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  • Avatar jhwkr542 
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    Joined: 02/15/2016

    But come on, a week before the season? That is just a lack of integrity.

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    Boooooooooooooooooooooooooooooo!

     

    in reply to: Andrew Luck Retires at age 29 #241483 Reply
    Liked by Larry Ragman
    Avatar jhwkr542 
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    Good luck! Hopefully, it’s not just a honeymoon phase. We’ll need followup!

    in reply to: Staring a new job….at age 54 #241216 Reply
    Avatar jhwkr542 
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    I would never just say sorry, we screwed up. It’d always be an explanation in the context of new info. We thought the dx was this, but since treatment hasn’t responded the way we had hoped, it appears it actually is this. Sometimes, you can do all the workup and still be wrong. Rarely do i think blatant physician mistakes make a huge difference in outcome. Most mistakes are small or just incorrect judgment decisions at the time. The diseases are the diseases. Sometimes earlier diagnosis only means the patient lives longer with the dx. Early stage tumors can end up metastasizing even with treatment. We all have our list of things we absolutely can’t miss. Everything else is in the gray area.

    Avatar jhwkr542 
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    I’d just put it in the bank.

    in reply to: First Post… What would you do with 5k? #240786 Reply
    Avatar jhwkr542 
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    You’ll have to balance across all accounts but unfortunately i think you’ll need to invest in some of those funds to meet your desired AA.

    in reply to: Guaranteed 3% return vs 2% ER funds in pretax accounts #240785 Reply
    Avatar jhwkr542 
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    VTSAX YTD 20.41% as of 7/31

    Avatar jhwkr542 
    Participant
    Status: Physician
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    Joined: 02/15/2016

    I would use the guaranteed account for your fixed income and try to get a taxable account as large as possible. Hopefully a spouse has some tax advantaged space.  But even this year, 20% growth – 2% in fees still crushes the 3% guaranteed. You may have to use one of these awful accounts.

    The other factor is that changing the funds is only part of the problem.  The account fee is completely unreasonable. So is Hartford’s additional fee. This is the stuff of lawsuits. If you can stomach it and could land another job, lawyering up is definitely an option. Seeing what other cases have won, I think these fees would be hard to defend when benchmarked with other plans of similar size.

    in reply to: Guaranteed 3% return vs 2% ER funds in pretax accounts #240707 Reply
    Avatar jhwkr542 
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    What does technically a non profit mean? A 501c3? Or not? If not, you’ll want to make sure this qualifies.

    Avatar jhwkr542 
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    Yeah, get it, it’s cheap. I have net worth around 0 and have $1MM.

    in reply to: Timing of Umbrella Insurance #240597 Reply
    Liked by Vagabond MD, G
    Avatar jhwkr542 
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    I imagine in your late 30s and 40s you start to think big picture and realize this is your life. At work, you’ve probably reached the majority of promotions. You’re now in charge of bigger projects, more people, etc. When bad days happen, you just feel stuck. At 20, you can change careers. At 30, you’re less established in an area and can move jobs more easily. Leaving a social circle and starting all over probably is an intimidating task. That’s why we see so many people here asking about job changes, because it’s scary. When you’re 16, you never asked anyone if you should go scoop ice cream instead of stock shelves.

    And what’s there to look forward to at 40? Retirement is far away. The fire movement would probably leave someone lonely without work friendships or if they don’t have something to retire to. I imagine kids become less fun/cute/loving in their awkward middle school years, which probably happens around this time. All the same stuff is happening to one’s spouse presumably too. If people are like us, it’s also incredibly difficult to get together with friends because everyone’s always busy. You add it all up and i can see how it’s the most depressing time of people’s lives. I didn’t even mention people’s health and self image isn’t the same as when they were 18.

    in reply to: The Happiness Curve #240263 Reply
    Avatar jhwkr542 
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    my mother does not know much about finances and wanted my advice to make sure that he is not acting impulsively with their savings.

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    He is. As long as it’s not dementia, you probably don’t have a say in it. If you have your mother’s ear, I’d tell her they could use a financial planner. A good CFP would certainly pay for themselves it sounds like.

    Avatar jhwkr542 
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    Yes, that’s an issue but not the main issue for this bill. It’s hard to have good faith negotiations for fair market rates when failing to reach a deal advantages one party so much more than the other.

    in reply to: Proposed federal bills limiting OON billing #240173 Reply
    Avatar jhwkr542 
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    medical school scholarship sponsor

    That clinical trial would be ended early. I question the diagnosis.

    Avatar jhwkr542 
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    With the new bill, the OON rate will be the legislated rate (median or some percentage of Medicare, which is likely lower than current market rates), not whatever the group chooses. So group f, being OON, can’t charge $100. They’d be required by law to charge the set rate. Your scenario exists currently. But if the OON rate becomes the much lower legislated rate via this bill, why would insurance companies even negotiate? The insurance companies all of a sudden are ok with OON rates because those are lower than their current rates.

    in reply to: Proposed federal bills limiting OON billing #240170 Reply
    Avatar jhwkr542 
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    So in that case, who is OON that will be negatively affected? Sorry, not trying to be dense, just trying to understand.

    Click to expand…

    I want to clarify your scenario: A, B, C, D, and E groups are all in network above. A and B have the lowest negotiated rates and are below median rate. They choose to go OON. Correct?

    Patients start complaining that they pay more because they’re OON and have to pay more co-insurance and have higher deductibles. Patients start moving to groups C, D, and E. Hospital #1 has contracted with group A. Because their contract requires them to be in-network with insurance Z, they give them a 90 day ultimatum. Either lose the contract or go back in network (presumably at their previous lower rate).

    southernerdoc did a good job of outlining how groups with better contracts would also be negatively affected.

    in reply to: Proposed federal bills limiting OON billing #240127 Reply
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