6 ms·

The problem in the US is healthcare. In my state the health insurance marketplace only has 'bronze' plans that are in-network only (with mediocre options) and

The problem in the US is healthcare. In my state the health insurance marketplace only has 'bronze' plans that are in-network only (with mediocre options) and high deductibles, it costs 6-800 for individual and close to 1500-2k for a family. The United States has rigged the employment market to forever keep you dependent on a corporate employer until retirement. Now these same companies are taking away remote work, forcing people close to expensive and increasingly annoying cities like New York City, where the median one bedroom is one million to buy. So, for giving your time to a company, your reward is never being able to be fully independent without huge risk. Healthcare is the Company Store Voucher of the modern era. Has anyone else considered leaving the United States long before retirement age?

adastra22 2y ago
ACA plans would be free / fully subsidized in that circumstance.
- anotheracc88 2y ago
  [flagged]
  - DiscourseFan 2y ago
    They are not going to gut the ACA, that would not only be extremely unpopular but also impossible in the current congress with only a 2 seat majority in the house for the Republicans.
    - EasyMark 2y ago
      They have to get it past the filibuster. Dems will not back down from that one, a lot of people don’t seem to realize what a slim margin the MAGAs have in Congress, it won’t take much to topple it. And their “Mandate” is more like a “Meh-ndate”
maximinus_thrax 2y ago
> Has anyone else considered leaving the United States long before retirement age? Yes. I'm American but was born in a small country in Eastern Europe. I was planning on moving back during the pandemic, however I was presented with some job prospects I couldn't reject and my move was delayed. But I do plan on retiring in my hometown within two years. There is universal healthcare which sucks for the most part, but private insurance is extremely cheap (compared to the US) and I could retire more than comfortably with my current nw. And by 'retire' I don't mean stop working, I mean I'm going to work on whatever I want. And to your original point about healthcare, it is the absolute single reason for why I did not take any sabbaticals or long term leave even while burned out, for my insomnia during layoff seasons and generally for my job related stress.
keyserj 2y ago
I'm in Illinois, my bronze marketplace plan was $247/mo this year, and the coverage was good (for what I used at least). 2025 plans look to be going up $50/mo or so which is annoying. Still a good chunk to have to pay, but nowhere near as bad as your situation. Makes me curious how much marketplace costs vary per state? In any case, as another person pointed out, the ACA plans also provide very high premium credits for low income households, covering up to ~80% of the costs (from what I've seen). But this also varies by state, I think.
iancmceachern 2y ago
Being your own employer is the only way to take charge of this. Platforms like Gusto, etc. make it so even small businesses can offer benefits and insurance like bigger companies do. I went though various big and small employers plans, several states' exchanges, and none were nearly as good as doing the legwork to get benefits setup for my own company. Now I choose.
- pcl 2y ago
  How do the costs pencil out on that, if you are signing up with Gusto etc. only for access to the health care plans? Presumably you need some minimum payroll or something?
  - iancmceachern 2y ago
    Yes, even of you are a one person company you need to pay yourself through some sort of payroll service so that you stay compliant with all the regulations and pay things like disability, various taxes, etc. So you already need them, or similar, to handle that stuff. The minimum payroll is defined by the minimum wage in your local area, keep in mind you can also choose how many hours you work.
    - le-mark 2y ago
      This sounds like one hell of a hack! Can you go into a bit more detail about how you have it set up?
      - iancmceachern 2y ago
        Someday I'll write a blog post about it. Feel free to reach out to me, contact info is in my bio. I'll be happy to share anything you'd be interested in.
        the__alchemist 2y ago
        This seems like an incredibly useful piece of information to anyone who doesn't have trad employment in the US. I found on Gusto's site info about how you can write off your insurance costs if you meet certain criteria. Is the benefit this, or something else?
m00x 2y ago
In Canada you just die before you get a family doctor :) Last time I went to the ER, the wait was 10h for kidney stones. Thankfully I passed out for 4h in the waiting room from the pain and the stones passed by the time I saw a doctor, so all they did was send me home. My family doctor died 10 years ago and I'm still on a list.
- nubinetwork 2y ago
  If you're from Ontario, you might want to call the health care connect people... I was on a list for roughly a year and a half, then out of the blue I got 2 referrals in 2 months (the first one never called me)... while the one I got isn't a typical family doctor, just having someone to help me with my needs is a start...
  - newsclues 2y ago
    Then you merely have unreasonably long waits for specialists and testing, and then more waiting for treatment!
    - psb217 2y ago
      It's super cool when you have to go through a chain of several specialists while dialing in on the problem. Especially when the default diagnosis is typically: "it's probably nothing, wait six weeks and make another appointment if it's still an issue...", lol.
- HWR_14 2y ago
  In the US, 70-80% of the time they just send people with unpassed kidney stones home from the ER. With painkillers and a giant bill.
  - Nifty3929 2y ago
    At least you get the painkillers. Not sure what else they'd really do for non-emergent kidney stones anyway. Painkillers is probably the best you can hope for, and getting them quickly and sent home sounds like a great outcome to me.
gorfian_robot 2y ago
in CA if you make less income than the minimum (like $18.5k as a single person) you are put onto the free Medi-Cal plan. so thats nice. :)
remyp 2y ago
I did. Healthcare was a big part of that decision. My older siblings have been through hell both medically and financially because of the US healthcare system. I decided to learn from their experiences and GTFO while I could. I miss my family and friends dearly, but it’s a massive relief (and privilege) to be able to get the care I need and not worry about whether the cost is going to bankrupt me.
- qwerpy 2y ago
  Where did you end up going? I have some savings and would like to retire early, and getting health insurance is an impediment to that. Need somewhere that doesn’t require a work visa and is a good place to raise a family. I have enough to do it in the US but would be happy to consider alternatives.
  - remyp 2y ago
    To Portugal. If you have enough assets to retire in the US then you probably qualify for the passive income visa. It’s not all smooth sailing, though. The immigration agency here (AIMA) currently has 300,000 cases in the queue. It’s so difficult to get an appointment that people are making hundreds of calls per day, standing in queues for hours only to not be seen, and filing lawsuits. Most people here make about €1200/mo and there’s a severe housing crisis that I have contributed to with my presence. The influx of people like me with vastly higher purchasing power is creating resentment: the far-right party quadrupled (5% -> 20%) their seats in parliament by running against immigration. Having said that, I do love it here. I’ve been considering blogging about my experience since there’s a dearth of clear-eyed information from real people who moved to Portugal and aren’t selling something. Anyhow, I’m happy to share more info and resources with anyone who wants to learn more. Please feel free to reach out - my contact info is in my profile.
    - tills13 2y ago
      Thanks for sharing your experience. And thanks for acknowledging your part in "the problem" -- truly, a lot of people in your position e.g. immigrate, and then try to pull the ladder up after them.
EasyMark 2y ago
The bronze plans are basically catastrophic insurance, not preventative care. If you want that you have to take it into your own hands in the USA; eat right, exercise, do the annual checkup Mine paid out when I had an appendix close to exploding and several days in the hospital. Of course I paid the deductible which was $6500, however the remaining portion would have put a large dent in my retirement fund, but thanks to the “bronze” plan, I was fine. So what is the risk for me?
winwang 2y ago
My friends have successfully relied on Medicaid during financial hardships + unemployment. At least in NYC, the Medicaid plans are quite decent. Also, for those who require plans similar to the one previously provided, COBRA (18 months) is decent -- expensive but presumably less expensive than "equivalent" in the marketplace if we're talking about a good corporate plan.
- mancerayder 2y ago
  18 months + 18 months in NY State for a total of 36 Just that COBRA costs quite a lot.

