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Comment by dmoy | Hacker News Reader

Lean fire on $600k-$800k is taking an extreme gamble on the cost of health insurance continuing to be subsidized way beyond Medicaid levels. Which you might be fine with, but it's a pretty big risk.

Unsubsidized healthcare in a lot of places in the US costs $10k-$20k per person per year. For early retirement that eats up like $400k-$500k per person.

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This is why you don't retire in a country with private healthcare

My parents live in the UK which has free healthcare. The situation is dire. The waitlist for chronic pain surgeries are 3-4 years long. Lots of people, including my parents, have resorted to flying out to other cheaper countries to get treatment.

Because politicians have made it their mission to chip away at the NHS over decades. This doesn’t say anything about the efficacy of statutory healthcare.

But it’s quite relevant to the question of whether you can just assume that some country will foot the bill for your health care needs at old age, and therefore you don’t need to worry about health expenses if you retire early. Rising costs of health care systems are a serious problem in most developed countries. “Eh, I’ll just move to Europe in old age” is not really a comprehensive plan to ensure you get good healthcare far in the future.

It does. In every public-healthcare country, this happens. Because incentives are stacked against delivering to the patient and for increasing spendings. It’s the tragedy of the commons.

> In every public-healthcare country, this happens.

Outside of Canada and the UK this isn't true.

> Because incentives are stacked against delivering to the patient and for increasing spendings.

Germany, The Netherlands and Japan all have regulated competition models.

> It’s the tragedy of the commons.

Public healthcare isn't a free for all, its regulated, actively managed and budgeted.

I wouldn't use the Netherlands as a great example either. The family doctor model is slowly disappearing, replaced by private clinics. It is relatively difficult to get appropriate treatment for anything, and there are long waiting queues even for intake appointments. It has only been getting worse in the past decade.

> > It’s the tragedy of the commons.

> Public healthcare isn't a free for all, its regulated, actively managed and budgeted.

Not what I mean. It’s racist. Public jobs are being reassigned in a racist way to help whoever the currently-elected leader wants to favoritize, and, as the NHS ad says: “This is us, now”, clearly demonstrating a no-whites ideal (NHS’s intentions, not mine).

Public health funnels money from people who paid to get coverage, to, on one part, those would be rejected in a normal system (non-insured people) because it’s easier to say yes when it’s diluted; to to, for the second part, people self-selected by the group of currently-employed people, ie in the UK it means that normal people are selected with all criteria but protected classes (the legal term, “protected classes”, I mean) have priority for those jobs.

You may pretend the NHS is not racist, but the NHS actions speak for themselves.

> The waitlist for chronic pain surgeries are 3-4 years long

The NHS has _many_ problems, don't get me wrong. But 3-4 years for "chronic pain surgery" isnt one of them. There are huge wait times, but 3-4 years is not representative. (Hip replacement times are ~4 months, much higher than it used to be)

Would I fly out to turkey to get a knee done? fuck no, half the problem is physio. Can you fly out and do it? you sure can.

This kind of doomerism is going to lead to farage getting his way and replacing universal healthcare for shitty half arsed insurance.

Is chronic pain an outlier here, or representative of wider trends? My uninformed prior is that surgery is not a good approach for chronic pain, and that the NHS is more likely to cover surgeries with a more clear-cut cost/benefit ratio

For things like hip replacements, cancer treatment and other physical ailments the NHS is pretty awesome. Some stuff it fails at I am sure, but as you say that is in part down to the way that it prioritises care based on results.

Private healthcare is still much cheaper in the UK, so you're still better off retiring there. Might not always be the case of course, but I would bet the situation will continue to be better than in the US.

Medicare isn't that much cheaper than exchanges although the cost decreases over time as you aren't earning significantly any longer. And lots of issues associated with moving countries.

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