Your health insurance in early retirement

If you are an American who wants to retire earlier than most, then your employer-supplied healthcare insurance might be your biggest worry. How are you going to substitute for it in retirement? 

Here is what I have found on this topic.  


The ACA (the affordable care act)

If ACA still exists when you retire, and you qualify for subsidies, you are in a great condition. Just make sure that there are local doctors under the ACA plan you buy. Great articles on ACA are already available. Here is one from GoCurryCracker. Two others come from RootofGood: here and here. 

The couple from the YouTube channel Our Rich Journey also discusses ACA.

 
Direct primary care

Direct Primary Care (DPC) is an alternative payment model for primary care, it is not an insurance. From the website of Direct Primary Care, here is the most important information about the system. DPC utilizes a flat-fee system that covers comprehensive primary care services. The website mentions in different places $70-$100 a month per member. DPC allows for sufficient time spent between patient and physician. DPC practices usually have extended hours, ready access to urgent care, and “patient panel sizes small enough to support this commitment to service”. As a DPC patient, you can choose your personal physician. Currently, there are over 1,000 DPC practices in 48 states that provide primary care to more than 300,000 patients. However, the DPC practices are unevenly distributed throughout the country. Check their map here. 

According to the news of DPC website, DPC is better than ACA. However, DPC is not an insurance plan and does not cover medical costs outside the primary care practice. Therefore, patients of DPC should have a high deductible or "health share" plan to be an ACA qualified healthcare plan. 

Here is a brief video about DPC that emphasizes the price, convenience and prevention concept. There is also a warning about the medical conditions that would not be covered by DPC or a high deductible or "health share" plan.

 
Healthcare sharing ministries

Another option are the healthcare sharing ministries. These are not insurance plans either. Such organizations take the biblical command to do good and share with others. The members commit to belief in God, freedom, and ethics. The benefit is that the members make affordable monthly contributions online to match the medical needs within their group. One such ministry is Liberty Shares that offers three different programs. Here are the monthly fees: for a single under 30 (and 30 and over):  $249 ($299),  for a couple under 30 (and 30 and over): $349 ($399), and for a family of under age of 30 (and 30 and over):
$479 ($529).
 
Under the Liberty Complete program, after fulfilling the annual "unshared" amount ($1,000 for an individual, $1,750 for a couple, $2,250 for a family), the members can share eligible medical costs up to $1 million per incident.

Other healthshare ministries are the Christian Healthcare Ministries, Medi-Share, Samaritan Ministries, and the Freedom HealthShare. Keep in mind that the monthly share payments are not deductible from the U.S. federal income taxes as medical expenses or charitable deductions.


Medical tourism and international insurance

Of course, medical tourism already exists and will expand in the future. If you are permanently stationed abroad, you may consider international medical insurance. 

From this website comes an example insurance rate for a husband and wife, ages 62 and 60. The plans are offered by IMG Global Medical. Plan 1 covers the couple worldwide excluding the U.S., Canada, China, Hong Kong, Japan, Macau, Singapore, and Taiwan. This plan costs $2,260 per year with a $10,000 deductible. Plan 2 covers the couple worldwide coverage (anywhere, including the U.S). This plan costs $41,546 with a $100 deductible (I could not confirm the cost of the second plan via a quote). Other companies have different deals, for example, CignaGlobal Medical Plan adjusts the price according to where you live. 


 Go to a doctor only when you need (abroad)

This option is not for everyone. But here is the experience of Mr Free at 33 in Chiang Mai, Thailand. 

The affordability of healthcare in Thailand is also mentioned by the adorable couple Our Rich Journey.

Any other ideas on how to release your yoke without the fear of a health collapse in the retirement years?

Cancer Incidence In Different Parts Of The USA

Different forms of cancer seem more prevalent in some areas of the USA compared to others.  For example, read here. Part of abstract:

For many cancers, there were distinct clusters of counties with especially high mortality. The location of these clusters varied by type of cancer and were spread in different regions of the United States. Clusters of breast cancer were present in the southern belt and along the Mississippi River, while liver cancer was high along the Texas-Mexico border, and clusters of kidney cancer were observed in North and South Dakota and counties in West Virginia, Ohio, Indiana, Louisiana, Oklahoma, Texas, Alaska, and Illinois.
CONCLUSIONS AND RELEVANCE:
Cancer mortality declined overall in the United States between 1980 and 2014. Over this same period, there were important changes in trends, patterns, and differences in cancer mortality among US counties. These patterns may inform further research into improving prevention and treatment.

