Here's the definition of kickback: a percentage of income given to a person in a position of power or influence as payment for having made the income possible: usually considered improper or unethical. In other words, if a doctor managed to prescribe a drug enough so that a pharmaceutical company made $100,000 profit, the company would then give the doctor some of the $100,000 as a "reward" for making them so much money. Trust me, there really isn't a way for pharma companies to track that information. I think what people here are referring to is pharma companies *bribing* doctors to prescribe drugs. The definition of a bribe: money or favor given or promised in order to influence the judgment or conduct of a person in a position of trust. Those pens and pads of paper and the odd lunch aren't bribes--it just isn't worth that much. Those pens and pads of paper are promotional materials--my bank hands out pens, my hair salon hands out pens. Are you taking a bribe when you receive or use a pen with your bank's name stamped on it? My sister-in-law is a doctor. She's in family practice. She spends at least one week every year taking continuing education courses in order to stay current in her field. She spends more time at home, reading medical journals and doing other research to help her patients. Her first child was born with multiple birth defects--dislocated joints, really messed up vertebra that caused a spinal cord injury which resulted in quadriplegia, floppy trachea requiring a trach and a ventilator. At birth, they gave him less than 24 hours to live, based on everything that was wrong. My nephew spent his first six months in NICU at the area's best hospital. His doctors, and my SIL knew who the best doctors were, could not figure out what the problem was. They treated the symptoms because that was all they could do. They were calling colleagues all over the country, trying to figure out what was wrong. A new doctor was recommended to them. When he saw the MRIs and CT scans and X-rays, he had the courage to tell them he couldn't help my nephew. But he referred them to yet another doctor, 500 miles away, at a major Children's Hospital in another state. Just before his second birthday, they got a diagnosis of the syndrome that Nephew was, and a plan of attack on how to treat the 13 different birth defects that he was born with. It's a rare disorder. And Nephew has some of the more rare symptoms and is missing one of the most common. There are many, many rare disorders and it is not possible for doctors to know them all. But it is possible for them to seek out help in finding out what a patient has. It can take a long time, though, until you find a doctor who can lead you to another doctor who has the knowledge you are seeking.

We have had USAA for nearly 16 years. We've had two smaller claims for our house - a leak in our roof that damaged our bedroom wall and a leak in our water heater that flooded our rec room. Both of those were many years ago. We've had at least 1-2 claims from car accidents that were dh's fault. Never had any problems with the homeowner's claims but our auto insurance went up slightly after dh's second accident, but mainly b/c they were within months of each other. I absolutely love USAA - they have always been incredibly helpful whenever we've called about anything (we have several different accounts with them). Dh's family had USAA when he was growing up. Their house caught on fire after faulty wiring in a Sears refrigerator in their garage caused a fire. They had incredible service from USAA. Someone had a horrible time with Allstate years ago. His house burned down after catching fire during renovation. I don't remember the story now, but he ended up suing them. I remember going by the house one day and he had a huge sign posted in front of his house chastising Allstate. I don't recall what exactly happened but I believe he did win the case eventually.

