Sky High Health Insurance (Ep 92)
Explore the tangled web of healthcare economics on this episode of Make The Dough Rise. We're tackling the sky high rise of health insurance costs, the historical roots of current policies, and the entangled systems that drive these soaring prices. Brian will also discuss what the migration of thousands of millionaires to new countries means for the global financial climate (BRICS).
Transcript - The following transcript was generated by a robot, so please excuse any typos or inaccuracies.
Walter Storholt, co-host 0:02
It's time to make the dough rise the financial podcast with Brian Doe, it's another edition of Make the Dough Rise Walter Storholt here alongside Brian Doe CERTIFIED FINANCIAL PLANNER at Livingworth Wealth Advisors. Good show on the way today is we're gonna tackle the tough topic of health insurance and the sky high prices and costs involved and what to do if you are planning for retirement trying to figure all that out. Brian, it's good to be with you this week. How are you
Brian Doe 0:33
know, everything's going great. We had a big homecoming week last week, and next week will be fall break, and we're going to head to the beach.
Walter Storholt, co-host 0:41
Nice, that'll be fun to think it'll still be warm enough and nice to get out there and enjoy.
Brian Doe 0:46
Yeah, it'll be pleasant. I think the temperatures are supposed to be in the mid 70s and sunny and the island that we're going to they cut in half years ago for to make a little passageway for the boats and fishing boats to more quickly get out to sea. And so the one end of the islands very developed and the other end is pristine untouched. And we're staying down on the end, close to the cut. And so we're gonna get kayaks and go over to the old, original all natural section of the islands. So well pet plenty of romping around and we're gonna do a fishing day One day, we're gonna go catch some red fish up in the bay. And then Natalie and I are going to leave a day early and go hit a couple more Florida springs on the way down.
Walter Storholt, co-host 1:29
Nice. Oh, that'd be great. Well, kayaking in the fall at the ocean is one of the best things you can do. So I think you're gonna have a fantastic time out there. Tell us all about the trip. When you come back. Look forward to here. I'll
Brian Doe 1:40
do it. I'll take good notes.
Walter Storholt, co-host 1:41
All right, very good. We've got healthcare to talk about. But before we dive into that main topic of the day, you wanted to do a follow up about some social security discussion that we've had recently. And we have kind of a follow up to an interesting story that you were relaying to us on a prior episode.
Brian Doe 1:56
Yeah, a couple things, I was going to go back and talk about the Social Security success story, and then maybe do a quick pass on the BRICS and the D dollarization. That we talked about in the past. So yeah, last Friday, I got some very good news, I have an individual client, right after she divorce, she started claiming a spousal benefit, which is perfectly legal in what you would do, but then not too long after remarried, and called Social Security, to change her name and notify them of the fact that she remarried. But it maybe wasn't articulated clearly enough that she was changing her benefit to her new spouse. Now, my argument was that it was kind of Social Security's job at that point to step in and say, Hey, why are you changing your name? Is there something going on with your marital status, and do we need to change your your benefit, but that's not quite how Social Security operates. Sometimes, I mean, half the time, you can get a very good representative. And then other times you can get representatives that they might be new, they may not know all the ins and outs, and they may not proactively help you make changes. And that's what happened in this case. And once she went to switch to her own benefit, because she had a good earnings record at at age 70, would was going to get a boost. They looked at our current situation said, Oh, you've been drawing the wrong benefit. And we're starting the process to reclaim and remember that. And so we went and met at Social Security office, we tried to talk to attorneys and find somebody to help represent. And they went very legalistic and very, almost confrontational or an unwilling to help and be reasonable. And they jumped ahead and said, you know, this is not our fault. This is your fault for not notifying us correctly. And we did, we started doing a lot of research and in the process found out that you can't actually hire an attorney to represent you against social security and disability claims. Because social security and disability are tied together. There is a ruling for that section of law or their government programs. That says if you work with an attorney to file a claim, the attorney has to get compensated by the Social Security Administration. And this works fine in the disability world where there's there's lots of cases they get paid on a share of what you actually collect. But because our case was so rare, no attorney was actually even set up or able to