I’ll chip in having worked in both systems. Things that work elsewhere often times don’t work in America.
Most places with socialized medicine - at least western countries have more homogenous populations. We also have a population here that would really have significant adaptations to understand that so much of the aggressive treatments that are expensive that relate to end of life care are not indicated, and not beneficial
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Right on point, I think. I also felt (when travelling to Europe) that food tasted more natural than here in America (more natural I mean their non bio/organic foods tasted on par with organic food I buy here in US). I read somewhere that there are few substances that are used in farming/making food in America that are actually banned in most of Europe.
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Having only worked in the US, my exposure to universal healthcare is military, VA, Medicare, and Medicaid. I haven’t noticed those beneficiaries to be healthier, and I have noticed that they abuse the system with frequent unnecessary use.
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FWIW
Keep all your medical records private.
Purchase everything incognito.
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Interesting but true. Having lived in Canada (free healthcare) I observed the same, many people (mostly elderly) were abusing the system having doctor visits weekly and ranting about why the sun is not shinning enough lol which put a strain on the system as a whole. I do however miss the ability to have labs free of charge as often as you’d like. BTW, I think that free healthcare is a great thing if done correctly, which I think it should not be 100% free but very low fee based per visit. i.e. $20 dollars something cheap enough that everyone can afford but significant enough that it reduces the unnecessary visits. As matter-of-fact government of Canada had put in place a committee to study the system and come up with recommendations and that is exactly what committee came up with- a very low cost per visit/use, plus to allow for private clinics for those that can afford it, but hey politics will screw it up one way or the other. Oh, this is a burden to the poor, while these poor had no problem buying 24 pack of beer at a cost $40 every week (yes beer is more expensive in Canada) lol but would be a problem if they had to pay 20 dollars for couple times a year LOL and the rich will get better access from private healthcare. Both stupid points since the rich actually do go/come to US for most of their needs anyway (who’s going to stop them how to spend their own money) and as noted above every poor person can afford $15 dollar charge once or twice a year.
Don’t know how it is now (left 17 years ago) but at that time I think they decided on some ridiculous low amount of $2 or something. Should have been at least $15 in my opinion and they also decided no private healthcare for the rich. Ahaa which in fact would have been great for the system as a whole since it was estimated that maybe as much as 10% might go for private on few occasions which would have resulted in less strain for the rest of “the poor” . I don’t want to start ranting about politics but one thing is for sure- every time someone tells you that they are doing this or that for your benefit be very, very scared lol.
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My first use of rapa was via Dr. Garcia before he retired. So far I haven’t been asked about it by any other doctor’s office, so I can hope it isn’t in the database. Definitely not going to tell any doctor about it now.
I had trouble buying extra life insurance last year for a similar reason.
I’m on year 16 of a 20 year term policy. Even without rapa in the equation, there’s little chance another policy would be worth it to me at my age (premiums would be insane). I suspect at least now most people, like me, start rapa when they’re old enough that they either already have life insurance or aren’t going to get it even without rapa. Will become more of an issue when people start rapa at a younger age.
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I know there’s another thread about getting blood tests for sirolimus levels. That would also tell the insurance company that you’re using it, if they were really paying close attention to you.
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Same boat. 17 years into a 30 year return premium policy. Return premium is a bit more expensive (for me $100 vs $65) but if you are young enough it will make sense in my opinion, so I get back $36,000 paid once 30 years is over assuming i don’t drop before that lol, while having a protection in case things don’t pan out.
Unlike medications, there isn’t a central database for lab results - so these fly under the radar, unless you provide the results and they get into your medical record that is supplied to an insurer with your permission.
The whole problem is that for insurance (life/health) it really incentivizes people to not disclose things to a standard medical practitioner, both due to them not understanding why you are doing what you are doing, and also due to getting graded as high risk by an insurer.
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I thought that declining health coverage (or increasing price of coverage) based on pre-existing conditions is illegal based on the Affordable Health Care Act? Isn’t declining medical coverage (Cigna) based on past use of sirolimus because of its relationship to organ transplants doing just that?
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When I bought a long duration term policy when my first child was born, I was not nearly optimistic enough about my future earning potential, hence the need to add enough to cover a potential gap until I retire and kids are through college.
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If you have an affordable healthcare act policy -which are the most expensive policies, and often with high deductibles. So yes, you can get cover with no consideration of pre-existing, but it’ll cost a lot. You’ll be excluded from all the non-ACA policies that are more favorable in cost and coverage.
Now for life/disability - you’ll be out of luck as there is no protection.
Our policy right now is considered a “great” deal - and isn’t an ACA one, but we are into $2400/month and the first $13.5K is out of pocket. Almost can’t wait to be on MediCare … it is crazy - and yes, has me personally avoid healthcare - and this is on a doctor’s income.
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Davin8r:
I don’t think that is exactly what the ACA says
Rather it provides for there to be some policies where that is the case, but stops short of requiring it for all policies. I found this on healthcare.gov:
All Marketplace plans must cover treatment for pre-existing medical conditions.
It’s definitely a requirement for a “Marketplace” plan. And definitely NOT a requirement for grandfathered plans. Other than that, I’m not sure.
In my case this is for a Medicare Part B Supplemental policy. Medicare has lots of regulations for these policies. For instance all type G must cover the same things. But only at initial signing (basically when you turn 65) are they required to accept any client and cannot require any medical screening. If you want to change policies after that point, they have the right to require screening, and to decline you.
I guess this is in a different category than general private health insurance. And/or not part of the ACA.
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Ok yeah, I did a little reading online. So if you were trying to get this policy within that first 6 month “open enrollment” period after you first became eligible for Medicare, then they couldn’t decline you based on the rapamycin. But after that period, if you either didn’t enroll or you want to change policies, they can screw you.
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You still can change policies under Medicare
if you stay with the same provider. I changed my Medicare Advantage policy plan this year with the same provider without any trouble.
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This is an interesting question.
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When an insurance company sells you life insurance, they “win” if you live longer than expected. But when they sell you a life annuity, they “lose” if you live longer than expected. Many companies sell both, attempting to balance the risks they face. But insurance companies rely heavily on actuarial analysis to price their policies, so they do get concerned about things that might mess up their analysis.
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The best life annuity is an investment-grade corporate bond. It keeps paying even after you die and usually gives a better return than a life annuity. You can pass it on to your children, grandchildren, etc… Life annuities are a sub-optimal investment because they go away when you die. I picked up a bunch of investment-grade corporate bonds yielding 8% over the past year. You can still find some yielding 6.8% like BNJ (Brookfield Finance).
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My grandmother always told me an ounce of prevention was worth a pound of cure… 
If you give people good healthcare from the prenatal period, through to midlife, I would bet that the expenditures for healthcare are a lot lower in the last two decades of life.
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I’ve been on medicare for 6 years. I didn’t think part B was something I even had a choice about. I thought A & B were just standard medicare covered by classic, standard medicare. . I also have a plan F (which pays the deductible or outstanding costs for anything not covered by part B. But my broker never discussed any options whatsoever on part a or b. Part D pretty much blows but it’s relatively inexpensive and is like catastrophic drug plan coverage. I’m confused.
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