Retiring early... Geographic arbitrage

My cost was $40
Really? It would be more accurate to say that your direct out of pocket cost was $40 etc etc etc. It is not a conspiracy, BTW, it is simple economics that most miss.

Sorry to hear about your issues though.

Who paid for the other $5000 the hospital charged for the 3 specialist for 2 hours?
 
Really? It would be more accurate to say that your direct out of pocket cost was $40 etc etc etc. It is not a conspiracy, BTW, it is simple economics that most miss.

Sorry to hear about your issues though.

Who paid for the other $5000 the hospital charged for the 3 specialist for 2 hours?
I did, in my life long contribution to the medicare system. Please dont take this too personal but maybe personal enough. As misinformation and innuendo that you posted drives me crazy and why the internet is so full of ____ because people read posts like yours and it takes on a false "truth"

I just dont understand why Americans trash their health care system, people who do not take care of themselves cost the system far more than anything.

The $5000 in charges that you insinuated was less then $600 for 3 specialists and the use of the hospitals cancer clinic specific to my cancer

I of course left my name off but here is my insurance statement.
I paid $40 it shows only $10 because I paid $30 online before the appointment. First charge is the hospital at $275 with a true cost of $104.91. the next 3 are the doctors. Dont take anything I wrote personally, it's just the internet age is killing us with false information.

Screenshot 2025-01-01 at 11.52.50 AM.webp
 
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As one of my physician colleagues says, "There are no normal people, only people who haven't had enough tests yet."

There is quite a lot of truth to that. If a physician looks hard enough they can always (or almost always) find something 'abnormal'.

A side bar in the Globe and Mail a few months ago showed the population who were over 80 years old and had no serious health concerns at all was almost 0%. There is always something - a touch of heart disease, blood sugars persistently high, recovering from a bout of cancer, arthritis, etc.
Isn't there some Latin phrase about that?
 
Good god, I cant agree more ... trust me, they will change their mind should they need the system to fix their cancer or some other serious illness they have no control over.

My wife and I just went to one of the top cancer clinics in the USA. We met with not 1, not 2 but 3 cancer specialists in their respective fields for over a two hour period, just exclusively for me to get opinions on the three types of treatments I can chose from and their consultation on where they think I am at. My cost was $40

5 days before Christmas through the amazing efforts of what will become my local specialist I had the latest PSMA PET SCAN (just available starting in 2023) to scan my body for specific cancer my cost $10. It hasn't spread.

5 days after Christmas I met with my local specialist and about to pull the trigger on the treatment I have selected based on all the input I have received. Let me tell you, when any of these complainers have an affliction that they had no control over, the USA is an AMAZING place filled with good doctors who treat patients with a passion. The treatment is not going to be fun but my confidence in these doctors, it was easy to pick up on their passion treating their patients. I would not want to be in any other country in the world for what I am about to go through.

PS! When you are struck with a serious illness, walking into a beautiful looking treatment center CERTAINLY makes you feel more comfortable and confident vs a run down clinic in some overseas land.
Had a friend with a very rare case of a certain Leukemia. They were sent to the Huntsman Cancer Center here in Utah. I'm sure you have heard of that facility-world class. They had nothing but good things to say. She had a team of a half dozen doctors. In the end she couldn't be saved.

But yea-everyone knocks the medical community....until you really need it.
 
Really? It would be more accurate to say that your direct out of pocket cost was $40 etc etc etc. It is not a conspiracy, BTW, it is simple economics that most miss.

Sorry to hear about your issues though.

Who paid for the other $5000 the hospital charged for the 3 specialist for 2 hours?
Because our medical is now from my wife and school district, it’s similar. If I had a hip replacement, it would be $40. The hospital stay, my understanding, is $100 I think up to 3 days. $0 deductible. This is PA. NJ is even better, $15 instead of $40.

This is the truth. Even with great medical, ie $0 deductible? I used the doctor 3x ($20 copay each) and Labcorp 2x. We didn’t use it unnecessarily in any way. That’s why I feel employers at times hide behind this veil where employees must pay more not them. It used to be more common that employers foot 90%, and deductibles were $100/$250/$500 with 90/10. One day, the HSA and HRA were invented (around 2014).

To me, the HSA teaches employees not to use the medical and we’ll give you a minimal amount that y out can keep when we fire you. My bro has like $40k now? But that’s nothing if he actually needed it. People skip routine care as they “feel” the $180 appointment. Even with kids. They hesitate rather than go when sick.

P.s. sorry to stray from the retirement topic.
Some good thoughts came about from the age discussion. I’m 58 btw.
 
Because our medical is now from my wife and school district, it’s similar. If I had a hip replacement, it would be $40. The hospital stay, my understanding, is $100 I think up to 3 days. $0 deductible. This is PA. NJ is even better, $15 instead of $40.

This is the truth. Even with great medical, ie $0 deductible? I used the doctor 3x ($20 copay each) and Labcorp 2x. We didn’t use it unnecessarily in any way. That’s why I feel employers at times hide behind this veil where employees must pay more not them. It used to be more common that employers foot 90%, and deductibles were $100/$250/$500 with 90/10. One day, the HSA and HRA were invented (around 2014).

To me, the HSA teaches employees not to use the medical and we’ll give you a minimal amount that y out can keep when we fire you. My bro has like $40k now? But that’s nothing if he actually needed it. People skip routine care as they “feel” the $180 appointment. Even with kids. They hesitate rather than go when sick.

