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Author: intercst Big funky green star, 20000 posts Top Favorite Fools Top Recommended Fools Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 735032  
Subject: Retire Early Group Health Plan Date: 3/14/2000 2:14 PM
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BuildMWell wrote,

Harley, for som reason, I cannot copy and paste any messages on this board. But, your last post on healthcare is a good one. Would you please bring it forward as a new topic? I would like to throw out an idea that makes a lot of sense. I know a plan that I believe would make all of us REs a deal on health Insurance. I mean great rates and a really easy plan for yearly physicals, co-pay, etc. etc.

We have the power to become our own group. And, as a group, we would command excellent rates and super coverage. My thought would be to pick a high deductable ($1500 to $2500) but to offer catestrophic coverage for ERs who join the group. This would help other REs to join us.

What do you think?


Great idea, but there are a couple of hurdles.

(1) While the Retire Early crowd is probably healthier than most other folks their age, the majority are in their 40's and 50's. One reason group health plans are so cheap is they often have losts of relatively healthy 20-year-olds in the group that serve to keep premiums low.

(2) What's your plan for "pre-existing comditions"? As we age, more of us have medical problems that insurers would just as soon not deal with. If the Retire Early Group Health Plan was generous in accepting folks with "pre-existing conditions" it would drive up premiums for everyone. Eventually, healthier Early Retirees would find they could purchase equivalent coverage elsewhere at a lower cost.

intercst
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Author: backslash Three stars, 500 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6073 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/14/2000 2:22 PM
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(2) What's your plan for "pre-existing comditions"? As we age, more of us have medical problems that insurers would just as soon not deal with. If the Retire Early Group Health Plan was generous in accepting folks with "pre-existing conditions" it would drive up premiums for everyone. Eventually, healthier Early Retirees would find they could purchase equivalent coverage elsewhere at a lower cost.

Affirmative. Due to pre-existing conditions for my wife and my daughter, I anticipate having to maintain my HMO membership from here to eternity. (hmmm...catchy title). I checked and it will cost me $500+/month to match my current coverage that I get with my company. So I am figuring on $1000/month in 4 years when I retire, just to be safe. I probably won't have to cover my daughter for too long after that, but I'll leave the number alone. I prefer to be overly cautious.

It might be possible to get a group plan going, even if only the older and pre-existing join. I would think even a little break for volumn might help the costs. All the healthy, young, and overly optimistic can just get their own policies.

Harley

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Author: JimmySD One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6088 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 12:04 AM
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It might be possible to get a group plan going, even if only the older and pre-existing join. I would think even a little break for volumn might
help the costs. All the healthy, young, and overly optimistic can just get their own policies.

Does anyone know how many regulars enjoy this board. And how many would we need to form a group for an insurance co.

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Author: BuildMWell Big gold star, 5000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6105 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 8:37 AM
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Sorry to take so long to get back on this. I had to do my volunteer work yesterday.

Pre-existing conditions is an interesting subject. On my medical insurance plan, which is with a large, well estblished and reputable company, I was encouraged to get annual physicals for which they would pay. When the bills from my doctor reached them, the company adjusters, or whatever you call those people, rejected all bills as "pre-existing conditions". When I questioned the company, they said that all new bills were considered pre-existing. We are still going round and round on this.

My experience with several different companies is this:

1) You send them your money

2) Your doctor, who is on their approved list sends his bills to them.

3) The insurance company denies all claims for some reason.

4) You have to fight for every dime.

5) Eventually, you have to give up because there are not enough hours in the day, or maybe they will make a small concession.

6) You send them some more money.

7) The company raises your premium 60%, even though they have not had to pay out any claims. (My premium started at $320 for my wife and me in May 1999, was incresed to $405 in September when I reached 55 and then increased to $588 last month for no apparent reason.) So far, not one claim has been paid. Everyone is marked "pre-existing conditions".

This entire system is a sham. The companies do not want single customers. The risk is way too high. They want the security of large numbers.

If you are an individual (or a couple)in a plan, the company puts you into a group anyway. Depending on how your group performs, your rates can go all over the place, as have mine. But, if you have your oun group, you can set your own standards and the rates will be determined by your specific group. And, that is what I was suggesting.

So, back to "pre-existing conditions". In my group, I don't want any of you cats with pre-existing conditions. I want strong, healthy, vital individuals who ain't got no stinkin' conditions. I want low rates. Now, if you have allergies as pre-existing...Ok. If you have in grown toe nails...OK. But, if there are conditions that scare insurance companies...do not apply. I am tired of paying high rates for the sick people. Let them pay their own high rates. Us healthy individuals need to have a way to reward ourselves for our good health.

In my opinion, our good health is a result of taking care of ourselves over the last 40 or so years. My guess is, most of us are healthy because we have treated our bodies like we treat our investments. And, that ought to be worth something. I'm betting it is, and I'm betting on you folks to see the same thing.

Sorry for the rant, but I am mad and I ain't gonna take it any more. If necessary, I will just self insure and put aside some money for the day I might get ill. But, $325 per month is about my limit for health insurance...and that is too high.

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Author: BuildMWell Big gold star, 5000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6108 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 8:47 AM
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JimmySD asked about numbers. I was with a small corporation of "well" people. We had under 50 employees total. The company chose a $1500 deductable and got outstanding rates. They paid the first $1500, so we were 100% covered. But, in our case, each of us would pay our own first $1500. but would have catestrophic coverage for any big problems that might show up later. And, we can have it at a reasonable price which we can monitor.

I want to pick my group. So far, you people are it. I'm betting on you to be as "well" as I am.

Sorry, JimmySD, I want those young, healthy, overly optimistic ER folks in my group. That is the whole point. So, bring your past histories with you. Show there are no pre-existing conditions and let's get some really good rates.

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Author: backslash Three stars, 500 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6122 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 10:29 AM
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When the bills from my doctor reached them, the company adjusters, or whatever you call those people, rejected all bills as "pre-existing conditions". When I questioned the company, they said that all new bills were considered pre-existing...

Sorry for the rant, but I am mad and I ain't gonna take it any more. If necessary, I will just self insure and put aside some money for the day I might get ill. But, $325 per month is about my limit for health insurance...and that is too high.


You sound like a perfect candidate for Canadian citizenship. That way you don't have to pay for coverage (directly, at least). Also, I would suggest that you might like to find some less fly-by-night company to have insurance with. The only other time I've heard a story like that was in John Grishham's The Client.

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Author: inparadise Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6124 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 10:50 AM
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Buildmwell: In my opinion, our good health is a result of taking care of ourselves over the last 40 or so years. My guess is, most of us are healthy because we have treated our bodies like we treat our investments. And, that ought to be worth something. I'm betting it is, and I'm betting on you folks to see the same thing.

My, my, my. How compasionate of you. How about my friend's 5 year old who came down with cancer. Was he irresponsible? How about someone who gets hit by a car, or Daryll with his spinal cord injury. Too bad? How about my husband who got juvenile diabetes at the age of 13, probably because of the milk his mother was shoveling in since she had been told how good it was for him. Guess he was irresponsible too. How about all the genetically inherited problems faced by so many people. Should we just shove them off on an iceberg and let mother nature take care of them?

You simply don't have a clue until you walk in someone's shoes. I agree many people have poor diets and exercise routines. In many ways the government has propogated them with their nutrition guidelines and their push on milk. However blanket generalisations such as yours are judgemental and spawn predjudice.

Really disappointed in your post.

InParadise

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Author: jtmitch Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6131 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 11:13 AM
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In response to the exchange between Buildmwell and InParadise...

I definitely have to go with InParadise on this one. I have a daughter with an incurable (but, thank God, not life threatening) genetic disease which requires very expensive infusion therapy. I have agonized over her health insurance problems. (As she is no longer my legal dependent, she is on her own policy at the moment, but that does not eliminate the anxiety of a parent who does not want to see his daughter left out in the cold.) The problems, as I see them, are:
1. The US is about the only major industrial country in the world which does not include health care among the services generally available to the population.
2. The insurance companies "cherry pick" the risk pools wherever possible leaving those who seriously need the insurance in a very untenable position. (And I am the first to agree that some -- but clearly not all of those who need significant medical care bring their conditions upon themselves);
3. This has led to individuals cherry picking insurance programs to join -- a natural thing to do given the economic nature of man. But the result is that the premise upon which the concept of insurance is based -- shared risk among a population that will have a statistically predictable number of claims -- is undermined to the disadvantage of those who need the insurance most.

As InParadise said "You simply don't have a clue until you walk in someone's shoes .

jtmitch


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Author: intercst Big funky green star, 20000 posts Top Favorite Fools Top Recommended Fools Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6135 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 12:16 PM
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jtmitch wrote,

In response to the exchange between Buildmwell and InParadise...

I definitely have to go with InParadise on this one. I have a daughter with an incurable (but, thank God, not life threatening) genetic disease which requires very expensive infusion therapy. I have agonized over her health insurance problems. (As she is no longer my legal dependent, she is on her own policy at the moment, but that does not eliminate the anxiety of a parent who does not want to see his daughter left out in the cold.) The problems, as I see them, are:


1. The US is about the only major industrial country in the world which does not include health care among the services generally available to the population.
2. The insurance companies "cherry pick" the risk pools wherever possible leaving those who seriously need the insurance in a very untenable position. (And I am the first to agree that some -- but clearly not all of those who need significant medical care bring their conditions upon themselves);
3. This has led to individuals cherry picking insurance programs to join -- a natural thing to do given the economic nature of man. But the result is that the premise upon which the concept of insurance is based -- shared risk among a population that will have a statistically predictable number of claims -- is undermined to the disadvantage of those who need the insurance most.


I agree with all three items on your list.

I suspect BuildMWell's "politically incorrect" sentiments regarding pre-existing conditions may be a result of his experience in buying health coverage for himself and his employees and getting screwed by the insurance companies. Often the only way for a small employer to manage the high cost of health insurance is to throw the sick overboard -- if you can do it without getting sued, and are cold-hearted enough to still be able to sleep at night.

The "cherry picking" jtmitch mentions happens on both sides. Consumers obviously are going to shop around for the cheapest policy. Insurance companies spend lots of money trying to separate the "sick" from the "well" and only offer coverage to the latter. When I researched the Retire Early article on health insurance 3 years ago I found estimates that underwriting expenses for health insurance firms run as high as 28% of premiums collected. The uninsured in this country only make up about 15% to 20% of the population. There's a good chance we could cover everyone for what we are spending on health care as a nation today if we used the 28% being spent on cynical underwriting schemes and just spent it on actual medical care.

intercst


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Author: theTman Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6136 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 12:24 PM
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What would be the worst case monthly budgetary cost for health insurance for a single, couple and family of four? What inflation rate should someone use for the cost growth rate?

There are so many options and variables it is hard to get an accurate estimate so I want to use the worst case.


"T"

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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6137 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 12:25 PM
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There is no way that I can address this topic without seeming insensitive, but being politically incorrect is like second nature to me.

jtmitch said:
1. The US is about the only major industrial country in the world which does not include health care among the services generally available to the population.

<rant>I am so tired of hearing this. The US is a lot of things and not a lot of things. The fact that we have not accepted socialized medicine as a role of government is a badge of honor. If we create a cradle-to-grave nanny government we will lose freedoms we value above all else. If we do not continue to be "the only ...", then we will be just like them. Try paying Canada's taxes. See how you like it. The market may not be a kind and generous place, but it beats the hell out of Big Brother.</rant>

2. The insurance companies "cherry pick" the risk pools wherever possible leaving those who seriously need the insurance in a very untenable position. (And I am the first to agree that some -- but clearly not all of those who need significant medical care bring their conditions upon themselves);

<rant> Insurance companies are businesses. If we don't allow them to make a profit, they will go away. If we create different risk pools, then the people who use the service pay for it. All else is social engineering. If we're going to do social engineering, it should stay at the social level and forget the business level.</rant>

3. This has led to individuals cherry picking insurance programs to join -- a natural thing to do given the economic nature of man. But the result is that the premise upon which the concept of insurance is based -- shared risk among a population that will have a statistically predictable number of claims -- is undermined to the disadvantage of those who need the insurance most.

Isn't freedom such a horrible thing?

If you want to live in a society where the cost of keeping everybody else alive is born by the other members of the society, then I suggest you find or form such a society and leave the government and the industry out of it. It seems to me that this approach would be similar to a farm co-op. A not-for-profit insurance company to compete with insurance companies might just bring prices down. Perhaps a church contains enough like-minded individuals who will voluntarily help out their fellow citizens by pooling their health care dollars and risks. People helping people at a local voluntary level is the goal to strive for. Complaining that governments have too little power or that businesses and individuals look out for their own interests is self-defeating. If we accept the opposite, the benefit we gain isn't worth what we lose.

We have this problem because employers provide health care benefits as a deductible business expense. Perhaps we could convince employers to stop providing health benefits and just give us the money instead. Then we would need to convince the government that everone (short or long form) should be able to deduct the premiums paid to whichever group we decided to join. We could then join local broad pool groups or narrow cherry-picked pools. I have no problem with a voluntary "residents of church X" group so long as my premiums are deductible. Isn't this the proper role of church and civic organizations?

