What Could Possibly Go Wrong?

[mathiverse]

Also I think this old post that discusses what happens if someone gets hit by a bus at the cost of $70k with $7k of yearly spending and a stash that covers them one time over is relevant: viewtopic.php?p=127678#p127678

I think it's a concrete example of some of what I was trying to say above.

Maybe the big insight is that FI is useful even if you decide semiERE is how you'll reach it. Having the stash and very low expenses makes this a short term rearranging of lifestyle to fill the stash back up rather than a major issue.

Although maybe even without the stash, assuming you have the skills like 7w5 does, maybe it's also still merely rearranging one's lifestyle. I don't see that 7w5 is having trouble dealing with the expenses related to her new chronic illness despite not having a stash.

@7w5: Is there more you wish you would have done given your current chronic illness, 7w5? Are you unhappy with the way you've had to rearrange your life to deal with the illness? Would more money have helped?

[GandK]

I think it's useful to point out that a lot of the illnesses we are worried about in this thread strike a lot more often in the 40+ crowd. For those of us in our 20s/30s that means we have one or two decades to accumulate before a likely issue. Plenty of time to accidentally overaccumulate. Even someone doing semiERE (especially the people on this forum doing semiERE who tend to make more than 2x JAFI per year during the years they work) for one or two decades has enough time to overaccumulate by accident and especially enough time to overaccumulate on purpose if they try to keep their expenses below one JAFI and explicitly have that goal in the long term.

I began having symptoms of antiphospholipid syndrome at 27. Anecdotal, yes, but age confers no actual protection against bodily system crashes. Only better odds.

The problem with the "save more" logic in the US is that any pile of money that is not properly tax sheltered is vulnerable to medical bills. So yes you can pile up money but if you do it incorrectly and happen to have a heart attack, there goes half of it.

At present, retirement accounts in the US are protected assets as long as you're still young enough that you don't yet have mandatory distributions on them. But because early retirement requires early access to funds, people doing ERE tend to pile money up in regular brokerage accounts, which can (and will, whenever possible) be pursued for "full sticker price" medical bills.

[George the original one]

EDIT: I think it's useful to point out that a lot of the illnesses we are worried about in this thread strike a lot more often in the 40+ crowd.

I'll reiterate this point. Seemed like half of my coworkers over the years had some major health problem between age 40 and age 60. Colon cancer and breast cancer often leading to death, but others had issues which put them on sick leave for a month, six months, even a year. In reality, it was probably only about 30% of coworkers. Serious accidents requiring rehabilitation, heart attacks, strokes, etc.

And it's not so much adapting to the health problem because people are doing that all the time, rather it's the lost opportunity while undergoing diagnosis and treatment that seems to matter most. Then comes the financial cost.

[mathiverse]

Also, this post from classical_Liberal seems relevant:

First congrats. Secondly, If I read another contrived argument about healthcare being the obstacle to retirement I'm gonna scream. MMM and other FIRE sites are fear mongering health care to push a political agenda, that's it. Here are the scenarios you fear:

1)Urgent onset of emergency medical need. Acute injury like an accident, emergency surgery, heart attack. A high cost deductible plan or healthshare can be had for less than $100 a month to cover this. It'll cost to you, maybe a 5-7K deductible plus any follow up care you chose to take.

2)Cancer or similar. This is in it's own class because it can be semi-chronic (ie requiring several months of acute treatment and a few years of follow up) or chronic. Generally chronic cancers falls into my last two categorie below and are often fatal. Options for the semi-chronic are two fold. Since treatment is generally not an emergency, you can use medical tourism to cuts costs to 1/10th the horror stories you read in the US. Or you can pick up an ACA policy. Remember, all you have to do to qualify mid-year is move. So, worst case here is that you are not set up to max subsidies and you have to pay for a gold-plated silver plan out of pocket for a few months, plus the deductible. Again, we are talking in the thousands, not hundreds of thousands to get you through the acute phase of treatment.

