Going without Healthcare

Health, Fitness, Insurance, ...
Michael_00005
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Re: Going without Healthcare

Post by Michael_00005 » Thu Jul 12, 2018 8:36 pm

Clarice wrote:
Thu Jul 12, 2018 5:12 pm
The collective wisdom on this forum is pay the effing insurance.
Ahh, a little humor, it's always nice to see some people still have that skill, and those who can reply without throwing a hidden wrench mixed in with the flowers. Sometimes confidence is misunderstood, but it is what it is.

The one comment that hit home was pain, no doubt that would be difficult, but I would not think pain killers or antibiotics are that expensive.
Treating the uninsured is a key reason why healthcare costs are out of control.
I would say the whole system is corrupt. Instead of dealing with the source of the problem we place a $10,000 band-aid over a hole in the boat. A short while later it falls off, and the uninformed are back buying more band-aids. I've never been one to game the system, or ask for handouts so no disagreements there. If a person can't pay turn him away, if that's what they want. This brings up another topic on types of doctors, there are at least 3 (see below). Some people must have a hard time believing you truly would not want or even except standard cancer treatments.
appendicitis, volvulus
I'm aware of studies for both of these issues, and both are somewhat common for meat eaters, the theory being a lack of fiber with leads to constipation. We could add kidney stones, same thing there.

It's difficult to properly make your point without writing a book. That and most people have not researched healthcare so there's bound to be misunderstandings with gaps in education (research) levels. Mostly (my thoughts) of what puts a person into bankruptcy are the biggies: Open heart surgery $125,000, then add in all the testing, lab-work and follow up visits and you could be over $200k. Diabetes "a lifetime, in the United States; the "figure ranges from around $55,000 to $130,000", these and many others can be completely avoided. Chemo, a years worth of this worthless drug could be close to $100,000... not doing that either.

The decision is likely more than a year away, so there is still some time.

3 types of doctors
1. those who go into medicine to help others (natural or true healers - help others because it feels good)
2. those who go into medicine for money (don't like to help others, but will do so it they can charge exorbitant fees)
3. Those who go into medicine for prestige or power (like it when you bow down to them - helping others is beneath them but they will play along, and then disappear given the 1st opportunity )
Getting over the fear of death is the ultimate freedom.
well said!
I love it when someone is brave enough to stretch the boundaries. That is the theme of ere.
Agreed, far too much goes unquestioned.
you're not completely sure whether it's just the worst stomach ache ever or something that might kill you.
Another good point, this would be a down side for sure. If going this route it would be a good idea to find health care professionals of like mind before you get sick. Also, expensive treatment equals not quality care.

Regarding death and seemingly random events, I think everyone is cared for, we just forget.
Last edited by Michael_00005 on Sat Jul 14, 2018 3:47 am, edited 6 times in total.

RealPerson
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Re: Going without Healthcare

Post by RealPerson » Thu Jul 12, 2018 8:58 pm

Lifestyle and nutrition definitely influence health and wellness. Genetics, lifestyle, nutrition and other factors, known or unknown, affect major diseases. These other factors can be viruses, which cause many cancers. Many of these infections are asymptomatic.

You are rightfully concerned about avoiding medical overtreatment. That does not mean that all medicine is overtreatment, nor does it mean that all expensive medicine is a waste of money. For example, there finally is an effective treatment for hepatitis C. The treatment is very expensive, but it saves your life. You can contract hep C at any age, whether you work out or not and whether you eat a plant based diet or red meat every single day.

I know a apparently healthy medical doctor, who suddenly developed a brain bleed. Turns out he had a genetically caused weakening of a blood vessel, which caused him to nearly die at age 29. He is now decades older and doing great, thanks to a $200,000 hospital stay.

Life carries risk, even if you live a healthy and cautious life. No diet can eliminate that risk. Insurance is a way to protect yourself from an untimely demise due to no fault of your own. If you buy no insurance for whatever reason, but expect society to pick up the tab if you become seriously ill, you are essentially freeloading on the rest of society that does buy insurance. That is not the ERE way as far as I know it. I don't mean this to be offensive, but I do think that medical insurance of some type is necessary. Modern medicine is one of the wonderful benefits of our expanding knowledge and improving technology. But is does cost money. And yes, the medical-industrial complex is very interested in profits.

sky
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Re: Going without Healthcare

Post by sky » Thu Jul 12, 2018 9:37 pm

What if the cost of health insurance continues rising? I suspect that without ACA subsidies I would be paying close to $1,000 a month. If not next year, in a few years.