4goneFool


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Author: intercst Big funky green star, 20000 posts Top Favorite Fools Top Recommended Fools Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6138 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 12:40 PM
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theTMan asks,

What would be the worst case monthly budgetary cost for health insurance for a single, couple and family of four? What inflation rate should someone use for the cost growth rate?

There are so many options and variables it is hard to get an accurate estimate so I want to use the worst case.


I believe the worst case would be if you had a pre-existing condition that forced you into some kind of high risk pool.

I live in Texas which actually has a pretty good high risk pool. The premiums run about $700 per month for a 60 to 64 year old individual. It's about $250 per month for a 40-year-old.

Let's say you're 40 today and want to know what your health insurance costs will be in 20 years when you're age 60. I'd use at least double the rate of inflation for the CPI (3.5% average historically) which is 7%.

$700 x 1.07^20 = $2,708 per month x 12 months = $32,496 per year for one person. About what you'd pay for a year at Harvard today.

intercst



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Author: BuildMWell Big gold star, 5000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6140 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 1:25 PM
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To InParadise: You apparently did not read my post and did not really understand where I am coming from. Your rebuttal is ridiculous and off the subject.

I am as compassionate as anyone in America. I have every feeling and concern you do, but I never said anything about the problems you address. They have nothing to do with the discussion.

Pre-existing conditions are pre-existing. Sorry, they just are. Now, if you or anyone else are lucky enough to have no preexisting conditions, all I want to do is give those people credit for having no pre-existing conditions and invite them to join my group. We will go to insurance companies and present our case. If the insurance company ofers us a decent rate, we will send them our money.

Next year when someone in our group is hit with some of the diseases or inflictions you so elequently site, our rates will go up. If we are lucky, our group will continue to enjoy low rates because of our health. I do not wish to hurt anyone. I just want to be fair to our side.

You are just wrong.

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Author: BuildMWell Big gold star, 5000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6143 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 1:45 PM
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Intercst, I take strong exception to your implication that I am "Politically incorrect" and "cold hearted".

You apparently cannot read either. I sleep well at night and you are no more moral or politicall correct than any of the rest of us. This is a tough old world and we each have to make our way. I am sorry for life threatening diseases and the problems other people want to lay on us, but the truth is: "The people with pre-existing conditions are already under an insurance plan, or the conditions are not germain. If the people are not under an insurance plan, then the conditions fell on an uninsured person, and they have no complaint."

Now, to my point. Many healthy ER people would like to pay a reasonable amount to have catestrophic coverage. Why should we be concerned about people who have pre-existing conditions, but are already insured or who have no coverage and also have pre-existing conditions? We cannot help either group.

I am very confused. What is wrong with my proposal? There is nothing hard hearted, cold blooded or politically incorrect with trying to tell it like it is. If a large group can offer their excellent health as a group and receive good rates, what is the harm and who is hurt? The insurance company can use our premiums to pay some of the cases you people site. I'm trying to help, not hurt.

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Author: intercst Big funky green star, 20000 posts Top Favorite Fools Top Recommended Fools Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6144 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 1:50 PM
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BuildMWell wrote,

Pre-existing conditions are pre-existing. Sorry, they just are. Now, if you or anyone else are lucky enough to have no preexisting conditions, all I want to do is give those people credit for having no pre-existing conditions and invite them to join my group. We will go to insurance companies and present our case. If the insurance company ofers us a decent rate, we will send them our money.

Next year when someone in our group is hit with some of the diseases or inflictions you so elequently site, our rates will go up. If we are lucky, our group will continue to enjoy low rates because of our health. I do not wish to hurt anyone. I just want to be fair to our side.


Your right about the likelihood that someone in your group will get sick and your rates will go up.

Say I'm a member of the Retire Early Group Plan and a "good consumer", too. I notice that I can save $10 a month by moving to the "Retired Even Earlier Group Plan." I do so and other healthy members of the former group follow. Eventually, since we're all good consumers, the first group plan collapses when it's only remaining member is the guy on the waiting list for a liver transplant.

Insurance only works well when you have large groups. I believe that market segmentation and cherry picking is the cause of much of the health insurance problems in America. Inefficient markets make it easier for sophisticated players to earn "excess returns" at the expense of less informed participants.

Just look at how much better the stock market became for the small players with the end of "fixed commissions" in the 1970's and the democratization of investment information available on the Internet today. There's a good chance we could see the same improvements in the health insurance markets if we removed some of these impediments to establishing a level playing field.

intercst



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Author: BuildMWell Big gold star, 5000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6148 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 1:59 PM
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Thank you 4GoneFool, you are on the right track. What you have outlined is actually the next step. Insurance companies are in business to make money, therefore they are not enthused about paying out any money. They are like a money check valve. It goes in but can only leak out.

Maybe the next step for us is to try to become a commune. We can pool our own funds and then pay for any medical bills out of the pool. I know of several of these, and they do not work well because the same people who abuse the insurance companies will abuse this system.

After seeing the choices and hearing my plan vilified, I am going to self insure. The heck with this. Forget I mentioned it. I'll just keep my money in my own account and not help anyone.

Now, how is that for be politically incorrect and cold hearted?

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Author: justpatrick Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6149 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 2:03 PM
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backslash,

I agree with your comment about Canadian citizenship. However, I think that people just want to get what they pay for stuff. Any insurance company is going to deny as many claims as they can...that way they can keep their rates down. I think this is well documented in a number of lawsuits. The Client was just a novel, but there are certainly enough cases out there that are real.

Oh, I also am glad that the US has not socialized the medical system. I want to pick what I spend my money on...and think that I can do a better job of spending my money than the government can.

Just my opinion, take it for what you will.






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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6150 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 2:04 PM
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Insurance only works well when you have large groups. I believe that market segmentation and cherry picking is the cause of much of the health insurance problems in America. Inefficient markets make it easier for sophisticated players to earn "excess returns" at the expense of less informed participants.

Well, don't forget to add the current lawsuit-happiness of this country. I'm not saying that no medical lawsuits are justified, but a lot of them are not.

A true story: a good friend of mine has a brother who was an OB/Gyn in Houston. He delivered a baby with a clubfoot (genetic condition). Naturally, the parents sued him. The insurance company advised him to settle, even though it was clearly nothing to do with him.

He had two choices at this point. First, he could settle. This would, of course, cause his malpractice insurance rates to go up (they were already high). Not appealing on many levels. Second, he could fight it out in court. He'd probably win on appeal (medical jury trials are invariably decided in favor of the plaintiff, regardless of the facts) but if he didn't, the malpractice insurance wouldn't pay -- they'd already offered to settle and he'd be on his own. Also, the court costs would be his responsibility.

His reaction? He settled, quit the medical profession, and is now a construction supervisor of some sort. Apparently, he's not alone -- Ob/Gyn specialists are getting harder and harder to find across the country.

My recommendation would be to grant licensed medical professionals civil immunity to lawsuits. Not only would this dramatically cut down on costs, it would increase the professional's responsibility. After all, if you are harmed by a medical professional, you should file charges with the medical board. You should also file criminal charges. Neither one of these two steps are generally taken as they are almost always part of the cash settlement agreement. If you truly believe that someone is a menace to you and others, this would be more important than a big fat check.

Just my opinions, of course.

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Author: Daryll40 Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6151 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 2:13 PM
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backslash,

I agree with your comment about Canadian citizenship. However, I think that people just want to get what they pay for stuff. Any insurance company is going to deny as many claims as they can...that way they can keep their rates down. I think this is well documented in a number of lawsuits. The Client was just a novel, but there are certainly enough cases out there that are real.

Oh, I also am glad that the US has not socialized the medical system. I want to pick what I spend my money on...and think that I can do a better job of spending my money than the government can.

Just my opinion, take it for what you will.


I agree that lawsuits have gotten out of hand, but they are not the main culprit in high medical expenses. Expensive technology is the real issue. The lawsuits, however bad they are, do help to keep incompetence in check somewhat.








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Author: intercst Big funky green star, 20000 posts Top Favorite Fools Top Recommended Fools Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6153 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 2:19 PM
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rjstanford wrote,

Insurance only works well when you have large groups. I believe that market segmentation and cherry picking is the cause of much of the health insurance problems in America. Inefficient markets make it easier for sophisticated players to earn "excess returns" at the expense of less informed participants.

Well, don't forget to add the current lawsuit-happiness of this country. I'm not saying that no medical lawsuits are justified, but a lot of them are not.

A true story: a good friend of mine has a brother who was an OB/Gyn in Houston. He delivered a baby with a clubfoot (genetic condition). Naturally, the parents sued him. The insurance company advised him to settle, even though it was clearly nothing to do with him.

He had two choices at this point. First, he could settle. This would, of course, cause his malpractice insurance rates to go up (they were already high). Not appealing on many levels. Second, he could fight it out in court. He'd probably win on appeal (medical jury trials are invariably decided in favor of the plaintiff, regardless of the facts) but if he didn't, the malpractice insurance wouldn't pay -- they'd already offered to settle and he'd be on his own. Also, the court costs would be his responsibility.

His reaction? He settled, quit the medical profession, and is now a construction supervisor of some sort. Apparently, he's not alone -- Ob/Gyn specialists are getting harder and harder to find across the country.

My recommendation would be to grant licensed medical professionals civil immunity to lawsuits. Not only would this dramatically cut down on costs, it would increase the professional's responsibility. After all, if you are harmed by a medical professional, you should file charges with the medical board. You should also file criminal charges. Neither one of these two steps are generally taken as they are almost always part of the cash settlement agreement. If you truly believe that someone is a menace to you and others, this would be more important than a big fat check.


I like your idea.

While I believe truly menacing physicians are relatively rare, no doubt the few that are out there escape punishment because they get to "buy off" their victims with a big malpractice insurance settlement. That costs us all money. Eliminating this deep pocket for the trial lawyers might focus the public's attention on being more aggressive in pursing criminal charges against the miscreants.

One drawback to your plan. How many physicians would trade lower malpractice insurance premiums for an increase in the chance they'd face criminal charges if they screw up?

intercst


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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6154 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 2:30 PM
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One drawback to your plan. How many physicians would trade lower malpractice insurance premiums for an increase in the chance they'd face criminal charges if they screw up?

I wasn't actually proposing that we let them vote on it... :-)

Actually, I think that it might be well recieved. I know a couple of Doctors, and they're both annoyed at the current level of malpractice lawsuits/insurance premiums, and annoyed that really bad Doctors never really seem to get punished. I'll float the idea past them the next time I see them, and see what they think.

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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6155 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 2:31 PM
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One drawback to your plan. How many physicians would trade lower malpractice insurance premiums for an increase in the chance they'd face criminal charges if they screw up?

One more thought -- there's nothing preventing people from filing criminal charges against bad physicians now -- except for the large cash settlements that they may recieve if they don't. I'd bet that most people who would file under the new system also file under the current one.

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Author: jtmitch Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6157 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 3:07 PM
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jtmitch originally said:
1. The US is about the only major industrial country in the world which does not include health care among the
services generally available to the population.

<rant>I am so tired of hearing this. The US is a lot of things and not a lot of things. The fact that we have not accepted
socialized medicine as a role of government is a badge of honor. If we create a cradle-to-grave nanny government </b)we
will lose freedoms we value above all else. If we do not continue to be "the only ...", then we will be just like them. Try
paying Canada's taxes. See how you like it. The market may not be a kind and generous place, but it beats the hell out of
Big Brother.</rant>

jtmitch replies: I'm not saying that we should have a government-run, socialized medical program nor did I suggest that. The fact remains that access to medical care/insurance for all citizens is less generally available here than in other countries (i.e., many people are shut out of the system who could afford to and would be willing to pay a reasonable amount for insurance but who cannot afford the catastrophic costs associated with serious illness.) If the risk pools were less segmented we would all have to pay more for coverage but more people would be covered and an insurance company or insurance cooperative could still make a decent profit. I suppose one's view of whether the added cost is worth it or not depends on a number of factors but we obviously are on different sides of the fence.

jtmitch originally said 2. The insurance companies "cherry pick" the risk pools wherever possible leaving those who seriously need the
insurance in a very untenable position. (And I am the first to agree that some -- but clearly not all of those who
need significant medical care bring their conditions upon themselves);

<rant> Insurance companies are businesses. If we don't allow them to make a profit, they will go away. If we create
different risk pools, then the people who use the service pay for it. All else is social engineering. If we're going to do
social engineering, it should stay at the social level and forget the business level.</rant>

jtmitch replies: Again, I guess we are back to a significant difference of opinion. If there was the will in this country to create a private system of health insurance which sought to make a profit (but not necessarily squeeze out every last bit of margin) it could be done. The risk pools would include the healthy and the unhealthy and the risk would be spread more equitably. The healthy would pay a little more than they would under the "cherry picking" model and the benefit would be to the less healthy who would have access to health care. You may call it social engineering; I see it as simply giving everyone the same shot at a life as free from illness as is reasonably possible.