3)Lifestyle related chronic diseases. This is the vast majority of health care spending in the US. So, prevention, prevention, prevention! Do not life the lifestyle that causes these diseases! ie retire for god's sake! If you fall into this category you are stuck in the traditional healthcare system and will need ACA or employer sponsored plan. Also chronic disease sucks, see below. Edit: FYI this is where the majority of the "$2000 a month, for the rest of your life" medications are needed.

4)Random, non lifestyle related chronic disease. OK, this is a problem, because there is little you can do to hedge against this. Luckily, it is also rather rare for this to develop after early adulthood, and prior to old age and medicare. Here I will tell you that anyone who gets sick like this is not super worried about money. Long term illness sucks, it sucks really, really bad. Virtually anyone suffering will tell you they would trade all of their money just to be healthy again. So if you are fated for this, for gods sake, please live your life exactly how you want before it happens! You will not regret it.

tl;dr: Yes healthcare in the US sucks, it's complicated and requires significant effort and brain power to navigate on the cheap. However, even as it is today, it's completely navigable by a currently healthy ERE'er with some slack in their system.

[RealPerson]

I knew someone whose Crohn's was so bad that occasionally the Mayo Clinic remove portions of the bowels. He eventually died from the disease. Hopefully this will not be your trajectory, but Crohn's is no joke.

In the case of a "random" chronic serious illness, the most cost effective approach I see is medical tourism. You could simply move to Mexico and enjoy cheap everything, including health care. If you are opposed to moving to Mexico, moving to a spot close to the border with Mexico is a viable alternative. There is a town in AZ full of medical semi-tourists/retirees who cross the border to go receive care in the adjacent Mexican town. It is a 20 minute drive. Very doable even if frequent medical care is required. You are very anchored in Michigan but with the severity of your health problems AZ could be a really good and cost effective solution. Try to modify the parameters of the system in case there are no good solutions in the existing system.

In the US health care system your situation really sucks. Looking across the border strikes me as a much better option. You should make a trip to check it out before committing to a move. Hablar Español ayuda pero so es necesario.

[7Wannabe5]

Although maybe even without the stash, assuming you have the skills like 7w5 does, maybe it's also still merely rearranging one's lifestyle. I don't see that 7w5 is having trouble dealing with the expenses related to her new chronic illness despite not having a stash.

@7w5: Is there more you wish you would have done given your current chronic illness, 7w5? Are you unhappy with the way you've had to rearrange your life to deal with the illness? Would more money have helped?

You made some good points and posted some good links/finds. I did hesistate to start this thread because it's a bit like I am a human who can barely carry a tune preaching to the choir of the already quite risk averse. classical_Liberal was totally on the mark with his description of likely reaction of somebody in my situation. I've got 8 years until Medicare and I have recently triggered a disease which usually hits people between ages 15 and 30, so not lifestyle related, although there are also environmental factors that currently fall into the category of known unknowns.

4)Random, non lifestyle related chronic disease. OK, this is a problem, because there is little you can do to hedge against this. Luckily, it is also rather rare for this to develop after early adulthood, and prior to old age and medicare. Here I will tell you that anyone who gets sick like this is not super worried about money. Long term illness sucks, it sucks really, really bad. Virtually anyone suffering will tell you they would trade all of their money just to be healthy again. So if you are fated for this, for gods sake, please live your life exactly how you want before it happens! You will not regret it.

The easiest solution for me, at the Level of ERE1, because I am already well-accustomed to living on less than 133% poverty level spending is simply to also keep my income below that level and ride Medicaid until I qualify for Medicare. The main problem with this solution is that it makes it more difficult for me to raise or transfer funds towards my projects. I also have other options which I am maintaining or enacting.