take on the case because we wanted to hire and get legal advice couldn't so I thought that was kind of an interesting thing that said, you know, they've basically got the deck stacked against you where you can't even go out and hire in it. Attorney to give you a good solid legal opinion and form an argument. So my advice then was to appeal and we were trying to get a hearing in front of a actual judge to get an administrative hearing. But in the process, we contacted a state representative. And turns out, they have actually very good and responsive resources to help constituents. And so we were trying to hit this on on all fronts. And we were able to elevate the case to somebody at Social Security who could really look at it. And we had better formulated our argument. In in the end, we did get a favorable ruling, I don't know if it was out of any kind of pressure, or if it was out of the sensibility of more qualified person looking at it or what it was. But they did rule in the the clients favor. And that's that was a huge win. If you ever run into a case like this, here's the takeaway, here's the lesson. If you have any kind of status, change, married, divorced, change a name, a spouse dies, call Social Security, and tell them everything and make very good notes of what you said and what you told them. And be very, very diligent about it. Put what you can in writing, because they're making very good notes when they talk with you. And if they have something in their notes that is in their favor, or maybe contradicts what you said or does not substantiate what you said, they're gonna go with their notes. And so I would implore people to document it, get it either in a face to face meeting with a follow up email and or letter, maybe send them an email just saying, just to recap, I have remarried, I have changed my name, we've got a spouse that has passed, am I collecting my best benefit? am I collecting my correct benefit? What are my different benefit options at this stage, and make them articulate to you in as clear terms and as as documented terms as you can get? But again, we've positively resolved it. and lessons learned there. If you're needing to contact the Social Security Administration, if you're trying to calculate which benefit to get, please reach out, give me a call. There's some good, you know, good lessons learned a lot about the law that is applicable. And we've got good calculators to help calculate, hey, which benefit should I start? When should I started? What's the tax implication of that? We've done 100 laps around that already. But yeah, that was interesting resolution to the case.
Walter Storholt, co-host 7:50
Yeah, talking about going the extra mile. That's awesome to hear how that story turned out. And all the different hoops that you had to jump through to figure out that problem, but great to have a success story. They're capped off. And again, if you do have questions for Brian want to reach out need help making those social security changes or figuring out any element of Social Security as it relates to your retirement future, you can always call 706451 9800, or go online to living worth.com and book a call through the website as well. So that's one update, Brian, but you also mentioned we had a recent episode, obviously breaking down bricks and everything related to that. What's the update on that front?
Brian Doe 8:29
Well, if we talked about the death of the dollar, and the BRICS, Brazil, Russia, India, China and South Africa are the big new rising economies, they have the huge share of the world's population and account for a major portion of the world's GDP. And they're all banding together to render the dollar, the power of the dollar obsolete and they're going to start their own currency block. And they've got all these other countries coming on board with them. And it's just going to be the rise of a whole new era in geopolitical power. And we think we've pretty well exposed the realities of that you'll have to go back and listen to that episode if you want. But I ran across one more statistic that kind of drove home my point about if this is such a awesome, great new currency arrangement, it should attract capital that should be in an environment that draws capital, both financial capital, intellectual capital, human capital, it should attract all of those things, and it's not. And the number that I saw was the migration of millionaires. And at the top of the list, in order of the acronym Brazil, Russia, India, China, every one of those countries had a net out migration of millionaires either already this year or expected as we go through the rest of this year, Brazil lost 1200. Russia lost 3000, India lost 6500, China lost 13,500 in South Africa last 500. So every single country in this BRICS, super global structure is seeing capital flight. And this is, you know, in probably intellectual capital flight and brain and human capital flight as well as these people leave, they've gotten rich in these countries, they've made some money with whatever business they have. But they don't want to stay there. These are not places that are friendly to future wealth creation in