P.s. sorry to stray from the retirement topic.
Some good thoughts came about from the age discussion. I’m 58 btw.
i am not talking about what you pay, or your medical plan .....i am talking about the cost.
 
i am not talking about what you pay, or your medical plan .....i am talking about the cost.
That is not known. One of our friends in a northern NJ hospital says they have 3 sets of books (as if there are 3 possible paths a hurricane can take), which seemed to be the Sopranos way. Does anyone believe there’s such a thing as a shot, or hip replacement, both costing $42,000? There are, in the books.
 
But yea-everyone knocks the medical community....until you really need it.
The medical system is broken regardless of some amazing folks in the medical community. $30k a year for medical insurance (family of 4) is insane. How much of this money goes to shareholders & big pharma excs
 
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The medical system is broken regardless of some amazing folks in the medical community. $30k a year for medical insurance (family of 4) is insane. How much of this money goes to shareholders & big pharma excs
Not calling you a liar. But post like yours without details leaves many questions. Just like car insurance threads- too many variables to have a meaningful dusussion.
 
The medical system is broken regardless of some amazing folks in the medical community. $30k a year for medical insurance (family of 4) is insane. How much of this money goes to shareholders & big pharma excs
That is because the people voted for national healthcare restrictions. You lost the right to pick a plan that worked for you instead you have to get a standardized government mandated health plan that covers the entire population even if you would like to eliminate some things from that plan that you would never need care for you no longer have that right.
But the people voted for it, however, if you are paying $30,000 that is only because you can afford it. Someone with a little to no income in the same health insurance will not have to pay a premium.
 
I know a neurosurgeon. He makes about 800k per year. That does not come from nowhere.
Good news for the surgeon that’s the great thing about being in a free country, he is free to make as much money as he can, just like any of us.
Being a doctor doesn’t mean you have to submit to servitude. That is North Korea material if he did.

If that pay was true, everybody should just become what he does and everybody will make $800,000 a year
 
Good news for the surgeon that’s the great thing about being in a free country, he is free to make as much money as he can, just like any of us.
Being a doctor doesn’t mean you have to submit to servitude. That is North Korea material if he did.

If that pay was true, everybody should just become what he does and everybody will make $800,000 a year
I think salary and height are two big things men fib about. Anyway, doctors are real people. Most of them have very stable and decent lives. But they are ordinary people. My doctor complained she paid $98 to ship a package at UPS, and they lost it. Never hit the ups system (she took a pic of the label).

I didn’t want to say you should create an online account it would be half, and even if they didn’t offer you should have asked for a receipt. Said the package was worth less than the shipping but she was annoyed just like you and me.

I for one consider doctors very above average intelligence no different than engineers. I think there was a point earlier in the thread that said they are not able to simply treat patients as they were trained. Insurance does have a say in it…
 
Yep. Good advice.

I am 61.

At 59, a medical event made me ineligible to work. Happened when I was skiing in Colorado. I was fine from every perspective except one - that of the FAA. The next couple of years, I spent a lot of time skiing, working out, pursing hobbies, spending time with family, all after the event, and I don’t care to discuss the details, but the point you make is the one I would make.

My career was taken away from me, by a completely unanticipated medical condition (hereditary, auto-immune) when I was 59. For nearly two years, I was not sure if I would ever work again.

But because of investment and planning that took place decades prior, we were OK. My wife retired from her job while I was on disability. We didn’t need her income. We lived our lives as we had been. No change.

I just went back to work in October. Not because I needed to, but because I wanted to. I like, check that, love, what I do and I am happy to be back. I work because I choose to, not because I need to, and that, my friends, is freedom.

No amount of diet, exercise, avoidance, or prep could have changed this condition that happened to me. It might help to know that I was a varsity athlete in college, in two sports, and a Navy fighter pilot. I had a strong physical/athletic background, and the most rigorous medical oversight on the planet. I’ve stayed in shape. I have worn the same size jeans since 1984, for example.

Still happened.

For the younger viewers, I would add - you can not know when your day will come - that day when you become unable to work. It will happen. Better to plan for it to happen early and be wrong, than the opposite, when you are up the creek, with no paddle. No options.
I lost a friend to sudden cardiac death, most likely from cardiac sarcoidosis. He was around 59-60.

Fortunately he left her a good portfolio, so she is ok. You never know.
 
I salute him. I WANT a neurosurgeon to make 800K. Would you want someone doing your brain surgery if they were making $100K?
If you can afford him/her...

We actually have an acute shortage of many specialties. Which is driving up the costs and there have already been 7 hospital closures in the US in the first 2 months of the year.
 
A lot involved. I find this piece written well enough to give one things to think about and prepare for.
https://www.thethailandlife.com/thailand-retirement-guide
The biggest issue with Thailand is double taxation. Most of the income from the US is exempt from double taxation (you claim foreign tax credit on your 1040) but in my case, a large chunk of income will be double taxed.

So tax residency in Thailand is out of question. Only a handful of countries will not require you to pay income tax if you stay there for more than 180 days per year. There are loopholes but who wants to deal with filing taxes in the US and in some other country. So it's either nomadic life or living in Malaysia or Vietnam.

The Philippines is out of question, unfortunately. They will probably become a second Ukraine in a couple of years.
 


The Philippines is out of question, unfortunately. They will probably become a second Ukraine in a couple of years.
I can see your concern about the Philippines. From what I understand after being there, we have assets there that are not talked about.

No foreign country unless they want to go to war with us would interfere as they would be attacking the United States as well.

Never mind the fact that both Russia and China know how close we are with them.
Heck, the largest World War II American cemetery is in the Philippines as well. That’s how close we are.
It’s an amazing place. Look up BGC.

Ukraine was a nothing to us the Philippines is part of our history. Filipino soldiers and American soldiers fought hand-in-hand together.
 
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