Podcasts I'm listening to

Some say that the modern “smart phones”, which Apple brought to us in 2007, have significantly changed our lives.  I do have to admit that you almost feel naked when you leave your phone behind or if it is running out of charge.  It’s like part of our bodies.  It has become a human need.

I do have to admit to certain level of dependence on my iPhone, and my iPad, but another aspect that continues to have a huge impact on my life, something that didn’t exist before the iPhone, is the availability of Podcasts.  I am an avid podcast listener.  There I said it.

I wish I could say that I have a healthy balance on my listening habits, but when it’s 2 AM and I should be sleeping, I find myself reaching in the dark for my iPad and the earphones to almost randomly select from the several podcasts I subscribe to.  And the rest of my night is then compromised.

Some of the podcasts I listen to are so engaging that I choose not to listen at night.  Just about any topic on those particular ones, suck my attention to the point that sleeping takes a second tier for the rest of the night.

A shout out goes to Afford Anything’s Paula Pan who manages to discuss very relevant topics to me and to explain the subjects in a clear and concise manner.  If there is one podcast that I wish I could have my children listen to, it would be Paula’s.  I’m 62 now and a little late to be considering “early” retirement, but I wish I had started listening to Paula about 20 years ago!  Unfortunately, she’s so young that 20 years ago she would have been in elementary school so probably would not have been as knowledgeable as she is now.  Lucky for me, I happened to have done some of the very ideas she recommends now so my retirement has not been one where I am wanting more.

Other podcasts that are better for me to listen in the middle of the night are the “Mighty Blue on the Appalachian Trail”, “The Good Life Project”, “Smart People”,  and “Back Story”.  These are more relaxing and good for learning but seldom wake me up to the point of losing the rest of the night sleep.

Recently I started following Australian Myles Wakeham’s Unconstrained podcast where he speaks his mind on a number of topics of interest to the financial independent community.  Myles introduces himself as one that made and lost millions and now is in a good position to speak about how to make it in America and how to prepare for a potentially rocky future when the nation confronts the huge deficits we are running with at this time.   One recent entry is very relevant to my most recent blog entries.  Myles was confronted with the low value of our American Healthcare system and suggests ways that the financially independent community can find better value elsewhere.   I like how he separates the 3 types of healthcare into 1) Preventative, 2) Elective and 3) Adverse/Chronic.  When considering cutting costs in healthcare by practicing medical tourism, you have to keep in mind that you can only consider those for categories 1 and 2 but need to keep some sort of medical health insurance to cover you for the 3^rd category. 

One of my big decisions of the upcoming year is that we will do more of the preventive healthcare for ourselves by doing a most of the preventive care abroad when we travel and maintain our healthcare insurance to be used in the event of any catastrophic incident or any illness that we may acquire as we age.  I will be writing more on my experiences as they come along.

Healthcare coding errors on my side

Continuing with the healthcare in America topic.  This topic may be boring to most, but if you are between the ages of 55 and 65 and happen to be unemployed or self-employed in America, there is no way you would know be interested in healthcare.  Of course, if you are poor enough to be covered by Medicaid, or rich enough that you assume money grows on trees, you probably don’t care either.  I’m lucky enough to be smack in the middle of all those metrics so I do care, and care a lot about healthcare, and especially the cost of healthcare in America.

Another example of the how broken the system is happened to me this week.  Let me call them “billing errors” or at least that’s how everyone I talked to this week ended up referring to them.

A couple of months ago, my wife and myself went to do our yearly wellness physical exam.  At the time we both had different healthcare insurance coverage.  Belinda’s coverage is a more comprehensive plan than mine.  It covers major illness and accidents as well as preventive coverage.  In my case I have two policies.  One, a high deductible that I have to cover me if I need to be hospitalized or if I have a major illness or accident.  Another that covers preventive healthcare and routine doctor’s visits.  With all this coverage, you would think we would feel quite relaxed about heading to the doctor.