I am more concerned with the solution at the Level of ERE2. I wanted to have an EarthShip option and a SpaceShip option, but now I am stuck with the SpaceShip option. It took me a minute to do the research and cut through the bureaucracy, but like always in my 1st World problems only life, I eventually made my way to the cushy high tech drug infusion center lounge chair with a view out on a lovely park with all sorts of birds gathering at a feeder. And I tried to relax and not think about how many children drowning in Bangladesh 30 years from now the cost of my treatment might save.

[chenda]

And I tried to relax and not think about how many children drowning in Bangladesh 30 years from now the cost of my treatment might save.

Don't ever feel guilty about treating your chronic illness. You have no obligation to suffer now so children 30 years from might not.

[7Wannabe5]

@chenda:

I know it's wrong-minded. I wouldn't reflect it on anybody else. I mean, I don't even feel judgy towards the morbidly obese guy I saw shooting himself up with insulin at an all-you-can-eat buffet in South Carolina. Life is weird. The world is complex. Guilt is just my bugaboo, like some other people have anxiety, pessimism, shame, or sadness. Anyways, I'm already planning to possibly volunteer for clinical trials so I can help the growing demographic of children who are developing Crohn's. I can't even imagine how terrible it would be to be a 9 year old with this disease.

Also, 57 is kind of a rough age to feel like you are becoming useless. I think it's best to just pretend that I am somebody who was diagnosed at 27 and has to get on with their life. If that means that I end up taking on a new full-time career, so be it.

[chenda]

Anyways, I'm already planning to possibly volunteer for clinical trials so I can help the growing demographic of children who are developing Crohn's. I can't even imagine how terrible it would be to be a 9 year old with this disease.

That's a great idea. A friend of mine has had Crohn's since her childhood (she believes it to be heriditary as her mum had it) and has done various trials and experimental therapy and has found it to be a very worthwhile experience, regardless of the efficacy of the treatments. She used to have a really good blog about it all but she took it down otherwise I'd send it to you.

Otherpoint I'd make is that financially speaking this sort of reminds me of whether one should consider imputed rent into the calculation of x Jacobs you are living on. In that you it sounds like you can continue with current financial spending if you moved to the Mexican border but might prefer to stay in Michigan for a similar lifestyle which would cost more and hence might require 2 Jacobs rather than 1, though as noted the equation is sufficiently rough-and-ready so as there's plenty of mitigation wriggle room that your environmently impact is not significantly different in any meaningful way.

[WFJ]

I may be misunderstanding the purpose of this thread given the discussion of whether healthcare can be covered under a budget of one Jacob for everyone on Earth. But here are my thoughts given what I think it's asking.

Getting to FI with a very low withdraw rate helps with this. If you get to FI at any point and then you practice ERE, then you will probably get incidental income and/or your stash will grow over time, then you end up FI with extra money to spare in many cases. Using Jacob as an example he has 2x or 3x or 4x what he needs, so if he had an extra $10k per year of medical expenses like 7 does, then he'd be covered.

In general, if you really overaccumulated, then you may have enough extra money to cover these kinds of issues without going back to work. Adopting ERE and ending up at a high Wheaton level makes it pretty likely you'll overaccumulate, probably it's case by case whether you'll overaccumulate to the extent of covering future potential health issues.

If someone is planning to go the semiERE, then this scenario might be a good example to show why aiming for FI in the medium/long term (maybe within a decade of semiERE?) is worthwhile even if you are fully bought into the semiERE premise. The older you are, maybe the shorter the timeline to FI should be in order to match the increasing risk that health catastrophe strikes? I don't know.

If you get an illness that you couldn't have prevented despite all the other ERE methods of healthcare (ie holistic, preventative measures) and you are FI, then you'll still have your lifestyle expenses covered or at least you'll have a decade or two of higher expenses covered with time to come up with a new game plan.

Another option is to go somewhere where you won't have to worry about huge healthcare bills in the future. I know a fellow who immigrated to South Korea (and will become a citizen in another two years) because he had health issues that he knew would cost him a lot in the United States. Canada and several other European countries could also have you covered. You have to plan ahead for that solution, however.

