Biden's Medicare Proposal

[RiverDog]

Joe Biden has come out with what seems to be a compromise on the Democrats "Medicare for All" chant as he's proposing that it be expanded to allow it to accept people 60 and older. I have two basic objections to this proposal:

1. Medicare does not pay doctors or hospitals nearly as well as private insurance does. Any expansion of Medicare is going to yield less income per patient for doctors and hospitals. The result will be more hospitals going out of business, mostly those in rural areas that are already stresses. Doctors being forced to see more patients per day and spend less time with each patient. With a larger case load for doctors to juggle, the result is almost certainly to be a reduced standard of care. They are going to have to infuse Medicare with more money to offset this effect, either through higher taxation or higher premiums for those already on Medicare.

2. Allowing 60+ individuals to go on Medicare will result in more people to retire early. Although I feel a bit hypocritical for bringing this up as I retired at age 63, nearly 3 years ahead of my full retirement date of 65 years and 10 months, but it's going to encourage more people to start drawing on Social Security ahead of their full retirement date, one of the things that many observers say is hurting the system. The push has been to try to give people an incentive to work longer. This proposal is counter to that line of thinking.

Comments?

[Aseahawkfan]

As I've already stated, I'd just prefer to move to a German or Scandinavian style of healthcare system at this point. Private healthcare is over-priced. I could just easily take your two complaints and alter them for talking about private healthcare:

1. Private health pays doctors or hospitals on a per patient basis. Any expansion of private healthcare is going to focus on higher yielding or maximum volume of patients to ensure maximum profitability. The result will be more hospitals going out of business because of insufficient higher yield or volume of patients, mostly those in rural areas that are already stressed and lack the volume of patients or high yield patients of an urban or upper class suburban area. Doctors being forced to see more patients per day and spend less time with each patient to maximize profits with increased patient volume. With a larger case load for doctors to juggle, the result is almost certainly to be a reduced standard of care or a focus on high yield patients and encouragement of use of services since selling a patient they have more illness leads to an increased profit per patient. They are going to have to pay more each patient to offset this effect, either through higher premiums or higher payment for medical procedures for those using private insurance.

Imagine that? Isn't private insurance already increasing at a high rate for this reason?

2. Allowing 60+ individuals to go on Medicare will result in more people to retire early, thus easing the pressure on private health insurance allowing them to charge less for younger patients less likely to have serious health issues. The less older folks putting pressure on the private healthcare system with high cost health problems due to aging and poor lifestyle catching up with them, the easier it would be for private healthcare to lower costs by focusing on healthier, lower cost patients that don't take up such a huge amount of the aggregate insurance money. Must like car companies that focus on drivers who have few accidents and put less of a drain on insurance money pool.

Easy to rewrite your arguments on private insurance. Private insurance is socialism through corporations. I have yet to hear this quality argument on your side as to why it is not. How many health insurers are there? Is there real competition in health insurance bringing down health insurance costs or improving the quality of care? I haven't seen it. Most people just get a very universal program from their employer paying the same amount as everyone else with a huge premium for adding family members. When they go to the doctor, they often have to pick a doctor or clinic in their network and pick from a small pool of doctors associated with their network. I'm not sure why or how you view that as capitalism providing a superior option to medicare or similar systems when there is not real competition for healthcare.

[RiverDog]

You haven't addressed the second point in my discussion: Social Security.

Expanding Medicare to age 60 is going to encourage more people to retire early, which would not only put a strain on Medicare, it would put a strain on Social Security.

I retired at age 63.5, so I had to buy my own health insurance for 18 months until I was eligible for Medicare. My premiums were over $1,000 a month for medical and prescription drugs, and that was just to cover myself. The rate would have been even higher had it not been subsidized by my former employer. I've heard that for people over age 60 that private insurance costs over $1500/month with very high deductibles. I had an option to take COBRA for 18 months, which would have still cost me over $500/month vs. my $200 a month if I would have kept working and maintained coverage under my employer's group insurance.

Medicare costs me $144.60 a month plus about $50/month for my supplement (high deductible Plan F) and about $15 a month for my Part D prescription drugs.

Bottom line is that with a minimum age of 65 to enroll in Medicare, there exists today a huge financial incentive for people to keep working at least until they are 65 and eligible for Medicare. If you lower the minimum age to 60, a very large number of people will jump at the opportunity to retire early and start drawing on SS at 80% of their full retirement amount when they reach age 62. That's one of the problems with the solvency of SS: Too many people are taking early withdrawals. The stated goal for the federal government for decades has been to try to keep people working longer. Expanding Medicare to age 60 runs counter to that goal.

The only way this proposal can not put more pressure on SS is if they eliminate early retirement, and even then, there's still going to be a lot of people retiring early as Medicare is cheaper than most employer sponsored group insurance.

Besides, is simply expanding Medicare to age 60 going to address "the problem" as you see it? Why stop at age 60?

[c_hawkbob]

I actually agree with Asea on this, and to answer your SS issue, expand that as well. There is no reason, other than gross mismanagement, that SS shouldn't be funded to excess anyway, It's not our fault that the government has mandated we all pay into this retirement system for our entire lives that they have so grossly mismanaged.

It's like the Kentucky State retirement system, less than a dozen years ago it was essentially fully funded, the the state began borrowing from it (or more accurately diverting funds scheduled to be paid into it to other places) and now it is the least funded retirement system in the country and all of the remedies on the table put the burden of fixing the problem back on the employees.

[RiverDog]

I actually agree with Asea on this, and to answer your SS issue, expand that as well. There is no reason, other than gross mismanagement, that SS shouldn't be funded to excess anyway, It's not our fault that the government has mandated we all pay into this retirement system for our entire lives that they have so grossly mismanaged.

It's like the Kentucky State retirement system, less than a dozen years ago it was essentially fully funded, the the state began borrowing from it (or more accurately diverting funds scheduled to be paid into it to other places) and now it is the least funded retirement system in the country and all of the remedies on the table put the burden of fixing the problem back on the employees.