their eyes. The other one that was on the list that I thought was interesting was the UK. And they actually had one of the largest losses, not as large as, as China, but they lost 3200 millionaires, I think that is a testament to is when Brexit hit, Britain had done a very poor job of renegotiating all of the trade agreements. And you've got currency issues now and you got trade restrictions, and you don't have free trade agreements in place that they had when they were part of the EU. And you were left with a vacuum or a lot of uncertainty about what the rules were going to be and how businesses were going to operate. And so, again, this drives my point home when you have an opaque system, or one that is not friendly and conducive to the free flow of trade, money, movement, economic and banking factors. The United States is uniquely positioned with Canada and Mexico on either side, we've got free trade agreements, we've got very connected borders, geographically close together. There's no hostilities over geographic territories, or you know, any, any kind of issue like that that's causing, like a political instability or a rivalry. Russia and China have border issues, China and India have border issues. India and Pakistan have have border issues, all of these countries, they really don't get along, they don't really like each other, they're just trying to pull this together, too, I think is a Hail Mary, that ultimately is is not going to work. So on the flip side, I looked at where all the millionaire's went care to take a guess where they went, Walter,
Walter Storholt, co-host 12:35
I'm gonna guess to to non BRICS countries,
Brian Doe 12:38
exactly. The US gained 2100, Australia 5200, interesting, Singapore 3200, United Arab Emirates, fourth up 4500 and Switzerland 1800, France 1000. So what do all those countries have in common, they're very open to commerce, they have free flow of capital. In the case of United Arab Arab Emirates, and Singapore, I think they have a geography and a tax in the case of United Arab Emirates a tax advantage. So they're, they're sort of close to where all these new millionaires are in whether it's Russia or China or India. Singapore is geographically convenient, United Arab Emirates, kind of right in the middle of Asia and in Europe. And then the people go into Switzerland and France, there's not the big tax advantage, but there is security and safety. And I suppose people looking more as that as a place where opportunity exists going forward. And they're going to better be able to either protect, preserve or amplify their their capital. So if you look at the movement of actual people on the ground, if this BRICS currency, whether it's the Chinese yuan, or something else that they make up, even the people that have it, don't want it, and where do they want to go, they want to come to a lot of these places that do have all of the factors that I said, are necessary for the good propagation of capital. And the ultimate final note is, is that if you look at Brazil, India, and China, which are three of the top bricks, they are at the top of the stack for income inequality. And so I think what you're seeing is a lot of people getting rich, this isn't trickling down to the middle class. And that ultimately is what what you want is to have all of society benefiting and you're just you're just not seeing that in the BRICS countries.
Walter Storholt, co-host 14:45
Great breakdown. Appreciate the follow up on both of those items. The Social Security when and this bricks death of the dollar conversation. We had a few episodes back, highly encourage folks to go and listen to that one and check it out for sure. But I kind of feel like now you're setting So Brian, you gave us the good news first. And now comes the bad news. When we get to the health care talk today? Well,
Brian Doe 15:06
unfortunately, I've been looking at not only client budgets, but my own budget. And what I've been noticing is that we're just getting clobbered in two big areas. The one that's no surprises, taxes. And we've talked about the end of the Trump era tax cuts will be coming to an end in a couple of years, we're going to revert back to some older tax law in 2026. If nothing happens, but nothing new there. But health care and insurance costs. Actually, all insurance costs are off the chart for me right now. And then health insurance has just been going up and up and up. And it seems like every year we get a little little bit less, for what more we're paying? Well, I
Walter Storholt, co-host 15:51
certainly feel this, Brian, there have been a couple of times going to the doctor recently where I look at the you know, the bill afterward, and I think about what I'm paying in premiums, and I'm like, oh, man, like, might as well just not even be insured, or just pay out of pocket and get some discounts at this point. I mean, it's, it's sad that there's that many times where that kind of thought enters your your head, you know, and that that's not really creating much value for people. I mean, other than just catastrophic coverage, like what is what is health care coverage really helping me out with these days.
