Slashing personal healthcare costs

Discussion in 'Financial Planning' started by dumbstruck, Jul 14, 2011.

  1. dumbstruck

    dumbstruck Guest

    Any suggestions for the frugal, esp for those with few med benefits?

    - Medical: Esp. with the draconian 2014 requirement on having
    insurance looming, am I correct that residents have to hook up with a
    company that is registered/permitted in their state? This is the case
    here, and means there are very few and very expensive (for the non
    affiliated) options. Are other states less restrictive? Are there
    national plans that would satisfy the feds even if "banned" by your
    state (even traveler plans with limited benefits)?

    - Eyecare: I am very picky about accuracy of eyeglass prescriptions,
    but have found the ultracheap mail order glasses give equal or better
    quality than local expensive ones. I'm talking about places where
    frames go as low as $5, lenses about $10, and shipping about $5 with
    perfect track records of lense accuracy (unlike local) in a dozen
    pair. You do have to tweak frames yourself, but with a little
    attention will get it RIGHT, and realize how your expensive frames
    were never really right (then you can adjust them too). You need to
    pay attention to get frames large enough because bargains tend to be
    made in China for their populations dimensions. Of course they have
    higher end frames and lenses also which are still great values.

    - Dental: This really hits me as a racket that's mainly about revenue
    generation - I can imagine their conferences on the subject. After
    stepping up my self care and eliminating almost all cavity or gum
    issues for years, a variety of dentists have just escalated efforts to
    cost me hundreds per year. The flurry of elaborate xrays just never
    stops in spite of my protests. They never find anything, but insist on
    long expensive exams which are basically a marketing programs for some
    proposed proactive treatment. And eternal pushing of expensive
    treatments such as $30 prescription toothpaste for which they must be
    getting kickbacks.

    For this, I propose taking charge of your schedule - which takes
    incredible fortitude to resist their pushback. Maybe still cleanings
    every 6 mo, but only exams and xrays once every other year. And no
    marketing programs, needless taking or viewing of photos, or
    supplement equipment/pastes etc. This is if you want to keep the
    commercial route; another possibility would be to be treated for
    nearly nothing at your dental college full time or alternate years.

    I do assume you have cleaned up your act of the normal problems by
    frequent brushing and flossing. The latter very easy without yucky
    fingers in your mouth, with things like disposable Placker Twinline. I
    don't know the generic name for these, but if you doubt they work, try
    them twice a day just for the week before a dental cleaning - they
    will throw up their hands like "Fonzie" with his comb, and say "can't
    be improved".
     
    dumbstruck, Jul 14, 2011
    #1
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  2. On Wed, 13 Jul 2011 17:42:41 CST, dumbstruck <>
    wrote:

    >I do assume you have cleaned up your act of the normal problems by
    >frequent brushing and flossing. The latter very easy without yucky
    >fingers in your mouth, with things like disposable Placker Twinline. I
    >don't know the generic name for these, but if you doubt they work, try
    >them twice a day just for the week before a dental cleaning


    Thanks for the tip. Being a proponent of reducing costs (spending and
    taxes) and then investing those dollars, I keep an eye out for
    anything that gets the job done for less.

    By the way, I found a package of Twinline (75 in a bag) for $2 at
    Walmart.
     
    HW \Skip\ Weldon, Jul 14, 2011
    #2
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  3. dumbstruck

    dapperdobbs Guest

    On Jul 13, 7:42 pm, dumbstruck <> wrote:
    > Any suggestions for the frugal, esp for those with few med benefits?
    >
    > - Medical: Esp. with the draconian 2014 requirement on having
    > insurance looming, am I correct that residents have to hook up with a
    > company that is registered/permitted in their state? This is the case
    > here, and means there are very few and very expensive (for the non
    > affiliated) options. Are other states less restrictive? Are there
    > national plans that would satisfy the feds even if "banned" by your
    > state (even traveler plans with limited benefits)?
    >


    Government getting bigger and bolder and ever more invasive. No
    smoking in public places like Santa Monica even with buses and cars
    choking everyone (compare a cigarette to a exhaust tailpipe?), even
    with nauseating regulation destroying everyone's peace of mind and
    destroying small businesses, light bulbs regulated, ethanol
    enforcement driving the price of bread up, HOA's dictating what kind
    of potted plants you can have, cities throwing people in jail for
    growing vegetables in their yards ... government mandating what the
    heck you can and can't do, buy, or have. Bah.