I didn't really start the thread to engage in a debate on Social Security, but being that you're one of my favorite posters that I'd like to see comment more often, I'll toss in my 2 cents.

I agree that SS has been grossly mismanaged by the government. The fund has been raided by politicians from both parties in order to avoid tough decisions regarding the reconciliation of the federal budget deficit. But it simply does not make sense to expand it, give the government even more money to mismanage, without fundamental changes to the system. SS is already being weighted down by a diminishing worker to retiree ratio due to the increase in life expectancy and people taking the early out. Lowering the minimum retirement age makes that ratio much worse and would result in its insolvency.

Social Security as currently configured is doomed to failure. There is simply no way that the system can sustain the current level of benefits without a substantial increase in the contribution rates of either the individual and/or their employer or a reduction of those benefits. Both of those options are politically impossible. Try winning an election by campaigning on raising taxes or cutting benefits. There's a reason why they call Social Security the third rail of politics.

Eventually I'd like to see the system converted into something more sustainable, something along the lines of a 401K that gives the individual more ownership of the funds deposited in their name. There's no reason why my daughter's contributions should be used to support her old man's retirement. Take the government out of the equation so that it is no longer subject to raiding by politicians. Rather, the government's involvement should be limited to that of a regulatory agency.

[Aseahawkfan]

You haven't addressed the second point in my discussion: Social Security.

Expanding Medicare to age 60 is going to encourage more people to retire early, which would not only put a strain on Medicare, it would put a strain on Social Security.

I retired at age 63.5, so I had to buy my own health insurance for 18 months until I was eligible for Medicare. My premiums were over $1,000 a month for medical and prescription drugs, and that was just to cover myself. The rate would have been even higher had it not been subsidized by my former employer. I've heard that for people over age 60 that private insurance costs over $1500/month with very high deductibles. I had an option to take COBRA for 18 months, which would have still cost me over $500/month vs. my $200 a month if I would have kept working and maintained coverage under my employer's group insurance.

Medicare costs me $144.60 a month plus about $50/month for my supplement (high deductible Plan F) and about $15 a month for my Part D prescription drugs.

Bottom line is that with a minimum age of 65 to enroll in Medicare, there exists today a huge financial incentive for people to keep working at least until they are 65 and eligible for Medicare. If you lower the minimum age to 60, a very large number of people will jump at the opportunity to retire early and start drawing on SS at 80% of their full retirement amount when they reach age 62. That's one of the problems with the solvency of SS: Too many people are taking early withdrawals. The stated goal for the federal government for decades has been to try to keep people working longer. Expanding Medicare to age 60 runs counter to that goal.

The only way this proposal can not put more pressure on SS is if they eliminate early retirement, and even then, there's still going to be a lot of people retiring early as Medicare is cheaper than most employer sponsored group insurance.

Besides, is simply expanding Medicare to age 60 going to address "the problem" as you see it? Why stop at age 60?

I did. I made a specious, unsupported claim that expanding medicare to people age 60 would lower cost to younger people by taking a bunch of people stressing the private system with exorbitant costs for their care by removing them to medicare, thus making private insurance cheaper. That was statement number two I modified.

[Aseahawkfan]

Let's discuss some capitalist ideas and how they relate to healthcare.

1. Earlier you stated you did not want wealthier people getting favored treatment over you because you pay for insurance. And that is not how capitalism works. Capitalism is supply and demand. If a supply is limited, then you don't get care first because you have insurance. You get care first only if your insurance is better and you can outbid a richer guy for the care you want. In a capitalist system, he who can pay the most gets what he wants first. This principle is only altered if it damages the overall business. Which is why businesses in general produce enough supply to meet a demand that is as profitable as possible. They also produce luxury items that are limited in supply for those with more money.

Now how does this apply to healthcare. What it means is that the medical system will and should produce healthcare that is specifically for wealthy people, more effective, and costing a higher amount than what a lower income person can afford. Is this acceptable to you?

Even burrton if he ever shows up again as an avowed capitalist will tell you this feature is part of capitalism. If he does not, then he is lying.

The upside of this for capitalism which if I did not mention I would be lying, is often these high cost procedures would eventually make it down to lower cost consumers as someone found a way to deliver the service or procedure at a cheaper cost to lower level consumers, but maybe not for the lowest level consumer.

Do you find it acceptable that different levels of medical care will be provided to people based on their income? This is a feature of capitalism and is working as intended.

We socialize things like the police and military so equal delivery of is a part of the system as socialism is better at equal delivery of a service or product. Would you prefer equal delivery for medical care or stratified delivery?

2. Do we have real competition for health insurance? I would say no, we don't.

Most employers in my experience offer very few healthcare options. My company in particular offers one. Some employers I've seen offer two to three. Very few offer more than that. Even the various healthcare options offered don't differ greatly, usually a few options better one way or the other. They are often much more expensive if you add family members.

Some higher end jobs offer much better healthcare. Thus showing the clear capitalist idea of a service stratified by income. The more you make or the higher the level of your job, the better the healthcare you will get. Your healthcare is heavily tied to your job and if for any reason you lose your job, you lose your healthcare unless you have a sufficient income to purchase the healthcare as a private option. I would say most don't have this kind of money.

Are you ok with this limited healthcare options tied to your employment? This means the unemployed will either have state healthcare, private healthcare, or no healthcare. This means workers at low income jobs, regardless of whether their healthcare needs are greater or lesser won't have sufficient healthcare to cover their needs and it might be cheaper from a productivity standpoint to let them and their children suffer or die because caring for them would be unprofitable.

Are you ok with this capitalist idea of unequal delivery based on income and it possibly being more profitable to let someone die or get very little care for a serious disease like cancer due to low quality, low income healthcare? Is this acceptable decision making to you?

And do you like having your healthcare tied to your employment so that you must do everything to hold on to a job to ensure you have affordable healthcare if you have insufficient income to pay for high cost of private health insurance?