adastra22 2y ago

ACA plans would be free / fully subsidized in that circumstance.

anotheracc88 2y ago
[flagged]
- DiscourseFan 2y ago
  They are not going to gut the ACA, that would not only be extremely unpopular but also impossible in the current congress with only a 2 seat majority in the house for the Republicans.
  - EasyMark 2y ago
    They have to get it past the filibuster. Dems will not back down from that one, a lot of people don’t seem to realize what a slim margin the MAGAs have in Congress, it won’t take much to topple it. And their “Mandate” is more like a “Meh-ndate”

maximinus_thrax 2y ago

> Has anyone else considered leaving the United States long before retirement age? Yes. I'm American but was born in a small country in Eastern Europe. I was planning on moving back during the pandemic, however I was presented with some job prospects I couldn't reject and my move was delayed. But I do plan on retiring in my hometown within two years. There is universal healthcare which sucks for the most part, but private insurance is extremely cheap (compared to the US) and I could retire more than comfortably with my current nw. And by 'retire' I don't mean stop working, I mean I'm going to work on whatever I want. And to your original point about healthcare, it is the absolute single reason for why I did not take any sabbaticals or long term leave even while burned out, for my insomnia during layoff seasons and generally for my job related stress.

keyserj 2y ago

I'm in Illinois, my bronze marketplace plan was $247/mo this year, and the coverage was good (for what I used at least). 2025 plans look to be going up $50/mo or so which is annoying. Still a good chunk to have to pay, but nowhere near as bad as your situation. Makes me curious how much marketplace costs vary per state? In any case, as another person pointed out, the ACA plans also provide very high premium credits for low income households, covering up to ~80% of the costs (from what I've seen). But this also varies by state, I think.

iancmceachern 2y ago

Being your own employer is the only way to take charge of this. Platforms like Gusto, etc. make it so even small businesses can offer benefits and insurance like bigger companies do. I went though various big and small employers plans, several states' exchanges, and none were nearly as good as doing the legwork to get benefits setup for my own company. Now I choose.