EdithKeeler
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Re: Going without Healthcare

Post by EdithKeeler » Thu Jul 12, 2018 10:23 pm

Health care is not the same as health insurance.

I have a pretty cynical view of the health care machine in the US, probably more so lately as I've been dealing with it with my mom. I also deal with aspects of it every day in my work.

I think it's really easy to say "I'll go without health insurance" when you're young and healthy and have never had anything bad happen to you. And the odds are probably in your favor, at least for a while. But odds are just that--if one in a hundred will get whatever disease, it's great if you're the 99 that don't, but if you're that one... you're fucked.

My mother has had very poor health for years and years, and I'm really watching her decline now. But at one time she was young and healthy, until a dude crossed the center line and hit her head-on. That accident caused multiple broken bones, multiple surgeries, complications from blood clots (which persist to this day), pleurisy, pneumonia, and a small addiction to pain killers that got resolved. Those problems cascaded into mental health complications, severe arthritis and hip and knee replacements eventually. Someone upthread asked "but won't the other guy pay?" Well, yeah... assuming he has insurance, and assuming he has limits, and in the US anyway, you generally self-fund for an accident until you reach your settlement. (This is what I do for a living: investigate, evaluate and settle liability insurance claims).And I've seen what can happen when a healthy person who ate all his veggies every day and was young and never thought he would get sick has a catastrophic accident that's not his fault. Hopefully there's workers comp insurance, or liability insurance, but sometimes there's not.

Crap can happen out of the blue. I handled a claim once where a guy left his jacket on a seat outside. On his way to fetch it, a construction worker dropped a small block of wood from about 3 stories up. Hit the guy on his toe and broke the toe. Had some minor surgery, but then he got an infection. They amputated his toe. Didn't get all the infection. The amputated part of his foot. Didn't get it all. Three more surgeries later, he had an amputation well above the knee. Just because he forgot his jacket. Fortunately there was insurance to pay for it (guy got $1.25 million--of course, his lawyer got 1/3 of that)--but at the end of the day, that money will not fully compensate him for his future medicals, prosthetics, etc.

Accidents happen, and if you're a victim, you'll need medical care. You could also get really sick with something. An acquaintance had just had a baby, was doing great... then she started feeling poorly. She was about 26 at the time, attributed it to being tired from the new baby. Got worse and worse until she was finally diagnosed with leukemia and it didn't respond to treatment. Husband of a friend was about 35--picture of health, avid sailor and golfer. Came home feeling poorly, thought it was a cold--ended up in the hospital 2 days later where he died--hairy cell leukemia. (This is starting to sound like https://www.youtube.com/watch?reload=9&v=9bOjc70f4p8--a favorite). Of course dying is the cheaper option. College roommate felt a lump in her breast in the shower. About 32, working on a successful law career. Double mastectomy with reconstruction with 2 YEARS of chemo. She's 54 and great now.... but she's really happy she had health insurance. Those medical issues didn't occur because of poor diet, and for none of them was there a history of similar health issues in the family.

Spend the money on the health insurance. Get a really high deductible. If nothing ever happens, great--you can say you averted bad luck by buying insurance. But if something bad happens, you'll be really, really glad you had it.

Farm_or
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Re: Going without Healthcare

Post by Farm_or » Fri Jul 13, 2018 6:19 am

It's so easy to see so many things wrong with our health care system that it's hard to accept how it is and focus on what to do about it.

Bottom line? HDLP. Protect against the catastrophic events and live healthy so you can keep the odds in your favor of never having to use it.

There is enough passion on the subject that we have to be optimistic. I think we have seen the worst and things will improve.

I am especially optimistic about the recent alliance to bring prescription medicine prices back in to the stratosphere. And the frequent references for price disclosure and reform. But I wish tort reform was on the political lips more. I guess that is unlikely due to the fact that most politicians have legal background?

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7Wannabe5
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Re: Going without Healthcare

Post by 7Wannabe5 » Fri Jul 13, 2018 1:24 pm

I in no way meant to imply that some youngster should choose suicide over seeking medical treatment and/or buying insurance. It's just that I am old enough to be thinking about possibilities for end game. Also, when you are on the downside of remaining life expectancy, as with calculations having to do with compound interest, it makes sense to consider the trade-off between remaining time spent earning money to buy health insurance, services, or even going to the nth degree in preventative practices, vs. time you have left to spend wandering through the woods or reading everything by Gorky or enjoying some fresh plum preserves on thick slice of hot-buttered bread.