4gone fool summarized: If you want to live in a society where the cost of keeping everybody else alive is born by the other members of the
society, then I suggest you find or form such a society and leave the government and the industry out of it.

jtmitch replies: We already live in such a society - don't we all pay to keep our neighbors alive (or at least their welfare and safety at a reasonable level) by paying for fire departments, rescue squads, traffic lights, air traffic control systems, a military? I think there's two extremes here - either only those who have the money get any services at all or everyone is entitled to every service known to man. Where medical care falls on that spectrum is obviously a contentious issue. I personally vote for a private system which is compelled by law to widen rather than narrow the population covered. If it costs me a little more, so be it.

jtmitch

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Author: inparadise Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6159 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 3:24 PM
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4goneFool: If we create different risk pools,then the people who use the service pay for it.

Actually, not always. Realizing that every situation can come up with an annecdote to prove it's point, I none the less will impose upon you with mine as it is the situation I know.

As I stated earlier, my husband has been an insulin dependent diabetic since age 13. Because he has this condition, he is considered a high risk to insure based on the statistics of other diabetics. However, because he is an anal engineer, he has had his sugar under control since very early on. (Or maybe the need to practice such tight control to stay healthy was what developed his personality to go into engineering. I'm still trying to figure you engineers out ;-)) We practice a vegan diet, (no animal products whatsoever,) exercise 6 days a week, take lots of suppliments, and he tests his sugars and adjusts his insulin accordingly. For these reasons, his doctor has said he is the most symptom free diabetic he has ever seen. Note that he has been diabetic for 24 years.

I challenge you Big Mac gobbling "healthy" people to a side by side stress test with him any day. Loser pays insurance for a year.

But to get back on track, my point is he does not use the insurance any more and possibly less than the time bomb McDonald burger lovers. Yet I am quite sure they will charge us more once we retire.

(Please note that our conversion to a vegan diet is a health related one. I don't particularly want to get into a discussion about whether or not it is ethical to eat meat.)

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Author: inparadise Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6160 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 3:30 PM
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BuildMWell: To InParadise: You apparently did not read my post and did not really understand where I am
coming from. Your rebuttal is ridiculous and off the subject.


I suggest you go back and read your post with a critical eye. I read it several times. Based on the number of recommendations I received to my reply, and the follow up posts from others, I am obviously not the only one who misunderstood you.

InParadise

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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6161 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 3:31 PM
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The previous conversation summarys:

4gone fool summarized: If you want to live in a society where the cost of keeping everybody else alive is born by the other members of the
society, then I suggest you find or form such a society and leave the government and the industry out of it.

jtmitch replies: We already live in such a society - don't we all pay to keep our neighbors alive (or at least their welfare and safety at a reasonable level) by paying for fire departments, rescue squads, traffic lights, air traffic control systems, a military?


I have an admittedly slanted view of all this -- I grew up in the UK, where socialized medical services are available.

Something that many people seem to neglect is that a socialized medical structure does not preclude a non-socialized structure alongside it.

I would bet that if you added up the costs for Medicare, Medicaid, and the various employer-born insurance programs, that you'd end up with enough to fund a fairly low-level national healthcare plan -- without actually having it cost any more money than we currently pay (as a society).

This only works if the national plan watches expenses closely, and provides only a necessary level of service. For example, if you're in England and have a condition that requires a procedure but is not time-critcal (such as an ingrown toenail), you might have to wait for an appointment. If you have a serious heart condition, you get sent to the head of the line. And so on.

There are plenty of doctors in England who are not part of the National Health system -- and plenty of people who wish to pay more, either out of their own pockets or through private insurance -- to be given preferential treatment. This is just fine! The public and private systems coexist quite nicely, IMO.

As long as we (as a society) are set up so that medical care is available even if you can't pay for it (eg: Medicare, hostpitals not allowed to turn you away) then we'd be better of (IMO) if we admitted the fact and dealt with it properly -- ie: attempted to minimize the expense while maximizing the gains. As long as we pretend that the programs (such as free hostpital care) don't exist, we'll never use them efficiently.

As a sidenote, I had to go to the emergency room with a friend of mine a couple of months ago. There were plenty of people in there with very minor complaints -- flu, sore throat, et cetera. I overheard some converations -- since they had no insurance, they had chosen to go to the ER (causing a delay and quite an expense) because they wouldn't be forced to pay. Think of the societal cost of this type of behaviour, which is encouraged under the present system.

Oh, well. </soapbox> for the day.

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Author: inparadise Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6163 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 3:39 PM
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BuildMWell: I am very confused. What is wrong with my proposal? There is nothing hard hearted, cold blooded or politically incorrect with trying to tell it like it is.

Speaking for myself, what really caught my ire is when you essentially said people with pre-existing conditions had become this way by neglecting their health, and therefor got what they deserved.

Definitely not PC.

I understand the desire for lower premiums. Thankfully my husband can't be denied a job because of his pre-existing condition.


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Author: backslash Three stars, 500 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6165 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 3:53 PM
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BuildMWell: To InParadise: You apparently did not read my post and did not really understand where I am coming from. Your rebuttal is ridiculous and off the subject.

InParadise: I suggest you go back and read your post with a critical eye. I read it several times. Based on the number of recommendations I received to my reply, and the follow up posts from others, I am obviously not the only one who misunderstood you.


I am not going to get into the issue of the insurance anymore, because it is a tight spiral leading nowhere.

However, I would like to address another problem brought up in this thread. It is the communication problem. BuildMWell, I am not saying you were being cold-hearted or mean. However, I will say that your post definitely was. I've re-read it a number of times, and even trying to put a different spin on it doesn't change it. On the other hand, I don't know what was in your head or heart when you wrote it.

This issue is part and parcel with written electronic communication. People who write posts absolutely must try to be sensitive to how their words will be perceived, unless they just don't care if they are thought to be jerks. And people who read posts, when they get annoyed, should try to reread the post with a different point of view, in order to not make overly quick or harsh judgements.

There is no perfect way to resolve this issue. The best solution I know of is to think before you type. This medium is so perfect for quick bursts of thought and opinions, but unless we can temper our tendencies, it can become a major free for all. Of course, if someone is consistently annoying, that's what the frowny face is for. JMO.

Harley

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Author: intercst Big funky green star, 20000 posts Top Favorite Fools Top Recommended Fools Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6168 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 5:42 PM
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rjstanford wrote,

I have an admittedly slanted view of all this -- I grew up in the UK, where socialized medical services are available.

Something that many people seem to neglect is that a socialized medical structure does not preclude a non-socialized structure alongside it.

I would bet that if you added up the costs for Medicare, Medicaid, and the various employer-born insurance programs, that you'd end up with enough to fund a fairly low-level national healthcare plan -- without actually having it cost any more money than we currently pay (as a society).

This only works if the national plan watches expenses closely, and provides only a necessary level of service. For example, if you're in England and have a condition that requires a procedure but is not time-critcal (such as an ingrown toenail), you might have to wait for an appointment. If you have a serious heart condition, you get sent to the head of the line. And so on.

There are plenty of doctors in England who are not part of the National Health system -- and plenty of people who wish to pay more, either out of their own pockets or through private insurance -- to be given preferential treatment. This is just fine! The public and private systems coexist quite nicely, IMO.

As long as we (as a society) are set up so that medical care is available even if you can't pay for it (eg: Medicare, hostpitals not allowed to turn you away) then we'd be better of (IMO) if we admitted the fact and dealt with it properly -- ie: attempted to minimize the expense while maximizing the gains. As long as we pretend that the programs (such as free hostpital care) don't exist, we'll never use them efficiently.

As a sidenote, I had to go to the emergency room with a friend of mine a couple of months ago. There were plenty of people in there with very minor complaints -- flu, sore throat, et cetera. I overheard some converations -- since they had no insurance, they had chosen to go to the ER (causing a delay and quite an expense) because they wouldn't be forced to pay. Think of the societal cost of this type of behaviour, which is encouraged under the present system.


Excellent post.

I spent a year in London in 1984-85 while I was working for Exxon. After growing up with all the disparaging comments regarding "socialized medicine" I was very surprised to see first hand that Britons of every socioeconomic group appear to embrace their National Health system.

As you point out, they have private hospitals, as well equiped as any in the US, that serve wealthy Britons and Saudi royalty. Private health insurance (IIRC they call it BUPA) is available to the upper 10% or so of the population that can afford it. (I noticed that most of the employment ads in the London newspapers offered BUPA and a company car as perks for many professional and executive positions.) With few complaints, the other 90% of the population seems satisfied with the national health system.

I've haven't looked at the statistics in several years, but I remember that the US spends a greater portion of its GNP on health care than Japan or the UK even though we leave a significant part of our population without health insurance. As you point out, it's not like the uninsured are completely without care. They're just getting sporadic treatment for common illnesses in very expensive facilities like emergency rooms that we all end up paying for in higher taxes and insurance premiums.

intercst



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Author: markr33 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6172 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 6:18 PM
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UK System :

With few complaints, the other 90% of the population seems satisfied with the national health system.

Actually, I was just over in Europe last week and watched Sky TV (or BBC - don't remember) and there was a whole segment on a cancer drug which a certain woman couldn't get because of the "county" (or whatever they call it there) she lived in. It seems that each "county" decides the level of the care included in the "free" national plan. (NIH ?)

The show then went on to discuss the terrible deficiencies of the UK health system as it stands today.


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Author: vargaj Three stars, 500 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6173 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 6:18 PM
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rlstanford wrote:

"socialized medical structure does not preclude a non-socialized structure alongside it"

This is all very true, but we have a problem in this country: If you let a private health system operate along side a public one, some people can't stand it. They will always argue that if you have this type of system, the rich will get excellent care and the average guy will get merely average care, and we can't tolerate such unfairness. Nevermind that such a system guarentees that everyone has acceptable care (unlike the current system where some people have insurance and others don't). So alas it would never fly here.

Joe Varga



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Author: JAFO31 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6175 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 6:51 PM
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<<<<My recommendation would be to grant licensed medical professionals civil immunity to lawsuits. Not only would this dramatically cut down on costs, it would increase the professional's responsibility. After all, if you are harmed by a medical professional, you should file charges with the medical board. You should also file criminal charges.>>>>

What criminal charges?

Curiously, JAFO

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Author: BuildMWell Big gold star, 5000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6177 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 7:16 PM
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InParadise: Never one time did I say the people with pre-existing conditions were responsible for their condition. Never, did not do it! All I said was, There is no reason we, as a group, should not take advantage of our numbers to try to achieve a low cost coverage.

If I am right, and thr ER group has, on average taken better care of ourselves, like we do our money, we should have a real ggod shot at low rates.

Someone asked about pre-existing conditions. I responded that we would not take people with these conditions because they:

1) Already have insurance and would only hurt our cause

2) Do not have insurance and want to find a cheap free ride. And, again, I personnally do not want them.


I explained my situation with pre-existing conditions...I have none, but my insurer claims I do. They denied payment for a physical exam which they recommend and say they pay for. But, the coded it "pre-existing". The point is, the insurer wants to deny everything.

Apparently, you folks like to read only what you want into things and then ignore the main direction of the post.

All I ever intended was to suggest a plan that might be good for some of us and solve a big problem for future RE people. One of the major things that scare people facing ER is a lack of health insurance.

I thought we might have a group policy for "healthy" non-preexisting ERs to ease their concerns and, at the same time, provide the same for us.

My only reason for excluding pre-existing conditions is they confuse the picture and would make it next to impossible to ever get this started. But, I can see this is too controversial anyway. Like I said, I will just go it alone.

Of all the people you will meet in your life, I promise you, you will find few with less of what you thought you saw here. I apologize if I did not express my thoughts clearly enough, but my only desire was to help solve a problem which I see as significant.

Let's just forget I ever brought up this topic.


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Author: JAFO31 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6178 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 7:16 PM
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<<<<Actually, I think that it might be well received. I know a couple of Doctors, and they're both annoyed at the current level of malpractice lawsuits/insurance premiums, and annoyed that really bad Doctors never really seem to get punished. I'll float the idea past them the next time I see them, and see what they think.>>>>

If the doctors are really that bad, the other doctors are, IIRC, obligated (or should be, if I am mistaken) to report them to medical licensing authorities and/or the privileges group at the hospital, but rarely do; and the other doctors may well be the bst judges of the medical skill of the other doctors.

Just my $0.02. Regards, JAFO

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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6181 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 7:44 PM
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What criminal charges?

Well, that would depend on the case. You could start with criminal negligence and move on from there in many situations.

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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6183 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 8:57 PM
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jtmitch replied:

I'm not saying that we should have a government-run, socialized medical program nor did I suggest that.

Of course you didn't. You only brought up the same tired meaningless fact that everybody else brings up when they're about to recommend that we apply our favorite nuclear-powered flyswatter to the problem of "fair" health care. The fact that the US is different does not mean that we should call on the federal gevernment to act. Its track record on tough social problems is deplorable. The only thing it does well is write checks. Even a limited simple law such as "Ignore pre-existing conditions" will have so many amendments and riders tacked onto it that it will become a gun control bill or a tax cut bill or an anti-smoking bill or anything but a simple bill that says "Ignore pre-existing conditions". I listen to congressional committee hearings on my way home from my <shudder> job every day and I can assure you, we don't want the federal government involved in "fixing" our health care system.