Brian Doe 16:19
And I think we've kind of hit a barbell, where it covers some basic health care coverage, very minimal, annual exam, a little bit of blood work, and but they're, you know, firsthand, my, my mother in law was a nurse practitioner, and she finally just retired because she'd had enough of, you know, the sort of the egg timer service model where you had to see X number of patients every hour, and they just ran them through there as fast as they could. And so I think they're trying to give a minimum amount of basic checkup and coverage to everyone. And then yeah, on the other end is just catastrophic. And so we're paying higher and higher premiums, the copay is a lot of our co pays have gone up to $80. And I remember copay used to be maybe 510 $15, or something like that, it was just enough to give you a little bit of skin in the game to just keep you from saying, hey, it's totally free to wear, you know, I feel like a basic visit is you've got to be paying a significant portion of it with an $80 copay. And each of the deductibles now I've got a family of five. So my health insurance premiums all together are running close to 2000 a month, just under that it's somewhere between 18 $102,000 a month. Crazy, which is just crazy. Yeah, I could buy more than a mortgage. Yeah, more than a mortgage. And so I really am concerned for people that don't have the incomes and the resources to pay for that. I think it ties into past conversations I've had about we've got a demographic problem because people are not having children because it's so expensive to and and certainly healthcare has got to be one of those things that factors in because if you're paying a couple $1,000 a month for health care, and then you each each person has $1. Co pays and everybody has a $3,000 deductible. Yeah, I don't I don't feel like I'm insured. And we don't have dental insurance, you just pay for that out of pocket. And so just over and over, I'm looking at paying more paying more and getting less getting less plus that well, is this just me Are they just picking on me. And this has not happened to everybody else. And so a little bit of research and the heritage.org did a full study and they looked at state by state what has happened to individual insurance premiums, not just the Obamacare premiums, but all premiums. And what they basically found is that healthcare cost has doubled for individual health care insurance since Obamacare, and it's different by different states, I happen to be in a Pennsylvania group plan. And so that premium from 2013 is up 150%. So we're you might have been paying, you know, 20 or $40 a month back in 2013. By 2019. This is this is all data. That was up to $604. And I think I saw that Georgia specifically was up maybe 180%. So almost a triple from from where we were before Obamacare came in. I don't know how to dissect what exactly caused all of that. But yeah, the data is there that everybody is paying a lot more. And the government's attempt to step in and make health care affordable has has done anything but
Walter Storholt, co-host 19:56
I think it's interesting because you kind of nailed this. I remember we weren't doing the podcast back when Obamacare first came to fruition, but I do remember over the past couple of years since 2019, when we started this podcast, Brian, you mentioning multiple times about how the cost of health care was going to outpace general inflation. And and maybe general inflation has caught up a little bit this past year. But but it's certainly looking at this data shows that the price rent increases have been definitely out of control and and probably made that those predictions and those statements true.
Brian Doe 20:30
Yeah, I've seen some inflation charts on the two biggest things that the government is involved in subsidizing, or controlling or regulating healthcare and education, higher education. And those were the two things that over the past couple of decades have skyrocketed in price. So I think what we're seeing is a consolidation and control has continued to move into government, big hospitals, and big insurance companies, a lot of practices are getting bought up and absorbed by the big hospitals in towns, I feel very much like you're getting what the insurance company approves for you to get in, if you want anything extra, or you want to spend extra time, it's really just not not available. And I think that consolidation, you have Medicare, obviously is the biggest provider of health insurance. And because of all these skyrocketing prices, I've never seen more people eager to reach age 65 so that they can at least just get on Medicare, and qualify for the basic coverage of Medicare. But I think this is I don't know if we've talked about in the past, but I'll repeat it if we have what what has happened is a continuation on of a problem that actually began in World War Two. And if you go back to World War Two companies were having trouble hiring employees, there was a shortage of workers who made it all the men shipped off for for war, they were trying to find qualified people for domestic production and manufacturing. But the government stepped in and said, Oh, we wages are getting out of control, we're putting in price controls, we're gonna cap wages. And so companies had their hands tied and couldn't pay competitive wages to get the people that they wanted. And so what they did was they slipped in benefits. Well, we can't give you a pay raise. But hey, we can give you health insurance. And so that was the origin of employer provided health insurance. And so many people today don't even realize that that connection, is there exist? And I've even seen, owners of companies say why why do I have to provide health care for everybody, not not because they weren't wanting to but just because it's clearly the only really good source that you have of getting a competitive group plan. Or if the company is large enough, they can do a private arrangement with the hospitals in town and just self self insure to try to control the costs. But yeah, that's the source of employer provided health insurance. And now today, if you're doing the gig economy, or if you're an independent consultant, or something like that, you don't have the purchasing power of a large corporation or company to get you a competitive rate. And that's, that's causing the individual to have to pay a suit to the super high premiums, or in my case, we're in a, we're in a much smaller group, we're still a group. But we're a small group. And so it helps a little bit, but we end up paying for it.