3. Let's do a few basic case studies.

Buying a car. When you buy a car, you have plenty of time to search for a car at a price level you can afford. There are a bunch of car producers. A bunch of banks offering differing rates on loans. Acquiring a car and at a price you can afford is usually a quality capitalist experience. You have a lot of choices. You have a lot of competition to provide you the money to purchase the car and the car itself. You have many different dealers offering different perks to buy from them competing for your business. You usually have plenty of time to choose with options for other ways to travel like Uber or public transportation. There is zero reason to socialize cars as the car buying experience and capitalism work great together.

Healthcare. What is that experience like? You get a job. Your company has already chosen what healthcare they will provide. You will take what your company provides, nothing, private healthcare of your choosing, or if low enough income you will get state help. Then once you get that healthcare, you will get the service the healthcare has agreed to provide, usually very similar between companies for the same cost level with few options. If you don't have too much wrong with you, you can pay out of pocket to doctors which is often cheaper than you would pay for healthcare. If you get anything major wrong, then you can attempt to pay out of pocket for severe treatment which is often costly far exceeding what even a middle income person can afford.

Let's take a broken leg. You break your leg. You or someone will call the local government subsidized 911 service. We have already decided to socialize emergency medical response. Transport to the hospital may be socialized or partly paid for by insurance and charged to the consumer. Once you arrive at the hospital, the staff will see to treating your broken leg. They will attempt to ascertain your insurance at some point to ensure you can pay for it. If you don't have insurance, then they start a tab and if possible forward you to a state facility for the uninsured if not an emergency. Your insurance pays the agreed upon amounts for treatment of a broken leg and any rehabilitation treatment required that is available to your level of insurance based on your job or income. You receive that. You don't have much control over this process unless you have the money to pay for additional treatment out of pocket. All things must be justified to the insurance company and agreed upon to be paid by them.

This exact same process occurs within a socialist system. Because for nearly all intents and purposes, American private health insurance works much like a socialist system. Huge pools of money are taken in the form of premiums and paid out to medical people at agreed upon rates for agreed upon treatment. All of this negotiated prior to the person requesting service. If you try to get something your insurance hasn't agreed to pay, then you will have to argue with your insurance company or pay out of pocket.

How does this substantially differ from a socialized system other than having to pay an insurance company a higher premium for them to make a profit? You don't have a lot of control over how your insurance company negotiates prices or services. There are a limited number of providers providing the same levels of service based on how much you can pay. Wealthy people still get service first because they can outbid you for services by paying out of pocket supplemented by insurance.

Is this superior to say a German or Scandinavian system? What proof do we have that it is?

[RiverDog]

Holy cow, what a rant! Let me try to break all that down into pieces small enough for us to swallow.

1. Earlier you stated you did not want wealthier people getting favored treatment over you because you pay for insurance. And that is not how capitalism works.

Now how does this apply to healthcare. What it means is that the medical system will and should produce healthcare that is specifically for wealthy people, more effective, and costing a higher amount than what a lower income person can afford. Is this acceptable to you?

If I am correct, you are referring to a statement I made regarding the coronavirus crisis that if I were in the same hospital as Jeff Bezos and my odds of surviving were better than he was, that I should get the ventilator before he does. That has nothing to do with capitalism. It's triage. Sure, there's going to be exceptions, like if it were a war and a general was given higher priority as he's more important to the overall effort than some buck private. But if the only difference is our bank account, there should be no priority given simply due to class. It's like organ recipients. It is illegal in the US to "buy" an organ. Recipients are screened by their survivability then it's first come, first served.

Do you find it acceptable that different levels of medical care will be provided to people based on their income? This is a feature of capitalism and is working as intended.

This is not how it works. My wife used to work in a nursing home. There were some residents that were on private insurance, some that were on Medicare, and others that were on Medicaid. If what you are saying is true, then the person on private insurance would get preferred treatment while the person on Medicaid would be at the bottom of the totem pole because private insurance pays much better than either Medicare or Medicaid. The caregivers don't have a clue as to which person is covered by which insurance. They all get treated equally. It's not like the sinking of the Titanic where the first class passengers got the seats in the life boats while those in 3rd class were left to drown.

2. Do we have real competition for health insurance? I would say no, we don't.

You may not see it as employees have to accept the carrier that the employer selects, but there are a lot of carriers out there. There are 10 in WA state that sell to small businesses. Here's a list of them:

https://www.insurance.wa.gov/health-ins ... businesses

Most employers in my experience offer very few healthcare options. My company in particular offers one. Some employers I've seen offer two to three. Very few offer more than that. Even the various healthcare options offered don't differ greatly, usually a few options better one way or the other. They are often much more expensive if you add family members.

Some higher end jobs offer much better healthcare. Thus showing the clear capitalist idea of a service stratified by income. The more you make or the higher the level of your job, the better the healthcare you will get. Your healthcare is heavily tied to your job and if for any reason you lose your job, you lose your healthcare unless you have a sufficient income to purchase the healthcare as a private option. I would say most don't have this kind of money.

Are you ok with this limited healthcare options tied to your employment? This means the unemployed will either have state healthcare, private healthcare, or no healthcare. This means workers at low income jobs, regardless of whether their healthcare needs are greater or lesser won't have sufficient healthcare to cover their needs and it might be cheaper from a productivity standpoint to let them and their children suffer or die because caring for them would be unprofitable.

Are you ok with this capitalist idea of unequal delivery based on income and it possibly being more profitable to let someone die or get very little care for a serious disease like cancer due to low quality, low income healthcare? Is this acceptable decision making to you?

And do you like having your healthcare tied to your employment so that you must do everything to hold on to a job to ensure you have affordable healthcare if you have insufficient income to pay for high cost of private health insurance?