This differences can be due to genetic differences between demographic groups variably distributed in these regions, differences in lifestyle including diet and physical activity, different distribution of age groups in these regions, socioeconomic status and access to health care, etc.  As the authors state, hopefully this information can be useful in optimizing prevention and treatment.

Easy baked mega-pancake

I love pancakes. However, they are comfort food and I do not have them frequently. They are not exactly the healthy breakfast I adhere to.

Also, flipping them one after another on the stove top takes forever. So, why not bake a huge pancake instead? 
Especially when the weather is hot.


Below is a recipe that I will perfect in the future and make healthier. For now, this is experiment "pancake 001". 

Expect the next recipe to incorporate fiber in the dough, less sugar in the filling and some flaxseed and chia seeds.

 
Pancake experiment 001

Ingredients:

1 cup pancake mix (such as Krusteaz, Buttermilk)
¾ cup water
3 eggs
butter (1/4 of a stick, or 2 Tbsp)
2-3 Tbsp jam of your choice

Instructions:
Heat the oven to 425°F. Generously grease a pan (mine is 10'' by 13''). Just before pouring the pancake batter, add a few pieces of butter to the empty pan and put the pan in the oven to melt the butter.

Mix the eggs with the water and then incorporate with the pancake mix. Pour in the pan onto the melted butter and bake for 14-15 minutes. If the edges are burnt, cut them out. Cover the pancake with the jam and roll tightly. Cut into pieces to serve. 

Diet after wisdom tooth extraction

The first day(s) after the extraction of a tooth, you might be able to sustain yourself only with liquids. Aim at non-sugary drinks such as unsweetened almond or soy milk, regular milk, plain yogurt thinned with water and homogenized well. 

Once you feel you can transition to soft food, here are a few ideas:

• oatmeal with a spoonful of each: peanut butter, fruit preserves and mashed banana

• cream of wheat with a spoonful of hummus, mashed sweet potato and diced boiled egg

• corn meal with a spoonful of mashed avocado.

• oatmeal with a thinly diced soft peach or apricot and sweetened with a mashed banana.

• cooked egg whites with hummus or a mashed avocado

• blended soups

• cottage cheese

• plain yogurt with a spoonful of fruit preserves or plain yogurt with a drop of vanilla essence, mashed banana and a sprinkle of flaxseed

• mashed potatoes

• tofu pieces prepared on the stove top with some salt

• tuna fish with mayo

• dessert: ice cream, blended soft fruit, microwaved apple slices, applesauce

Carbon Dioxide Secretion And Weight Loss

Here is a hypothesis paper that suggests that carbon dioxide excretion maybe linked to problems with weight loss.  Abstract:

Weight regulation depends on the difference between weights of absorbed and metabolised carbon and excretion of the end products of metabolism, calories and carbon dioxide, which can be independently and variably excreted. Calories can be variably excreted as heat by vasoconstriction or vasodilation and carbon dioxide can be excreted variably as exhaled carbon dioxide (the major route of carbon excretion). Unless there are changes in ventilatory carbon excretion, 'metabolism,' 'genetic factors,' 'hormones' or 'exercise' do not provide complete explanatory mechanisms for weight changes, obesity and failure of diets. Low sensitivity of respiratory centres to carbon dioxide may cause overweight and dietary failures after initial weight loss.

Individuals less sensitive to carbon dioxide, and thus with impaired respiratory activity, may have more trouble with obesity and weight loss, opening up new avenues of prevention and treatment.

