Posts Made By: James Lacey

Originally Posted by Rod Kaufman

The GOP stance on the govt shutdown and why they won't include the ACA premium credits in the current funding bill is because funding from the ACA goes to illegal immigrants.

"Based on recent fact checks and current law, the GOP claim that benefits from the Affordable Care Act (ACA) go to "illegal immigrants" is false. Undocumented immigrants are explicitly barred from eligibility for federally funded health coverage programs like the ACA Marketplace, Medicaid, and Medicare." AI

And yet the GOP powers that be want the Democrats to negotiate with them to end the govt shutdown on good faith even though they lie about the ACA from the getgo!

Yes, it's bonkers! I have to tune it out when Mike Johnson or some other GOP talking head wants to say they are the ones who care about Americans and the high cost of healthcare. From what I can tell, they are instead doing everything in their power to make ACA fail, regardless of who they hurt in the process. As I said, I can afford it, and I'll have to pay the premium regardless, but I know quite a few people who will lose their healthcare completely.

My wife was first officially diagnosed over a decade ago, and we've been saving and preparing for our inevitable situation for a long time, because her father had the same disease. Hence, we had genetic testing done on her that showed she was at high risk. The APOE gene has a specific mutation, e4/e4, that almost assures you will develop Alzheimer's, and my wife has it. It has nothing to do with lifestyle, and no amount of clean living would have prevented it. My wife has never drunk, smoked, or done anything obviously bad for her health. If anything, she's been a model for clean living, yet she still has the disease. She just lost the genetic lottery.

Originally Posted by Maurice Clark

Hi James,

Very sorry to hear about your wife's condition. I hope you can have a wonderful time together before it becomes to serious.

Regarding the cost of medical insurance, that was one of the main reasons I was not interested in retiring in the US. (and not wanting to miss out on the southern skies!) Here in Oz, most medical is free for someone on a pension (our equivalent of Social Security) and what isn't, such as pharmaceuticals,  is heavily discounted. Even if you are not on a pension, Healthcare costs are far less that in the US.

Stay safe.

Maurice

Even if you are on Medicare, you will be paying a lot for health insurance. Medicare alone will cost you $200 per month, and you will likely couple that with a supplemental policy for at least $100 per month. That takes care of hospital, doctors, and prescriptions, but then you have to pay out of pocket for dental, vision, and hearing care. You can also obtain supplemental policies for these items, which typically cost at least an additional $150 per month. Most of them have a 1-year waiting period before they cover anything significant, and what they do cover is pretty minimal. For the luxury of having health insurance, you can expect to pay around $500 per month per person. Accessing healthcare costs even more, but I will say that Medicare Part B (for doctors) has a very low deductible ($300 or so annually), and once you meet that, you don't pay anything. Part A (hospital) and your supplemental plan will also ensure that you pay next to nothing. Regardless, you will generally pay for dental, vision, and hearing services out of pocket. So, healthcare costs, even for those age 65 and older, can be a significant hurdle. I'd gladly take it, though, since without the enhanced premium tax credits for the ACA, I'm looking at probably around $1,600 per month in premiums alone. If I need to access healthcare, there are deductibles, copays, and coinsurance. In a worst-case scenario, I would hit my out-of-pocket maximum, which is about $10,000 for an individual.

Originally Posted by James Lacey

Even if you are on Medicare, you will be paying a lot for health insurance. Medicare alone will cost you $200 per month, and you will likely couple that with a supplemental policy for at least $100 per month. That takes care of hospital, doctors, and prescriptions, but then you have to pay out of pocket for dental, vision, and hearing care. You can also obtain supplemental policies for these items, which typically cost at least an additional $150 per month. Most of them have a 1-year waiting period before they cover anything significant, and what they do cover is pretty minimal. For the luxury of having health insurance, you can expect to pay around $500 per month per person. Accessing healthcare costs even more, but I will say that Medicare Part B (for doctors) has a very low deductible ($300 or so annually), and once you meet that, you don't pay anything. Part A (hospital) and your supplemental plan will also ensure that you pay next to nothing. Regardless, you will generally pay for dental, vision, and hearing services out of pocket. So, healthcare costs, even for those age 65 and older, can be a significant hurdle. I'd gladly take it, though, since without the enhanced premium tax credits for the ACA, I'm looking at probably around $1,600 per month in premiums alone. If I need to access healthcare, there are deductibles, copays, and coinsurance. In a worst-case scenario, I would hit my out-of-pocket maximum, which is about $10,000 for an individual.

