Early Retirement

[wetwillie]

I think there is some nuance being lost on this discussion around how much money we spend on on health care at end of life.

True, there is probably a better solution than the current one where in our last years on the planet we will all most likely give everything we have left from a lifetime of work to hospitals or insurance companies as opposed to our families, but 

How are m4A type plans in other countries setup for this? I assume some type of rationing happens.

[Kat Kid]

I think there is some nuance being lost on this discussion around how much money we spend on on health care at end of life.

True, there is probably a better solution than the current one where in our last years on the planet we will all most likely give everything we have left from a lifetime of work to hospitals or insurance companies as opposed to our families, but 

How are m4A type plans in other countries setup for this? I assume some type of rationing happens.

Rationing is one of the dumbest boogeyman in health care discussions, our country rations care through our insane insurance industry that is a complete black box with coding, in-networks/out of network, Rx, referrals from primary care, insane write downs on billing, the bullshit is endless! And as if that weren’t bad enough, people have almost no say in because our employers control it but it isn’t even really something you can negotiate with them like salary.

In other countries the secret sauce is mostly just boring crap like administrative costs are much lower, Doctors just don’t get paid as much and they don’t have as much pharma and medical device companies. That’s basically it.

I still think we can have a robust pharma industry even if we cut out insurance companies, but honestly I don’t see it happening any time soon because everyone in this country just looks existential problems in the race and accepts that nothing can ever change for the better or argues that it actually is good.  I hope it gets better.

[Purple Derpathy]

Quite a number of asinine comments the past 3 pages. Do we not have a resident Doc who can weigh in on this? 

I

[CNS]

I think there is some nuance being lost on this discussion around how much money we spend on on health care at end of life.

For sure.  That is changing as well, though, we, as a people, are living less well, but longer too. 

[catastrophe]

Quite a number of asinine comments the past 3 pages. Do we not have a resident Doc who can weigh in on this? 

I

The doctors I’ve spoken to don’t know the first thing about insurance or how much healthcare costs. Or maybe they just pretend not to know.

[Pete]

Quite a number of asinine comments the past 3 pages. Do we not have a resident Doc who can weigh in on this? 

I

The doctors I’ve spoken to don’t know the first thing about insurance or how much healthcare costs. Or maybe they just pretend not to know.

Agreed.

[Stupid Fitz]

Quite a number of asinine comments the past 3 pages. Do we not have a resident Doc who can weigh in on this? 

I

The doctors I’ve spoken to don’t know the first thing about insurance or how much healthcare costs. Or maybe they just pretend not to know.

Agreed.

yeah, most of them hate the BS admin costs and tasks that go along with everything. I'm sure they get tired of hearing everyone bitch about it at every appointment as well.

[Fedor]

Quite a number of asinine comments the past 3 pages. Do we not have a resident Doc who can weigh in on this? 

I

The doctors I’ve spoken to don’t know the first thing about insurance or how much healthcare costs. Or maybe they just pretend not to know.

Agreed.

They know a lot about Medicare and Medicaid tho.  Some guy I follow on twitter (who I'm pretty sure is a doctor) said that new Medicare rules are only allowing him to charge $18 a visit, which would not even pay overhead at a clinic.

[catastrophe]

Makes you think that a single payer system would make it a lot easier to talk about healthcare costs and what is appropriate.

I assume the Twitter doctor doesn’t take Medicare then?

[Fedor]

Makes you think that a single payer system would make it a lot easier to talk about healthcare costs and what is appropriate.

No, this is a ridiculous statement.  A command economy has no idea what is appropriate.

I assume the Twitter doctor doesn’t take Medicare then?

No idea.  But for those that do it is pretty apparent that non medicaid/medicaire patients (i.e. insured) are subsidizing the program. 

[kim carnes]

Medicare isn’t viable on its own.

[catastrophe]

I cannot think of a single reason doctors would accept Medicare patients if puts them in the red. If that’s the argument you’re making you’ve got to explain that piece to me.

[Justwin]

I cannot think of a single reason doctors would accept Medicare patients if puts them in the red. If that’s the argument you’re making you’ve got to explain that piece to me.

Some doctors don't accept Medicare/Medicaid patients.

Others that accept them can afford to accept them because private insurance covers the fixed costs the doctor has.  On the margin, they may make money on Medicare patients.  However, if everyone was a Medicare patient, there wouldn't be enough in reimbursement to cover their fixed costs.

[catastrophe]

And what are their fixed costs that private insurance is subsidizing?

[Justwin]

And what are their fixed costs that private insurance is subsidizing?

I was mostly just making the argument that I have heard.  My guess on fixed costs would be rent, support staff, malpractice insurance, etc.

[chum1]

I wish I would have done some truly epic crap when I was younger and am finding this inspirational.

https://twitter.com/SangerNYT/status/1371502647258255364

[Pete]

Chum midlife time?!?!

[Pete]

UPDATE:  I didn't think I would need this thread, but with the promise of cryto fortunes basically guaranteed, I should probably go back and re-read this for good ideas.

[star seed 7]

So, I need to take out some money from my 401k and my work said since I'm not working right now I will have to take out everything, remove the amount I want, and put the rest in a rollover account. I need to keep this money accessible for an occasional withdrawal when needed (1 or 2 times a year). What kind of account would be best for this?

[steve dave]

So, I need to take out some money from my 401k and my work said since I'm not working right now I will have to take out everything, remove the amount I want, and put the rest in a rollover account. I need to keep this money accessible for an occasional withdrawal when needed (1 or 2 times a year). What kind of account would be best for this?

Right now you can get ~5% on money market funds pretty much everywhere. I’d roll it into a vanguard IRA I guess. May not be understanding the question though.


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[star seed 7]

Yeah a money market is what my thought was. I just know nothing about this stuff.

[Katpappy]

Get a financial advisor as the good ones will do all the work and only charge a small percentage of your total investment  The amount they charge gets smaller after you invest the usual $500,000 or more.  My wife is retiring next month and my FA will let her invest with my account credit, but she will have her own account, and therefore, get credited at the same percentage as I'm getting or lower.

EDIT:  forgot to suggest that if your mom has a FA, then you might be able to add your investment with your own account but get a lower yearly charge.

[ben ji]

So, I need to take out some money from my 401k and my work said since I'm not working right now I will have to take out everything, remove the amount I want, and put the rest in a rollover account. I need to keep this money accessible for an occasional withdrawal when needed (1 or 2 times a year). What kind of account would be best for this?

Taking it out of your 401k is one thing...do that and roll it into an IRA with fidelity/schwab/vanguard whoever.

Once you do that you can withdraw whatever you need for your yearly expenses but will have to pay taxes on that. I would keep 1-3 year of expected expenses in a Money market/bond/whatever account and leave the remainder in an index fund.

Step 1 - Roll your 401k into an IRA
Step 2 - Figure out how much you need for the next year and withdraw that and pay the taxes
Step 3 - Rough estimate on how much you might need in the next 1-3 years and put that in a MM account in your IRA where it can't really go down.
Step 4 - Leave the rest invested in an index fund tracking the stock market and once a year withdraw 1 year worth of funds and transfer it to your MM account to replenish the funds you spent in the last year.

(I am not a financial advisor and just a dork who loves kstate sports and finances and bird hunting)

[catastrophe]

Not sure if it runs into the same problem if you’re not working but there’s some kind of mechanism to loan yourself money from your 401k then pay it back to yourself. I’ve never even remotely understood why that’s ok but I know someone who did it.

[star seed 7]

Ben ji, that sounds pretty much exactly like what I should do. This blog is amazing.