Moving to America would be a great idea...

[UKRay]

...but what happens if I get sick?

The time has almost come to bite the bullet. I have finally found a property I really like (and can afford) in the Smokey Mountains, I'm right on the edge of putting my house on the market and I'm getting mentally prepared to pack up my workshop and move halfway round the world (okay, maybe not halfway but you know what I mean...).

There are all kinds of reasons why this would be a great idea and almost the same number that make me think I should sit tight and wait a while. One of the biggest worries I have is that, being here in the UK with free healthcare has made me complacent. I don't understand how healthcare works in the US and I can't get any unbiased information about health care insurance and I'd like to tie this up nice and early.

What is this going to cost for two people and is there any insurance company which would be better than any other? How do things change as you get older - do insurance costs rise? What are the implications of not having insurance? - Do you simply not get treated? - Suppose you don't have any money (not in my plans, but hey, who knows what might happen in this crazy world)?

This is a very real issue and I'd appreciate some genuine advice. Thanks guys.

[esantoro]

Perhaps my input here is biased, since I am very critical of health services in the U.S. The "care" in health care is a misnomer, and it should be called instead "health business", as that is what it is, a business that is set up to make the most profits and pay out the least in services. Many private health care providers will turn older people away as they are a greater risk.

My guess is that to insure two people over the age of 50 will cost $1000 or more a month, and then you may still have a yearly deductible of around $2500 or more.

Insurance companies vary by geography and local and state guidelines.

I know that many people wait until they have to go to the emergency room, because supposedly they cannot be turned away in the event of an emergency. Though the hospital will try to collect payment for such services, perhaps there are some limits to their ability to actually collect.

I may be naive in thinking this, but we may be two years away from universal health care in this country.

Though all of Michael Moore's films do go a bit off the edge in their analyses, Moore nonetheless does raise significant points. With that in mind, go see "Sicko". PBS has also put out a good documentary on health care in this "company"... I mean country ("Sick Around America").

If you're interested I can send you these two documentaries.

ed

...but what happens if I get sick?

The time has almost come to bite the bullet. I have finally found a property I really like (and can afford) in the Smokey Mountains, I'm right on the edge of putting my house on the market and I'm getting mentally prepared to pack up my workshop and move halfway round the world (okay, maybe not halfway but you know what I mean...).

There are all kinds of reasons why this would be a great idea and almost the same number that make me think I should sit tight and wait a while. One of the biggest worries I have is that, being here in the UK with free healthcare has made me complacent. I don't understand how healthcare works in the US and I can't get any unbiased information about health care insurance and I'd like to tie this up nice and early.

What is this going to cost for two people and is there any insurance company which would be better than any other? How do things change as you get older - do insurance costs rise? What are the implications of not having insurance? - Do you simply not get treated? - Suppose you don't have any money (not in my plans, but hey, who knows what might happen in this crazy world)?

This is a very real issue and I'd appreciate some genuine advice. Thanks guys.

[Rawhide]

...but what happens if I get sick?

The time has almost come to bite the bullet. I have finally found a property I really like (and can afford) in the Smokey Mountains, I'm right on the edge of putting my house on the market and I'm getting mentally prepared to pack up my workshop and move halfway round the world (okay, maybe not halfway but you know what I mean...).

There are all kinds of reasons why this would be a great idea and almost the same number that make me think I should sit tight and wait a while. One of the biggest worries I have is that, being here in the UK with free healthcare has made me complacent. I don't understand how healthcare works in the US and I can't get any unbiased information about health care insurance and I'd like to tie this up nice and early.

What is this going to cost for two people and is there any insurance company which would be better than any other? How do things change as you get older - do insurance costs rise? What are the implications of not having insurance? - Do you simply not get treated? - Suppose you don't have any money (not in my plans, but hey, who knows what might happen in this crazy world)?

This is a very real issue and I'd appreciate some genuine advice. Thanks guys.

