a view of health care from around the world...health statistics, life expectancy for older...
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DaVinci Financial DesignsJim Agostini, CFP®, ChFC®LPL Registered Principal3200 Devine StreetSuite 200Columbia, SC 29205Office 803-741-0134Mobile 803-530-5375jim.agostini@dav-fd.comwww.davincifinancialdesigns.com
August 2014A View of Health Care from Around theWorld
Retirement Myths and Realities
Tips for Traveling Abroad
Why are you paying more at the pump?
A View of Health Care from Around the World
See disclaimer on final page
We hope you find the information inthis newsletter valuable. Please feelfree to call us if you have anyquestions or concerns. We lookforward to speaking to you soon.
Jim, Brad, Carolyn, Ashley andJessica.
The United Stateshealth-care system hasbeen impacted by theAffordable Care Act(ACA). But how doesdelivery of health care inthe United Statescompare to that of othernations? And where does
the United States rank with respect to the costof health care per capita and as a percentageof gross domestic product?
Types of health-care systemsWhile each country has its own system ofhealth care, most health-care systemsgenerally fall within the parameters of one offour models, with the health-care system of theUnited States consisting of aspects of each ofthese models.
The Beveridge Model. Countries such as theUnited Kingdom, Finland, Denmark, Spain, andSweden generally follow this model, namedafter social reformer William Beveridge. Healthcare is deemed to be a right for each citizenand is provided by the government andfinanced primarily through taxes. Hospitals andclinics may be government owned, and medicalstaff, including doctors, may be governmentemployees. Medical providers are paid by thegovernment, which generally dictatestreatments provided and the cost for services.
The Bismarck Model. The Bismarck Modelrequires that all citizens have health insurance.Health care is provided by private doctors andhospitals whose fees and charges are paid forby insurance. The insurance programs arenonprofit entities and must accept allapplicants, including those with pre-existingmedical conditions. Insurance is funded throughemployer and employee payroll taxes.Countries that use a form of the BismarckModel include Germany, France, Belgium, theNetherlands, Japan, and Switzerland.
The National Health Insurance (NHI).Combining aspects of both the Beveridge andBismarck Models, the NHI Model is used inseveral countries, with the most prominentbeing Canada. Health care is provided through
private providers who are paid bygovernment-run insurance. Citizens pay intothe government insurance program primarilythrough taxes. As the sole payor, thegovernment directly influences the cost ofmedical care and the services covered.
The Out-of-Pocket Model. Used by themajority of countries, including China, thismodel provides little or no government healthcare. Instead, those who can afford care get itand those who cannot pay for care generally donot receive care.
The United States Model. The United Statesincorporates all of these systems to varyingdegrees. Medicare is akin to the NHI Model;servicemembers and veterans receive healthcare similar to the Beveridge Model; and theACA can be described as a type of Bismarckplan, although health insurers are typicallyfor-profit entities.
Comparing the cost of health care*The following information compares health-careexpenditures of several countries as apercentage of gross domestic product as wellas per capita.
2012 totalexpenditureon health as% of GDP
2012 totalexpenditureon health percapita
United States 17.9 $8,895.10
Canada 10.9 $5,740.70
UnitedKingdom
9.4 $3,647.50
Switzerland 11.3 $8,980.00
France 11.7 $4,690.00
Germany 12.4 $4,683.20
Japan 10.1 $4,751.70
China 5.4 $321.70
*Information derived from The World BankHealth, Nutrition, and Population Data andStatistics (www.datatopics.worldbank.org)
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Retirement Myths and RealitiesWe all have some preconceived notions aboutwhat retirement will be like. But how do thosenotions compare with the reality of retirement?Here are four common retirement myths toconsider.
1. My retirement won't last that longThe good news is that we're living longer lives.The bad news is that this generally translatesinto a longer period of time that you'll need yourretirement income to last. Life expectancy forindividuals who reach age 65 has been steadilyincreasing. According to the National Center forHealth Statistics, life expectancy for olderindividuals improved mainly in the latter half ofthe 20th century, due largely to advances inmedicine, better access to health care, andhealthier lifestyles. Someone reaching age 65in 1950 could expect to live approximately 14years longer (until about age 79), while theaverage 65-year-old American today canexpect to live about another 19 years (to age84) (Source: National Vital Statistics Report,Volume 61, Number 4, May 2013). So whenconsidering how much retirement income you'llneed, it's not unreasonable to plan for aretirement that will last for 25 years or more.
2. I'll spend less money after I retireConsider this--Do you spend more money ondays you're working or on days you're notworking? One of the biggest retirementplanning mistakes you can make is tounderestimate the amount you'll spend inretirement. One often hears that you'll need70% to 80% of your preretirement income afteryou retire. However, depending on your lifestyleand individual circumstances, it's notinconceivable that you may need to replace100% or more of your preretirement income.
