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Preparing (FINANCIALLY) for the possibility of socialized medicine

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  • fatlittlepig fatlittlepig 
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    I hope some form of it happens (whether it’s full single payer vs the ability to buy into medicare). It’s long overdue.

    Fatlittlepig

    #239835 Reply
    TheHappyPhilosopher TheHappyPhilosopher 
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    There is approximately a 0.0% chance there will be socialized medicine in this country in 2020 or 2024. At most there would be a small amount of people shifted from private insurance to medicare (medicare for a few? Not at catchy a slogan), but I doubt even this will happen. Every prediction I’ve seen about medicine, with the exception that it will continue to get more expensive and complicated have been wrong.

    But…if you are worried about a change in income to spending (which could happen for a variety of other more likely reasons like illness, disability, burnout, having to financially support aging parents, divorce, etc. etc.) then the standard “save more, spend less and invest wisely” doesn’t change. Changing your asset allocation and investment strategy in preparation for socialized medicine is madness.

    #239836 Reply
    Avatar JBME 
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    sigh. OP, are you familiar with how a bill becomes law? it’s waaaaayyy too early to say this is likely to happen. Even if the two main democratic candidates running on socialized medicine win the white house, we don’t live in a dictatorship. laws have to pass both houses of congress first before they get to the desk of the president. The Democrats hold 47 seats out of 100 in the Senate today. You assume all 47 would vote for socialized medicine. Yet if you listen to many of these Democratic senators, you know that all 47 won’t vote for it. So the Democrats need way more than 50 seats in the senate to account for defections in order for it to pass that chamber.

    Remember universal healthcare has been an idea within the Democratic party since the days of FDR and Truman. It took over 70 years for it to get done, and it’s not even universal today.

    We could also get hit by a meteor tomorrow. Just do what your IPS says

    #239840 Reply
    MPMD MPMD 
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    Only regret would be if we get a warren-type wealth tax and you wished you had enjoyed your savings instead of handing it over to the feds. 

    Click to expand…

    nytimes: “the proposal is to tax a family’s wealth above $50 million at 2 percent a year, with an additional surcharge of 1 percent on wealth over $1 billion.”

     

    really?

    Click to expand…

    you can’t even imagine how much money and time is spent misinforming people about what these policies actually are.

    actually you probably can.

    #239844 Reply
    Liked by wonka31, Lordosis, Peds
    Lordosis Lordosis 
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    Only regret would be if we get a warren-type wealth tax and you wished you had enjoyed your savings instead of handing it over to the feds. 

    Click to expand…

    nytimes: “the proposal is to tax a family’s wealth above $50 million at 2 percent a year, with an additional surcharge of 1 percent on wealth over $1 billion.”

     

    really?

    Click to expand…

    you can’t even imagine how much money and time is spent misinforming people about what these policies actually are.

    actually you probably can.

    Click to expand…

    If I was worth 50M or better yet 1B and a policy like that was enacted I would be moving to a more tax friendly country.  That would be madness.  Catch me if you can!

    “Never let your sense of morals prevent you from doing what is right.”

    #239866 Reply
    Liked by hatton1, Craigy
    Craigy Craigy 
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    Only regret would be if we get a warren-type wealth tax and you wished you had enjoyed your savings instead of handing it over to the feds. 

    Click to expand…

    nytimes: “the proposal is to tax a family’s wealth above $50 million at 2 percent a year, with an additional surcharge of 1 percent on wealth over $1 billion.”

     

    really?

    Click to expand…

    you can’t even imagine how much money and time is spent misinforming people about what these policies actually are.

    actually you probably can.

    Click to expand…

    If I was worth 50M or better yet 1B and a policy like that was enacted I would be moving to a more tax friendly country.  That would be madness.  Catch me if you can!

    Click to expand…

    Definitely worth springing for the $10M monaco 1 bedroom apartment.  At $100M of wealth, it would pay for itself in 5 years.

    LEVEL 1 WCI FORUM MEMBER.

    #239878 Reply
    Liked by Lordosis
    ENT Doc ENT Doc 
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    Earnest refinancing bonus

    I hope some form of it happens (whether it’s full single payer vs the ability to buy into medicare). It’s long overdue.

    Fatlittlepig

    Click to expand…

    Dislike.  As much as I could go on and on about the rampant dysfunction in our current system (much of which is government induced) I would never actively desire for my colleagues to have their individual liberty taken away by means of forced governmental servitude.  A public subsidized option, if taken to perpetuity, has the same effect of single payer.  From a public health perspective, having coverage is the least efficient means of ensuring proper health.  Policies that induce lifestyle changes are far more efficient.  And allowing monopolistic control of an industry has historically led to worse value for the consumer.  But yes, let’s do all that.