Ray,

For two people, healthcare can be quite expensive. I would estimate about $300-500 ($1000 Ed?, boy I could be way off) a month if you shop around... I'm not sure how things change as you age, but I'm pretty sure there's a threshold for raising and lowering costs. The implications of not having insurance; well I believe it used to be that a person not having insurance was likely to not get treated without proving you could pay somehow...quoting and msn article..."Fortunately, a federal law passed in 1986 to prohibit a practice commonly known as "patient dumping" gives you the right to emergency care regardless of your ability to pay. The federal law applies to hospitals that participate in Medicare -- and that includes most hospitals in the United States. However, the patient-dumping law does not give you carte blanche. In a nutshell, the federal patient-dumping law entitles you to three things: screening, emergency care and appropriate transfers. A hospital must provide "stabilizing care" for a patient with an emergency medical condition. The hospital must screen for the emergency and provide the care without inquiring about your ability to pay. There are some charity hospitals in most metropolitan areas, but generally speaking, you may not receive the best care there. Some others with more knowledge are sure to chime in later...

Edited May 11, 2009 by Rawhide

[wildrose]

I have been "blessed" when it comes to insurance, overall, as either my job or my husband's, or both, have supplied us with insurance. This was done by taking a deduction from our paycheck each pay period. Then, when we went to a doctor (of our choice), we would pay a "copay". With my husband's current job, for example, it costs us 25.00 to see a physician of our choice, and 35.00 for specialists such as an allergist or chiropractor. There is a yearly "cap" on such things as chiropractic care, for example, so if I go very often, then I have to pay for the visits entirely.

Health care often also covers a decent amount of emergency room, hospitalization costs and tests (like MRIs or such). Again, you are paying for this from your own paycheck. If you don't have an employer who provides insurance, work part time or are self employed, you can buy yourself insurance from one of many companies.

I have a few borderline poverty level friends who have no insurance at all. That is a HUGE risk. As was mentioned, you can get ER service with no insurance - they're not allowed to turn you away, I think - but is that fair to those there with REAL emergencies? Not really.

I do think the system needs and overhaul, I won't deny that. But the only time I personally had a problem was when my husband was between jobs and we had to buy "COBRA" - a system that lets you keep your company's insurance briefly, at a higher cost.

I should mention that I have allergies and asthma, my husband has allergies, I have high blood pressure, and he has sleep apnea. So we're needing health care!

[Ian]

Ray, insurance varies from state to state. In Massachusetts anyone earning under 30,00 is covered. Most employers offer health insurance, therefore 260 million people are covered out of 300 million. The majority of people who don't have coverage are self employed, or, like me, working part time and not eligible for coverage from work. With the balance largely made up of illegal immigrants.

If you get old and sick, you are, of course covered by State health insurance. Buying your own insurance is ridiculously high ($450 monthly for a single person, but that varies hugely state to state too) - therefore I don't have it. However, I haven't been to a doctor in 20 years, even when I was covered, and I figure if I get wrecked I am covered somewhat through my auto and motorcycle insurance and no hospital can turn anyone away by law because they are unable to pay.

Even though I don't have insurance, and knock on wood, haven't seen the need to see a doctor, the level of health care in the US is very good. I remember reading someplace that the survival rate for colon cancer in the US is in the 80% range, but in the 40% range in the UK. That will change if universal health care goes into effect with the same long waits for surgery, shortages of doctors and nurses that the rest of the state insured world has.

But having said all that, the Smokey Mountains are about as beautiful an area as any on earth, and the climate is great too. Without making comparrisons to any other country, moving to America was the greatest thing that my parents ever did - I love it here.

You should be able to get insururance rates online. I haven't looked, but I bet Tennessee has a site with links to the info you're looking for.

Edited May 11, 2009 by Ian

[Jordan]

Health cost is a misnomer it should be called insurance costs or legal extorsion by the insurance industry, as they are the ones that profit and dictate health care in this country. As an example Mr. Perot made his gazillions in medical billing the government plans like medicare/caid etc. Most small business owners opt into large pools to afford coverage by an insurance company but it is still very expensive. You should be able to find adequate coverage but it will take a whole lot of investigating to sift through all the plans. I don't envy you on that, the profiteers make it very confusing with a lot of hidden costs and they design most to cover the common cold type stuff, but god forbid you have or develope something serious or long term. As far as the reformers out there not one is willing to address the elephant in the room ie. insurance companies, as either they are owned by them, do not have the political will, or just do not have the cash to fight them. Good Luck in your plans and I think you will not regret moving to the US. I may be biased (lol ya think) but even with all its warts it is still one of the best countries in the world to live in.

[TwinOaks]

Ray, just about all states here in the U.S. provide a state funded mental institution. You'll be just fine.

Small rant:

Even if you can't afford third party medical coverage, there's a good chance you can qualify for medicaid or medicare (State (guv'mint) funded healthcare). I'm thinking a huge percentage of the illegal aliens here in this country are already using it....for free.