In order to estimate how much you'll need toaccumulate, you need to estimate the expensesyou're likely to incur in retirement. Do youintend to travel? Will your mortgage be paidoff? Might you have significant health-careexpenses not covered by insurance orMedicare? Try thinking about your currentexpenses and how they might change betweennow and the time you retire.
3. Medicare will pay all my medical billsYou may presume that when you reach age 65,Medicare will cover most health-care costs.
But Medicare doesn't cover everything.Examples of services generally not covered bytraditional Medicare include most chiropractic,dental, and vision care. And don't forget thecost of long-term care--Medicare doesn't payfor custodial (nonskilled) long-term careservices, and Medicaid pays only if you andyour spouse meet certain income and assetcriteria. Without proper planning, health-carecosts can sap retirement income in a hurry,leaving you financially strapped.
Plus there's the cost of the Medicare coverageitself. While Medicare Part A (hospitalinsurance) is free for most Americans, you'llpay at least $104.90 each month in 2014 if youchoose Medicare Part B (medical insurance),plus an average of $31 per month if you alsowant Medicare Part D (prescription coverage).In addition, there are co-pays and deductiblesto consider--unless you pay an additionalpremium for a Medigap policy that covers all orsome of those out-of-pocket expenses. (As analternative to traditional Medicare, you canenroll in a Medicare Advantage (Part C)managed care plan; costs and coverages vary.)
4. I'll use my newfound leisure hours to______ (fill in the blank)According to the Bureau of Labor Statistics2012 American Time Use Survey, retirees age65 and older spent an average of 8 hours perday in leisure activities. (Leisure activitiesinclude sports, reading, watching television,socializing, relaxing and thinking, playing cards,using the computer, and attending arts,entertainment, and cultural events.) Thiscompares to an average of 5.4 hours per dayfor those age 65 and older who were stillworking.
So how did retirees use their additional 2.6hours of leisure time? Well, they spent most ofit (1.6 hours) watching television. In fact,according to the survey, retirees actually spent4.5 of their total 8 leisure hours per daywatching TV.
And despite the fact that many workers cite adesire to travel when they retire, retireesactually spent only 18 more minutes, onaverage, per day than their workingcounterparts engaged in "other leisureactivities," which includes travel.
According to the Bureau ofLabor Statistics 2012American Time Use Survey,retirees in 2012 spent 4.5 oftheir total 8 leisure hoursper day watching television.
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Tips for Traveling AbroadFor many people, there's perhaps nothing moreexciting than traveling to a new country,experiencing different cultures, tasting exoticfoods, and exploring unfamiliar landscapes. Butbefore you take off on an internationaladventure, consider that a little preparation anda few precautions can help prevent a lot ofunexpected headaches.
Obtain and copy necessarydocumentationMost U.S. citizens need a valid U.S. passportfor international travel. Although some countriesallow you to enter with just a birth certificateand driver's license, all people traveling abroadby air must have a valid passport to reenter theUnited States. Those traveling by land or seamust have proof of both their U.S. citizenshipand identity; in many of these cases, the newU.S. passport card will suffice. You do not needa passport to travel to or from a U.S. territory(e.g., U.S. Virgin Islands or Puerto Rico).
It can take up to six weeks to receive apassport, so plan accordingly. Expeditedoptions are available for additional fees. Alsonote that some countries will not accept apassport that expires within six months of yourtrip. Contact the embassy of your destinationcountry for more information.
Finally, be sure to make copies of yourpassport, itinerary, airline tickets, and otherimportant documents. Leave one set with afriend or relative at home and carry the otherset with you, separately from the originals.
Plan ahead to stay healthySome countries require inoculations and othermedical preparations before entering. You canresearch your destination atwww.travel.state.gov. In addition, U.S. Centersfor Disease Control offers information aboutyour destination's medical requirements atwww.cdc.gov/travel/.
Many health insurance companies do not coverpolicyholders while they are in a foreigncountry. Even if you and your family arecovered, you may not receive the samebenefits overseas. Contact your insurer'scustomer service department to find out if youhave coverage while traveling abroad, and ifany restrictions apply. If needed, you cantypically purchase short-term supplementalhealth coverage from an insurance company,travel agent, tour operator, or cruise line. Thesepolicies are often combined with medicalevacuation coverage, which helps defray thecosts of an emergency medical trip back home.
If you take prescription medication, bring atleast enough to last your entire trip. Carry
medications in their original, labeled containersand pack them in your carry-on luggage. Askyour pharmacist for the generic name of yourmedications in case you need more whileabroad, and ask your doctor to write a letterexplaining your need for the medications. Somecountries restrict the types of medicationsallowed into the country without medicaldocumentation.
