 753
Joined: Wed Aug 29, 2012 5:58 pm
Location: Nebraska, US

Re: Longterm holistic approach on health(care) without reliance on social security

Post by Dream of Freedom »

  • HSA for tax-advantaged medical spending
  • Diet
  • Exercise
  • Safety
  • Egronomics
  • Go over any medical bills with a fine tooth comb and speak up if it's wrong

white belt
Posts: 1444
Joined: Sat May 21, 2011 12:15 am

Re: Longterm holistic approach on health(care) without reliance on social security

Post by white belt »

Win the genetic lottery because many health issues/conditions are caused by genetic factors. Living a healthy lifestyle helps, but thinking you have complete agency over your health is a fantasy. In other words, being prepared to radically change your lifestyle due to an illness/condition/disease is probably a prudent approach.
Last edited by white belt on Sun Dec 03, 2023 3:15 pm, edited 1 time in total.

theanimal
Posts: 2608
Joined: Fri Jan 25, 2013 10:05 pm
Location: AK
Contact:

Re: Longterm holistic approach on health(care) without reliance on social security

Post by theanimal »

white belt wrote:
Sun Dec 03, 2023 3:10 pm
Win the genetic lottery because many health issues/conditions are caused by genetic factors. Living a healthy lifestyle helps, but thinking you have complete agency over your health is a fantasy.
theanimal wrote:
Thu Jan 06, 2022 2:06 am
One statistic that stuck out to me: the genetics that we get from our parents only contribute about 20% to the control of aging. The other 80% is determined by how you live your life.
viewtopic.php?t=11158

white belt
Posts: 1444
Joined: Sat May 21, 2011 12:15 am

Re: Longterm holistic approach on health(care) without reliance on social security

Post by white belt »

theanimal wrote:
Sun Dec 03, 2023 3:15 pm
viewtopic.php?t=11158
Right but aging is only one piece of the puzzle. My father (retired 10+ years before after discovering MMM) had to get triple bypass in his early 60’s despite being in the top 1% of his age group in terms of exercise, healthy diet, low stress levels, and body weight. He doesn’t smoke or drink alcohol either. Maybe if he had listened to his doctor and started taking a statin in his 40s then he wouldn’t have had to go through that? But taking a lifelong prescription drug for a “lifestyle” disease is anti-ERE. I just point this out to note the limits of the viewpoint that we have 100% agency over health.
Last edited by white belt on Sun Dec 03, 2023 3:31 pm, edited 4 times in total.

User avatar
Ego
Posts: 6329
Joined: Wed Nov 23, 2011 12:42 am

Re: Longterm holistic approach on health(care) without reliance on social security

Post by Ego »

OutOfTheBlue wrote:
Sat Dec 02, 2023 8:51 pm
What strategies/actions are you using/considering regarding health and medical care [if you don't rely on social healthcare] in your life span?
One way or another, social healthcare undergirds every healthcare system in the world, so it is impossible to not rely on it. It is possible that someday those systems could breakdown completely. Is this a theoretical question about how to plan for that possibility?

Regardless, it makes sense to position yourself so that you need to use the current system as little as possible. Most of the conditions that plague the developed world are chronic diseases that are preventable. Many who fail to prevent those conditions do so because they have other things competing for their time and energy. One of the most valuable things that early retirement does is it frees up time and energy to focus on health and wellness.

@Seppia pointed out above that the most resilient strategy is to have many options and arbitrage the best fitting pieces from several systems.

chenda
Posts: 3255
Joined: Wed Jun 29, 2011 1:17 pm
Location: Nether Wallop

Re: Longterm holistic approach on health(care) without reliance on social security

Post by chenda »

Ultimately you are just delaying the inevitable.

7Wannabe5
Posts: 9285
Joined: Fri Oct 18, 2013 9:03 am

Re: Longterm holistic approach on health(care) without reliance on social security

Post by 7Wannabe5 »

Yes, I always rather admired the philosophy of Maude in "Harold and Maude." Pick an expiration date for yourself and check-out into the compost heap.I It's much more difficult to make the decision in the moment when you are having a crisis or becoming increasingly ill.

chenda
Posts: 3255
Joined: Wed Jun 29, 2011 1:17 pm
Location: Nether Wallop

Re: Longterm holistic approach on health(care) without reliance on social security

Post by chenda »

I think there was a Japanese tradition where after a certain age one would wonder off into the mountains on a winters night and let nature take it's course.

white belt
Posts: 1444
Joined: Sat May 21, 2011 12:15 am

Re: Longterm holistic approach on health(care) without reliance on social security

Post by white belt »

Ego wrote:
Sun Dec 03, 2023 3:20 pm
One way or another, social healthcare undergirds every healthcare system in the world, so it is impossible to not rely on it. It is possible that someday those systems could breakdown completely. Is this a theoretical question about how to plan for that possibility?
[...]
@Seppia pointed out above that the most resilient strategy is to have many options and arbitrage the best fitting pieces from several systems.
I realize I was maybe overly dismissive/condescending in my last post, but the above quote sums up what I was trying to say. I’m assuming on the ERE forums we can move past the introductory advice of eat healthy, exercise, reduce stress, etc etc. That’s the prerequisite and if you’re not there, then you’re wasting your time trying to optimize other aspects.