[Hilly]

Ray, how well does your healthcare system work over there? Is there a long wait for certain procedures, such as MRI's and other expensive diagnostic procedures? Are people there put on waiting lists to be given cancer treatments and such? I'm just really curious about how other countries work with socialized medicine.

We are supposed to be getting socialized health care here in the U.S., once all the "wonderful, intelligent, caring, human" beings in Washington D.C. figure out how it's done.

From what I hear though, it won't be health care at all, it will be health care rationing, like in other countries. And even if you can afford private health insurance here, the government will dictate the standard by which all privatized health care is to work. So, if I were you, I'd be afraid. I'd be very, very afraid.

[OutBackP]

Nooooooo you can't move just yet! I still haven't popped over for a visit. I'm up to 20 miles on the push bike only another few to go and I'll be round

[TomSwede]

Nooooooo you can't move just yet! I still haven't popped over for a visit. I'm up to 20 miles on the push bike only another few to go and I'll be round

I second that!!! And you have a leathercrafter show to run too;-)

Tom

[Johanna]

I have no idea what living in England is like, but the Smoky Mountain region is one of the nicest places in the US, and I would move there, given the chance. Winters are mild, summers aren't too hot, the scenery is beautiful and the people are friendly. If you want the property checked out, I will be glad to make a roadtrip recon mission for you.

Johanna

[UKRay]

As I said, lots of reasons to go and lots to stay.

Thanks for your honesty guys. I had a feeling things weren't going to be easy where this was concerned. Right now I'm disgustingly fit and well but, well, tempus fugit and all that...

This business of health care is a tricky one if your income fluctuates wildly. All the crafts and leather folk I know say this business is either feast or famine. One day you get orders and the money rolls in and the next - nothing. How can you afford healthcare insurance with an income stream like that?

Okay, I'm lucky and have several sources of income but all depend on me being fit and well enough to work long hard hours. Over here if I am ill I simply go to the doctor and if I need treatment I go to a state run hospital and receive a very high standard of treatment.

Sure the NHS (National Health Service) has its detractors and sometimes things do go horribly wrong - but show me a private hospital that never has problems and I'll show you a bunch of liars. In the main things are fine and thousands of people are treated every day. Yes, many of our hospitals are antiquated, desperately in need of a facelift and losing staff because of poor wages but, IMHO those who remain are fiercely loyal and work way beyond the call of duty to deliver health care that is second to none.

Sure, the waiting lists can sometimes be long but the treatment always happens in the end. People with serious conditions are given priority - as they should be - and folks retain the right to pay for immediate treatment if they want to. Privately funded treatment is freely available and clears the way for others who don't have the money. (Okay - this is simplistic but I'm an enthusiast!)

A brief anecdote may explain my huge respect for the NHS - Some years back I had the misfortune to pick up schistosomiasis, this was compounded by malaria and a baaaaaaaad unidentifiable tummy bug and, having arrived back in the UK very sick I eventually ended up as a guest of the Hospital for Tropical Diseases in London. I went in there on a blue light and didn't know what was going on for the first few days but I can tell you there was always someone there whenever I woke up and everything I needed was right where it should be. It took three weeks before they finally threw me out and I can't explain how much affection I developed for the folks who work there. I was an outpatient for two years... Total cost - zilch.

On my last visit I even had a brief chat with Princess Anne!

I would miss it if I moved to the US. But maybe the benefits outweigh the disadvantages of paying for treatment? Can you really get treatment when you want it? Do your hospitals have waiting lists? Is everything in the fee paying world rosy?

Edit due to taking so long to write this that there were loads more posts by the time i finally pressed the button, Doh!

Thanks for the offer of a house check, Johanna. Especially as I think Tn is a bit of a long way from you isn't it?

Okay guys - I won't go until after the show...

Paul - you have better get a shift on matie. Pedal harder!

Mike - no more than I expected. How does it feel to be so predictable? LOL

Edited May 12, 2009 by UKRay

[Suze]

I have no idea what living in England is like, but the Smoky Mountain region is one of the nicest places in the US, and I would move there, given the chance. Winters are mild, summers aren't too hot, the scenery is beautiful and the people are friendly. If you want the property checked out, I will be glad to make a roadtrip recon mission for you.