Walter Storholt, co-host 23:38
Yeah, it's not only costs that we're talking about either, in this healthcare discussion, it's it's a broader scope than that. And again, this was pretty much forewarned about moving in this direction that they were going to be now longer wait times and slower turnarounds on things and we're kind of seeing that come to fruition as well, especially in
Brian Doe 23:57
up in places like Canada, where they've really pushed for nationalized health care and, or your body chanting Medicare for all, as bad as things seem to be here in the US. If you look at Canada and Britain, both they've, you're actually seeing in migration back to the privatization of health care in England, because the the public model is just not working.
Walter Storholt, co-host 24:21
It's kind of interesting. My wife works in health care. And but we were in a, we were in a group and everyone was talking about how long it takes to get XY and Z done. And we discovered a very common thread between all of the art industries. People are saying, Walter, how long does it take, if if I wanted to start a podcast? How long does that take? And I'm like, well, technically, I could launch one today. But you know, most people, it takes four to six weeks to do a podcast and then my wife Connie is, you know, talking about her, you know, if someone comes in with pain and they need an injection or need a procedure, this and that. How fast can they be seen about four to six weeks, and then I forget what the other couple of industries were at To table and but somebody else was like, yeah, that's about our turnaround time do so everything was four to six weeks at this table. And so we had a good chuckle about how, you know, that sounds fast in some industries, but then four to six weeks can sound like an eternity if you're in pain or having an ailment or some other issue.
Brian Doe 25:16
But I'll add my statistic to that if you're in financial pain, and he walked in and we did a financial plan, consolidated assets got portfolios up and running and did projections in four to six weeks. If you're a cooperative, we could probably do the same.
Walter Storholt, co-host 25:32
Another perfect timeline, another perfect turnaround. So yeah, America, the land of four to six week turnarounds? That's right. That's right, which, you know, may be a good thing, in some cases, maybe not in others, but at least not as bad as some people in places. Well, very simple podcast
Brian Doe 25:48
and financial world, you have transparency. And I think that's just what we're lacking in the healthcare sector. Because if you've ever gone in and just said, How much is this going to cost? Just for fun, try that next time you go into your general practitioner, hospital, anything that's tied in very closely to the insurance reimbursement mechanism, they literally can't give you a cost you have no idea and you don't know what your bill is going to be you don't know how much they're going to charge there's there's this massive disconnect. And like I said, I mentioned the the coding and all that that goes to the insurance and Medicare reimbursement systems. There is a solution to this and we we see it because in a lot of people argue that we need even more government control or more, you know, consolidation or get get all this under one umbrella. And my experience is that that just makes things more bureaucratic, less responsive, longer, wait times and everything. And if you contrast that all of the things that you pay out of pocket for like I said dental I'd go in as I don't have insurance, I just need to know the cash price. Well, there's enough people doing that, that they can actually give you a reasonable price. I don't feel like I overpay for my my dental coverage. If you see pay for service procedures, which would be elective or especially like cosmetic type surgery, you can go in and say you know how much does does this cost and they can give you a price you see a lot with the longevity and biohacking. There's a lot of people out there looking for performance enhancement, anti aging treatments and things like that. And they can be fairly expensive. You see a lot with stem cell treatments and things like that. Those are all being privately paid for and guess what, they can tell you the cost, you can pay for it, and you can get it if you have if you have the money and the resources to do it, obviously. Yeah, that's definitely a caveat. Right? And so my personal experience and I want to make a case for is where I see a breakdown in my service and responsiveness and I'm getting a lot of runaround for this insurance that I'm paying a premium for. There's a local doctor who does a concierge service and I get migraines like a son of again, I've had them for since seventh grade. Well, I was getting a local you know, general practitioner, it was very hard to get refills and you in appointments and you go in and you just kind of get like I said the egg timer treatment and then when I would need prescriptions refilled if I called you leave a message on an answering machine and we have 48 hours to respond and then wait 48 hours and you find out they never got the message and things weren't called in and by then I'm you're in crippling pain and the basement can't even come out of the bunker I'm in such a bad bad shape. And then they were getting concerned about I think you're taking too much of this and I cancelled my prescription and tried to send me to your neurologist and made the appointment without consulting me. I'm like this is crazy. What they're what they're doing here. And so I signed up for this concierge medicine and it's just