EDIT: I think it's useful to point out that a lot of the illnesses we are worried about in this thread strike a lot more often in the 40+ crowd. For those of us in our 20s/30s that means we have one or two decades to accumulate before a likely issue. Plenty of time to accidentally overaccumulate. Even someone doing semiERE (especially the people on this forum doing semiERE who tend to make more than 2x JAFI per year during the years they work) for one or two decades has enough time to overaccumulate by accident and especially enough time to overaccumulate on purpose if they try to keep their expenses below one JAFI and explicitly have that goal in the long term.

I'm in the 40+ crowd and kept working well beyond ERE "number" for healthcare costs considerations.

Health and related insurance information is the only reason I joined ERE forum. I am planning to keep ACA (although have no experience with the care provided) and also balance with a more expansive coverage/maintenance program in a developing country (location is developing health tourism, nearly all common food is farm to table, no industry within 100+ miles). I am currently living in an area that is flooded with carcinogens and related activities and recently developed a condition that is related/correlated with carcinogens. Trying to arrange a WFH/remote location but will resign shortly if this is not possible.

IMHO, the health care issue is the #1 threat to all FIRE plans as even a temporary loss of health can result in a complete failure of the best laid FIRE plans.

If a probit/logit model of FIRE success were used where dependent variable was "Pass/Fail FIRE", a health dummy variable where independent health lasts until 90 =1, 0 otherwise would be positive and significant at the 0.000000000000001 level and at least a 50% increase in probability of FIRE success. Other independent variables like stock return, bond returns, CAPE rates, return volatility, return distribution, fat tail return, divorce, others would also be significant, but power would be minimal or insignificant compared to the health dummy variable IMHO.

I've had family members from the country-side live independently without ever seeing a doctor to the age of 96, another died in his sleep at 75. Close friends have had parents fall ill and die over a decade, without much control over the situation.

Not really sure if there is any way to estimate Health and ERE as it's almost like a reverse lottery/pageant, where a health loser, sustains all the loses, while non-health losers just enjoy almost no gains. Kind of like the opposite of "The average beauty contestant wins $20,000" where one wins a million and 49 win nothing. Modeling the expected value of entering a beauty pageant might create the same issues with modeling health outcomes and FIRE.

[Married2aSwabian]

Agree, @George. I’ve also seen quite a few coworkers in their 40s have health issues: heart attacks have been unusually common and sometimes with tragic results. This can be a result of poor lifestyle choices and stress, but heredity also plays a role. A friend of ours in Germany also lost his battle with a brain tumor last year. He was 55. So, at a similar age, do I have fears of similar fates swirling around my brain occasionally - of course. It’s a lot easier to feel like you’re invincible when you’re in your 20s or 30s.

Ultimately, even in our eff’d up American system, time is more precious than having perfect health insurance or more money at this point in my life. Time is NOT money, time is LIFE … and I’m reclaiming it!

[7Wannabe5]

In the case of a "random" chronic serious illness, the most cost effective approach I see is medical tourism. You could simply move to Mexico and enjoy cheap everything, including health care. If you are opposed to moving to Mexico, moving to a spot close to the border with Mexico is a viable alternative. There is a town in AZ full of medical semi-tourists/retirees who cross the border to go receive care in the adjacent Mexican town. It is a 20 minute drive. Very doable even if frequent medical care is required. You are very anchored in Michigan but with the severity of your health problems AZ could be a really good and cost effective solution. Try to modify the parameters of the system in case there are no good solutions in the existing system.

It looks like the drug prices in Mexico are about 1/3 of the prices in the U.S. However, it still doesn't save an individual whose medical expenses are very high from at least having to pay total out of pocket limit plus uncovered expenses which on most ACA plans (even at highest level of credit) or employer provided plans are going to amount to around $8000 per year at the very least.

Your individual expenses may vary with your symptoms and based on what your insurance covers, but the CCFA puts the average annual expense per IBD patient at about $19,000.