Johanna

need a navigator? Of course with me navigatting we might end up going by way of California or Canada or maybe even Mexico.......

and it is really hard to type with a cat laying on your hands

[whinewine]

Ray:

I feel so blessed: I have decent coverage through the employer I retired with. When my wife retires, she will have no medical coverage, except through my plan & the 'wellness coverage' she is putting money toward to purchase upon her retirement. My one son has fair coverage through his employer & the other has it through the military.

Having said that, the woman for whom I deliver flowers is self employed and cannot afford coverage, so whenever she needs care, she is required to pay the 'suggested list retail price' that the hospitals/doctors/pharmacists tell her she's got to pay...

When I became eligible for medicare, my former employer had a list of medicare supplemental plans from which I could choose for my coverage. Some were absolutely atrocious & some were very good, and some were available in my county of residence & some were not. So even in my State, available plans varied from county to county and coverage by coverage. The plan I chose is ranked 5th in the entire US among all available medicare plans, and the coverage is superb. Thank God for a good employer! (There are so few here with good health coverage.)

And the Smokies are beautiful & wonderful & I'd like to move there someday. I used to travel there every summer to dig gemstones (ruby, sapphire, garnet, aquamarine [and further east, emeralds]).

russ

Edited May 12, 2009 by whinewine

[Johanna]

I live in Ohio. You go south on I75 through Ky and you're in Tennessee. Keep on going, you wind up in Georgia where I have some dear friends. Plus, Randy & Claudia invited me to Nashville. What more reasons could a person need for a roadtrip?

~J

[Jordan]

Ray you are absolutely right that the people at the hands on care level are a highly dedicated and fiercely loyal bunch. That I believe is a worldwide trait of a caregiver. Speaking from my own experience it is when the dolts that don't have any contact with patients get involved that things go south. Usually money is involved somehow. LOL, I was a licensed mental health tech for what seemed a lifetime in southern california. (for those of you that suggested therapy your not far off the mark, you'll notice I said licensed not certified! LOL) Most of both sides of the family are currently or have retired from the medical fields and I can honestly attest to thier patient care loyalty. The ones that didn't, became bankers..... go figure.

[Janice]

British Columbia is an amazingly beautiful and diverse place. It is in Canada.

Al Stohlman loved living here in the caribou.

We have health care here that is universal, although some parts of that are changing.

Where I live, we may get snow in winter, but it doesnt usually stay for more than a day.

WAY less populated though, except for the lower mainland.

Edited May 12, 2009 by Janice

[gypsumvalley]

Okay, here is some advice from a person that has been there, done that on health insurance, seen all sides of it, and hopefully you can take some advice from this. But I'll tell you my background in health care, health insurance and small business, so that you know that I know what I am talking about. First, I live in Kansas, so I am most familiar with companies here. I have owned my own gun business for going on six years, and I am in charge of benefits, which at first seem complicated, but with a little info, are actually easy to discern. For the last 15 years, I have had experience working in non-profit community health and disaster aid, recreation, health care, and *gasp* selling health, life, property, commercial and liability insurance. To be honest, the insurance license is actually been the most helpful thing in understanding how the health care system works and how it can work for you, and how to get the most out of an insurance company.

First, overall, we do have some of the best healthcare in the world, some of the best scenery, and about the nicest people I think I've ever met around the world. With our large amount of research facilities, non-profit hospitals (st. Jude) and progressive health care, don't sweat moving here just because you worry about insurance. If you've got a good business plan and you take 10% of every deposit and put it in a savings account to pay for sales tax & insurance like we do, you won't wake up in a cold sweat like we used to before we did that! Now we don't worry where the money to pay insurance & taxes will come from, because it's already there.

I will warn you, this is starting to get lengthy, but some people spend more time picking lotto numbers than an insurance company, and will wish themselves back when they find out something "isn't covered".

Before you shop: CHECK OUT THE COMPANY'S RATING ON YOUR STATE GOVERNMENT'S WEBSITE (look for insurance commissioner website of your state). There are really good companies, and there are bad companies, and every company in between. Insurance rates are regulated by the state, and each state does keep track of complaints and bad companies. When you find a few companies you like, then you can start calling. Ask to speak to references/customers of the companies, and if your sales agent can't find you any at all, then look for a different company. (my current health insurance and my current property insurance companies did give me at least three references when I asked.) Make sure to ask how they file claims, and ask their references how easy it is to file claims, or to have the medical provider file them, or how quick and easy reimbursements are.