I guess I am in a bit of a speak my grouchy old mind mood today, but young men who are myopically obsessed with arcane particularities of health matters, seem a bit wimporama to me. Yeah, gut microbes, that's a thing, but if I were a young man with a healthy young man's body, I'd be out there white water rafting and jumping out of a tree and getting well laid or something like that, rather than fretting about the current composition of my fecal matter. You'll have plenty of time for that on the downside.

Michael_00005
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Re: Going without Healthcare

Post by Michael_00005 » Fri Jul 13, 2018 6:15 pm

I was thinking about this today from older studies where they break everything down. Google and social media will revolutionize the health industry very soon, it so easy to find information now. My 1st attempt to find what I was looking for:

"Analyzing medical death rate data over an eight-year period, Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error in the U.S. Their figure, published May 3 in The BMJ, surpasses the U.S. Centers for Disease Control and Prevention’s (CDC’s) third leading cause of death — "

https://www.hopkinsmedicine.org/news/me ... _in_the_us
Last edited by Michael_00005 on Fri Jul 13, 2018 7:32 pm, edited 1 time in total.

prognastat
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Re: Going without Healthcare

Post by prognastat » Fri Jul 13, 2018 6:27 pm

If despite everyone else here recommending against it for good reasons you still feel it is smart to go without healthcare then pay the penalty rather than paying for healthcare and go without.

It is quite obvious that you aren't looking for feedback to come to the best answer and were hoping for confirmation that it was a good idea.

George the original one
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Re: Going without Healthcare

Post by George the original one » Fri Jul 13, 2018 6:40 pm

Michael_00005 wrote:
Fri Jul 13, 2018 6:15 pm
I was thinking about this today from older studies where they break everything down. Google and social media will revolutionize the health industry very soon, it so easy to find information now. My 1st search found this:

"Analyzing medical death rate data over an eight-year period, Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error in the U.S. Their figure, published May 3 in The BMJ, surpasses the U.S. Centers for Disease Control and Prevention’s (CDC’s) third leading cause of death — "

https://www.hopkinsmedicine.org/news/me ... _in_the_us
Worth noting from your link: "The researchers caution that most of medical errors aren’t due to inherently bad doctors"

Michael_00005
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Re: Going without Healthcare

Post by Michael_00005 » Fri Jul 13, 2018 7:17 pm

There are some well thought out responses here, appreciate the feedback.

Summarized results:
1. Most health issues and costs can be avoided by living a healthy lifestyle, but some remain. And of those that remain, there are cases where allopathic medicine not only works but could be the best option. You might like this book on self reliance, it corresponds well: “Zen and the art of motorcycle maintenance”

2. The most concerning issue would be where immediate emergency care is required. Here options and time disappear.

3. To some extent a person could search and find their own healthcare options in advance, allopathic medicine is not the only game in town, but it generally is the most expensive. And in some cases you can find doctors who revert back to a bygone era… expect to see more of this in the future: https://www.youtube.com/watch?v=GKBMFCFYe4A

4. Personally I’m attracted to some health centers where they deal with “cause”, rather than “symptom”. “Dr. McDougall's Health & Medical Center” being one example. Expensive but nothing like institutional care, this option could be the goto when dealing with chronic ailments, of non-emergency nature.

5. Another question is discovered: “Does expensive care mean better treatment?”

6. If a person avoids standard healthcare they can largely avoid the 3rd leady cause of death. “medical mistakes would be the third leading cause of U.S. deaths”

Now we can filter down to, this:
7. Is ([% chance you need emergency care, and these cost become unmanageable] + [the rare benefit of long term standardized care] + [added risk of iatrogenic harm - 3rd leading cause of death]) > [Cost of insurance]

8. Until Medicare kicks in

"It is quite obvious that you aren't looking for feedback"; has the verdict already been decided? The decision is likely months away.
Last edited by Michael_00005 on Sat Jul 14, 2018 3:43 am, edited 5 times in total.

prognastat
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Re: Going without Healthcare

Post by prognastat » Fri Jul 13, 2018 7:21 pm

Michael_00005 wrote:
Fri Jul 13, 2018 7:17 pm
6. No disagreement was found on the subject of “freeloading”, but the subject continues for some reason. So maybe the point is that it’s easy to talk the talk, but not walk the talk… a valid point. It’s worth noting here that when a person follows a PBD they essentially do the world a favor, by reducing environmental destruction, and gross water waste, among other issues; definitely a path that leaves a light print. “Cowspiricy” makes a good point on this subject… again we go off topic.
This doesn't only depend on the person wanting to freeload. Even if you didn't depending on the nature of the emergency you may receive medical care you can't pay for or might bankrupt you simply by not being in a state to be able to consent to medical treatment and them performing emergency measures regardless.