On edit: Without the enhanced premium tax credits, in a worst-case scenario, I could be out the entire premium cost ($1,600 x 12) plus the out-of-pocket maximum ($10,000), for a total of around $30,000 in a single year. It's better than going bankrupt or having to pay for something like a heart-bypass operation out of pocket, but still. That's a lot of money that ordinary people cannot afford.

On the other hand, if I did have access to Medicare or something similar, I would be looking at mostly only the premium costs for Medicare Part A and B, plus a supplemental plan, so maybe a worst-case scenario would be around $3,600.

When you find yourself in my situation, it becomes abundantly clear that whoever designed this system wants you working till age 65 and getting your healthcare insurance through your employer, since otherwise it's simply not affordable.

Originally Posted by Jim Moscheck

Sorry about your wife James. My mom had Alzheimers and lived for 17 years after the diagnosis so I know what you are going through. Hopefully with the right medications you'll still have some quality time together. Aricept helped my mom for the first 12 years or so. Prayers for your wife and to you.

My wife was first diagnosed about 10 years ago, but honestly, it could have been done even earlier. We got her on all of the maintenance medications that are available right away (memantine and donepezil), but those can only do so much, and she has progressed pretty rapidly in the last year and a half. It's not correct to say her short-term memory is bad; it's more accurate to say it doesn't exist. She could not live on her own even for a day at this point. If something happens to me, she will have to be institutionalized almost immediately. I have prepared for eventualities and imagined potential tragedies as best I can; all the necessary estate planning documents are in place. However, you can only do so much, and in the end, you have to let family members know what your wishes are and hope they step in and take over if you are somehow no longer available. All of our assets will be placed in a trust for my wife's benefit upon my death. Two of our children will serve as trustees. Beyond that, and shopping around for institutions you like and communicating those to your family, there's not much else you can do to prepare.

Most of our kids tell me it's time to find care for her, but I'm unable to do so as long as she still knows who I am and is not a danger to herself or me. She is not too much trouble to take care of, although she does need help with dressing and hygiene every day, and is wholly unreliable and unable to stay on task for even the simplest things. The good news is that she has no other health problems and has shown no significant personality changes, such as combativeness or anger. Her father never did either, and I suspect she will follow a trajectory similar to his. It does drive me crazy from time to time, I'm only human after all, but I would say that overall, we do pretty well. Her neurologist tells me I'm doing a better job than people who are trained to take care of these kinds of patients. But I'd be lying if I said it's easy.

You hear about all these new drugs that are being introduced, such as Aduhelm, Leqembi, and a newer one called Kisunla, which reduces the amyloid plaque buildup that's causing the problem. Unfortunately, she can't use any of these because of her APOE e4/e4 genetic mutation. The genetic mutation already puts her at higher risk for stroke, and the use of the medications increases the risk of stroke as well, so the two coupled together are a recipe for disaster. What's worse than an Alzheimer's patient? An Alzheimer's patient who has had a stroke.

Listen carefully to the ads for the drugs like Kisunla, and you will hear phrases like "...can cause Amyloid-Related Imaging Abnormalities (ARIA)..."  and "Some people have a genetic risk factor that may cause an increased risk for ARIA." These are the statements warning about the increased risk of stroke while using the drugs, and that the APOE e4/e4 mutation makes the risk even higher.

You can only have the APOE e4/e4 mutation if you inherited a bad copy of the gene from your father and your mother. So, to say it's a stroke of bad luck (no pun intended) is putting it mildly.

Originally Posted by Rod Kaufman

I'll just say that the manner in which you've approached all of this is an outstanding example for those who may find themselves in a similar situation. It is truly comprehensive and commendable.

That's very kind of you to say. Even though we did our best to prepare for this, I still feel fortunate to have ample financial resources to take care of both of us. If you can't take care of it yourself, then your options are limited, and often you have to turn your loved one over to the social workers and Medicaid, which is pretty awful.