As the quote from Merkel indicates, this is really an issue about death. What are you willing to die for? Philosophy and religion address this issue extensively, but there are no easy answers. I believe there are individuals like Rob Greenfield, Suelo, etc who have accepted the risk of dying of a treatable/preventable medical issue so that they abide by their principles. They represent one end of the spectrum. I admire them. I think the typical developed world human has never had to risk death for anything, so it’s very difficult to predict how one will react to such a situation. If you’re not willing to die for your principles, then your strategy should include multiple methods to interface with the medical system.

User avatar
Seppia
Posts: 1987
Joined: Tue Aug 30, 2016 9:34 am
Location: South Florida

Re: Longterm holistic approach on health(care) without reliance on social security

Post by Seppia »

Ego wrote:
Sun Dec 03, 2023 3:20 pm
@Seppia pointed out above that the most resilient strategy is to have many options and arbitrage the best fitting pieces from several systems.
Everybody understands the concept of moving to NYC or SF or wherever to make more money. We can use the same approach with other stuff as well.
See what your needs are, what your strengths and weaknesses are, what the world has to offer, and act accordingly.

Unless one is competing, or doing it for pleasure, it’s best to just try find the lowest bar that can be cleared easily.

User avatar
Ego
Posts: 6329
Joined: Wed Nov 23, 2011 12:42 am

Re: Longterm holistic approach on health(care) without reliance on social security

Post by Ego »

white belt wrote:
Sun Dec 03, 2023 10:25 pm
I’m assuming on the ERE forums we can move past the introductory advice of eat healthy, exercise, reduce stress, etc etc. That’s the prerequisite and if you’re not there, then you’re wasting your time trying to optimize other aspects.
This reminds me of the Matthew Arnold quote, "Freedom is a great horse to ride, but you have to know your destination."

I believe it is common for people, even those pursuing ERE, to work so hard to achieve freedom that they do irreversible physical, social and/or psychological harm in the process. It is possible to focus so intently on riding the horse that one loses any notion of the destination.

So, I believe step #1 of the holistic approach involves keeping an eye on the destination. Work towards buying freedom without harming physical, social and psychological wellbeing.

In other words, it is wise to apply the Hippocratic Oath of, "First do no harm", to oneself. In a world full of temptations towards slippery slopes, this is easier said than done.

jacob
Site Admin
Posts: 15783
Joined: Fri Jun 28, 2013 8:38 pm
Location: USA, Zone 5b, Koppen Dfa, Elev. 620ft, Walkscore 77
Contact:

Re: Longterm holistic approach on health(care) without reliance on social security

Post by jacob »

7Wannabe5 wrote:
Sun Dec 03, 2023 3:54 pm
It's much more difficult to make the decision in the moment when you are having a crisis or becoming increasingly ill.
This.

Decisions easily turn into a "we pay what we must because we can". This can be tested in advance on a pet. I know I failed my previous standards when that rubber met the road. Decision-making could be greatly assisted if doctors were willing to make the same decisions for their patients as they/some do for themselves instead of "offering additional options" with increasingly lower ROI to their patients to abide a philosophy of "healthcare as a consumer product".

Frita
Posts: 940
Joined: Thu Mar 15, 2018 8:43 pm

Re: Longterm holistic approach on health(care) without reliance on social security

Post by Frita »

@Jacob
Decision-making could be greatly assisted if doctors were willing to make the same decisions for their patients as they/some do for themselves instead of "offering additional options" with increasingly lower ROI to their patients to abide a philosophy of "healthcare as a consumer product".


How does the American medical business/system prevent such a doctor-patient conversation based on human-to-human connection taking place? Awhile back I was speaking with a physician in a casual acquaintance setting. The person said that working for a healthcare corporation, when working with a patient, there was a computer screen that pop up and dictate conversations/diagnosis/treatment/medication. Going off script was not an option. The person no longer works in healthcare and said prior work dealing with insurance was similarly familiar.

Post Reply