And this applies to anybody whose income is above 133% poverty level ($1416/month) which currently qualifies you for Medicaid. So, if your annual income is $18,000, you can expect to spend about half your income on medical expenses, even with highest ACA credit towards policy payment. The breakdown would be roughly $3000 for additional premiums towards lowest deductible policy, $4000 to max out deductible and out-of-pockets, and $2000 on uncovered expenses.

Since ACA credits also decrease as income increases, there is sort of a huge moat between income low enough to qualify for Medicaid and income high enough to not worry about the expense and/or VERY good employer sponsored insurance policy. That's why my current plan is to stay on Medicaid and attend STEM program in grad school until I magically pop out with above average income potential. Then 3 or 4 years of employment at above average income ought to adjust my flabby social security payments equation to the extent that the cost of online grad school classes will be more than covered.

the equation is sufficiently rough-and-ready so as there's plenty of mitigation wriggle room that your environmently impact is not significantly different in any meaningful way.

Not really sure if there is any way to estimate Health and ERE as it's almost like a reverse lottery/pageant, 4 4where a health loser, sustains all the loses, while non-health losers just enjoy almost no gains. Kind of like the opposite of "The average beauty contestant wins $20,000" where one wins a million and 49 win nothing. Modeling the expected value of entering a beauty pageant might create the same issues with modeling health outcomes and FIRE.

There's also the open question of whether any individual's medical expense should be morally credited to their "account" at the level of actual expense pre-insurance or "just" post-insurance expense. None of us know if we are going to be the "lucky winner" of the beauty pageant, so that is what insurance is for. Obviously, different societies manage this in different ways. For instance, at Level Red, I would likely just be left out on a rock somewhere. What I was trying to approach with my weak calculations somewhere up-thread is the approximate monthly cost of private insurance and contributions to government programs/research absent "preventable" or "broken window" expenses. It's still got to be something north of $200 per month, so almost 1/3 of ERE2 budget based on current global population and assuming medical care has average embedded energy costs.

Anyways, what would be most cool would be if I could hack this system at the level of science rather than bureaucracy. Probably the best I can do is Russian Roulette of clinical trials.

[WFJ]

I enjoyed a lot of time off in my 20's, 30's and worked almost all of my 40's. I am currently about to ERE again and will try to maintain professional designation in case health requires some kind of recurring payments. The nature of illnesses are so wide ranging that it's probably impossible to develop a model. The first dummy variable is Health =1, 0 otherwise, then quick death = 1, 0 otherwise. The only bad outcome is (0,0) as in (1, either) you are healthy and either live or die quickly, (0,1) sick, but die quickly not affecting ERE plans, but (0,0) is sick and die slowly and most likely expensive. Assigning probabilities to these two simple states of nature is impossible but all that matters in estimating health issues in ERE.

[7Wannabe5]

The nature of illnesses are so wide ranging that it's probably impossible to develop a model. The first dummy variable is Health =1, 0 otherwise, then quick death = 1, 0 otherwise. The only bad outcome is (0,0) as in (1, either) you are healthy and either live or die quickly, (0,1) sick, but die quickly not affecting ERE plans, but (0,0) is sick and die slowly and most likely expensive. Assigning probabilities to these two simple states of nature is impossible but all that matters in estimating health issues in ERE.

I agree that it is close to impossible for a given individual at this point in medical science/technology, but it's certainly not impossible to analyze statistically. What I am wondering about in this thread is the likelihood of (0,0) from all possible maladies/misfortunes give that I know that the relatively low, but not insignificant, prevalence rate of the (0,0) expensive to treat disease with which I am afflicted is 319 per 100,000 humans in North America and the incidence is 20.2 per 100,000 person-years. For example, if we assume that there are 100 such (0,0) possibilities with prevalence rates ranging from Alzheimer's at 1 out of 14 individuals over age 65 and incidence rates such as 200 closed head injuries per 100,000 humans per year in U.S. resulting in 80 -90,000 long-term disabilities (approximately twice as many men as women) per year through less likely possibilities, and assume independence, this might be roughly equivalant to spinning 100 roulette wheels each with 1/10,000 chance of catastrophic fail, every year for approximately 30 years, which amounts to approximately 26% risk of catastrophic health financial failure over 30 years if my assumptions and calculations are correct.