My sane recommendation for someone wanting to rely on healthcare minimally would be one that was previously mentioned High Deductible Health Plan(HDHP). This would protect your from the most catastrophic events that could bleed you dry, but allows you to pay the minimal amount and avoid going to healthcare practitioners for anything, but the most serious emergencies.

Augustus
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Re: Going without Healthcare

Post by Augustus » Fri Jul 13, 2018 7:25 pm

EdithKeeler wrote:
Thu Jul 12, 2018 10:23 pm
+1

Even if the external cause is ordered to pay, if you get stuck with a doozy the external cause will likely file bankruptcy and you're still stuck with the bill. You think the a average consumer with 200 in savings can afford to pay out a million after wrecking your life? Most car insurance only covers like 10-300k doesn't it? Medical care can easily surpass that. 3 days in an ER cost a friend of mine 70k, and it wasn't even that bad.

The key decision for OP is if he's okay to accept the bankruptcy risk. If he is, fine. I have too much to lose, so I insure.

Michael_00005
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Re: Going without Healthcare

Post by Michael_00005 » Fri Jul 13, 2018 8:26 pm

As a kid we would go visit grandpa who stayed in elderly apartments. And I remember how he would constantly remind us that we could not be too loud, playing with the coiled door-stop for example was off limits. And how others are constantly watching each other in the building looking for the slightest slip up in breaking a rule. And If a rule was broken someone would quickly go and tell a supervisor. These are full grown adults you understand, "what is going on here?", I would think. And even as a kid the thought would be like, “that is moronically childish!”. BTW, getting old has nothing to do with age, it’s mostly attitude. Reflecting this is probably due to having nothing to do all day, that and letting the mind run wild without direction. From there it goes straight into the ditch.

What a waste, to let the goal of life deteriorate into policing others!
Last edited by Michael_00005 on Mon Jul 16, 2018 4:36 pm, edited 1 time in total.

Farm_or
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Re: Going without Healthcare

Post by Farm_or » Sat Jul 14, 2018 6:53 am

@michael- It's funny how childhood memories of our grandparents can stick with us. I also remember frequent visits to my grandfather, only he was frequently in a hospital. He had a myriad of problems - most of which were within his control, but due to their typical seventh grade education level, were ignorant of how/why.

But the long lasting effect it had on me was the importance of health to life satisfaction. To 7wb5 point, you can't jump out of trees and so forth without first being in good health. You can't enjoy life without good health.

Thanks for the observation on growing old and becoming control freak. It would seem that the more restricted your realm, the greater the emphasis would be on what remains. Or it could be a greater consciousness on influence/ experience over ignorance?

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7Wannabe5
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Re: Going without Healthcare

Post by 7Wannabe5 » Sat Jul 14, 2018 8:36 am

To 7wb5 point, you can't jump out of trees and so forth without first being in good health. You can't enjoy life without good health.
Right, but there seems to be a bit of a tendency towards Bartleby the Scrivener style infinite regress on this topic, both in this forum and society in general lately. It does not make good sense to spend 10 hours engaged in something expensive and/or unpleasant in order to gain yourself 8 hours of longevity, and people misapply statistical data all the time. Just because a moderate adherence to a practice is good, does not mean that an extreme, rigid adherence is better, and it is ridiculous to rely on general population results when a mechanism and your individual risk factors are known.

Also, perhaps a bit of sour grapes on my part since very difficult to jump out of a tree when your butt is 14 inches rounder than your waist, even if you are in good health. I mean, you can try to jump, but then you just fall with a great "THUMP", like Winnie-the-Pooh.

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Chris
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Re: Going without Healthcare

Post by Chris » Sat Jul 14, 2018 9:52 am

Michael_00005 wrote:
Fri Jul 13, 2018 7:17 pm
6. If a person avoids standard healthcare they can largely avoid the 3rd leady cause of death. “medical mistakes would be the third leading cause of U.S. deaths”
I would be careful about how you interpret this, due to selection bias.

The people who died by medical error may have been kept alive for years by medical intervention. For example, someone could have been treated successfully for cancer, survived a decade longer than if they hadn't received treatment, only to be killed by a prescription being mixed up. That person would be included in this statistic, although they benefited from medical treatment. So they would have avoided the second-leading cause of death for a period of time, to eventually die (years later) by the third-leading cause.