3. Let's do a few basic case studies.

Buying a car. When you buy a car, you have plenty of time to search for a car at a price level you can afford. There are a bunch of car producers. A bunch of banks offering differing rates on loans. Acquiring a car and at a price you can afford is usually a quality capitalist experience. You have a lot of choices. You have a lot of competition to provide you the money to purchase the car and the car itself. You have many different dealers offering different perks to buy from them competing for your business. You usually have plenty of time to choose with options for other ways to travel like Uber or public transportation. There is zero reason to socialize cars as the car buying experience and capitalism work great together.

Healthcare. What is that experience like? You get a job. Your company has already chosen what healthcare they will provide. You will take what your company provides, nothing, private healthcare of your choosing, or if low enough income you will get state help. Then once you get that healthcare, you will get the service the healthcare has agreed to provide, usually very similar between companies for the same cost level with few options. If you don't have too much wrong with you, you can pay out of pocket to doctors which is often cheaper than you would pay for healthcare. If you get anything major wrong, then you can attempt to pay out of pocket for severe treatment which is often costly far exceeding what even a middle income person can afford.

Let's take a broken leg. You break your leg. You or someone will call the local government subsidized 911 service. We have already decided to socialize emergency medical response. Transport to the hospital may be socialized or partly paid for by insurance and charged to the consumer. Once you arrive at the hospital, the staff will see to treating your broken leg. They will attempt to ascertain your insurance at some point to ensure you can pay for it. If you don't have insurance, then they start a tab and if possible forward you to a state facility for the uninsured if not an emergency. Your insurance pays the agreed upon amounts for treatment of a broken leg and any rehabilitation treatment required that is available to your level of insurance based on your job or income. You receive that. You don't have much control over this process unless you have the money to pay for additional treatment out of pocket. All things must be justified to the insurance company and agreed upon to be paid by them.

This exact same process occurs within a socialist system. Because for nearly all intents and purposes, American private health insurance works much like a socialist system. Huge pools of money are taken in the form of premiums and paid out to medical people at agreed upon rates for agreed upon treatment. All of this negotiated prior to the person requesting service. If you try to get something your insurance hasn't agreed to pay, then you will have to argue with your insurance company or pay out of pocket.

How does this substantially differ from a socialized system other than having to pay an insurance company a higher premium for them to make a profit? You don't have a lot of control over how your insurance company negotiates prices or services. There are a limited number of providers providing the same levels of service based on how much you can pay. Wealthy people still get service first because they can outbid you for services by paying out of pocket supplemented by insurance.

Is this superior to say a German or Scandinavian system? What proof do we have that it is?

I'll try to answer some of your questions later. I really only meant the thread to apply specifically to Biden's proposal, not the entire health care debate.

[Aseahawkfan]

If I am correct, you are referring to a statement I made regarding the coronavirus crisis that if I were in the same hospital as Jeff Bezos and my odds of surviving were better than he was, that I should get the ventilator before he does. That has nothing to do with capitalism. It's triage. Sure, there's going to be exceptions, like if it were a war and a general was given higher priority as he's more important to the overall effort than some buck private. But if the only difference is our bank account, there should be no priority given simply due to class. It's like organ recipients. It is illegal in the US to "buy" an organ. Recipients are screened by their survivability then it's first come, first served.

It's government regulation of capitalism to try to ensure a fair outcome because normal capitalism or private industry operates off a supply-demand system with highest bidder getting what they want or need first.

This is not how it works. My wife used to work in a nursing home. There were some residents that were on private insurance, some that were on Medicare, and others that were on Medicaid. If what you are saying is true, then the person on private insurance would get preferred treatment while the person on Medicaid would be at the bottom of the totem pole because private insurance pays much better than either Medicare or Medicaid. The caregivers don't have a clue as to which person is covered by which insurance. They all get treated equally. It's not like the sinking of the Titanic where the first class passengers got the seats in the life boats while those in 3rd class were left to drown.

No. What I am saying is that private health insurance in America is basically socialized medicine for profit and that we are already socialized through corporations. You are further proving my point that there would not be much change in care with a fully socialized system because corporations and companies in general offer the same care.

You may not see it as employees have to accept the carrier that the employer selects, but there are a lot of carriers out there. There are 10 in WA state that sell to small businesses. Here's a list of them:

https://www.insurance.wa.gov/health-ins ... businesses

Do they offer substantially different prices or competitive services?

You didn't read that list did you?

3 are Kaiser
4 are Blue Cross-Blue Shield (Asuris offers Regence Blue Shield)
2 are united healthcare.

I could go on, but some of these are re-insurers, not insurers themselves offering plans from a bigger insurance company. All similar plans.

No real competition.

Already done the research on this a while back. Each state might have a local big insurer like Group Health who is now Kaiser. Then are some big regional or national insurers like United Healthcare, Blue Cross-Blue Shield, or Aetna. Very limited competition.

[Aseahawkfan]

As far as Biden's proposal, it's just a slow step towards eventual socialized healthcare. I say just make the jump. Study the German and Scandinavian models of healthcare, then work from there to build a similar system. Why keep wasting our time and energy arguing over something inevitable when we can spend more time and energy building towards a high quality system of socialized healthcare similar to Scandinavian nations and Germany (maybe Canada) that supports our capitalist system. This idea that socialized healthcare and capitalism don't work together has been thoroughly and spectacularly debunked by nations with great economies and standards of living like Canada, Germany, and the Scandinavian nations who also employ a socialized healthcare system. Why we as Americans want to continue to argue it and screw ourselves over when these nations are thriving with socialized healthcare is beyond me.

Hell, Germany, Canada, and most of the Scandinavian nations are even handling the corona virus better than us. Maybe being able to manage healthcare across the nation from a Federal source might make it easier to coordinate during a pandemic. Who can say.

[RiverDog]

As far as Biden's proposal, it's just a slow step towards eventual socialized healthcare.

I almost would rather see us go to Medicare for All rather than the piecemeal approach.

If they were to infuse Medicare with a lot more funding so that it pays providers roughly the same as private insurers, then I might be more receptive. But my big fear is that it is going to result in a lower quality of care.

The other thing I worry about is that it will cause more people to retire early and further de-stabilize Social Security. Once again, SS would have to receive a very large infusion of money to keep it solvent if we reduce even further the worker to retiree ratio.