    #239880 Reply
    fatlittlepig fatlittlepig 
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    From a public health perspective, having coverage is the least efficient means of ensuring proper health.  Policies that induce lifestyle changes are far more efficient.

    Click to expand…

    Gotta do both.

    #239886 Reply
    ENT Doc ENT Doc 
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    From a public health perspective, having coverage is the least efficient means of ensuring proper health.  Policies that induce lifestyle changes are far more efficient. 

    Click to expand…

    Gotta do both.

    Click to expand…

    I don’t disagree that both should be our aim.  But do you think the best and most efficient way to achieve the former is by putting the government in charge of all medical care?

    #239887 Reply
    Avatar Panscan 
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    Wealth tax is not going to start at 50 million, no way. 1/10th of that if not less.

    In reality will only hurt people who worked for their money as the others will structure their assets in a way to avoid the tax, like everything else

    #239892 Reply
    Avatar Dusn 
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    1) Many specialists in Canada make far more than specialists in the US.   Ophthalmologists in Canada frequently make >1mil, so do interventional radiologists.  They also have far less malpractice and insurance headaches.  So socialized medicine, by itself, does not necessarily mean physicians are going to be paid less.

    2)  Unfortunately in the US the physician lobby is very weak compared to pharma, insurance, etc.  So in the US, physicians will probably be paid less.   But we’re going to get paid less with or without socialized medicine; physicians get cuts to reimbursement every year regardless but I have yet to see pharma get cuts.  The problem is our weak lobbying groups and the fact that political lobbies have such a huge influence on how our tax money is spent.  I don’t see private insurance acting much better than the gov’t in this regard.

    3)  At least in my speciality, the biggest issue for new grads is Private Equity buying out all the practices before they make partner.  Now PE is learning how to buy out all the smaller referral practices to force large groups to sell out at a lower price.  That’s a threat that is here and now and shows no signs of stopping.  Socialized medicine won’t matter much once physicians have become like the pharmacists working for Walmart.

    4) Socialized medicine might solve the biggest issue with FIRE (how to pay for healthcare).  If socialized medicine succeeds (doubtful), there will likely be mass retirements.  Save up and at least you can enjoy early retirement with the rest of us.

    #239903 Reply
    fatlittlepig fatlittlepig 
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    From a public health perspective, having coverage is the least efficient means of ensuring proper health.  Policies that induce lifestyle changes are far more efficient. 

    Click to expand…

    Gotta do both.

    Click to expand…

    I don’t disagree that both should be our aim.  But do you think the best and most efficient way to achieve the former is by putting the government in charge of all medical care?

    Click to expand…

    We have money to send our kids to distant lands to fight interminable, misguided wars. We spend money on fighter jets, cruise missiles, and foreign aid to countries. I think we can do a little less of that and guarantee medical care for all citizens, as a fundamental right as a citizen of this country. Common sense. When there’s a single payer, we can negotiate for lower prices, maybe instead of 10 different statins we’ll have one or two at an improved price, same goes for procedures and care that have not been shown to be beneficial (if you want to call that rationing then let’s ration). If, as a byproduct of this, an orthopod makes 500K instead of 600K and fatlittlepig makes 250 instead of 300 so be it.

    FLP

    #239906 Reply
    Avatar Panscan 
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    I don’t know how something that costs money can be a right. Terminology is very important. We can say it’s a service we want to provide for people. I don’t think it’s a right.

    Do people have a right to a home?

    #239927 Reply
    Craigy Craigy 
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    Wealth tax is not going to start at 50 million, no way. 1/10th of that if not less.

    In reality will only hurt people who worked for their money as the others will structure their assets in a way to avoid the tax, like everything else

    Click to expand…

    Regardless if it started at $50M, it will soon find its way down to those with less.  Even unadjusted, eventually inflation takes its toll.

    LEVEL 1 WCI FORUM MEMBER.

    #239931 Reply
    Avatar jz 
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    Status: Physician
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    I”ll push back against @panscan statement that  the cognitive practice of medicine involves memorization. Cognitively, good medical practice requires pattern recognition, pattern recognition, pattern recognition, pattern recognition, etc.   In the wild, on the screen, listening to pts. visual observation, EKG reading, and more pattern recognition.    When you’ve got that down, you need more pattern recognition, pattern recognition, pattern recognition, and more pattern recognition.

    #239932 Reply
    Liked by Dusn, hatton1

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