Second, even if you think you can't afford it, buy some cheap health insurance for "major catastrophic illness or injury." The main reason I say this is not because I have sold (not currently assigned by a company), but because I have SEEN what happens when friends, neighbors and others have not had health insurance, and they were bankrupted and lost everything. Just because you get emergency care doesn't mean that you don't have to pay for it, and trust me, hospitals, nursing homes, assisted living, etc. will not forget or forgive. Plus, hospitals don't give discounts if you don't have insurance. Here in Kansas, Blue Cross & Blue Shield negotiate provider discounts, and it is almost half of what the "actual bill" is (take it or leave it, I wonder sometimes if those bills are not inflated because of these "discounts" but that is a morality discussion and won't pay the emergency room bill when it comes.) I didn't sell health insurance for BCBS, but I picked them for our group insurance because they have the best service and some of the lowest rates for people of my age (and doctor's offices WILL file claims to them because they know that that BCBS will always pay out any vaild claim.)

Second, buy the best insurance you can afford. If you can afford above the "disaster coverage", then by all means, see what you can afford. As we all get older, we need different levels of coverage, and you need to think about it every year when you renew your policy. I review my insurance coverage for myself and employees, and I have to know what their needs are when I sign them up (or don't sign them up!) I only have 2 employees now "phew!", but when I was working in the recreation field, I had up to 25 employees at a time, some permanent, some temporary, and had to know what the benefits were and how to sign them up.

Finally when you get your policy, sit down and read it. Know what is covered and what isn't!! And call your agent if you don't understand any wording or phrases in your policy. I personally loved answering these types of questions, as it helped the customer understand the company, and their policy.

Another good idea if you are closer to retirement age than I am (I've still got over 20 years to go!): go ahead and become a citizen. Our medicare system is not perfect, by any means, but I do not know if you are covered if you are a resident alien, or if any company fully insures people over 65. I sold supplements, or add-ons to the medicare plan, but I don't claim to know all the ins & outs of insurance past 65.

You can post or PM me if you have any questions about insurance, I'd be glad to help (and don't worry, I can't sell right now cause I am not assigned to any company!)

Cheers,

Suzanne

Edited May 12, 2009 by gypsumvalley

[troy]

Hi Ray

OOH great, I've just met a great leatherworker and he decides to defect - well I can't allow it, it's just not english but I will allow you to go if you can fulfill one aim;

1, the property you buy has a swimming pool

2, it has a bar

3, it has an anexe the size of a small football pitch and accomodates all my needs when I invade

4, it has a small runway to handle the jet so I don't have to bother with all that customs nonsence.

Ok thats more then 1 but you get the point, and if you try and sneak out I'll build a mote around your house - you've been warmed, the institution of leatherstampers and benders UK has spoken!!!!!!

[Luke Hatley]

Troy.........I WANT HIM TO COME...

Let him feel the Ground that his Relatives walked on when they Migrated

to this part of the World.

after all he can still vacation in Europe...

He has talked about doing this before..... and this is a a hard decision to make.

But what ever...... "we still be cousins"

Edited May 12, 2009 by Luke Hatley

[rdb]

I'll be here on the NC side of those mountains, if you want better barbecue...lol.

In the US, if you have money, there's some good doctoring going on here. "If you ain't got the money, Honey", it can be devastating. That's the US, Ray, from one extreme to the other, and everything in between...

We want pictures! of you sitting on top of a Smokey's Mountain, on one of them thar three legged things...lol

[UKRay]

Thanks for all the kind thoughts, guys. It is very much appreciated.

Right now the jury is out. If healthcare was the only issue I now think I'd be inclined not to worry too much as long as I had some insurance in place (so thanks for the very useful advice) but there are other factors that still have to be weighed up, not the least that my parents are still alive and getting older and, although the temptation is to convince them to come with me, I definitely couldn't afford four lots of insurance!

12 months can make a lot of difference and so as soon as the house sells I'm still going to try for the house in Tn. If nothing else it will be a great place for holidays for a couple of years and those fish can only get bigger....

Light the BBQ, Dave. I'll be over shortly... Best invite Luke too. I'll bring the beer and three legged stools...

[Bob]

Ray, have you even considered Canada? The fishing and hunting is really good, and the health care system is quite good. Check out the real estate at mls.ca

Besides Ray, Canadians are the most friendly on the globe..... well I think so anyway.

Edited May 13, 2009 by Bob