I want to see some specifics on how the Dems are going to pay for these grandiose schemes outside of their nebulous "tax the rich" or "tax Amazon" generic answer any liberal gives to address financial concerns.

[Aseahawkfan]

I almost would rather see us go to Medicare for All rather than the piecemeal approach.

If they were to infuse Medicare with a lot more funding so that it pays providers roughly the same as private insurers, then I might be more receptive. But my big fear is that it is going to result in a lower quality of care.

The other thing I worry about is that it will cause more people to retire early and further de-stabilize Social Security. Once again, SS would have to receive a very large infusion of money to keep it solvent if we reduce even further the worker to retiree ratio.

I want to see some specifics on how the Dems are going to pay for these grandiose schemes outside of their nebulous "tax the rich" or "tax Amazon" generic answer any liberal gives to address financial concerns.

The 60 year old limit might cause them to retire earlier if they have enough money to cover their expenses, but I doubt it. My mother retired earlier to take care of her mother when she got older and had trouble taking care of herself. She gets a very low amount per month. Retiring early when you don't have a good retirement nest egg is not a great idea. That hit on your social security is terrible.

I'm not even sure most would take Medicare at 60. From what I understand Medicare absent some better plan like Medicare Advantage isn't that great. The private health insurance provided by an employer would probably beat base Medicare if not allowed to be had as supplemental insurance.

You and your wife have supplemental insurance to boost your Medicare right or something from your employer? That kind of stuff would have to be worked out before we shifted. That is why I recommend studying the German, Canadian, or Scandinavian models prior to implementing them and planning careful for a switch.

[RiverDog]

The 60 year old limit might cause them to retire earlier if they have enough money to cover their expenses, but I doubt it.

Take if from a guy that's been there within the past couple of years. There are A LOT of people that would take an early out at age 60, and a whole bunch more when SS is available at age 62. If insurance coverage hadn't cost my wife and I over $2000/month to buy on the open market, at least one of us would have pulled the plug at 60, and if one of us hadn't retired at 60, we darn sure would have at 62. We had plenty of savings to supplement SS, and I would have been eligible to draw from my pension. But we wouldn't have been able to afford paying $2000/month in premiums for 5 years. The cost of insurance was the only reason that kept me working as long as I did. I would have done anything get off graveyards and have my weekends off. I personally know of a lot of friends and co-workers that would retire if they had such an opportunity.

Half my graduating class in high school have expressed a jealousy at my ability to retire at 63.5. Many are just now hitting the rocking chair as we were born from September 1954-August 1955, so we're hitting 65 years old and are eligible for Medicare. Since my birthday is in October, I'm a few months older than the majority of my 550 classmates, so there have been a number that are asking questions of me about Medicare and Social Security via Facebook.

Trust me. There are A LOT of people that would take an early out if they could get on Medicare at age 60.

I'm not even sure most would take Medicare at 60. From what I understand Medicare absent some better plan like Medicare Advantage isn't that great. The private health insurance provided by an employer would probably beat base Medicare if not allowed to be had as supplemental insurance.

Medicare Advantage is horrible. It's like a HMO. You have to see doctors that are in their network. With traditional Medicare, you can see any doctor or specialist you want so long as they accept Medicare, which most do. There are a lot horror stories out there about people that signed up for a Medicare Advantage plan, found out they had cancer, then couldn't see the specialist their doctor had recommended. And if you start taking MA then decide you want to change back to a traditional Medicare, you may have trouble getting a Medicare supplement as they aren't required to accept you. I'm not sure if it covers international travel, but my guess is that it doesn't. MA wasn't available in my county last year so I never even considered it. It is cheap, and some plans include dental. It's like any other insurance: You don't know how good it is until you need it.

You and your wife have supplemental insurance to boost your Medicare right or something from your employer? That kind of stuff would have to be worked out before we shifted. That is why I recommend studying the German, Canadian, or Scandinavian models prior to implementing them and planning careful for a switch.

Both of us have the traditional Medicare Part B with a Plan F high deductible supplement. It costs each of us $144.60/month for Plan B, a little less than $50 a month for the supplement. The supplement has a $2300 annual deductible, something that we'll never reach unless we have something catastrophic happen. There's a difference of about $175 a month in premiums over Plan F policies that don't have a deductible, so worse case scenario is that we'd be out a couple hundred bucks if we ever had enough expenses to meet the deductible. The Plan F is the Cadillac of supplements that they just eliminated this year except for those already enrolled were grandfathered in. Plan F covers international travel, too.

My wife and I are very pleased with Medicare as it stands now. My wife has two very serious ailments, MS and rheumatoid arthritis. She went on disability because of it back in 2015 so she's been on Medicare for 4 years. She's seen multiple doctors and specialists during that time, had MRI's done, etc, so we have quite a bit of experience with it. The problem isn't for the end user, it's that it doesn't pay the providers nearly as well as private insurance.

[Aseahawkfan]

Take if from a guy that's been there within the past couple of years. There are A LOT of people that would take an early out at age 60, and a whole bunch more when SS is available at age 62. If insurance coverage hadn't cost my wife and I over $2000/month to buy on the open market, at least one of us would have pulled the plug at 60, and if one of us hadn't retired at 60, we darn sure would have at 62. We had plenty of savings to supplement SS, and I would have been eligible to draw from my pension. But we wouldn't have been able to afford paying $2000/month in premiums for 5 years. The cost of insurance was the only reason that kept me working as long as I did. I would have done anything get off graveyards and have my weekends off. I personally know of a lot of friends and co-workers that would retire if they had such an opportunity.

Half my graduating class in high school have expressed a jealousy at my ability to retire at 63.5. Many are just now hitting the rocking chair as we were born from September 1954-August 1955, so we're hitting 65 years old and are eligible for Medicare. Since my birthday is in October, I'm a few months older than the majority of my 550 classmates, so there have been a number that are asking questions of me about Medicare and Social Security via Facebook.