You may call it social engineering; I see it as simply giving everyone the same shot at a life as free from illness as is reasonably possible.

Social engineering is not a bad phrase, but let us recognize it when we are doing it and let us not use the color of law to enforce it. I am admittedly a free markets advocate, but I see no problem with us actually getting value from non-market organizations when it comes to social engineering. Different branches of government are good at different things, but no government branch is good at dealing with anything as complex as "fair" health care. Building and maintaining roads, fighting fires, fighting wars and even air traffic control are much simpler than regulating an industry that will fail if it doesn't make a profit and be vilified if it does. This is why I suggested a medical co-op. Well managed co-ops can be efficient on shoestring budgets. You might call it communism, but it is communism on a community level where you look each other in the eye as you you pass on the street. Everybody hates to think that they are getting "charity" when they are being subsidized by others, but imposing government-coerced charity only makes it worse. Governments are a poor substitute for neighbors. Even huge organizations like AARP can be much more efficient than the government at securing "fair" rates for its members. Let's let the government continue to be the safety net and let the market be unencumbered by "controls" imposed by people who pander for votes and campaign contributions.

4goneFool


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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6187 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 9:12 PM
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Actually, not always. Realizing that every situation can come up with an annecdote to prove it's point, I none the less will impose upon you with mine as it is the situation I know.

You bring up a very valid point. No system will ever be fair to all individual participants. There will always be exceptions to the rule and your anecdotal evidence is sufficient proof of that. The problem I see with every proposed solution is that they will always be chasing perfection. All too many of the solutions will lose sight of the point of diminishing returns. It is axiomatic that perfection will have an infinite cost. Every anecdote that reveals an imperfection might therefore lead to the impossible quest. This is why I struggle to keep goverment out of some things. Any suffering or perceived injustice becomes an opportunity to pander for votes or campaign contributions. Voices of reason have a difficult time penetrating the fog of theatrics that accompanies emotional politics.

4goneFool


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Author: duggg Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6192 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 10:21 PM
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Regarding pre-existing conditions, I find myself in an unenviable position on the eve of my early retirement this May.

I have been with the same company and same health insurance provider for over five years. My employer has been dutifully paying my insurance premiums during that entire time.

I recently applied for individual coverage with the same insurer. But my application was rejected for pre-existing conditions, even though they continue to insure me under my employer's group plan.

To add insult to injury, the applications of other insurance carriers ask if any insurance carrier has ever rejected an application. Naturally, I must now answer yes, and just sit back and wait for the next rejection letter to arrive.

I might point out that three years ago, my doctor determined that I had high blood pressure and high cholesterol, which I indicated on my individual application. The application did not ask how many thousands of miles I bicycle every year.

Here's what I would like to know: My employer currently pays $100/month to my current insurer. Why won't that same insurer accept that $100/month from me?









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Author: intercst Big funky green star, 20000 posts Top Favorite Fools Top Recommended Fools Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6194 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/15/2000 10:31 PM
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mark33 wrote,

<<<<UK System :

With few complaints, the other 90% of the population seems satisfied with the national health system.>>>>

Actually, I was just over in Europe last week and watched Sky TV (or BBC - don't remember) and there was a whole segment on a cancer drug which a certain woman couldn't get because of the "county" (or whatever they call it there) she lived in. It seems that each "county" decides the level of the care included in the "free" national plan. (NIH ?)

The show then went on to discuss the terrible deficiencies of the UK health system as it stands today.


I don't doubt the story.

But how is the "county" denying access to a cancer drug any different than having your HMO do the same thing in this country?

While we're at it, I've got another UK vs. US health system anecdote to share with you.

In the US, just about everyone is eligible for Medicare if they get kidney disease and need dialysis or a kidney transplant (if they're lucky enough to find a donated organ.) There are something like 20,000 people in the US on kidney dialysis.

In the UK, they apparently have only about 50 "beds", nationwide, for long-term kidney dialysis. If you got a short-term problem that can be cured with a few weeks of treatment they'll give it to you. But they limit long-term dialysis to younger, otherwise healthy patients. It's just one of the cost saving decisions they make to insure that there is money to spend on less costly treatments that benefit a greater number of citizens.

intercst


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Author: lkfrey Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6208 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 3:54 AM
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"I challenge you Big Mac gobbling "healthy" people to a side by side stress test with him any day. Loser pays insurance for a year.

But to get back on track, my point is he does not use the insurance any more and possibly less than the time bomb McDonald burger lovers. Yet I am quite sure they will charge us more once we retire.
"

Good for you. We all live with our choices and the results of those choices. If we give up our power to a doctor, spouse, TV ad, or some other thing, we will still live ourselves with results.

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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6216 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 10:26 AM
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If you got a short-term problem that can be cured with a few weeks of treatment they'll give it to you. But they limit long-term dialysis to younger, otherwise healthy patients. It's just one of the cost saving decisions they make to insure that there is money to spend on less costly treatments that benefit a greater number of citizens.

It sounds heartless, but you actually end up helping a much higher number of people. If we had the money to help everyone, great. As long as we don't... these decisions, while hard, make a lot of sense. Most people support these types of measures -- as long as they never affect them, or someone they know. Emotion often wins out over economic sense.

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Author: hocus Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6222 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 11:20 AM
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My employer currently pays $100/month to my current insurer. Why won't that same insurer accept that $100/month from me?

This thread is in need of a pep talk. I quote the question above just as an illustration of dozens of questions that have been brought to the table and that show that our employer-based system of health coverage has left all of us far less informed than we would be if we purchased health care the way we do cars or houses. I have a lot of work to do in learning more about the ins and outs of obtaining health coverage.

Here's how the Doomed will respond to the questions/concerns voiced on this thread:

You know, this health stuff is really complicated. I'm starting to think it would be safer just to stay at my job like everybody else. I owe it to my family.

That's the wrong answer. We are dealing with this stuff, not because we like it, but because we are forced to if we want to have complete Retire Early plans in place. Once we've dug to the bottom of the information pile, though, we will be in far safer positions than the Doomed. Knowledge of alternatives over time generates confidence in the future.

Someday, many of the Doomed will be tripped up by one of the many things they don't know about health care. We will see the problems coming and deal with them before its too late. The core Retire Early principle is doing your own calculations and making your own decisions. Which is a pain in the short run. In the long run, we will be better off.

There are ways around all of the problems, although it takes a little time and imagination to find some of them. Blind acceptance of a relationship based on dependency is not the way to go. Expecting your employer to take care of you, without studying the exact details of how that is going to happen, is a mistake. It is the strategy of the Doomed.

That's what I'm good at--pep talks. I'll leave it to the math wizards to offer actual answers to the questions raised. ;-)

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Author: inparadise Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6230 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 12:22 PM
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BuildMWell: So, back to "pre-existing conditions". In my group, I don't want any of you cats with pre-existing conditions. I want strong, healthy, vital individuals who ain't got no stinkin' conditions. I want low rates. Now, if you have allergies as pre-existing...Ok. If you have in grown toe nails...OK. But, if there are conditions that scare insurance companies...do not apply. I am tired of paying high rates for the sick people. Let them pay their own high rates. Us healthy individuals need to have a way to reward ourselves for our good health.

In my opinion, our good health is a result of taking care of ourselves over the last 40 or so years. My guess is, most of us are healthy because we have treated our bodies like we treat our investments.


Buildmwell, imo the above implies that those who are not healthy are that way because they did not take care of themselves. I could simply just be sensitive to the topic.

My only reason for excluding pre-existing conditions is they confuse the picture and would make it next to impossible to ever get this started

Yet you say your insurance company considers you to have pre-existing conditions.

Of all the people you will meet in your life, I promise you, you will find few with less of what you
thought you saw here. I apologize if I did not express my thoughts clearly enough, but my only desire was to help solve a problem which I see as significant.</i?

Very happy to hear that. Quite honestly, it did not jive with your previous posts and I believe I stated something to that effect. Or possibly I erased it to keep to the subject line rather than get too snippy.

I don't think the original topic is without merit.

InParadise

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Author: inparadise Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6231 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 12:26 PM
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4GoneFool: This is why I suggested a medical co-op. Well managed co-ops can be efficient on shoestring budgets.

Isn't this how HMOs got their start?

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Author: Melman Two stars, 250 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6233 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 12:39 PM
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I have been an aspiring ER for many years, and have followed this board since it began. There are so many messages now that I don't have time to read them all, but I try to check in from time to time.

With regard to message #6222, is the board developing an "attitude"? Are we really referring to non-ER's as "the Doomed"? That is an elitist mindset that really doesn't do anyone any good.

I try to LBMM, but I have a hard time getting involved in the "LBYM" discussions for the same reason. Those boards tend to look down their noses at anyone who doesn't/can't/won't share their philosophy.

Hoping I'm reading more into this than was intended...


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Author: intercst Big funky green star, 20000 posts Top Favorite Fools Top Recommended Fools Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6234 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 1:04 PM
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Melman asks,

I have been an aspiring ER for many years, and have followed this board since it began. There are so many messages now that I don't have time to read them all, but I try to check in from time to time.

With regard to hocus's message #6222, is the board developing an "attitude"? Are we really referring to non-ER's as "the Doomed"? That is an elitist mindset that really doesn't do anyone any good.

I try to LBMM, but I have a hard time getting involved in the "LBYM" discussions for the same reason. Those boards tend to look down their noses at anyone who doesn't/can't/won't share their philosophy.

Hoping I'm reading more into this than was intended...


I think you are reading more into hocus's than intended.

Hocus is certainly eloquent enough to speak for himself, but I believe his reference to the "Doomed" is meant to describe those who choose not to take responsibility for their affairs and hope things will work out in the end. It's unlikely that anyone with even the minimal amount of ambition required to find the Retire Early board falls into this group. The fact that you are LBYM shows that you already taking proactive steps to chart your own course.

Those boards tend to look down their noses at anyone who doesn't/can't/won't share their philosophy.

I hope that's not happening on the Retire Early board.

I think those of us who been successful in following one Retire Early strategy or another will often argue forcefully that ours is the best way to do it, but we can all learn from those kinds of debates. I know I have. If someone says "His way is the best", you shouldn't immediately conclude that means he's belittling your philosophy.

intercst





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Author: hocus Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6238 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 2:02 PM
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With regard to message #6222, is the board developing an "attitude"? Are we really referring to non-ER's as "the Doomed"? That is an elitist mindset that really doesn't do anyone any good.

I call them "the Doomed" more out of concern than mockery. I worry about people who are counting on a long series of checks for years to come and who are going to be hit by a freight train when the checks stop. My personal interest in Retire Early ideas began during the recession of the early '90s, when I heard stories from about six different friends or relatives put out of work.

The world is not the way it used to be. Let me offer one example of the kind of thing on my mind. When banks determine whether you are eligible for a mortgage, they ask how much you earn. There seems to be a presumption that you will continue to earn at roughly the same level for 15 or 30 years. I question if this presumption is valid in a new world where both white-collar and blue-collar workers can see their place in the world change overnight.

I'm not saying whether these changes are good or bad. There are some good aspects to them. But there are real dangers for those not prepared. My goal is to offer a wake-up call. It mostly goes only to those already on the board, but there may be some fence-sitters who come here from time to time.

I understand the spirit in which you raise your questions. I can assure you the phrase is not rooted in elitism. It's possible, though, that I sometimes am too drawn to the colorful phrase. If the phrase causes the people I am hoping to reach to turn away, it defeats me. Your comment will certainly cause me to think twice before using it again.

I have to add in honesty, though, that "the Doomed" concept has real appeal to me. It conveys the idea that people are sleepwalking their way to a bad fate. I don't wish this on them at all, but the complacency of workers who have no savings and are running up debt while times are good makes me want to shake them sometimes.

Thanks, Melman, for expressing your concern. And thanks, intercst, for your post.

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Author: JAFO31 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6246 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 5:11 PM
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rjstanford:

[JAFO's prior post] <<<What criminal charges?>>>

"Well, that would depend on the case. You could start with criminal negligence and move on from there in many situations."

This answer intrigued me, so I did some quick research regarding Texas law.

First, criminal negligence is not itself a crime; it is a mental state (mens rea, which is generally required for most crimes).

Penal Code Setion 6.02 provides in part that one does "not commit an offense unless . . . with crimial negligence [one] engages in conduct as the defintion of an offense requires."

The four culpable mental states, from highest degree of intent to lowest are:
Intentional;
Knowing;
Reckless; and
Criminal Negligence.

Generally speaking, except for a handful of crimes (which I cannot recite of the top of my head, nor have I taken the time to reserach), "intent" is required for a criminal conviction.

In addition, and something that I should have mentioned in my first post, is the caonviction of a crime carries a higher burden of proof -- beyond a reasonable doubt -- than civil lawsuits. Thus, requiring thhis higher burden means fewer doctors (in this discussion) will be penalized than under the civil law.

Penal Code 6.03 recites that criminal negligence occurs when "WRT cirsumstances surrounding his/her conduct or the result of his/her conduct, he/she ought to be aware of a substantial and unjustifiable [emphasis added] risk that the circumstances exist or the result will occur. The risk must be of such a nature and degree that failure to perceive such risk constitutes a gross deviation [emphasis added] of the standard of care that an ordinary person would exercise under all the cirsumstances as viewd from the actor's viewpoint."