    Tell your politicians you've had enough government for a while, thank
    you, and watch the price of medical come down. In the meantime, let
    your doctors know you pay cash or check, and see if they don't offer
    you a discount of 30% over the ridiculously elaborate "insurance"
    plans that are no guarantee of payment to begin with!
     
    dapperdobbs, Jul 14, 2011
    #3
  4. dumbstruck

    Elle Guest

    On Jul 13, 5:42 pm, dumbstruck <> wrote:
    > For this, I propose taking charge of your schedule - which takes
    > incredible fortitude to resist their pushback. Maybe still cleanings
    > every 6 mo, but only exams and xrays once every other year.


    I agree. I have questioned my dentists anytime they have asked for
    more than one x-ray a year. I think this is a helpful excerpt:

    --
    If a patient is at low risk for dental problems, never has new
    cavities, eats a healthy diet and practices excellent oral hygiene -
    brushing and flossing daily - he or she may need X-rays only once
    every two to three years, said Dr. Dara Cunnion, a pediatric dentist
    at the Boston University School of Dental Medicine.

    But you should be assertive in talking to your dentist about X-rays,
    and how often you really need them, said Frank Masse, a retired MIT
    nuclear physicist who now runs a consulting service for hospitals and
    medical clinics. Masse said he allows his dentist to take X-rays "only
    if there is a real need," adding that "it's been many, many years
    since I had a whole-mouth exam."

    >From http://articles.boston.com/2008-04-...tal-x-rays-pediatric-dentist-dentists-caution

    ---
     
    Elle, Jul 15, 2011
    #4
  5. dumbstruck

    Ron Peterson Guest

    On Jul 13, 4:42 pm, dumbstruck <> wrote:
    > Any suggestions for the frugal, esp for those with few med benefits?


    > - Medical: Esp. with the draconian 2014 requirement on having
    > insurance looming, am I correct that residents have to hook up with a
    > company that is registered/permitted in their state? This is the case
    > here, and means there are very few and very expensive (for the non
    > affiliated) options. Are other states less restrictive? Are there
    > national plans that would satisfy the feds even if "banned" by your
    > state (even traveler plans with limited benefits)?


    Just being able to get medical insurance is a big help. National plans
    and a public option would make it easier for people to move to where
    there are jobs, but it would require federal oversight of the plans
    instead of the current state oversight.

    I had a nephew get a stent after a severe blockage. He didn't have
    insurance, but the medical providers lowered his bill. (I wouldn't
    count on that happening for those that have considerable savings or
    income.)

    It's impossible to compare medical insurance rates in general, so it's
    a matter of getting bids probably through an insurance agent. I think
    a high co-pay might be better than a high deductible because the
    insurance company will negotiate lower charges for all charges instead
    of just major medical costs.

    One can save by not smoking, exercising, and having a good diet.

    Get the flu vaccine every year and treat any chronic condition like
    diabetes or hypertension.

    --
    Ron
     
    Ron Peterson, Jul 15, 2011
    #5
  6. dumbstruck

    Don Guest

    On Jul 13, 4:42 pm, dumbstruck <> wrote:

    > The flurry of elaborate xrays just never
    > stops in spite of my protests. They never find anything, but insist on
    > long expensive exams which are basically a marketing programs for some
    > proposed proactive treatment.


    Dental ripoffs are a real problem indeed, but I wonder if regular X-
    rays are not important in detecting oral cancer in its early stages as
    much as finding out anything about the teeth.
     
    Don, Jul 16, 2011
    #6
  7. dumbstruck

    JoeTaxpayer Guest

    On 7/13/11 7:42 PM, dumbstruck wrote:

    > - Dental: This really hits me as a racket that's mainly about revenue
    > generation - I can imagine their conferences on the subject. After
    > stepping up my self care and eliminating almost all cavity or gum
    > issues for years, a variety of dentists have just escalated efforts to
    > cost me hundreds per year. The flurry of elaborate xrays just never
    > stops in spite of my protests. They never find anything, but insist on
    > long expensive exams which are basically a marketing programs for some
    > proposed proactive treatment. And eternal pushing of expensive
    > treatments such as $30 prescription toothpaste for which they must be
    > getting kickbacks.