Vitamin D Against Colon Cancer

Roles of vitamin D in colon cancer prevention, abstract:

Colorectal cancer (CRC) is the neoplasia that is most frequently associated with vitamin D deficiency in epidemiological and observational studies in terms of incidence and mortality. Many mechanistic studies show that the active vitamin D metabolite (1α,25-dihydroxyvitamin D3 or calcitriol) inhibits proliferation and promotes epithelial differentiation of human colon carcinoma cell lines that express vitamin D receptor (VDR) via the regulation of a high number of genes. A key action underlining this effect is the multilevel inhibition of the Wnt/β-catenin signaling pathway, whose abnormal activation in colon epithelial cells initiates and promotes CRC. Recently, our group has shown that calcitriol modulates gene expression and inhibits protumoral properties of patient-derived colon cancer-associated fibroblasts (CAFs). Accordingly, high VDR expression in tumor stromal fibroblasts is associated with longer survival of CRC patients. Moreover, many types of immune cells express VDR and are regulated by calcitriol, which probably contributes to its action against CRC. Given the role attributed to the intestinal microbiota in CRC and the finding that it is altered by vitamin D deficiency, an indirect antitumoral effect of calcitriol is also plausible at this level. In summary, calcitriol has an array of potential protective effects against CRC by acting on carcinoma cells, CAFs, immune cells and probably also the gut microbiota.

The first FI genius in America

The vast majority of us are sick and tired of their jobs, bosses and colleagues.

We all want out. We all want freedom. There is a Peter Pan in each one of us. We still want to play. 


This is why blogs about financial freedom and financial independence (FI) are becoming more and more popular.

But how many of us know the way out of drudgery?

Have you realized that the way out has been carefully obfuscated, made confusing and complicated?

I am reading a great book that confirms my notion that there is a scheme. 

... Deliberately or not, the majority of the population is always kept on the edge of financial insecurity, if not poverty. They are not given the power of knowledge. Financial knowledge.

The ONLY reason is to keep the majority of us working.

 
The book I am reading is The Americanization of Benjamin Franklin by Gordon S. Wood. Here is a quote from this book that triggered today’s blog post:

“…everyone but an idiot knows that the lower classes must be kept poor, or they will never be industrious.” 
  
Arthur Young, 1771

Well, today some people would be more industrious when un-tethered. But how to achieve the financial freedom? Unless you were a financial major in college, you may never get a few important lessons in finances and mostly, in personal finance. 

Schools skip on the most critical lessons:

1. Life is unfair

2. Your health is your first priority

3. How to master your personal finances

I have previously reflected on the issues with the American educational system (here and here).  I have published on the future of America and its children.

We need to learn the critical lessons on our own, if we are smart and curious enough. The life of Benjamin Franklin is one good lesson that we should not skip on.

Let's find out how Franklin achieved his own financial freedom.

He did so at a relatively young age.  In 1784, at age of 42, Franklin retired from work and took "the path of leisure". He acquired a few slaves and moved to a better, bigger house. 

The leisure for this man, however, was education, experimentation, and Enlightenment. He learned foreign languages: Latin,French, Italian, Spanish, and German. He became a diplomat, statesman, civil activist, politician, scientist, and inventor.

And yet, before all these achievements, he made it financially.

How?

He was a hustler.

Franklin was a tradesman, printer, editor, writer, manager, and shop owner selling books and stationery, soap and cheese. 

He took on any new opportunity to earn money: he became a clerk to the Pennsylvania Assembly and secured for himself the printing business of the organization. 

Later, he became the public printer for New Jersey, Delaware, Maryland. 

He started newspapers and magazines. 

He wrote a famous almanac. 

Served as a postmaster of Philadelphia and this helped his newspaper business.

Partnered with many printers outside Philadelphia: by 1743, Franklin owned three printing firms in different colonies and was in partnership with many others. 

Established many paper mills and became one of the largest paper dealer in the English-speaking world. 

He bought rental properties.

Became a creditor for loans small and big.

Participated in land speculation.


As a result, Franklin's income reached around £2,000 pounds a year.  If £100 in 1784 is equivalent in purchasing power to about £14,755.55, then today, in 2019, Franklin’s annual income would be £295,111 or $372,735.52.

The financial independence achieved by Franklin allowed him to dedicate his talent and capabilities to creative and productive projects, with which he secured his recognition for centuries to come.