night and day I walk in they are set up to accommodate you. You've got a dedicated text line and phone number that you can call that anyone will answer anytime a day if it's a real emergency, obviously want to call after hours unless you really need it. But it has cut down me running around to three different doctors. Now it's $250 a month basically a premium cable subscription type price per month, but I get great service. They do thorough thorough checkups, blood panels every year. A couple scans if I have anything I want to get baselines on heart and I don't even know what all they're they're checking, but I just feel like I'm getting a really, really, really thorough analysis baseline. It's, it's been a nice experience. But again, it's to the point. If you've got the resources to afford it and pay for it, and you need it. You're seeing some private market options. Merge, because the healthcare system is just groaning under the weight of, you know, you get a lot of baby boomers in retirement, there's a demographic element to it for sure. And then just the rigmarole of who's paying, what are the insurance companies covering the big hospitals. So trying to run things profitably. And just see this is kind of breaking down,
Walter Storholt, co-host 30:22
the market finds away. So it sounds like it's, it's figuring its way through that, albeit a bit painfully, because of all the other movements and things we've got to consider, but certainly interesting to hear about some of the solutions that are popping up. So for a final bow on the episode today, Brian, if we are looking for solutions to figuring out this whole issue with healthcare? Well, it seems like that's kind of hard. We can't we don't really control these things. We can't control that spending and those increased in prices. So I don't know, are we left hanging without really a solution here?
Brian Doe 30:53
Unfortunately, well, I did see one solution. I don't know if this is necessarily a healthcare solution. But it is a retirement home solution. I saw an article a couple booked 51 cruises back to back for a solid year, because it was less expensive to live on vacation on a cruise ship with all the meals and entertainment and everything provided that it was to go into the retirement home.
Walter Storholt, co-host 31:19
I mean, that makes total sense, doesn't it? You add up the cost. It's nice and fixed, your all your meals are covered, you know the expense of everything. Boy, it makes it living on a budget nice and easy.
Brian Doe 31:30
Yeah, I think as long as you don't have a stroke and need a neurosurgeon or something like that, you're sure it's probably probably just fine. But I think the bottom line is, you need to seriously look at what healthcare costs are gonna be in the future, whether it's insurance or actual care that you need, and start budgeting for that because the insurance coverage that my parents and grandparents had no longer exists. Or if it does, consider yourself very, very lucky, I would just plan to put an extra emergency fund medical line item in your monthly budgets, something like that, because I think the problem is going to continue to get more and more severe as the full wave of baby boomers go into retirement, you've got the Gen X as a smaller demographic population. So you've got a smaller base paying in to Medicare, and a larger base drawing on the benefits. So I only see it getting squeezed further from here. So prepare yourself.
Walter Storholt, co-host 32:33
Best thing you can do just prepare your overall financial solution to handle things like health care, where we don't have a lot of control over one, how much we're going to need it ourselves and to what those premiums are going to look like what out of pocket expenses are going to be, and how much it's going to increase in the future. We know all those things are likely to increase that both the need and everything else. So put together a plan that can account for that and handle that flexibility. If you're looking to take over that kind of control in your financial future, but not sure where to start. Well, Brian Doe is seasoned financial professional. In fact, a CFP. That's the designation you may have heard of that before CERTIFIED FINANCIAL PLANNER, with more than 20 years of experience can be your trusted partner through the planning process. If it's wanting to create a solid retirement plan will receive expert guidance when it comes to your investments or avoiding costly tax traps those kinds of things. Brian is going to have you covered on all of those angles. As a CERTIFIED FINANCIAL PLANNER professional, he meets all the highest standards of education, training and ethics, always putting your best interests as the saver and investor first. So take advantage of a complimentary 15 minute call with Brian to get some of that clarity around your financial goals and prepare for a more secure tomorrow. All you have to do to not miss out on that opportunity is call today. pave the way to financial success with Brian and the team at living worth Wealth Advisors. All you have to do to get in touch is call 706-451-9800 or go to living worth.com and click book a call. It's that easy living worth.com and click book a call. We've got links and contact info in the description of today's show so you can find it easily. Brian thanks for the thorough breakdown on all these different issues on today's show and we'll look forward to chatting again soon. Sounds good. I hope it was helpful. It was have fun at the beach and we'll talk to you next time right back here on make the dough rise.
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