    Uh, "Just say 'no'."
    My xrays are every 2 years, but if you wish, you are the customer, and
    can just tell them you're there for a cleaning. The risk is whether a
    tiny hole that can be easily drilled and filled before getting worse,
    turns into, well, something worse.
     
    JoeTaxpayer, Jul 16, 2011
    #7
  8. dumbstruck

    bo peep Guest

    On Jul 13, 5:42 pm, dumbstruck <> wrote:
    > After
    > stepping up my self care and eliminating almost all cavity or gum
    > issues for years, a variety of dentists have just escalated efforts to
    > cost me hundreds per year. The flurry of elaborate xrays just never
    > stops in spite of my protests. They never find anything


    There are other problems that can come up besides cavities and gum
    problems. Teeth sometimes just "give up the ghost" for no visible
    reason. That can lead to needing a root canal, or even developing an
    abcess. Getting an abcess fixed is much less desirable than getting
    multiple xrays over the years. Been there - done that.
     
    bo peep, Jul 17, 2011
    #8
  9. dumbstruck

    dumbstruck Guest

    Thanks all; I'm sort of "dumbstruck" about all the constructive
    replies to my question (and venting?) which might tempted some cheap
    shots instead.

    On Jul 15, 11:39 am, Ron Peterson <> wrote:
    > It's impossible to compare medical insurance rates in general, so it's
    > a matter of getting bids probably through an insurance agent. I think
    > a high co-pay might be better than a high deductible because the
    > insurance company will negotiate lower charges for all charges instead
    > of just major medical costs.


    But the co-pay model is starting to be demolished - see the article
    how a committee has ruled 6 sex-related issues must be tended to with
    zero co-pay, and how you will pay for it in mandatory annual fees even
    if you don't indulge in such risk factors or biologically cannot. The
    committee was not to look at the cost of this - only whether zero co-
    pay gives any better results:
    http://www.nytimes.com/aponline/2011/07/19/us/politics/AP-US-Free-Birth-Control.html?_r=2&ref=news

    I wonder if there will be any escape of this forced collectivization
    of coverage for increasingly irresponsible and wasteful medcare. With
    zero co-pay the hypochondriacs zoom up the cost. Then if you even
    change a health plan, you face not being grandfathered for a pre-
    existing condition and zooming your rates. Very different options are
    available from state to state, but some of the nationwide web quoters
    give suspicious numbers (eg. try having them quote your present plan).
     
    dumbstruck, Jul 25, 2011
    #9
  10. dumbstruck

    Elle Guest

    On Jul 24, 7:27 pm, dumbstruck <> wrote:
    > I wonder if there will be any escape of this forced collectivization
    > of coverage for increasingly irresponsible and wasteful medcare.  With
    > zero co-pay the hypochondriacs zoom up the cost.


    But collectivized (socialized) medical systems are said to "ration" to
    deal with overdemand of non-efficacious services.

    Some seem to want to eliminate waste via socialized medicine. Then ill-
    informed critics jump on them for promoting real efficiency,
    incorrectly and pejoratively labeling their goals as "rationing."

    > Then if you even
    > change a health plan, you face not being grandfathered for a pre-
    > existing condition and zooming your rates.


    The Patient Protection and Affordable Care Act* (passed in 2010) says
    denying someone coverage for a pre-existing condition or charging a
    different premium for said condition is illegal.




    *Many know this as "ObamaCare."
     
    Elle, Jul 29, 2011
    #10
  11. dumbstruck

    Elle Guest

    On Jul 24, 7:27 pm, dumbstruck <> wrote:
    > I wonder if there will be any escape of this forced collectivization
    > of coverage for increasingly irresponsible and wasteful medcare.  With
    > zero co-pay the hypochondriacs zoom up the cost.


    But collectivized (socialized) medical systems are said to "ration" to
    deal with overdemand of non-efficacious services.

    Some seem to want to eliminate waste via socialized medicine. Then ill-
    informed critics jump on them for promoting real efficiency,
    incorrectly and pejoratively labeling their goals as "rationing."

    > Then if you even
    > change a health plan, you face not being grandfathered for a pre-
    > existing condition and zooming your rates.