IOW, my point is that the risk of catastrophic financial failure due to health may be much higher than simple review of the top 5 causes of death might indicate. Something, something, something...that Taleb wrote about. AND also WAAAAAAAAAY higher than financial-financial failure following something like 4% Rule of Thumb.

[IlliniDave]

IOW, my point is that the risk of catastrophic financial failure due to health may be much higher than simple review of the top 5 causes of death might indicate. Something, something, something...that Taleb wrote about. AND also WAAAAAAAAAY higher than financial-financial failure following something like 4% Rule of Thumb.

If you look at causes of financial failure, using bankruptcy filings as a proxy, medical situations top the list at around 45% of all filings. Some of those are due to unpayable bills, some due to loss of the ability to continue working. Something like 20% of all filings are people over 55, and about 12-13% are over 65, and it might be reasonable to assert that among those older cohorts, more than the overall 45% of them ultimately trace back to medical situations.

That said, the numbers I could find suggest the bankruptcy rate in the US is under 1%/year, so worst case it's probably something under 30% when you try to guess at a cumulative number for a 30-35 year stretch of time (a typical retirement planning duration). About all we can maybe conclude is if a person does hit financial ruin in old age, medical conditions are the most likely culprit.

I am not aware of anyone who has actually failed using the ol' 4% rule. I also don't know anyone who is employing it, at least that I am aware of. In general you would probably need to superimpose some sort of financial catastrophe over it to crash and burn. My understanding is that things like 401s and IRAs are shielded from collections until the owner is above RMD age, so a big medical hit might wipe out taxable accounts but still leave an oversaver early retiree something to fall back on.

I'm among those who padded a good bit for the dual reason of having something significant left over for the kiddies, and to the extent possible absorb some of the vagaries of life, including medical issues in the out years. I did it based on instinct more than the gross statistics since I am pretty far from the median in some financial measures.

[7Wannabe5]

@IlliniDave:

It's interesting that your rough estimate working from bankruptcy filing is within rough confirmation zone of my very rough estimate working from catastrophic ailment statistics. However, I should have clarified that what I meant by "failure" was ability of invested funds to last 30 years given increased expense due to chronic health problem/expense as opposed to outright bankruptcy. Actually, I probably overstated the likelihood, because, for example, even if overall expenses are doubled on an annual basis due to health related expenses, and you retired on basis of X% SWR, you would still be operating within 2X% SWR scenario which wouldn't have 100% likelihood of failure.

[IlliniDave]

... I should have clarified that what I meant by "failure" was ability of invested funds to last 30 years given increased expense due to chronic health problem/expense as opposed to outright bankruptcy...

That's more or less what I understood you to mean, which is why I cited bankruptcy as merely a proxy. I've never run across any sort of hard data on depletion of retirement assets. I suspect most of the health-related bankruptcies among older cohorts occur in situations where people did not have any appreciable assets, much less a nest egg sized to support them for 30 years. I'd imagine the numbers would be higher if they included people who undergo meaningful impact to their financial lifestyle while escaping bankruptcy. It's a tough nut to crack in the sense of putting a number on it. For my own case I assume there's < 50% probability I'll encounter an outsized financial-medical issue (chronic or sudden). I left myself some wiggle room to try to mitigate the more dire potential impacts, mainly the brute force approach of going beyond 25X, and X being a number I can reduce if necessary. No guarantees even then, of course, and that approach isn't for everyone.