Trust me. There are A LOT of people that would take an early out if they could get on Medicare at age 60.

Most of your friends have enough money to survive with a much lower social security amount? Good for them. I don't know how many are in that position. My other gets like 2/3 I think of her normal social security for early retirement. She survives on it with a paid off house, but she definitely doesn't have a lot of wiggle room without much savings.

Medicare Advantage is horrible. It's like a HMO. You have to see doctors that are in their network. With traditional Medicare, you can see any doctor or specialist you want so long as they accept Medicare, which most do. There are a lot horror stories out there about people that signed up for a Medicare Advantage plan, found out they had cancer, then couldn't see the specialist their doctor had recommended. And if you start taking MA then decide you want to change back to a traditional Medicare, you may have trouble getting a Medicare supplement as they aren't required to accept you. I'm not sure if it covers international travel, but my guess is that it doesn't. MA wasn't available in my county last year so I never even considered it. It is cheap, and some plans include dental. It's like any other insurance: You don't know how good it is until you need it.

Maybe my father has something else. He said having supplemental insurance with Medicare helped expenses a lot.

[RiverDog]

Most of your friends have enough money to survive with a much lower social security amount? Good for them. I don't know how many are in that position. My other gets like 2/3 I think of her normal social security for early retirement. She survives on it with a paid off house, but she definitely doesn't have a lot of wiggle room without much savings.

The minimum percentage for early withdrawal of Social Security is 80% of FRA (Full Retirement Amount). If all your mom is living on is SS income, then you're right, she doesn't have a lot of wiggle room.

I certainly don't want you to interpret this as criticism of your mom as I know nothing about her circumstances, but no one should ever go into retirement with Social Security as their sole source of income. You have to have some other source of income, whether it be a pension, annuity, IRA, or whatever. I would say that about 3/4 of my high school classmates are still working or retiring this year. It's not all about going to college and climbing the corporate ladder, either. One classmate was a Forrest Gump-type of mentally challenged individual, didn't graduate, worked for the county as a janitor for 40 years, and retired at 62 with a nice pension from the state.

Medicare Advantage is horrible. It's like a HMO. You have to see doctors that are in their network. With traditional Medicare, you can see any doctor or specialist you want so long as they accept Medicare, which most do. There are a lot horror stories out there about people that signed up for a Medicare Advantage plan, found out they had cancer, then couldn't see the specialist their doctor had recommended. And if you start taking MA then decide you want to change back to a traditional Medicare, you may have trouble getting a Medicare supplement as they aren't required to accept you. I'm not sure if it covers international travel, but my guess is that it doesn't. MA wasn't available in my county last year so I never even considered it. It is cheap, and some plans include dental. It's like any other insurance: You don't know how good it is until you need it.

Maybe my father has something else. He said having supplemental insurance with Medicare helped expenses a lot.

I would guess that your dad has a traditional Medicare Part B with a supplement. It's almost mandatory that a person have a supplement as Medicare doesn't pay for everything and they're paying for less and less all the time.

Medicare is a corn maze, but there are LOTS of advocacy groups out there that are of enormous help. Our local hospital puts on free classes on Medicare, will even will set up one-on-one appointments. They'll actually fill out the paperwork and lick the stamp for you. There's also free classes on Social Security, Taxes in Retirement, Retirement Planning, etc, put on by professionals in the finance industry, some with free dinners, although you will usually have to listen to their sales pitch, give them your phone number or email address. I'm always getting stuff in my mailbox offering free dinners.

[Aseahawkfan]

I certainly don't want you to interpret this as criticism of your mom as I know nothing about her circumstances, but no one should ever go into retirement with Social Security as their sole source of income. You have to have some other source of income, whether it be a pension, annuity, IRA, or whatever. I would say that about 3/4 of my high school classmates are still working or retiring this year. It's not all about going to college and climbing the corporate ladder, either. One classmate was a Forrest Gump-type of mentally challenged individual, didn't graduate, worked for the county as a janitor for 40 years, and retired at 62 with a nice pension from the state.

Pensions are getting more and more uncommon. My father built up a 401k, but my mother not so much. She retired early to take care of her elderly mother with some pressure from her siblings. She is not well set up at all.

It would be interesting to see what percentage of retired folk are more like you versus like my mom. Given what I've read of American savings and companies putting downward pressure on retirement all the time whether social security will be welfare by the time current generations retire. You may have been one of the last generations to have solid retirement options, with most folks now relying on 401k tied to increases in the stock market. Though some kind of state or government job will still be the best option for the pension route as I think they are the main jobs still offering that type of retirement. I know even Boeing in their new contract eliminated pensions for matching 401ks instead.

[RiverDog]

Pensions are getting more and more uncommon. My father built up a 401k, but my mother not so much. She retired early to take care of her elderly mother with some pressure from her siblings. She is not well set up at all.

Pensions are a relic of the past. They were well intended but ill conceived and are suffering from exactly the same fate as SS: Life expectancy has increased and the retiree/worker ratio has decreased. Plus companies in traditional union type jobs that typically had pensions, like automakers, have been eliminating thousands of jobs through automation, which further diminishes the worker-retiree ratio. Older established companies are being weighted down because of them. I can remember 10-15 years ago reading that for every new Ford car or truck that you purchased, $1500 goes directly to their pension fund, whereas Nissan and Honda, relatively newcomers to the American workforce without the "legacy" costs associated with having a large number of former retired workers, was given a huge competitive advantage. Governments, including the military, needs to get out of the pension business and convert to some form of 401K or individual retirement program.

It would be interesting to see what percentage of retired folk are more like you versus like my mom. Given what I've read of American savings and companies putting downward pressure on retirement all the time whether social security will be welfare by the time current generations retire. You may have been one of the last generations to have solid retirement options, with most folks now relying on 401k tied to increases in the stock market. Though some kind of state or government job will still be the best option for the pension route as I think they are the main jobs still offering that type of retirement. I know even Boeing in their new contract eliminated pensions for matching 401ks instead.