The trouble with LTC insurance is that it is like health or auto insurance - carriers enter the market, and some of them price poorly and end up leaving the market. A good carrier may close a book of business (e.g., stop selling a particular type of policy) and come out with a slightly different policy calculated to provide a better profit margin or improved mortality. This is the way insurance works, it's just good business to them. LTC is not a new product at all. Met Life has been selling LTC insurance for 25 years. Lincoln Benefit (I think I accidentally listed it above as Lincoln National, which is a different company) has a huge block of LTC business and for many years was the low-cost carrier. They are owned by Allstate and are in no danger of going under. They closed their current book of business to bring out a completely new LTC product, one of the new hybrid LTC/annuity policies. None of their existing policyholders will see any raise in premiums or adjustment to the terms of their current policies; the "book" is merely closed for new business. That's how a GOOD carrier works, as opposed to a bad one. Where do you find a good carrier? That's the difficulty, you need to find a good agent, not just a "friend who works in the insurance business." Hard to find, just like trying to find a good car mechanic, LOL! Nursing homes around here vary from $3500 to $6000 month. Even if our policy does not cover all the costs, a drain of $1000/mo is a lot better than $72,000 per year, I'm sure you'd agree. The reason I don't rely on the statistic about nursing home care only being needed for an average of 2 years is that as the Boomer population ages, I believe that length of stay average will rise rapidly. And in fact, the largest growing age group in the US is the group over age 80. Since our policy pays for at home care as well as convalescent or nursing care, we feel we have done what we can to MINIMIZE risk. You cannot eliminate all risk; it's impossible. A recent article in the WSJournal calculated that someone with a net worth of at least $5M wouldn't need LTC insurance. Remember that these days, being worth $1M or $2M is so commonplace that the government statistics don't even track it any longer; the bar is now at $100M+. There is no way my DH and I could afford long-term care without insurance. Even though our net worth is well over $1M we simply don't have that kind of liquidity without having to sell the house. My DH had a minor stroke at 50 -- not only is he virtually uninsurable now, but his mortality got halved right there. His chances of being disabled as he ages are considerably higher. Had we waited to obtain LTC insurance for even a few years, we would never have been able to afford it even if we could have found a carrier willing to write a policy on him. I agree that not having health insurance is foolish; on the other hand, if you can stagger along until age 65 (and assuming that somewhere along the line your employer or spouse's employer paid the Medicare A costs) a Medigap policy with zero-doughnut drug benefit is available at a relatively reasonable cost, certainly a lot less than the $900/mo cost (for an individual; $1200/mo for a couple) for my husband's current employer HMO plan. But it is almost a certainty that somewhere down the line, if you and/or your spouse live long enough, one of you will need LTC. And right now, nobody will pay for that except you. With all the disadvantages of private insurance, the fact remains, waiting for the government to take care of your LTC needs is a very dicey proposition indeed. What I point out to most younger people I know is that if they are going to buy a home and have children, they really need term life insurance. Nowadays with most couples dependent upon two incomes to make it, it is disastrous to consider burdening your lives with debt and obligations without buying life insurance. As mortality has improved, the premiums for term life have dropped substantially in the last couple of years. $40/mo will buy a $500K level premium term for 20 years on a 40-yr old in good health. When I worked at a financial planner's office for a while, it was interesting to see that there were quite a few clients who were widows, from ages 50-75. Their major assets were the home and insurance proceeds. Without the latter, some of them would have been in serious financial difficulties. My apologies for seeming to get OT here, but my point is that if you are going to own a home, there is not just health insurance but other insurance issues which are just as important for long term financial planning. To ignore them is being penny-wise and possibly pound-foolish. Thinking that "the odds are it won't happen to me" is taking a big risk. Nothing wrong with that, but I often wonder why people are willing to take such huge risks with their personal retirement finances when they are so often vociferous in proclaiming they want minimal risk when investing in the stock market.

LifeCare have their positives and negatives. Negatives: Expensive. Be sure to find out if or how often they have raised rates on long-time residents. Facility's financial condition. It is rare but HAS happened that a facility will close down. More likely these days, is that a non-profit is bought by a for-profit corp. It's cheaper to buy capacity than build it new. New ownership can and usually will make changes to the facility as it sees fit. Existing tenants aren't going to have a say in most matters; they are basically renters. Arbitration is a standard clause in contracts. Residents and their families have little legal leverage. Make sure you thoroughly understand those nitpicky legal clauses and how they may affect you if your circumstances change (spouse dies; money issues, etc.). Make a list of what is covered and what is not. You do not want nasty financial surprises when you suddenly need Skilled Nursing or Memory Care. Your own research is important. Does the social environment fit your needs and wants? Do you like the food? What auxiliary services are provided/not provided (beauty salon, field trips, scheduled off-site transportation to shopping or doctors' appts., etc.)? What activities are offered, and do you like them? Have you toured the Skilled Nursing Care and/or Memory Units to see how the residents are treated on an everyday basis? Positives: Existing social opportunities. Isolation is more damaging than most people realize. The arrival of the mailman should not be the highlight of your day when you're older, LOL. Someone around to help 24/7. Housekeeping, maintenance, gardening, and (sometimes) laundry are done for you. We do have LTCi. Ours is sponsored by the state pension fund and therefore we have a full-time omsbudman and project care managers assigned to anyone filing a claim. Most seniorcare facilities offer us a substantial discount on both buy-in and rent because of our LTCi policies.