[WFJ]

I agree that it is close to impossible for a given individual at this point in medical science/technology, but it's certainly not impossible to analyze statistically. What I am wondering about in this thread is the likelihood of (0,0) from all possible maladies/misfortunes give that I know that the relatively low, but not insignificant, prevalence rate of the (0,0) expensive to treat disease with which I am afflicted is 319 per 100,000 humans in North America and the incidence is 20.2 per 100,000 person-years. For example, if we assume that there are 100 such (0,0) possibilities with prevalence rates ranging from Alzheimer's at 1 out of 14 individuals over age 65 and incidence rates such as 200 closed head injuries per 100,000 humans per year in U.S. resulting in 80 -90,000 long-term disabilities (approximately twice as many men as women) per year through less likely possibilities, and assume independence, this might be roughly equivalant to spinning 100 roulette wheels each with 1/10,000 chance of catastrophic fail, every year for approximately 30 years, which amounts to approximately 26% risk of catastrophic health financial failure over 30 years if my assumptions and calculations are correct.

IOW, my point is that the risk of catastrophic financial failure due to health may be much higher than simple review of the top 5 causes of death might indicate. Something, something, something...that Taleb wrote about. AND also WAAAAAAAAAY higher than financial-financial failure following something like 4% Rule of Thumb.

I agree that this is much higher than reviewing the top 5, but difficult to collect applicable data. If someone demanded data for this, I would define two variables; Genetics and environment. Genetics, for each individual, write down all the blood relatives you can think of and place them in the different quadrants. You then have a probability of your genetic relatives and a likely measure of your quadrant (probability of (0,0)). Environment, write down your last 10, 50+ friends you've interacted with in your local community and do the same with their parents/relatives. You then have an estimate of the environmental factors in each quadrant.

If one moves a lot, their environmental factor will be weighted lower. This is not a scientific estimate, but a good estimate IMHO.

Looking at mass date from any centralized source if fraught with measurement errors and more likely to provide false information than anything useful. I would ignore anything "X country has better healthcare because men who are taller than 5'9 with blue eyes who can afford to travel to hospitals we collect data from live significantly longer than all men in the US. X country healthcare is better despite spending X less than the US" as although statistically accurate, it's useless due to several biases in data collection that are usually hidden in footnotes or tables.

The above estimate has affected my FIRE plans as nearly all my blood relatives live very long and die quickly. Some live independently into their 90's, so I probably need a larger stash than many, but probably don't need as large to pay for end-of-life care.

[Alifelongme]

@ 7W5
For what it’s worth:
I had my genome sequenced and subscribe to service that informs me about new genetic research on the regular basis.
It helped me a lot since I did not know that I had a gene variants that are linked to Familial hypercholesterolemia, Celiac disease, Gout, Hemochromatosis, and Non-alcoholic fatty liver disease.

Observing my parents developing these conditions and opting for pills rather than changes in diet and lifestyle was educational, to say the least. So, when I was diagnosed with hypercholesterolemia I decided to try everything before succumbing to medical symptoms management, aka prescription pills. I have experimented with my diet, exercises schedule, and general lifestyle, while monitoring it with home tastes .
After years of experimentations I zeroed in on vegan, no gluten, no added sugar, no industrially produced oils diet.

Results: my cholesterol is under control, never had gout ever show up despite the fact that my both parents have it and I have a gene variant.

As for Celiac , Giving up bread was one of the best decisions although I did not develop any symptoms (yet) but the quality of my life improved significantly after that.

For Hemochromatosis I donate blood every 2 moths.

As for Non-alcoholic fatty liver disease the diet above seems to solve that as well.

I have no idea how long I can evade taking pills , but it’s been at least 3 years so far.

I monitor my cholesterol level, glucose, and bp fairly often to know what works and what’s not.

Hope it helps someone.

[Alifelongme]

Oh and btw , I developed macular degeneration in both eyes, and a subsequent tear in one.
That was not genetic, it was acquired working in a high stress environment and potentially can lead to blindness in the near future.
Solution : switch to audio books instead of the screen, spend more time outside, and learn Brail.