Originally Posted by James Brown

I could not agree more.   Wow.   It is amazing the compassion and competence you show James.    I hope I never walk your path, but if I were to, I’d hope to do half as well as you are.   J

She would do the same for me; that's what keeps me going most of the time. That and my kids are watching, and one day they may have to take care of me! Hopefully, I'm setting a proper example. Haha.

Originally Posted by Brian McFarland

You said it; James is inspiring.

I've certainly gained an education on aging, care for older adults, Alzheimer's, Medicare, the ACA, and health insurance in general, which I never really wanted! They are complex and confusing subjects, and by now, I'm probably over-qualified to work for the Area on Aging Agency. What's really saved my bacon, though, is AI; it's incredible how much these tools can summarize and distill down subject matter that would otherwise take hours to understand in just a matter of minutes. For example, I was researching whether I could make a Health Savings Account (HSA) contribution from a qualified investment account (i.e., IRA), and it turns out that you can make a one-time Qualified HSA Funding Distribution (QHFD) for up to your annual HSA contribution limit for that year. However, it must be a direct transfer from your IRA to your HSA, which requires numerous forms with fine print.

Additionally, timing is crucial; for example, you must remain HSA-eligible for 12 months after the transfer. Microsoft Copilot provided me with a step-by-step guide, including forms, tips, and pitfalls to avoid. I probably would have gotten it done w/o all this help, but it sure made things a lot easier, and it provided me the results in minutes.

Originally Posted by Rod Kaufman

"Hegseth blasted by Loomer, conservatives over Qatari air force facility in Idaho"

"The air arm of Qatar’s armed forces, Qatar Emiri air force pilots would train to fly F-15s in the U.S."

"Steve Bannon, former White House chief strategist during Trump’s first term, told Newsweek there “should never be a military base of a foreign power on the sacred soil of America.”

"And conservative commentator Amy Malek wrote on X that “Qatar has spent $100 billion buying influence in the U.S., and it’s paying off.”

“I am in shock that Washington would approve a deal letting Qatar, Hamas’s #1 financier, open a Qatari Air Force facility on U.S. soil,” she wrote. “Qatar bankrolls Hamas, ISIS, the Taliban, al-Nusra, and the Muslim Brotherhood."


https://thehill.com/policy/defense/5550230-trump-allies-oppose-qatar-base/

I hope the Qatari Air Force doesn't have any fat generals. That would be embarrassing and a bad look.

Originally Posted by Jim Moscheck

"Donald J. Trump
@realDonaldTrump

THE BIDEN FBI PLACED 274 AGENTS INTO THE CROWD ON JANUARY 6. If this is so, which it is, a lot of very good people will be owed big apologies. What a SCAM - DO SOMETHING!!! President DJT"


Well let me be the first. I'm sorry, but how was it Biden's FBI when Trump was president on Jan.6th and had been for the previous four years and had full control of congress for the last two? Wasn't it the Trump administration's DOJ? Did Biden have some "secret" powers? Trump wasn't in charge?

It must be nice to be able to manufacture whatever reality you prefer to live in and then believe it's true, like having ended eight wars, for example. I'm not sure if he's truly delusional, or if his constant stream of confrontation, provocation, and spectacle is a calculated move to wear us all down to the point of fatigue. I honestly think most people no longer care what he says or does. It's almost non-stop at this point; every day, there is another LOL or WTF moment with this guy.

Originally Posted by william chiu

Thank you to VP Kamala for paving the way by working behind the scenes for 107 days:
- blocked a Palestinian from speaking at DNC 
- purposely losing the state of MI
- prevented foreign aid to Palestine to end
- represented a party that enjoys signing weapons of death
she has been instrumental in setting the present stage.

We are forever thankful.  god is great.

Anyone who thinks that Trump has achieved peace in the Middle East is as delusional as Trump himself. It's a multi-phase plan that hasn't even completed phase one yet. And on top of that, it requires the complete demilitarization of Hamas (good luck with that), a full Israeli withdrawal from populated areas, broader prisoner releases, and the establishment of a transitional government in Gaza. In the long term, Israel and the international community must fulfill promises of reconstruction and regional normalization. It's great that there is a plan, and it's being worked on, but if history has taught us anything, it's that peace in the Middle East is always fleeting and tends to disappear quickly.

It seems that you may be one of the people who believe that peace in the Middle East is a sign of the end times. I hope that's not true, because the list of the eschatological predictions that have been proven wrong to date is quite long.