Note the proof difficulties, "a substantial and unjustifiable risk" , "gross deviation from the standard of care" , and what doctor will admit to being unaware or not obtaining informed consent.

Except for cases in which death results and criminally negligent homicide might be an appropriate charge, I again ask what criminal charges should ordinarily be brought?

Curiously, JAFO


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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6247 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 5:26 PM
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Except for cases in which death results and criminally negligent homicide might be an appropriate charge, I again ask what criminal charges should ordinarily be brought?

Geez. Now I'm left out in the cold. This was an idea that a bunch of us had kicked around in one of those nice bar bull-sessions late one night -- to be honest, I'm not remembering the specifics (although we did talk about them at the time) and I tried to bluff my way out when you asked the first time. Whoops! I'll have to call around and get back to you on this one.

In addition, and something that I should have mentioned in my first post, is the caonviction of a crime carries a higher burden of proof -- beyond a reasonable doubt -- than civil lawsuits. Thus, requiring thhis higher burden means fewer doctors (in this discussion) will be penalized than under the civil law.

Agreed -- with the rider that I feel few (if any) doctors are penalized under the civil law. Since the vast majority of civil lawsuits are settled out of court (indeed, many are filed with that intention) and doctors carry malpractice insurance, there's very little real harm. To put it another way, I don't believe that many suffer any more than they did the day the suit was filed (win, lose or settle) in that their premiums are going up.

Note the proof difficulties, "a substantial and unjustifiable risk" , "gross deviation from the standard of care" , and what doctor will admit to being unaware or not obtaining informed consent.

To turn that one around, is it reasonable to expect that anything short of a technically perfect situation be penalizable? Those sound like fairly good guidelines for the most part..

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Author: BuildMWell Big gold star, 5000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6248 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 5:28 PM
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Hocus, are you going to look into this health coverage issue? I seriously believe we have a opportunity to do something here if we choose.

Think about this. Let's assume we have 50 people who are interested in a program. And they are all married, to keep this simple. So, we have 100 people who need health coverage. Let's further assume the $200/mo. per person, which I now pay, is average. That is $40,000 per month or $480,000 per year. I do not know about you, but that looks like big bucks to me.

Now, let's assume further that we took just these facts to an insurance company. I bet we can get a real deal on catestrophic, $1500 deductable coverage.

In fact, I bet we could be self insured, invest the money, and make a pile for everyone of us and pay all the claims. Or, we could come up with any number of variations which would give us the back up insurance while still making a profit. Basically, it would be a mutual insurance company with each of us ERs as stockholders.

We would give the account to a brokerage firm to manage for us...at our direction and we would have to set up an organization to monitor and pay clains.

There is strength in numbers. I believe we may just have the numbers. Why waste our money on the existing system? Why not do what the Fool recommends and take control?

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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6249 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 5:40 PM
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Think about this. Let's assume we have 50 people who are interested in a program. And they are all married, to keep this simple. So, we have 100 people who need health coverage. Let's further assume the $200/mo. per person, which I now pay, is average. That is $40,000 per month or $480,000 per year. I do not know about you, but that looks like big bucks to me.

Unfortunately, that's small money to someone like BlueCross/BlueShield.

In fact, I bet we could be self insured, invest the money, and make a pile for everyone of us and pay all the claims. Or, we could come up with any number of variations which would give us the back up insurance while still making a profit. Basically, it would be a mutual insurance company with each of us ERs as stockholders

Its a nice idea, but on $480K/year one decent accident affecting just one person could easily put the group under.

Individual services like http://insweb.com already provide large-scale plan aggregating for individuals -- I doubt that anything will <1000 people will do significantly better from what I've seen. A healthy 45-year old non-smoker will pay ~$185/month for traditional (ie: non-HMO/PPO (more expensive)) insurance with 100% coverage and a $1500 deductible, for instance.

If you can find anywhere that's significantly cheaper, I'd love to hear about it -- I just think that you're being a little bit optimistic.

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Author: hocus Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6250 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 5:54 PM
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Hocus, are you going to look into this health coverage issue? I seriously believe we have a opportunity to do something here if we choose.

I am going to need health insurance, along with everyone else. I was planning to get coverage through a group, along the lines of how intercst handled it. I haven't come up with exact prices yet. If a group materializes from the board, I would certainly take a look at it.

I can foresee some difficulties in putting it together. For example, you'd have to have people respond by e-mail, etc., and some might be reluctant to do so. Another problem is that different people on the board will be retiring at different times. It may be that the number willing to sign on at the date you want to start would be smaller than what you need.

But that's not to say it's not worth a try. My guess is that the way to start is to contact some companies, get exact prices, post them to the board, and see if you get a sufficient number of responses. Does that make sense?


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Author: BuildMWell Big gold star, 5000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6253 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 7:14 PM
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Hey, Rjstanford, we're just kicking around some ideas. It pays to br overly optimistic. That way we can really look silly as the facts come out.

But, it is a good idea to look at options, sort out the details and see if there is way to get rich here someway.

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Author: jpkiljan One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6254 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 7:19 PM
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4GoneFool:

Please add me to your list of people you'd like to rant about. I think JTMitch and the people in just about every other western country have got it right. What we have now hurts the poor and it hurts our children. I'd have a lot more faith in the current US healthcare system if there were a fewer people who decide to just opt out and go with no insurance at all for themselves and their families (about 15% in my state, if I remember right); and, if the US infant mortality rate wasn't (from the last time I looked the data) trailing just about every other industrialized country.

What we have now just widens the gap between the poor and the rich in our country. It makes me wonder what social price we are going to have to pay for this situation in the future and what incentive those who are now sitting at the bottom of the economic heap have to save anything if they know they can loose it all to pay for a family member's medical condition.

Government is, by its very nature, inept, inefficient and bureaucratic; but the private sector has outdone the feds and gone beyond the pale in a Byzantine array price structures, billing complexity, prior condition pre-qualifiers, market manipulation, continuous-coverage certifications, waivers and political lobbying. It makes about as much sense to keep government (we call it 'gubmit' out West) out of our national heathcare system as it does to turn our military or criminal justice system over to the private sector. Would we want to fight just the cheapest wars or only the ones that bought us the lowest oil prices? Concentrate on arresting just the criminals with the most assets to recover (you can go home now kids!)? Those ideas seem absurd; but, for some reason, we think the 'for-profit' sector can best manage our basic medical safety net.

After many years we're starting to make progress in healthcare and someday I think our country will actually get it right; but, for now at least, count me among those who think it is as screwed up as a Chinese fire drill (apologies to the Chinese, here).

I sincerly hope you and your family keep your health in the coming years, 4Gone.

Don't forget to add me to that list!

-- JPKiljan

The Forgone Fool wrote:

There is no way that I can address this topic without seeming insensitive, but being politically incorrect is like second nature to
me.

jtmitch said:
1. The US is about the only major industrial country in the world which does not include health care among the
services generally available to the population.

<rant>I am so tired of hearing this. The US is a lot of things and not a lot of things. The fact that we have not accepted
socialized medicine as a role of government is a badge of honor. If we create a cradle-to-grave nanny government we will lose
freedoms we value above all else. If we do not continue to be "the only ...", then we will be just like them. Try paying Canada's
taxes. See how you like it. The market may not be a kind and generous place, but it beats the hell out of Big Brother.</rant>

2. The insurance companies "cherry pick" the risk pools wherever possible leaving those who seriously need the
insurance in a very untenable position. (And I am the first to agree that some -- but clearly not all of those who need
significant medical care bring their conditions upon themselves);

<rant> Insurance companies are businesses. If we don't allow them to make a profit, they will go away. If we create different
risk pools, then the people who use the service pay for it. All else is social engineering. If we're going to do social engineering,
it should stay at the social level and forget the business level.</rant>

3. This has led to individuals cherry picking insurance programs to join -- a natural thing to do given the economic
nature of man. But the result is that the premise upon which the concept of insurance is based -- shared risk among a
population that will have a statistically predictable number of claims -- is undermined to the disadvantage of those
who need the insurance most.

Isn't freedom such a horrible thing?

If you want to live in a society where the cost of keeping everybody else alive is born by the other members of the society, then
I suggest you find or form such a society and leave the government and the industry out of it. It seems to me that this approach
would be similar to a farm co-op. A not-for-profit insurance company to compete with insurance companies might just bring
prices down. Perhaps a church contains enough like-minded individuals who will voluntarily help out their fellow citizens by
pooling their health care dollars and risks. People helping people at a local voluntary level is the goal to strive for. Complaining
that governments have too little power or that businesses and individuals look out for their own interests is self-defeating. If we
accept the opposite, the benefit we gain isn't worth what we lose.

We have this problem because employers provide health care benefits as a deductible business expense. Perhaps we could
convince employers to stop providing health benefits and just give us the money instead. Then we would need to convince the
government that everone (short or long form) should be able to deduct the premiums paid to whichever group we decided to
join. We could then join local broad pool groups or narrow cherry-picked pools. I have no problem with a voluntary "residents
of church X" group so long as my premiums are deductible. Isn't this the proper role of church and civic organizations?

4goneFool

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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6257 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/16/2000 9:52 PM
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JPKiljan wrote:
The Forgone Fool

This was childish and uncalled for. You can disagree with me all you want, but let's keep it civil. I won't demand an apology, but I think you owe me one. If I ever resort to name calling, you can remind me of this and be assured I will apologize.

Please add me to your list of people you'd like to rant about.

I don't rant about people. In this case I was ranting about a meaningless fact that is always being cited to justify employing the least precise tool in our troubleshooter's toolbox. I even proposed an alternative solution which you did not address. You could have chosen to pick apart my idea, but instead, you chose to attack me. This is a common tactic of big government advocates, so I have fortunately developed a fairly thick skin.

Those ideas seem absurd; but, for some reason, we think the 'for-profit' sector can best manage our basic medical safety net.

Actually we have the government as "our basic medical safety net" and I have no problem with that. Medicaid serves its purpose just like SSI. I don't want to live in a nanny state and I'm pretty sure I wouldn't want to live in one even if I drop to the bottom strata of the economic scale. The fire-aim-ready approach of our federal government is highly unlikely to be fair, just, cost-effective or comprehensive. The profit motive in our health care system drives the innovation that makes our system routinely produce technological miracles. Without the profit motive, we wouldn't have such things as balloon angioplasty, laser eye surgery or any of the non-invasive procedures we now benefit from.

What we have now just widens the gap between the poor and the rich in our country. It makes me wonder what social price we are going to have to pay for this situation in the future and what incentive those who are now sitting at the bottom of the economic heap have to save anything if they know they can loose it all to pay for a family member's medical condition.

I respectfully disagree. What we have now is a capitalist economy that would go into recession if the burden of government became too great. Then the multitude of unskilled laborers that currently gets health care benefits from their capitalist pigdog employers would be laid off and Uncle Sam's coffers would soon be empty. We would be in really deep kimshi if that happened.

I'd have a lot more faith in the current US healthcare system if there were a fewer people who decide to just opt out and go with no insurance at all for themselves and their families (about 15% in my state, if I remember right);

The statistics show that the vast majority of uninsured are young single healthy males who are working and going to school so they can get higher paying jobs. For the most part, these are the people who least need medical insurance (except for those who ride donorcycles).

and, if the US infant mortality rate wasn't (from the last time I looked the data) trailing just about every other industrialized country.

The high infant mortality has been mainly attributed to poor dietary habits among unwed teenage mothers who are able to avail themselves of pre-natal care through medicaid but fail to do so despite the many community outreach programs that seek to educate them. This is not a problem that a national health care system can solve.

Don't forget to add me to that list!

If I added you to any list at all, it would be to the list of people who should be sentenced to watch CSPAN 1 & 2 for a whole session so they would see how our federal government works. Call it tough love if you will, but I think it might change your mind about relying on Big Brother for anything as fraught with opportunity as a national health care policy.

And BTW, my name is 4goneFool because when I joined TMF, it appeared that I had four more years until I could RE. I actually think that will now happen much sooner.

4goneFool


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Author: JAFO31 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6265 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 11:39 AM
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rjstanford:

<<<<Except for cases in which death results and criminally negligent homicide might be an appropriate charge, I again ask what criminal charges should ordinarily be brought?>>>>

"Geez. Now I'm left out in the cold. This was an idea that a bunch of us had kicked around in one of those nice bar bull-sessions late one night -- to be honest, I'm not remembering the specifics (although we did talk about them at the time) and I tried to bluff my way out when you asked the first time. Whoops! I'll have to call around and get back to you on this one."

Did not mean to cause any consternation. Late night bar bull sessions - I vaguely remember those. I look forward to the reply.

<<<<In addition, and something that I should have mentioned in my first post, is the caonviction of a crime carries a higher burden of proof -- beyond a reasonable doubt -- than civil lawsuits. Thus, requiring thhis higher burden means fewer doctors (in this discussion) will be penalized than under the civil law.>>>>

"Agreed -- with the rider that I feel few (if any) doctors are penalized under the civil law. Since the vast majority of civil lawsuits are settled out of court (indeed, many are filed with that intention) and doctors carry malpractice insurance, there's very little real harm. To put it another way, I don't believe that many suffer any more than they did the day the suit was filed (win, lose or settle) in that their premiums are going up."