pcl 2y ago
How do the costs pencil out on that, if you are signing up with Gusto etc. only for access to the health care plans? Presumably you need some minimum payroll or something?
- iancmceachern 2y ago
  Yes, even of you are a one person company you need to pay yourself through some sort of payroll service so that you stay compliant with all the regulations and pay things like disability, various taxes, etc. So you already need them, or similar, to handle that stuff. The minimum payroll is defined by the minimum wage in your local area, keep in mind you can also choose how many hours you work.
  - le-mark 2y ago
    This sounds like one hell of a hack! Can you go into a bit more detail about how you have it set up?
    - iancmceachern 2y ago
      Someday I'll write a blog post about it. Feel free to reach out to me, contact info is in my bio. I'll be happy to share anything you'd be interested in.
      - the__alchemist 2y ago
        This seems like an incredibly useful piece of information to anyone who doesn't have trad employment in the US. I found on Gusto's site info about how you can write off your insurance costs if you meet certain criteria. Is the benefit this, or something else?

m00x 2y ago

In Canada you just die before you get a family doctor :) Last time I went to the ER, the wait was 10h for kidney stones. Thankfully I passed out for 4h in the waiting room from the pain and the stones passed by the time I saw a doctor, so all they did was send me home. My family doctor died 10 years ago and I'm still on a list.

nubinetwork 2y ago
If you're from Ontario, you might want to call the health care connect people... I was on a list for roughly a year and a half, then out of the blue I got 2 referrals in 2 months (the first one never called me)... while the one I got isn't a typical family doctor, just having someone to help me with my needs is a start...
- newsclues 2y ago
  Then you merely have unreasonably long waits for specialists and testing, and then more waiting for treatment!
  - psb217 2y ago
    It's super cool when you have to go through a chain of several specialists while dialing in on the problem. Especially when the default diagnosis is typically: "it's probably nothing, wait six weeks and make another appointment if it's still an issue...", lol.
HWR_14 2y ago
In the US, 70-80% of the time they just send people with unpassed kidney stones home from the ER. With painkillers and a giant bill.
- Nifty3929 2y ago
  At least you get the painkillers. Not sure what else they'd really do for non-emergent kidney stones anyway. Painkillers is probably the best you can hope for, and getting them quickly and sent home sounds like a great outcome to me.

gorfian_robot 2y ago

in CA if you make less income than the minimum (like $18.5k as a single person) you are put onto the free Medi-Cal plan. so thats nice. :)

remyp 2y ago

I did. Healthcare was a big part of that decision. My older siblings have been through hell both medically and financially because of the US healthcare system. I decided to learn from their experiences and GTFO while I could. I miss my family and friends dearly, but it’s a massive relief (and privilege) to be able to get the care I need and not worry about whether the cost is going to bankrupt me.

qwerpy 2y ago
Where did you end up going? I have some savings and would like to retire early, and getting health insurance is an impediment to that. Need somewhere that doesn’t require a work visa and is a good place to raise a family. I have enough to do it in the US but would be happy to consider alternatives.
- remyp 2y ago
  To Portugal. If you have enough assets to retire in the US then you probably qualify for the passive income visa. It’s not all smooth sailing, though. The immigration agency here (AIMA) currently has 300,000 cases in the queue. It’s so difficult to get an appointment that people are making hundreds of calls per day, standing in queues for hours only to not be seen, and filing lawsuits. Most people here make about €1200/mo and there’s a severe housing crisis that I have contributed to with my presence. The influx of people like me with vastly higher purchasing power is creating resentment: the far-right party quadrupled (5% -> 20%) their seats in parliament by running against immigration. Having said that, I do love it here. I’ve been considering blogging about my experience since there’s a dearth of clear-eyed information from real people who moved to Portugal and aren’t selling something. Anyhow, I’m happy to share more info and resources with anyone who wants to learn more. Please feel free to reach out - my contact info is in my profile.
  - tills13 2y ago
    Thanks for sharing your experience. And thanks for acknowledging your part in "the problem" -- truly, a lot of people in your position e.g. immigrate, and then try to pull the ladder up after them.

EasyMark 2y ago

The bronze plans are basically catastrophic insurance, not preventative care. If you want that you have to take it into your own hands in the USA; eat right, exercise, do the annual checkup Mine paid out when I had an appendix close to exploding and several days in the hospital. Of course I paid the deductible which was $6500, however the remaining portion would have put a large dent in my retirement fund, but thanks to the “bronze” plan, I was fine. So what is the risk for me?

winwang 2y ago

My friends have successfully relied on Medicaid during financial hardships + unemployment. At least in NYC, the Medicaid plans are quite decent. Also, for those who require plans similar to the one previously provided, COBRA (18 months) is decent -- expensive but presumably less expensive than "equivalent" in the marketplace if we're talking about a good corporate plan.

mancerayder 2y ago
18 months + 18 months in NY State for a total of 36 Just that COBRA costs quite a lot.