    The Patient Protection and Affordable Care Act* (passed in 2010) says
    denying someone coverage for a pre-existing condition or charging a
    different premium for said condition is illegal.




    *Many know this as "ObamaCare."
     
    Elle, Jul 29, 2011
    #11
  12. dumbstruck

    dumbstruck Guest

    On Jul 29, 5:18 am, Elle <> wrote:
    > Some seem to want to eliminate waste via socialized medicine. Then ill-
    > informed critics jump on them for promoting real efficiency,
    > incorrectly and pejoratively labeling their goals as "rationing."


    I won't debate philosophy, but note the qualifications of a fellow
    "ill-informed critic" http://en.wikipedia.org/wiki/Theodore_Dalrymple
    who has been writing about his experiences as a UK doctor (for the
    underpriviledged) for decades. I've followed hundreds of his weekly
    Spectator articles illustrating the inherent dysfunction their
    socialized medicine created for him. He writes critical books about
    it too, as well as British Medical Journal articles and US thinktank
    writeups.

    > The Patient Protection and Affordable Care Act* (passed in 2010) says
    > denying someone coverage for a pre-existing condition or charging a
    > different premium for said condition is illegal.


    Thanks! That is an interesting feature which will inflate typical
    costs but prevent a catch 22 for people forced into coverage but not
    able to pay a jacked up special premium. In searching for when this
    takes effect (2014) I found a very interesting summary of the act's
    timeline http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act
    . It for instance will ban high-deductible ways of making your plan
    affordable - whatever happened to the freedom for citizens to
    negotiate their own contracts with service providers?. The writeup
    does say the act is, and has always been, disliked by majority of
    polled citizens (sez Obama was elected on a no-mandatory health care
    platform) so maybe some alterations before 2014.

    But I did find a loophole I am starting to like - a qualifying 501(c)
    (3) cost-sharing religious ministry. You don't send them insurance
    premiums; they just tell you which member is sick and you send your
    monthly contribution directly to the patient. Only a few qualified
    ones exist (all Christian, with long track records) and no more will
    be approved. It has a further advantage of not being regulated by
    state insurance boards, which in my case jacks up the needless
    coverage almost as much as 2014 fed requirements anyway. Any opinions?

    There is also a mandate loophole for native Americans (any open
    enrollment into less popular non casino owning tribes?) and the Amish
    (Mennonites too?). The Amish loophole seems to lock you out of social
    security system as well, but that could be a big advantage for young
    folks who haven't yet thrown away money into SS contributions. The
    point of seeking a loophole is for those finding the 2014 mandates too
    expensive, wasteful, or even violating the very foundation principles
    of their country.
     
    dumbstruck, Aug 2, 2011
    #12
  13. dumbstruck <> writes:

    [We're heading towards the edges of topicality here]

    re: panel's recommendation that healthcare reform include
    provision of birth-control with zero copayments

    > I wonder if there will be any escape of this forced collectivization
    > of coverage for increasingly irresponsible and wasteful medcare. With
    > zero co-pay the hypochondriacs zoom up the cost. Then if you even


    I think from an economic perspective you have to look carefully
    at unintended consequences and cost escalation. Your use of the
    word "hypochondriacs" here - in context of talking about birth
    control - suggests that all medical treatments have the same
    consequences and costs. But birth control is (a) very cheap
    and (b) not something abused by hypochondriacs and (c) likely
    to create vast other savings (ie. unintended pregnancies are
    very much more expensive). This is entirely unlike, say, if
    the healthcare reform provided zero-copayment provisions for
    MRIs.

    While it doesn't quite match what we're talking about here
    directly, I do highly recommend a quick read of Tyler Cowen's
    recent (very short) book, The Great Stagnation. He talks for
    a good while about the failure of pricing signals and one
    of the three things he puts on display regarding this, of
    course, is healthcare. When there is no pricing signal,
    things get overused. But in our country, with our system
    of third-party payers for most healthcare, the signals are
    long since gone and - at least as importantly - we are not
    getting better outcomes for all that spending. WHen there
    are viable pricing signals, people do slow down spending
    when they are no longer getting value for their money. When
    someone else pays, whether they get value or not, they
    keep spending.