According to a 2015 report from the Federal Reserve, 31% of all retired Americans have no pensions or retirement savings, so your mom is certainly not alone. If she has her house paid off, then she shouldn't have a huge problem making it. I would imagine that she's getting somewhere in the neighborhood of $1500/month. So long as she doesn't have any debts, she should be able to get by but she's not going to be able to go on any expensive vacations.

I prefer a 401K's anyway. They're portable, you can take them from employer-to-employer, you can roll it over into a qualified self directed IRA if your next employer doesn't have one, you can contribute to them (you can't contribute to a pension), and you can determine how to invest it. Plus pensions aren't necessarily fully guaranteed. A 401K, less any vesting rights on company contributions, is all yours. No one owes you anything.

Boeing was very wise to get out from under their pension and convert to a 401K. They can vary their contributions, cut it back in years that are lean, like this year and their 737 Max problems, use it to give their employees a bonus in years they do well. They can't compete against an international company like Airbus that doesn't have them.

[Aseahawkfan]

Pensions are a relic of the past. They were well intended but ill conceived and are suffering from exactly the same fate as SS: Life expectancy has increased and the retiree/worker ratio has decreased. Plus companies in traditional union type jobs that typically had pensions, like automakers, have been eliminating thousands of jobs through automation, which further diminishes the worker-retiree ratio. Older established companies are being weighted down because of them. I can remember 10-15 years ago reading that for every new Ford car or truck that you purchased, $1500 goes directly to their pension fund, whereas Nissan and Honda, relatively newcomers to the American workforce without the "legacy" costs associated with having a large number of former retired workers, was given a huge competitive advantage. Governments, including the military, needs to get out of the pension business and convert to some form of 401K or individual retirement program.

This is true. Something is going to have to change substantially. 401ks are not bad, but with the market getting hit like it is right now I"m not sure they are great answer either.

According to a 2015 report from the Federal Reserve, 31% of all retired Americans have no pensions or retirement savings, so your mom is certainly not alone. If she has her house paid off, then she shouldn't have a huge problem making it. I would imagine that she's getting somewhere in the neighborhood of $1500/month. So long as she doesn't have any debts, she should be able to get by but she's not going to be able to go on any expensive vacations.

She is not even getting close to this. About half of that is what she's getting. Maybe it's based on what you've made throughout your life and she never made much. Some people just aren't very good at making money. She's one of those people. Which is another reason I've accepted that some people aren't interested in what capitalism encourages people to be interested in: the pursuit of material goods and services. I'm not real certain society should view such people as someone that doesn't matter. We should be able to come up with some happy medium for people that don't have a huge interest in money and material goods.

I prefer a 401K's anyway. They're portable, you can take them from employer-to-employer, you can roll it over into a qualified self directed IRA if your next employer doesn't have one, you can contribute to them (you can't contribute to a pension), and you can determine how to invest it. Plus pensions aren't necessarily fully guaranteed. A 401K, less any vesting rights on company contributions, is all yours. No one owes you anything.

They are definitely better with good matching. A good matching can really boost your investment.

Boeing was very wise to get out from under their pension and convert to a 401K. They can vary their contributions, cut it back in years that are lean, like this year and their 737 Max problems, use it to give their employees a bonus in years they do well. They can't compete against an international company like Airbus that doesn't have them.

Pensions were a killer for Boeing. World has changed too much to make pensions viable.

[RiverDog]

This is true (about pensions). Something is going to have to change substantially. 401ks are not bad, but with the market getting hit like it is right now I"m not sure they are great answer either.

The only guarantees in life are death and taxes. There is no hiding place from a severely depressed economy as we've seen in the past 2 months. We have a good friend, a former neighbor near 70, who never held a steady job in her life mainly because her hubby wanted her at home. They got divorced, she lost the house she'd live in for 35 years, and now lives in an apartment and just gets by living on very meager SS and whatever money she made when they sold the house. No kids or family to draw on for support. But she survives, very active in her church with a large network of friends.

As much sympathy as I have for your mom and others that have had more than their share of misfortune, we simply can't design a 100% fool proof system that's going to prevent everyone regardless of personal circumstances from ever falling through the cracks. That was the promise of communism, and we saw how that worked out. If we all had guarantees, there wouldn't be near the motivation to work.

She (your mother) is not even getting close to this ($1500/month).

Yea, you're right. My wife was a nurse for 40 years and gets slightly more than her FRA at a little over $1800/month pre tax. $700-800/month would be pretty tough to live on if you had significant housing expenses. But if 1/3 of recipients are living on SS alone, it can be done.

I prefer a 401K's anyway. They're portable, you can take them from employer-to-employer, you can roll it over into a qualified self directed IRA if your next employer doesn't have one, you can contribute to them (you can't contribute to a pension), and you can determine how to invest it. Plus pensions aren't necessarily fully guaranteed. A 401K, less any vesting rights on company contributions, is all yours. No one owes you anything.

Pensions were a killer for Boeing. World has changed too much to make pensions viable.

Pensions are a killer for all older, established companies. And it's not just pensions, either. A lot of them have other "legacy" costs like health insurance that they're having to pay their retired employees. I was lucky in that I got grandfathered into a retiree medical program.

[Aseahawkfan]

The only guarantees in life are death and taxes. There is no hiding place from a severely depressed economy as we've seen in the past 2 months. We have a good friend, a former neighbor near 70, who never held a steady job in her life mainly because her hubby wanted her at home. They got divorced, she lost the house she'd live in for 35 years, and now lives in an apartment and just gets by living on very meager SS and whatever money she made when they sold the house. No kids or family to draw on for support. But she survives, very active in her church with a large network of friends.

As much sympathy as I have for your mom and others that have had more than their share of misfortune, we simply can't design a 100% fool proof system that's going to prevent everyone regardless of personal circumstances from ever falling through the cracks. That was the promise of communism, and we saw how that worked out. If we all had guarantees, there wouldn't be near the motivation to work.