Michael_00005
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Re: Going without Healthcare

Post by Michael_00005 » Mon Jul 16, 2018 4:25 pm

Some fun facts:
A study published in the American Journal of Medicine showed medical expenses accounting for approximately 62 percent of personal bankruptcies in the U.S. Interestingly, it also showed less than one quarter of debtors -- whether medical or nonmedical -- were uninsured when they filed for bankruptcy
So 75% of people going into bankruptcy still had insurance.

https://www.entrepreneur.com/article/314375

Using a few Google searches, this table was quickly compiled. Minus overhead expenses, etc., you could hire out a doctor for the year at $7.21 per month if you had a large enough group.

Doctor Desc
$189,000 Average cost to hire a doctor (1 yr)  *1.
2,184 Average patient panel size for a practitioner       *2.
$86.54 Yearly cost to hire a single practitioner using above panel size (189,000 / 2184)
$7.21 Monthly cost to hire a practitioner per person (2 visits per yr) (86.54 / 12)
  • "1. With a base pay offer of $189,000 a year, on average, family practitioners, pediatricians, and psychiatrists are offered the lowest pay of all physicians, according to the medical search and consulting firm Merritt Hawkins & Associates' 2012 Review of Physician Recruiting "

    "2. In 2011, primary care practices reported an average patient panel size of 2,184, according to a 2012 report from MGMA. For example, if a physician sees 18 patients per day, working 240 days per year, and patients visit your practice twice per year, that physician's panel would be 2,160 patients."

EdithKeeler
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Re: Going without Healthcare

Post by EdithKeeler » Mon Jul 16, 2018 8:47 pm

Doctor Desc
$189,000 Average cost to hire a doctor (1 yr) *1.
2,184 Average patient panel size for a practitioner *2.
$86.54 Yearly cost to hire a single practitioner using above panel size (189,000 / 2184)
$7.21 Monthly cost to hire a practitioner per person (2 visits per yr) (86.54 / 12)
I am not quite sure what point you’re making here.....

Your costs
1) don’t include the cost of malpractice insurance, which can be high, and which cost is typically borne by the medical group
2) don’t contemplate lab tests, diagnostic testing, etc. etc. (which can be really high.... especially when you’re talking MRIs, etc.
3) don’t consider specialists at all
4) don’t addresss hospital costs
5) prescriptions?
6) medical equipment?

If it was just as simple as a general practioner providing care, medical care would be cheap, cheap, cheap.

RealPerson
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Re: Going without Healthcare

Post by RealPerson » Mon Jul 16, 2018 10:18 pm

EdithKeeler wrote:
Mon Jul 16, 2018 8:47 pm
I am not quite sure what point you’re making here.....

Your costs
1) don’t include the cost of malpractice insurance, which can be high, and which cost is typically borne by the medical group
2) don’t contemplate lab tests, diagnostic testing, etc. etc. (which can be really high.... especially when you’re talking MRIs, etc.
3) don’t consider specialists at all
4) don’t addresss hospital costs
5) prescriptions?
6) medical equipment?

If it was just as simple as a general practioner providing care, medical care would be cheap, cheap, cheap.
My thoughts exactly. The cost does not lie with the PCP prescribing an antibiotic for strep throat. It is all the stuff you listed. Modern medicine is not an island, it is a web. The size and extent of the web is almost entirely out of the control of the individual patient, especially for serious and/or urgent conditions. You just cannot control the cost of this web.

It would be helpful for the OP to talk to people who have survived cancer or any one of a myriad of life threatening diseases. Especially how much they felt in control of the cost of their treatment. It is a perspective you just cannot imagine if you are a young and healthy person.

jennypenny
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Re: Going without Healthcare

Post by jennypenny » Tue Jul 17, 2018 4:48 am

I agree with EK and RP ... it's the hospitalizations and specialized surgeries that will derail your ERE, not the everyday OOP stuff (similar to how it's the big expenses like housing that make the biggest impact on your ERE path). Practicing self-care and avoiding medical issues is a good practice and can definitely save money, but those medical bankruptcies are usually the result of a catastrophic illness or injury.

I also wonder how many medical bankruptcies are the result of poor self-care combined with living paycheck to paycheck. They always say people don't have $1000 to cover an emergency so it's no surprise that even a moderately serious medical issue could bankrupt them. Healthcare costs are an obvious issue is the US, but if you're overweight/out of shape and eating a SAD then a bypass shouldn't come as a complete surprise. I don't mean to sound unsympathetic because I know people get hammered out of the blue by huge medical bills (my family included). I just wonder how inflated that number by poor choices leading up to the medical issue.

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