Finally, review the options for health care atyour destination before you arrive. It's best toprepare for an unpleasant surprise rather thanhave to search for a doctor at the moment youneed one.
Avoid costly mistakesPlanning to use your mobile phone? Contactyour carrier and review your plan forinternational roaming. Calling, texting, andposting updates to your social media sites canbe extremely expensive if you don't plan ahead.
Similarly, ask your credit or debit card bankabout foreign transaction fees. Since many donot charge these fees, it may pay to shoparound. Also, inform your card companies thatyou will be traveling so that they won't suspendyour card for suspicious activity while you'reaway, and can provide a toll-free numbershould you need to contact them.
If you plan to use cash or traveler's checks,keep some on your person and some in aseparate safe location. Also, before deciding touse traveler's checks, be sure to confirm theyare readily accepted. And remember to checkexchange rates so you can accurately calculateyour vacation budget.
Consider travel/baggage insuranceIn addition to supplemental health insurancecoverage, you may want to consider purchasingtravel insurance, particularly if the peace ofmind outweighs the premium cost. Some typesof policies protect you in case the trip iscancelled or interrupted due to certain events,such as weather, illness, or death of a lovedone. Investigate whether your credit card ortravel club offers this type of coverage as well.
Although most airlines will reimbursepassengers for luggage lost during transit (up tocertain limits), you might also want to considerbaggage insurance for protection when yourbags are not in possession of the airline.
These are just a few tips to consider beforetraveling overseas. For more comprehensiveinformation, visit the U.S. State Departmentwebsite at www.travel.state.gov.
Check with the U.S. StateDepartment for travel alertsand warnings. You mightalso consider registeringwith the U.S. government'sSmart Traveler EnrollmentProgram (STEP), athttps://step.state.gov/step/.STEP assists U.S. citizenstraveling and living abroad.
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DaVinci Financial DesignsJim Agostini, CFP®, ChFC®LPL Registered Principal3200 Devine StreetSuite 200Columbia, SC 29205Office 803-741-0134Mobile 803-530-5375jim.agostini@dav-fd.comwww.davincifinancialdesigns.com
Prepared by Broadridge Investor Communication Solutions, Inc. Copyright 2014
IMPORTANT DISCLOSURES
Securities offered through LPL Financial,Member FINRA/SIPCInvestment advice offered through DaVinciFinancial Designs, a registered investmentadvisor and separate entity from LPLFinancial.
Broadridge Investor CommunicationSolutions, Inc. does not provideinvestment, tax, or legal advice. Theinformation presented here is not specificto any individual's personal circumstances.
To the extent that this material concernstax matters, it is not intended or written tobe used, and cannot be used, by ataxpayer for the purpose of avoidingpenalties that may be imposed by law.Each taxpayer should seek independentadvice from a tax professional based onhis or her individual circumstances.
These materials are provided for generalinformation and educational purposesbased upon publicly available informationfrom sources believed to be reliable—wecannot assure the accuracy orcompleteness of these materials. Theinformation in these materials may changeat any time and without notice.
Why are you paying more at the pump?Have you ever stood at thepump wondering why you'repaying so much to fill up yourvehicle? The answer is ...complicated. According to the
U.S. Energy Information Administration (EIA),many factors contribute to the cost of a gallonof gasoline, including the price of crude oil(which accounts for the majority of the cost),refining costs and profits, taxes, and distributionand marketing expenses.
The price of crude oil is dependent on globalsupply levels relative to demand, and can beinfluenced by political events in majoroil-producing countries, supply disruptions(which often result from hurricanes and stormsin supply zones), and market speculation.Supply and demand is also one of the reasonsthat U.S. gas prices tend to fluctuateseasonally, with prices generally rising in thespring and remaining higher in early summer.But refining costs also play a role. Prices tendto rise as refineries shift from winter to summergasoline blends in order to meet federal andstate environmental guidelines. Gasoline mustbe blended with other ingredients to reduceemissions, and costlier ingredients are used in
the summer blend.
How much you pay for gasoline also dependson where the pump is located and who owns it.For example, prices are generally highest onthe West Coast due to higher state taxes andtransportation costs from distant refineries. Butno matter where you live, you know that pricesalso vary locally from one station to the next.Why? Generally it's because the cost of doingbusiness for an individual station owner varies.The price the station pays for gasoline, thestation's location and volume of business, andwhether it must match or beat prices from localcompetitors all contribute to how much you payfor a gallon of gas.
What's the outlook for the future? The EIAexpects the average price of gasoline to fall in2015 to $3.39 per gallon. Despite theincreasing demand from emerging economies,U.S. crude oil reserves and production areexpected to increase, and U.S. demand isexpected to decrease as vehicles become morefuel efficient.
Sources: "Factors Affecting Gasoline Prices"and "Short-Term Energy Outlook", May 6, 2014,www.eia.gov
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