You don't need communist guarantees to take into account people that don't pursue money and material goods like its the end all be all. Plenty of 1st world developed nations take better care of their old. Americans at the moment just seem stuck thinking we can't build a nation like Germany or Sweden with some changes in thinking. It's not a zero sum game or a you have to do this to accomplish this world. We have to analyze some nations doing a better job of taking care of their old and people in general and make some adjustments. America has its share of innovations, but there are plenty of times when we've taken the ideas of other nations and developed them for America whether technology or government. Even our Founders drew upon the works of European and Greek/Roman philosophers for the design of our government.

Yea, you're right. My wife was a nurse for 40 years and gets slightly more than her FRA at a little over $1800/month pre tax. $700-800/month would be pretty tough to live on if you had significant housing expenses. But if 1/3 of recipients are living on SS alone, it can be done.

She's managing it. She's used to living on a very tight budget and doesn't complain as she felt it was more important for her to take care of her elderly parents. I send her some help now and again. She's still healthy enough she could pick up a part time job somewhere for a little extra cash. And it would get her out of the house, which would be nice. Preferably something social and easy for 15 or 20 hours a week.

Pensions are a killer for all older, established companies. And it's not just pensions, either. A lot of them have other "legacy" costs like health insurance that they're having to pay their retired employees. I was lucky in that I got grandfathered into a retiree medical program.

That is why I think socialized healthcare is inevitable. Companies don't want the headache of paying for or managing healthcare. It would be better to take all those premiums that go to healthcare companies and build a giant, national pool of healthcare money to draw from. It would be like insurance on a national scale with a much larger pool of money to draw from. It's more of a matter of how to do it, how to price it, and how to manage it at this point. As far as it happening, you may live to see it, but it may be the next generation. But it's coming unless folks like Buffett, Bezos, and that other guy can figure out a better way to do healthcare than Germany and Scandinavia.

[RiverDog]

She's managing it. She's used to living on a very tight budget and doesn't complain as she felt it was more important for her to take care of her elderly parents. I send her some help now and again. She's still healthy enough she could pick up a part time job somewhere for a little extra cash. And it would get her out of the house, which would be nice. Preferably something social and easy for 15 or 20 hours a week.

That's great to hear. Speaking of retired folks that work part time, I saw where Costco didn't lay off their food sample servers, many of whom are retired folks that need the part time work, when they stopped serving free samples due to the pandemic, rather they put them to work wiping down stuff like shopping baskets, sanitizing door handles, etc. The sample servers don't even work for Costco.

Pensions are a killer for all older, established companies. And it's not just pensions, either. A lot of them have other "legacy" costs like health insurance that they're having to pay their retired employees. I was lucky in that I got grandfathered into a retiree medical program.

That is why I think socialized healthcare is inevitable. Companies don't want the headache of paying for or managing healthcare. It would be better to take all those premiums that go to healthcare companies and build a giant, national pool of healthcare money to draw from. It would be like insurance on a national scale with a much larger pool of money to draw from. It's more of a matter of how to do it, how to price it, and how to manage it at this point. As far as it happening, you may live to see it, but it may be the next generation. But it's coming unless folks like Buffett, Bezos, and that other guy can figure out a better way to do healthcare than Germany and Scandinavia.

Oh, I think it's inevitable, too, but not because it's a headache for companies to pay for and/or manage health care. IMO the nation has been trending towards the left side of the scale ever since Roosevelt with a Reagan or Contract with America Congress tossed in at random intervals. There'll be a lot of liberal ideas advanced, less military spending, socialistic medicine, more stringent environmental regulations, etc.

[Aseahawkfan]

Oh, I think it's inevitable, too, but not because it's a headache for companies to pay for and/or manage health care. IMO the nation has been trending towards the left side of the scale ever since Roosevelt with a Reagan or Contract with America Congress tossed in at random intervals. There'll be a lot of liberal ideas advanced, less military spending, socialistic medicine, more stringent environmental regulations, etc.

It is hard to argue against when you're looking across the sea and nations like Germany and Scandinavia and even places like Japan and England seem to be doing fine with more working class friendly policies for their people. And even our next door neighbor Canada seems to be doing fine with more working class friendly policies.

I can see how younger people watching Youtube and interacting with people on a global level might look and say, "Why can't that be us?" It's much harder to sell the whole America is the greatest and we really need our huge military with so many other nations choosing a different path. Fortunately that is happening not just here, but everywhere where people have access to the global information network via the internet. I imagine even people in the Middle East, Africa, and Central and Latin America are like 'why are we continuing to live this way when we can live like Europe or America?"

I hope they keep communicating too. It's been shown that people who can communicate in a common language and share more in common even if that culture is built over the internet are less likely to make war and seek to harm each other and more likely too cooperate. We've never had a better tool for cross cultural and global communication of ideas until now. We just need America to not withdraw, but continue to show the world freedom is a valuable cultural trait and can indeed thrive and survive without communistic or socialist like controls.

[RiverDog]

[I hope they keep communicating too. It's been shown that people who can communicate in a common language and share more in common even if that culture is built over the internet are less likely to make war and seek to harm each other and more likely too cooperate. We've never had a better tool for cross cultural and global communication of ideas until now. We just need America to not withdraw, but continue to show the world freedom is a valuable cultural trait and can indeed thrive and survive without communistic or socialist like controls.

I agree wholeheartedly. Interpersonal relationships with people from other countries is instrumental in avoiding misunderstandings that can result in a war. We have so many ties with Japan today that it's inconceivable that we'd ever go to war with them.

I have several friends that I went to high school with that was a foreign exchange student from Japan that I still maintain contact with, and we all say the same thing as you're saying. As a matter of fact, one of the guys insisted that each of his kids embark on the same type of exchange program that he did. When my daughter was a freshman in college, I encouraged her, and she agreed to, sign up for a program where Japanese students would share a dormitory room with an American. You create enough of those encounters and the likelihood of war diminishes.