If you really feel that few are currently punished (when more should be, my assumption from reading your other posts), I am less sure why you are interested in punishing fewer. Also, higher premiums is a form of punishment; hitting them in the pocketbook.

<<<<Note the proof difficulties, "a substantial and unjustifiable risk" , "gross deviation from the standard of care" , and what doctor will admit to being unaware or not obtaining informed consent.>>>>

"To turn that one around, is it reasonable to expect that anything short of a technically perfect situation be penalizable? Those sound like fairly good guidelines for the most part.."

For criminal punishment - time behind bars - yes; but that does nothing to make the injured party whole. I presume that your idea would also prevent civil lawsuits when there are criminal charges filed, otherwise there is a real equal protection clause issue, IMO. If I (not a doctor) injure you, I might suffer criminal penalties and a civil remedy; if my brother-in-law (the doctor) injures you, you have no civil remedy and must be satisfied with the criminal penalty. Any other delineation favors one class of injured party and disfavors another.

Regards, JAFO


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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6267 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 11:49 AM
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If you really feel that few are currently punished (when more should be, my assumption from reading your other posts), I am less sure why you are interested in punishing fewer. Also, higher premiums is a form of punishment; hitting them in the pocketbook.

This neglects the fact that the doctors in question suffer higher premiums from the second that the suit is brought. There is no real correlation between culpability and punishment any more, if you only look at the premiums.

For criminal punishment - time behind bars - yes; but that does nothing to make the injured party whole. I presume that your idea would also prevent civil lawsuits when there are criminal charges filed, otherwise there is a real equal protection clause issue, IMO.

Financial settlements from an insurance company do nothing to make the injured party whole either. I could retreat a little from my position -- allow for injury-related compensation but remove the quite rediculous punative portions of the suits.

If I (not a doctor) injure you, I might suffer criminal penalties and a civil remedy;

I should have mentioned earlier that I find this particular form of double jeopardy appaling!

Doctors are already singled out for different treatment in the courts, however. They are, for instance, immune from protection in Good Samaritan cases (which has done a marvelous job of preventing doctors from stopping to assist at accident sites).

I'm enjoying the conversation btw -- even though we're on different ends of it (best kind IMO). Its having the regrettable tendency to make me think more than I had intended though... :-)

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Author: Calligraphool One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6276 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 1:46 PM
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4goneFool writes:

The statistics show that the vast majority of uninsured are young single healthy males who are working and going to school so they can get higher paying jobs. For the most part, these are the people who least need medical insurance (except for those who ride donorcycles).

What's worse than lies, and worse than damn lies? :-)

My mother will turn 60 this year, has been running the saw shop since Dad died almost 7 years ago, and has had no health insurance since she quit her day job to take care of Dad and help run the shop while he faded away. Sole proprietorship. She applied to Blue Cross and got turned down. She has worked hard her whole life for the drones and now they won't insure her at any price. Could you blame her if she did choose to go to the emergency room? No, she is a responsible person and puts her doctor visits and mammograms on the MasterCard.

Oncologists take MasterCard, but not checks. Guess how I know. Dad had to put all of his cancer treatments on the credit cards. Yes, emotion about a personal situation will be more important to an individual voter than will the greater good of the masses. Just as one's personal profit motive is more important to worker motivation than the "greatest good for the greatest number".

My boyfriend's business (another sole proprietorship)finally got up enough cash last year so that he could sign up with Kaiser, and so far has been very happy with them. Age 35. They didn't even ask about pre-existing conditions. Before that he knew other things that most people don't, such as that it is $125.00 at a nearby industrial clinic to have a small piece of metal removed from one's eye.

Not all uninsured people are deadbeats looking to mooch off of the taxpayers. I know you didn't say they were, but I've been seeing an undercurrent of that sort of feeling in several postings. I don't have the Great Solution to the U.S. healthcare situation, but I do think we could be doing more to help uninsured people get insured. If there really are that many healthy young people in the pool, it should cost less, right? :-) :-) :-)

Calligraphool

PS: The preceeding message has been filtered through Headache-O-Meter, so Calligraphool apologises in advance for anything offensive or unintelligible she may have said.


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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6282 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 2:46 PM
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What's worse than lies, and worse than damn lies? :-)

Promises from politicians. :-)

Yes there are always exceptions in the statistics. That's part of the definition. I try to be careful to not use absolutes wherever I know that absolutes are meaningless. I learn much of what I write about from CSPAN's Washington Journal where topics that never get discussed on mainstream media are discussed on a daily basis. I would have assumed that the vast majority of uninsured were illegal aliens or urban minorities, but the statistics showed otherwise.

Young, healthy, single males have this immortality fantasy and consiously choose to postpone health insurance until later instead of subsidizing those who use it. One exception is skydivers. I've never met one who would admit to not having health insurance. They feel they are immortal, but they don't want to tempt the sky gods who regularly prove they are breakable. Cast and splints screw up their aerodynamics. I speak from experience here so I hope I haven't offended any fellow skydivers.

My mother will turn 60 this year, has been running the saw shop since Dad died almost 7 years ago, and has had no health insurance since she quit her day job to take care of Dad and help run the shop while he faded away. Sole proprietorship. She applied to Blue Cross and got turned down. She has worked hard her whole life for the drones and now they won't insure her at any price. Could you blame her if she did choose to go to the emergency room? No, she is a responsible person and puts her doctor visits and mammograms on the MasterCard.

Your mother sounds like a great candidate for a local medical co-op. If it wasn't for the fact that most people get their health care as an employment benefit, community based medical co-ops might have half a chance.

Not all uninsured people are deadbeats looking to mooch off of the taxpayers. I know you didn't say they were, but I've been seeing an undercurrent of that sort of feeling in several postings. I don't have the Great Solution to the U.S. healthcare situation, but I do think we could be doing more to help uninsured people get insured. If there really are that many healthy young people in the pool, it should cost less, right? :-) :-) :-)

I hope you didn't detect this undercurrent in anything I've written. Certainly none was intended. I agree we could be doing more. I want the best quality of medical care to be available to all at an affordable price. Unfortunately, the devil is in the details and in case this hasn't been clear from my posts, I have zero faith in the ability of the federal government to do anything but make things worse.

Calling on the federal government is the easy way out, but not the smart way out. Whenever a difficult problems presents itself, especially if there are emotional components to the problem (poor people, old people and children are the poster favorites), some people throw their hands in the air and say "this is a job for those guys on the hill who lie to us every 2, 4, or 6 years". I don't know the answer, but I have no doubt that a good answer won't come from our elected officals. I hope my co-op idea at least provided food for thought.

4goneFool



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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6284 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 3:01 PM
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Your mother sounds like a great candidate for a local medical co-op. If it wasn't for the fact that most people get their health care as an employment benefit, community based medical co-ops might have half a chance.

I'd missed this point. Has she tried the local chamber of commerce? Just about all of them that I know of offer group health insurance, with risk pooling, et cetera. No guarantees on pre-existing conditions, but acceptance rates are generally very high (approaching 100%). Prices are reasonable, if no better than you'd get at insweb.com/ -- its the acceptance rate that's the attraction.

Calling on the federal government is the easy way out, but not the smart way out.

I would agree with this, with one exception. We already have close to a socialized medical system. Between Medicare, Medicaid and regulations forcing hospitals to take all comers regardless of ability to pay, it already exists. We'd be better off admitting that fact and building a system to service it efficiently than insisting that it doesn't exist (and leaving poor folk with headaches to tie up emergency room staff).

Just my opinion, of course.

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Author: JAFO31 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6287 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 3:44 PM
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rjstanford: "Financial settlements from an insurance company do nothing to make the injured party whole either."

Sometimes money is all we can do; true return to status quo ante is often physically impossible, at least at our current level of knowledge.

"I could retreat a little from my position -- allow for injury-related compensation but remove the quite ridiculous punitive portions of the suits."

I am no big fan of punitives; another possible intermediate position is to allow punitives to continue to exist but not pay them to the party bringng the suit, but to pay them to (in this case, medical malpractice) the local agency that provides medical care to the indigent.

[JAFO's prior post] <<<<If I (not a doctor) injure you, I might suffer criminal penalties and a civil remedy;>>>>

"I should have mentioned earlier that I find this particular form of double jeopardy appalling!"

Double jeopardy has a particular legal meaning, but I understand what you mean.

"Doctors are already singled out for different treatment in the courts, however. They are, for instance, immune from protection in Good Samaritan cases (which has done a marvelous job of preventing doctors from stopping to assist at accident sites)."

Law of unintended consequences, I suspect. I have not read the Hippocratic Oath for sometime, but it might be possible that doctors are (or are suppused to be) duty-bound to render aid in these situtations.

"I'm enjoying the conversation btw -- even though we're on different ends of it (best kind IMO). Its having the regrettable tendency to make me think more than I had intended though... :-)"

So am I; and for the record, I am a transactional lawyer and do not do criminal work or litigation, so we may not be quite as opposite as you think.

Regards, JAFO


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Author: JAFO31 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6289 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 4:03 PM
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<<<<I want the best quality of medical care to be available to all at an affordable price.>>>>

To dream the impossible dream (or therein lies the problem). Medical care costs money; under any capitalist system (and probably any other system, as well), it is impossible to provide the best medical care to everyone at any price less than very expensive.

Althoug everyone points to the rationing of medical care in the current socialistic systems, especially as a shortcoming, we ration medical care in this country just as much, it is just more hidden and done by price and insurance coverage.

Until we all can admit that medical care will always be rationed under any system, we will never, IMO, have a rational discussion about the "preferred" system for rationing care.

Regards, JAFO

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Author: JAFO31 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6290 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 4:13 PM
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4gonefool: "Young, healthy, single males have this immortality fantasy and consiously choose to postpone health insurance until later instead of subsidizing those who use it."

I do not doubt this concept. It is why so many die from stupid actions.

"I would have assumed that the vast majority of uninsured were illegal aliens or urban minorities, but the statistics showed otherwise."

Can you point us in the direction of the specific statistics? Who collected the statisitcs and how were they collected? Are the statisitcs calcuated as a percentage of class (i.e. control for population sizes relative to the whole) or are they raw totals? etc. etc. etc.

As Twain said, "there are lies, there are d@mned lies, and then there are statistics."

Curiously, JAFO





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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6291 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 4:17 PM
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I would agree with this, with one exception. We already have close to a socialized medical system. Between Medicare, Medicaid and regulations forcing hospitals to take all comers regardless of ability to pay, it already exists. We'd be better off admitting that fact and building a system to service it efficiently than insisting that it doesn't exist (and leaving poor folk with headaches to tie up emergency room staff).

Excellent points. I would agree with you except for one thing, the builders of this new system aren't up to the task. Their solution would almost assuredly stifle competition and innovation. Competition drives effiency. Innovation drives advancement. Regulation and bureaucracy are brakes. As I said, I don't know what the answer is, but I'm sure it can't be found in the hallowed halls at the end of the mall.

4goneFool


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Author: jgoss1074 One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6295 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 4:46 PM
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"Doctors are already singled out for different treatment in the courts, however. They are, for instance, immune from protection in Good Samaritan
cases (which has done a marvelous job of preventing doctors from stopping to assist at accident sites)."

Law of unintended consequences, I suspect. I have not read the Hippocratic Oath for sometime, but it might be possible that doctors are (or are suppused to be)
duty-bound to render aid in these situtations.


It's ironic, because doctors are heavily discouraged from treating victims of an accident on the scene. However in some states certified EMTs and Paramedics are _required_ to stop at any accidents they encounter to offer assistance.

Jim

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Author: rjstanford Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6296 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 4:53 PM
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It's ironic, because doctors are heavily discouraged from treating victims of an accident on the scene. However in some states certified EMTs and Paramedics are _required_ to stop at any accidents they encounter to offer assistance.

Legally yes, they're required to. However, the physicians that I've talked to about it (unofficially of course) would never stop. Quite simply, if they arrive at an accident scene, they become liable for the survival of the people in the accident. If someone passes away 5 seconds after the doctor arrives, he's lawsuit-bait.

As an aside, if they work for a hospital and it provides their malpractice insurance, it generally won't cover situations such as this one ("voluntary" work outside the hospital job). That means that they're on their own (and no matter how rich you think a doctor is, one settlement will often bankrupt them).

And people wonder why they "fail to notice" an accident?

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Author: yamalama One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6297 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 4:59 PM
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Competition drives effiency.

Yes, but efficiency in what? If you're looking to maximize the quality of health care available to those who can afford it, then unencumbered capitalistic competition is by far the most efficient way to get there. But if the concern is how to deliver high quality health care to everyone, including those who can't afford it, how is competition going to make that efficient? If the competition isn't driven by money (and it isn't, if we're talking about people who can't afford to pay) then what do you expect to drive it?