    But he also makes it very clear that different kinds of
    spending add (or don't add) value in different ways. Which
    brings me back to my earlier point - overspending on way too
    many, say, heart stents - and I guarantee you that regardless
    of ObamaCare, we were and will be spending buckets of money
    on that since most of them are paid for by Medicare anyway -
    makes little economic sense. While spending more on preventing
    unwanted pregnancies does get us a huge return on that
    investment. And the costs of those unwanted pregnancies, very
    much like the costs of healthcare for the elderly, do not all
    fall on the private sector - they fall very much through to
    the government programs. Middle class people with private
    healthcare are rather less likely to have those unwanted
    pregnancies than are people who are already getting government
    benefits - and even more telling, once they have those unwanted
    pregnancies they are more likely to run up further government
    costs since we provide a social safety net for the sake of
    those kids.

    Anyway, this has all been a very long-winded way to say that
    I strongly suspect that the "return on investment" to all
    of us, particularly the taxpayers, from providing zero-copay
    birth control is likely to be quite high.


    --
    David S. Meyers, CFP(R)
    http://www.MeyersMoney.com
    disclaimer: for educational purposes only. This is not financial advice.


    ======================================= MODERATOR'S COMMENT:
    I'm allowing this discussion for the moment, but if gets too politically heated, it'll be shut down. Please try to keep discussion related specifically to financial issues.
     
    David S Meyers CFP, Aug 2, 2011
    #13
  14. dumbstruck

    Thumper Guest

    On Tue, 2 Aug 2011 03:58:48 CST, dumbstruck <>
    wrote:

    >On Jul 29, 5:18 am, Elle <> wrote:
    >> Some seem to want to eliminate waste via socialized medicine. Then ill-
    >> informed critics jump on them for promoting real efficiency,
    >> incorrectly and pejoratively labeling their goals as "rationing."

    >
    >I won't debate philosophy, but note the qualifications of a fellow
    >"ill-informed critic" http://en.wikipedia.org/wiki/Theodore_Dalrymple
    >who has been writing about his experiences as a UK doctor (for the
    >underpriviledged) for decades. I've followed hundreds of his weekly
    >Spectator articles illustrating the inherent dysfunction their
    >socialized medicine created for him. He writes critical books about
    >it too, as well as British Medical Journal articles and US thinktank
    >writeups.
    >
    >> The Patient Protection and Affordable Care Act* (passed in 2010) says
    >> denying someone coverage for a pre-existing condition or charging a
    >> different premium for said condition is illegal.

    >
    >Thanks! That is an interesting feature which will inflate typical
    >costs but prevent a catch 22 for people forced into coverage but not
    >able to pay a jacked up special premium. In searching for when this
    >takes effect (2014) I found a very interesting summary of the act's
    >timeline http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act
    > . It for instance will ban high-deductible ways of making your plan
    >affordable


    Don't believe everything you read in Wikipedia.
    Thumper

    > - whatever happened to the freedom for citizens to
    >negotiate their own contracts with service providers?. The writeup
    >does say the act is, and has always been, disliked by majority of
    >polled citizens (sez Obama was elected on a no-mandatory health care
    >platform) so maybe some alterations before 2014.
    >
    >But I did find a loophole I am starting to like - a qualifying 501(c)
    >(3) cost-sharing religious ministry. You don't send them insurance
    >premiums; they just tell you which member is sick and you send your
    >monthly contribution directly to the patient. Only a few qualified
    >ones exist (all Christian, with long track records) and no more will
    >be approved. It has a further advantage of not being regulated by
    >state insurance boards, which in my case jacks up the needless
    >coverage almost as much as 2014 fed requirements anyway. Any opinions?
    >
    >There is also a mandate loophole for native Americans (any open
    >enrollment into less popular non casino owning tribes?) and the Amish
    >(Mennonites too?). The Amish loophole seems to lock you out of social
    >security system as well, but that could be a big advantage for young
    >folks who haven't yet thrown away money into SS contributions. The
    >point of seeking a loophole is for those finding the 2014 mandates too
    >expensive, wasteful, or even violating the very foundation principles
    >of their country.



    ======================================= MODERATOR'S COMMENT:
    Please remember to trim quotes.
     
    Thumper, Aug 2, 2011
    #14
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