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Slashing personal healthcare costs

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".
Reply to
dumbstruck
On Wed, 13 Jul 2011 17:42:41 CST, dumbstruck wrote:
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.
Reply to
HW \"Skip\" Weldon
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!
Reply to
dapperdobbs
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."
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Reply to
Elle
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
Reply to
Ron Peterson
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.
Reply to
Don
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.
Reply to
JoeTaxpayer
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.
Reply to
bo peep
Thanks all; I'm sort of "dumbstruck" about all the constructive replies to my question (and venting?) which might tempted some cheap shots instead.
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:
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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).
Reply to
dumbstruck
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."
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."
Reply to
Elle
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."
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."
Reply to
Elle
I won't debate philosophy, but note the qualifications of a fellow "ill-informed critic"
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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.
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
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. 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.
Reply to
dumbstruck
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 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
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Reply to
David S Meyers CFP
On Tue, 2 Aug 2011 03:58:48 CST, dumbstruck wrote:
Don't believe everything you read in Wikipedia. Thumper
======================================= MODERATOR'S COMMENT: Please remember to trim quotes.
Reply to
Thumper

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