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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6301 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/17/2000 8:33 PM
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Can you point us in the direction of the specific statistics? Who collected the statisitcs and how were they collected?

Sorry, no I can't. If this were usenet, I would be more careful about making sure I can attribute all statistics. As I believe I stated earlier, I learn much of this stuff while listening to CSPAN's Washington Journal on CSPAN radio. It's a wealth of info that gets ignored by sound-byte mainstream media. I am an honest person, but I don't expect you to believe me. CSPAN has an archive of their shows if you're really interested.

Are the statisitcs calcuated as a percentage of class (i.e. control for population sizes relative to the whole) or are they raw totals? etc. etc. etc.

This was presented as "the overwhelming majority of uninsured adults are young single males with minimum wage jobs who are going to school to obtain higher paying jobs" which I guess means just what it says, a raw count. I find it believable because this segment of the population is surprisingly large. Many people were also considered underinsured, but I'm not really sure what that means.

4goneFool



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Author: jpkiljan One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6308 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/18/2000 2:02 AM
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The FourGoneFool wrote:

This was childish and uncalled for. You can disagree with me all you want, but let's keep it civil. I won't demand an apology,
but I think you owe me one. If I ever resort to name calling, you can remind me of this and be assured I will apologize.



Oh calm down! No one has called anyone any names except when you called me 'childish and un-civil' just now. Perhaps you are confusing me with another poster. In keeping with your promise, your apology is accepted in advance. Your motives are not in question here, it is your conclusions and the facts you use to support them that are being challenged.

Sorry, but you may have a long wait for that apology you say you expect.



. . .I even proposed an alternative solution which you did not address. You
could have chosen to pick apart my idea, but instead, you chose to attack me.



Again, none has attacked you yet. It is your conclusions about the proper role of government (federal, state and local) that is being disagreed with. The alternative solutions you proposed in this (and other posts) weren't picked apart because they seem to have merit. They may also be used to fix what is broken about the system.



This is a common tactic of big government
advocates
, so I have fortunately developed a fairly thick skin.



Ouch! I'm certainly glad this wasn't name calling or a personal attack. This espcially hurts after spending so much of my working career trying to privatize government functions, but that's another story and you don't know me very well, yet.



Actually we have the government as "our basic medical safety net" and I have no problem with that. Medicaid serves its
purpose just like SSI.



I will argue vigorously that medicaid, medicare, big city hospital emergency rooms, county public health clinics and the few remaining charitable hospitals don't provide a medical safety net for our society and certainly not for it's children.



I don't want to live in a nanny state and I'm pretty sure I wouldn't want to live in one even if I drop to the
bottom strata of the economic scale. The fire-aim-ready approach of our federal government is highly unlikely to be fair, just,
cost-effective or comprehensive. The profit motive in our health care system drives the innovation that makes our system
routinely produce technological miracles. Without the profit motive, we wouldn't have such things as balloon angioplasty, laser
eye surgery or any of the non-invasive procedures we now benefit from.



On this we most certainly disagree. Medical research has not ground to a halt in countries with even the most socialized of medical systems. The list of medical research benefits coming out of Europe is pretty impressive. Just check out some of the European pharmicutical web pages. I think even the Russians were the first to invent corrective eye surgery.



. . . What we have now is a capitalist economy that would go into recession if the burden of government
became too great. Then the multitude of unskilled laborers that currently gets health care benefits from their capitalist pigdog
employers would be laid off and Uncle Sam's coffers would soon be empty. We would be in really deep kimshi if that
happened.



Sounds good, but you have neglected to explain why Germany, Sweden, the Netherlands, the UK and other countries with a much bigger 'burden of government' are not wallowing in a prolonged and continuous recession. Canada, with provincial medical coverage, has wallowed for the last couple of years because of the huge drop in comodity prices that small country is dependent upon. Just for fun, I looked at my last year's tax returns. I paid $6300 in federal tax and $2500 in state tax. In the meantime, my employer and I paid $6500 in medical insurance premiums, co-pays and the like. (This year it rises another 15% for the same coverage--about six times the general rate of inflation.) I'd still be ahead financially if my overall income taxes went up 70% and my healthcare costs were paid for.



The statistics show that the vast majority of uninsured are young single healthy males who are working and going to school so
they can get higher paying jobs. For the most part, these are the people who least need medical insurance (except for those
who ride donorcycles [sic]).



And, of course, these would be the people that it would cost the least to add to the system.



The high infant mortality has been mainly attributed to poor dietary habits among unwed teenage mothers who are able to avail
themselves of pre-natal care through medicaid but fail to do so despite the many community outreach programs that seek to
educate them. This is not a problem that a national health care system can solve.



Legions of unwed mothers not eating well and stubbornly refusing readily available pre-natal care are knocking holes in our under-five mortality rates! I can see why you were worried about sounding politically incorrect in your first post. Sounds like a good 10-minute topic for CSPAN, though. Pardon my skepticism, but I would love to see someone actually prove this or even provide a plausible reason as to why it doesn't happen in other industrialized countries whose unwed status matches or exceeds our own.



[Don't forget to add me to that list!]

If I added you to any list at all, it would be to the list of people who should be sentenced to watch CSPAN 1 & 2 for a whole
session so they would see how our federal government works. Call it tough love if you will, but I think it might change your
mind about relying on Big Brother for anything as fraught with opportunity as a national health care policy.



That would be painful, indeed! I cannot stand cable news' teasers, sound-bite reporting, and 'Let's put out what gets them excited' format. Thoughtful pro and con editorials is what appeals to me--the truth usually bubbles to the top pretty quickly. You can find that kind of reporting if you look for it. Thanks for keeping me on the list though--I kinda consider it a 'badge of honor' as you called it.



And BTW, my name is 4goneFool because when I joined TMF, it appeared that I had four more years until I could RE. I
actually think that will now happen much sooner.



And I certainly hope you make it--it feels nicer the closer you get.


-- John



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Author: Airmom One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6310 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/18/2000 5:36 AM
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4goneFool said:
Young, healthy, single males have this immortality fantasy and consiously choose to postpone health insurance until later instead of subsidizing those who use it. One exception is skydivers. I've never met one who would admit to not having health insurance. They feel they are immortal, but they don't want to tempt the sky gods who regularly prove they are breakable. Cast and splints screw up their aerodynamics. I speak from experience here so I hope I haven't offended any fellow skydivers.

I have been saying that one of the things I wanted to do before I died was to go skydiving. Well, my boyfriend took my sayings seriously and gave me a tandem jump gift certificate for Christmas. I plan on using it in June. I need to wait until the last life insurance policy I bought about 2 years ago passes the contestibility period in May. Wouldn't want my teen age son to be without a mom and money at the same time.

Anyway, I thought I wanted to do this. However, the closer this dream gets to being a reality, the more fear grips my heart. What is skydiving really like?

Will I be pushed out of the plane if I get too scared to jump out?

What are my real chances of injury or death?

What are my chances of loving it and making it my new hobby? If it does become my new hobby, how expensive is it (so I can adjust my ER budget)?


Airmom
Getting closer to ER with
each passing moment




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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6311 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/18/2000 8:45 AM
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Airmom asked:
Anyway, I thought I wanted to do this. However, the closer this dream gets to being a reality, the more fear grips my heart. What is skydiving really like?

It is absolutely, without a doubt, the most fun thing you can do with your clothes on. The experience is completely indescribable. The adrenalin rush tops that of anything I've experienced and that would include hangliding, scuba diving, driving very fast, and all sorts of high g amusement park rides.

Will I be pushed out of the plane if I get too scared to jump out?

I've never heard of that happening. It probably depends on whether your husband is in the plane with you. :)

What are my real chances of injury or death?

Your chances of death are extremely low, well below the chances when landing with any plane. Your chances of injury are similar to those with sports like touch football. Ankle sprains are the most common injury.

What are my chances of loving it and making it my new hobby?

Most people who jump once are very glad they did it, but never jump again. Many returnees only jump a second time, just to prove they can. I would say the odds are against you making it a hobby. I stopped at 40 jumps when I ran out of money while in college and haven't been back in freefall since, but I still get a rush out of thinking about it.

If it does become my new hobby, how expensive is it (so I can adjust my ER budget)?

It is for some people, a very costly obsession/addiction. You can figure on several hundred dollars per weekend as being the upper limit of your exposure, unless you decide to combine it with travel to the many social events and tournaments.

4goneFool


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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6315 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/18/2000 9:49 AM
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jpkiljan wrote:

No one has called anyone any names except when you called me 'childish and un-civil' just now.

You consider calling me "The ForGone Fool" (go back and reread your post) to be not name calling and you consider calling your actions childish and un-civil to be name calling. Hmmmmm. I think this is a shoe-fits. What I did was criticism. What you did was name calling.

Ouch! I'm certainly glad this wasn't name calling or a personal attack. This espcially hurts after spending so much of my working career trying to privatize government functions, but that's another story and you don't know me very well, yet.

For the record, I did not call you a big government advocate and I did not assume you were one. I merely stated that name calling and personal attacks are a common tactic of big government advocates. I did not say this tactic was used exclusively by big government advocates. You're right, I don't know you, but your reading skills seem to lack precision.

Legions of unwed mothers not eating well and stubbornly refusing readily available pre-natal care are knocking holes in our under-five mortality rates! I can see why you were worried about sounding politically incorrect in your first post. Sounds like a good 10-minute topic for CSPAN, though. Pardon my skepticism, but I would love to see someone actually prove this or even provide a plausible reason as to why it doesn't happen in other industrialized countries whose unwed status matches or exceeds our own.

I noticed that at first you mentioned an infant mortality rate and then it became an under-five mortality rate. Is this deliberate obfuscation or are you really this imprecise? As is often quoted by the advocates of big government, other industrialized countries don't have an unwed mother status that matches or exceeds our own. I could run down the long litany of things big government advocates use to try to justify government intervention in our lives, but I prefer to dig for grains of truth behind the meaningless "we're different" statistics they quote.

That would be painful, indeed! I cannot stand cable news' teasers, sound-bite reporting, and 'Let's put out what gets them excited' format. Thoughtful pro and con editorials is what appeals to me--the truth usually bubbles to the top pretty quickly. You can find that kind of reporting if you look for it.

You're confusing CSPAN with MSNBC or Fox News. CSPAN doesn't do teasers, sound-bite reporting or the hot topic format. They let the cameras roll on sessions of congress, political conventions, state of the union speeches, etc. They don't pop in and provide analysis like Brokaw, Jennings and Rather. They just let the cameras roll and let you decide for yourself what was said and what it meant. You can get your thoughtful pro and con analysis from the between-session shows and their call-in viewers run the range from very knowledgeable and insightful to totally deranged. They have the widest range of talking heads too. They are a non-profit or not-for-profit service paid for but not under the control of cable companies. When cable tv was in its infancy, this deal was struck with the government that certain community service stations would be created. Some show local and state government. CSPAN shows national government. Their guests aren't paid and yet they get the full range of authors, policy wonks, politicians, civil servants, reporters and advocacy groups as guests on their morning show. Frequently, the call-in viewers ask tougher questions than you will ever hear from reporters and except when the politicians are on, you get a lot of honest answers. This is brain food.

This thread has taken on the characteristics of a usenet Kobayashi-Maru. I'm ending my part here with a request that you read more carefully and don't assume what isn't there. My original rant was not personal. I'm sorry that you took offense.

4goneFool


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Author: ariechert Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6316 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/18/2000 10:43 AM
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I am just seeing if I understand how to get stuff into italics and if I can make it work. - Art

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Author: ariechert Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6317 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/18/2000 10:45 AM
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I am just seeing if I understand how to get stuff into italics and if I can make it work. - Art
Hurrah! Eureka, it worked!


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Author: mpkear Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6319 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/18/2000 11:09 AM
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Hello Airmom,

What are my real chances of injury or death?

Actually, I don't know the answer to this one. Very slim though I do believe.

I did a tandem jump about 13 years ago. Think about it this way. The instructor, unless he is on a suicide mission, is going to do his best to ensure that you do not get hurt.

We jumped from about 12000 feet and opened the chute at around 5500 feet. While freefalling, keep your mouth closed. I opened mine and then had trouble closing it because of the wind.

You'll love it. I haven't done it since then because I had to try white-water rafting and I had to climb some mountains and go on a hot air balloon ride. Now with two young boys I spend most of my time working or with the family.

If you haven't tried it yet go on a hot air balloon ride. I went on mine in Colorado and it was beautiful. I loved it so much that for my parents 25th wedding aniversary I set it up for them to go on one.

Have fun

Mark :-)




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Author: YZF1K Two stars, 250 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6339 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/18/2000 5:32 PM
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Airmom:

Skydiving is definitely in the top 3 or 4 things you can do with your clothes on. There's an adrenaline rush leading up to jumping, but the actual jump really isn't as big a deal as you'd think. The first few seconds give you the sensation of free fall (with the light feeling in your stomach) but, after that, there really isn't any sensation of speed or falling because you don't have anything close to judge yourself against. The idea that you are out there pretty much on your own as you look around from the rather unique perspective is actually pretty cool, as well.

