3 ms·

I always wonder how americans can achieve FIRE with the healthcare system. It seems doable until something goes wrong and you get a huge bill?

1123581321 6y ago
Most Americans who want health insurance have it. Insurance pays the the bulk of a huge bill. The individual pays a small fraction of a huge bill through deductibles, co-payments and co-insurance (depends on the policy.) This fraction can be paid from the savings a FIRE retiree would have accumulated without significantly affecting their investment income. The individual pays a larger fraction of smaller medical bills, but because the bills are small, this is also affordable to someone with savings. The majority of medical events are inexpensive.
- redis_mlc 6y ago
  Everything you said is the opposite of reality in America in 2020.
  - 1123581321 6y ago
    This Wikipedia article is a good summary, especially the breakdown of uninsured populations. https://en.m.wikipedia.org/wiki/Health_insurance_coverage_in_the_United_States https://en.m.wikipedia.org/wiki/Health_insurance_coverage_in... There are a number of reports of out-of-pocket spending and insurance plan policy detail is generally available. Do you have a preferred source for that data? This conversation is about FIRE, but a summary of the prevelance of burdensome healthcare costs in respect to the broader US population was published here: https://www.commonwealthfund.org/publications/issue-briefs/2019/may/how-much-us-households-employer-insurance-spend-premiums-out-of-pocket https://www.commonwealthfund.org/publications/issue-briefs/2... Again, these are just gentle introductions to the data. I would be happy to read what you’re looking at.
_bxg1 6y ago
I never thought about that side of it; you do need health insurance. Anybody have an answer?
- 535188B17C93743 6y ago
  This is what I came up with: https://www.usatoday.com/story/money/2019/06/04/early-retirement-how-afford-health-insurance/1333554001/ https://www.usatoday.com/story/money/2019/06/04/early-retire... Looks like private insurance, previous employer benefits, your spouse's insurance (if they're still employed), and bare-bones plans are all options.
rayhendricks 6y ago
There are a good amount of healthcare resources for retirees and government workers in [WA, USA]. Before he passed away last summer my grandfather was using $26000USD/mo of insurance benefits which the state paid for as he was a retired public employee[0]. Literally added up all the expenditures because I was visiting and bored. This was mainly GP/Antibiotics at a hospital/PT work. The only thing they don't cover is long term care, of which we are currently paying $7500USD/mo for my grandmother. Yeah, it's a lot of money and they sold their [Grandparents] house last year for approximately $490,000USD after realtors comissions and fees thankfully before COVID. But I hope that puts things in to perspective for those outside the USA. Basically you have to do a medicare trust for your house or pay $6000-$13000USD/mo for longterm care. Usually what happens is people spend down the parental assets then apply for medicare and they try and find them a nursing home or memory care bed. [0] https://www.hca.wa.gov/employee-retiree-benefits/retirees/how-determine-eligibility#determining-eligibility https://www.hca.wa.gov/employee-retiree-benefits/retirees/ho...

1123581321 6y ago

Most Americans who want health insurance have it. Insurance pays the the bulk of a huge bill. The individual pays a small fraction of a huge bill through deductibles, co-payments and co-insurance (depends on the policy.) This fraction can be paid from the savings a FIRE retiree would have accumulated without significantly affecting their investment income. The individual pays a larger fraction of smaller medical bills, but because the bills are small, this is also affordable to someone with savings. The majority of medical events are inexpensive.

redis_mlc 6y ago
Everything you said is the opposite of reality in America in 2020.
- 1123581321 6y ago
  This Wikipedia article is a good summary, especially the breakdown of uninsured populations. https://en.m.wikipedia.org/wiki/Health_insurance_coverage_in_the_United_States https://en.m.wikipedia.org/wiki/Health_insurance_coverage_in... There are a number of reports of out-of-pocket spending and insurance plan policy detail is generally available. Do you have a preferred source for that data? This conversation is about FIRE, but a summary of the prevelance of burdensome healthcare costs in respect to the broader US population was published here: https://www.commonwealthfund.org/publications/issue-briefs/2019/may/how-much-us-households-employer-insurance-spend-premiums-out-of-pocket https://www.commonwealthfund.org/publications/issue-briefs/2... Again, these are just gentle introductions to the data. I would be happy to read what you’re looking at.

_bxg1 6y ago

I never thought about that side of it; you do need health insurance. Anybody have an answer?

535188B17C93743 6y ago
This is what I came up with: https://www.usatoday.com/story/money/2019/06/04/early-retirement-how-afford-health-insurance/1333554001/ https://www.usatoday.com/story/money/2019/06/04/early-retire... Looks like private insurance, previous employer benefits, your spouse's insurance (if they're still employed), and bare-bones plans are all options.

rayhendricks 6y ago

There are a good amount of healthcare resources for retirees and government workers in [WA, USA]. Before he passed away last summer my grandfather was using $26000USD/mo of insurance benefits which the state paid for as he was a retired public employee[0]. Literally added up all the expenditures because I was visiting and bored. This was mainly GP/Antibiotics at a hospital/PT work. The only thing they don't cover is long term care, of which we are currently paying $7500USD/mo for my grandmother. Yeah, it's a lot of money and they sold their [Grandparents] house last year for approximately $490,000USD after realtors comissions and fees thankfully before COVID. But I hope that puts things in to perspective for those outside the USA. Basically you have to do a medicare trust for your house or pay $6000-$13000USD/mo for longterm care. Usually what happens is people spend down the parental assets then apply for medicare and they try and find them a nursing home or memory care bed. [0] https://www.hca.wa.gov/employee-retiree-benefits/retirees/how-determine-eligibility#determining-eligibility https://www.hca.wa.gov/employee-retiree-benefits/retirees/ho...