The fact that skydiving wasn't the rush I thought it was going to be probably has to do with my high expectations more than anything else. It was a lot of fun and if it weren't for the money and distance involved, I'd almost certainly do it more often. Still, the feeling from skydiving was nowhere near what I get from riding my motorcycle (yeah, yeah, "donorcycle", whatever). Taking the bike hard into a corner, dragging my knee, and putting 150 horses to the ground on the way out of the corner is something that skydiving just can't touch.

I think the bottom line is that you will be very pleased with yourself after you skydive.

--

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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6342 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/18/2000 6:18 PM
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YZF1K wrote:
The first few seconds give you the sensation of free fall (with the light feeling in your stomach) but, after that, there really isn't any sensation of speed or falling because you don't have anything close to judge yourself against. The idea that you are out there pretty much on your own as you look around from the rather unique perspective is actually pretty cool, as well.

The knowledge that you are "out there" without any connection to the earth (the ultimate in having no visible means of support) coupled with the feeling that you aren't actually falling (because you are so far up that you can't sense yourself approaching the earth) was to me quite amazing. You become the center of the universe. You stop thinking that you are falling toward the earth and start thinking that perhaps the earth is coming toward you. That doesn't begin to describe the feeling, but it does cover the perception. One of my old skydiving buddies had this concept that he called GINETES principle. It stands for "Gravity Is Non-Existent. The Earth Sucks."

I won't argue about which is the better adrenalin rush. I used to ride my Yamaha XS1100 very fast and I loved the twisties near The Rock Store. The adrenalin rush of skydiving tapered off to well below that level. At my DZ, we called our experiences airgasms and there was nothing like the first. I was a new person afterwards because I had conquered my biggest fear.

4goneFool


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Author: dory36 Three stars, 500 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6354 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/18/2000 11:54 PM
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Following some links from another thread, I found something I think is really appropriate for this thread.

Take a look at http://www.theonion.com/onion3527/thats_not_funny.html


(I think the message is . . .LIGHTEN UP!)

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Author: Airmom One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6359 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/19/2000 5:42 AM
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4goneFool wrote:
At my DZ, we called our experiences airgasms and there was nothing like the first.
Ah, a new sensual experience. A woman can always use more of those. <smile>

I was a new person afterwards because I had conquered my biggest fear.
Then, let's get it on! I love the thought of becoming a new person.

Thanks to everyone who responded. I'll let you know how the jump goes.

Airmom

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Author: lkfrey Big red star, 1000 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6360 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/19/2000 6:00 AM
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"What is skydiving really like?"

Have fun Airmom!

When I was an undergraduate I parachuted once. Can't say I went skydiving because they hooked the parachute up to a cord that opened it automatically and there was basically no free fall. They had given me a little radio so they could help me find my way to the field I was supposed to come down in. The radio didn't work and I couldn't orient myself well enough to find the targeted landing area. So they sent a truck to recover me from some poor farmers newly planed field.

The view was great, and I've always loved being able to say I did it, but really it was quite anticlimactic. Seems to me hang gliding might be even more fun, but I haven't tried that one (maybe after I retire.)



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Author: inparadise Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6466 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/20/2000 8:29 AM
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You'll love it. I haven't done it since then because I had to try white-water rafting and I had to climb
some mountains and go on a hot air balloon ride. Now with two young boys I spend most of my time
working or with the family.


Wow, this is getting way off topic. But what the heck. If you liked the white-water rafting, when your boys are both over 12 you can go on a 7 day trip down the Grand Canyon. Not cheap, but what an experience. My husband and I did it for our second honeymoon, (in two months,) and it was the perfect escape from corporate america. No cell phones, no voice mail, no TV... I am very much looking forward to our youngest turning 12 so we can do it as a family. Make sure not to take the large motorized rafts. We were in the small 4-6 man hand powered rafts. We camped riverside and took hikes up the side canyons every day. Food was good, talk was great. Shooting stars at night were amazing! And of course the rapids...

If you are interested, I'll dig up the number of the outfit we used. A very professional group.

InParadise

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Author: mpkear Big red star, 1000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6485 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/20/2000 10:11 AM
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Wow, this is getting way off topic. But what the heck. If you liked the white-water rafting, when your boys are both over 12 you can go on a 7 day trip down the Grand Canyon. Not cheap, but what an experience.

Sounds great. It'll be awhile though. Youngest one is only 2. How long have you been living in St. Croix? I spent 3 years in PR and got over to visit St. Thomas and St. Croix a couple of times. Loved it.

I've always planned on getting to the Grand Canyon. One of these days.

Mark :-)

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Author: inparadise Big funky green star, 20000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6501 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/20/2000 11:45 AM
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Mark: Sounds great. It'll be awhile though. Youngest one is only 2. How long have you been living in St. Croix? I spent 3 years in PR and got over to
visit St. Thomas and St. Croix a couple of times. Loved it.


Actually, my youngest is two also, the oldest is 5. See you on the river in ten years!

We have been on St. Croix for four years now and are loving it for the most part. There are logistical problems with living on an island that erupt into a primal scream of frustration from time to time, and island fever can get you stir crazy, but then you go down to the beach and gaze out over that turqoise sea. Amazing how the sea can melt my frustrations away and put things back into perspective.

The company my husband works for takes very good care of their employees, as this is actually considered a hardship location. Most people can't take being so far away from their families. We moved down here to save money since they provide housing, utilities and private schools. In return we deal with very long hours, (but no longer than my husband used to put in if you included the commute,) and the occasional hurricane. Unless health care gets much better, it is not a place we would retire to, however, at least not full time.

Basically loving it,

InParadise

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Author: JAFO31 Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6549 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/20/2000 4:37 PM
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4gonefool:

[JAFO's prior post] <<<<Can you point us in the direction of the specific statistics? Who collected the statisitcs and how were they collected?>>>>

"Sorry, no I can't. If this were usenet, I would be more careful about making sure I can attribute all statistics. As I believe I stated earlier, I learn much of this stuff while listening to CSPAN's Washington Journal on CSPAN radio. It's a wealth of info that gets ignored by sound-byte mainstream media. I am an honest person, but I don't expect you to believe me. CSPAN has an archive of their shows if you're really interested."

No problems with me. And I start with a presumption of honesty and good intentions for other posters until they demonstrate otherwise with their posts. I was not intending to impugn your name, honesty or integrity; sorry if it sounded that way. It was more my general distrust for statistics until I know more about the details --- lies, d@mned lies, and then there are statistics. (M. Twain)

[JAFO's prior post] <<<<Are the statistics calcuated as a percentage of class (i.e. control for population sizes relative to the whole) or are they raw totals? etc. etc. etc.>>>>

"This was presented as "the overwhelming majority of uninsured adults are young single males with minimum wage jobs who are going to school to obtain higher paying jobs" which I guess means just what it says, a raw count. I find it believable because this segment of the population is surprisingly large. Many people were also considered underinsured, but I'm not really sure what that means."

Not sure what underinsured means in this context either. Raw count numbers can be misleading, though, because there is no context.

Just my $0.02. Regards, JAFO


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Author: jpkiljan One star, 50 posts Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6592 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/21/2000 2:56 AM
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And now for my last relpy (read carefully!):

Four Gone Fool wrote:

You consider calling me "The ForGone Fool" (go back and reread your post) to be not name calling and you consider calling
your actions childish and un-civil to be name calling. Hmmmmm. I think this is a shoe-fits. What I did was criticism. What you
did was name calling.


Oh rubbish! I think you are being overly sensitive. There are three ways of interpreting your signature name and, without a reference frame, I just picked the wrong one. If you took offense, I do indeed apologise--nothing was meant by it. I guess you didn't have wait so long for your apology after all.


I noticed that at first you mentioned an infant mortality rate and then it became an under-five mortality rate. Is this deliberate
obfuscation or are you really this imprecise? . . .


No, it's just poor sentence structure mixing two ideas. One-year mortality is the most tracked indicator. The argument made is that our children (not just infants) are most shortchanged by our national for-profit healthcare system--after all, they can't go out and buy their own coverage. In places like rural Africa where kids start dying again when they are weaned at about 24 months, the public health programs often target older children (up to five). I well remember a "Give your child some peanuts or meat every week." bill board in Ghana when I was there.


. . .As is often quoted by the advocates of big government, other industrialized
countries don't have an unwed mother status that matches or exceeds our own. . .


Sorry, but you are wrong again. And there you go again with that 'big government advocate theme!' In the US about 33% of births are to un-wed mothers. In Austria, France, the UK and Finland, the rates range from 25% to 35%. In Sweden and Denmark they are 40% (references available if you need them).


You're confusing CSPAN with MSNBC or Fox News. CSPAN doesn't do teasers, sound-bite reporting or the hot topic
format. They let the cameras roll on sessions of congress, political conventions, state of the union speeches, etc. They don't
pop in and provide analysis like Brokaw, Jennings and Rather. They just let the cameras roll and let you decide for yourself
what was said and what it meant. You can get your thoughtful pro and con analysis from the between-session shows and their
call-in viewers run the range from very knowledgeable and insightful to totally deranged. They have the widest range of talking
heads too. They are a non-profit or not-for-profit service paid for but not under the control of cable companies. When cable tv
was in its infancy, this deal was struck with the government that certain community service stations would be created. Some
show local and state government. CSPAN shows national government. Their guests aren't paid and yet they get the full range
of authors, policy wonks, politicians, civil servants, reporters and advocacy groups as guests on their morning show.
Frequently, the call-in viewers ask tougher questions than you will ever hear from reporters and except when the politicians are
on, you get a lot of honest answers. This is brain food.


You are right on this one and I was wrong. I was painting cable news with too broad a brush. I was so impressed by your mini-review (above) of CSPAN, I started watching it (it is now carried by my satellite). The balance and depth of their coverage is pretty amazing. You haven't made a convert yet, but you are certainly close. I'll put a few more hours in before I decide and you won't even have to tie me to that chair in front of the set 8^) . Thanks for the lead.


This thread has taken on the characteristics of a usenet Kobayashi-Maru. I'm ending my part here with a request that you read
more carefully and don't assume what isn't there. My original rant was not personal. I'm sorry that you took offense.


Good heavens! I wasn't offended--mostly disappointed in your 'rant' against Mitch's (the original poster) defense of government involvent in healthcare. You have a long history of thoughtful (and, at the very least, well-intentioned) posts on this board--certainly a better record than my mine--and for the most part I have read these with interest.

It was fun, but I agree it should end (till the next subject, anyway).

Since you got to make a request, I get to give you one now. Lighten Up! How that MF motto read? To Enlighten and to Amuse?

Good luck with that ER!

-- John


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Author: 4gonefool Big gold star, 5000 posts Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: 6647 of 735032
Subject: Re: Retire Early Group Health Plan Date: 3/21/2000 7:06 PM
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Oh rubbish! I think you are being overly sensitive. There are three ways of interpreting your signature name and, without a reference frame, I just picked the wrong one. If you took offense, I do indeed apologise--nothing was meant by it. I guess you didn't have wait so long for your apology after all.

Thank you. Perhaps I was overly sensitive or misconstrued the intent of your interpretation, but you can never offend someone by calling him what he calls himself. This is a simple civil courtesy I employ even on those rare occasions when I want to convey a strong negative opinion about a person or about his/her conduct.

This simple courtesy is often the difference between flaming (which turns me off) and acceptable civil discourse (which clearly I enjoy). My best example is the following. When somebody says "Clinton is a scumbag," they are clearly calling him a name because he clearly is not what he is being called. They are also dishonoring the office of the Presidency by not saying, "President Clinton is a scumbag." When somebody says, "President Clinton is a liar," you enter a gray area because he is being called a "name" that describes his perceived behavior (as if most other politicians aren't liars) and you have at least not dishonored his office. When somebody says, "President Clinton was extremely and possibly criminally dishonest," the speaker has entered the realm of pure criticism and while not being colorful or amusing, the speaker's position is clear and the President's defenders are forced to defend his honesty and find it more difficult to claim this was a personal attack.

Sorry, but you are wrong again. And there you go again with that 'big government advocate theme!' In the US about 33% of births are to un-wed mothers. In Austria, France, the UK and Finland, the rates range from 25% to 35%. In Sweden and Denmark they are 40% (references available if you need them).

You're probably right about the statistics, I'm not an expert on the subject. But maybe I'm not wrong about the claims of the big government advocates. They do claim that there is a greater need for spending on outreach programs because there are more unwed mothers per capita in the US. Perhaps both you and the big government advocates are right. This would be possible if the unwed mothers in the other countries have more children on average. Their statistics might be measuring unwed mothers (per capita) while yours are measuring the per capita number of births to unwed mothers.

Since you got to make a request, I get to give you one now. Lighten Up! How that MF motto read? To Enlighten and to Amuse?

Fair enough. I take your advice to heart. I try hard to enlighten. I will try harder to amuse. My vehement distrust of the use of goverment to solve complex problems saps my normally present sense of humor. The old cartoon about the elephant being a mouse designed by a committee springs to mind whenever I hear a federal program being proposed. I would much rather feed a mouse than an elephant. If we could get an elephant's worth of work from a mouse sized tax hike, I would be ecstatic, but history has shown the reverse to be more likely.

4goneFool


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