The visit was good.  Great outcomes for both of us.  Cholesterol in the normal range.  All metabolic indicators, perfect.  Nothing to complaint about.  As we were walking out, the nurse asked if we wanted to get the flu vaccination.  “It’s free” she said.  I was planning to have it anyway but Belinda always hesitates to deal with needles so she was planning to pass the offer.  I mentioned that for the sake of the grandchildren we should be vaccinated and did I say it was free?  Don’t know what did the trick but she agreed to be vaccinated at the time.

We went home happy with the results and happy to having done something to maintain ourselves healthy.  Two months later, the bills started arriving.

Belinda was being charged the full cost of the doctor’s visit.  Not only the physical exam but the vaccination as well.  The vaccination was even divided into the flu vaccine itself ($40.00) and the immunization administration ($54.00).    From “free” to $94.00 felt like robbery.  And also the charge for the physical exam was only partially covered, when her policy claimed to cover preventive health procedures at 100% without deductible.  I called the clinic and the insurance broker that sold us the policy.  The outcome?  Still not fully resolved but the clinic claims that they called the insurance and they had told them that the immunization was not covered at all, and that Belinda’s policy did not cover preventive healthcare.  The insurance broker checked the statement and the policy and concluded that the clinic had made a filing error thus they would need to resubmit with the proper code for it to be processed correctly.  Still waiting for a positive outcome.

In my case, I also received a bill from Quest Diagnostics for blood work in the amount of $682.48.    Almost seven hundred dollars for measuring my cholesterol and blood chemistry?  Of course, I had to call the doctor.  First, the blood had been drawn at the clinic, not at Quest.  How did my blood end up at Quest and now they are billing me directly?  The clinic said that it must be that Quest did not have my insurance card when they processed the blood.  And I asked, why would they have it when I never went to Quest to request the service.  It must have been an error.

As of this writing neither of those items have been resolved.  We are looking at about $1,000 for our physical exams but all could be resolved because they may have done some billing or coding errors.  From my life of science, I know errors happen.  I also know that errors happen randomly.  Somehow all the errors I keep seeing benefit the insurance companies and the doctors.  Never me.  Maybe if I keep visiting my doctor often, I will be rewarded with a coding error that benefits me some time in the future.  I’ll sit back and wait my turn. 

Healthcare in 2019 America

The state of the healthcare in the USA in 2019 is in complete disarray.  The Democrats tried to open up healthcare coverage to many previously uninsurable individuals but since then, the Republicans have been bent out of shape on destroying what was created.  They have not been able to drive the last nail in the ObamaCare coffin but the hammer is already in the elevated position ready to pounce.

Those of us self-employed and worse, old but not old enough to qualify for Medicare, are finding ourselves in a healthcare desert.  This is especially true if you are not poor enough to qualify for Medicaid or make at least a little money to disqualify from what remains of ObamaCare.  The healthcare desert created by the Republicans, is a frightening place full of alligators and snakes and wolves with and without sheepskins.

I meet all the qualifications to be in the healthcare desert so I’ve been paying for private healthcare insurance since I retired from my medical writer job.  Private insurance is not bound by any of the rules that bounded insurances under the AHA (Affordable Healthcare Act, AKA Obamacare).  They can select anyone they want to be under their insurance and deny anyone that does not meet their profile without accountability to anyone.

I consider myself relatively healthy for my age.  I don’t take any prescription drugs, exercise daily, have normal weight, blood pressure, cholesterol, etc.  I thought I would be an easy hit behind second base.  Oh, but I forgot to mention the blood clot that I developed 4 years ago when I broke a toe days before getting on a series of airplane flights of about 26 hours from Ho Chi Ming City, Vietnam to Miami.  At the end of those flights I ended up in the hospital.  When I was released from the hospital, I was prescribed an anticoagulant for the next few months to prevent new clots: PRE-EXISTING CONDITION!!!  PRE-EXISTING CONDITION!!!!  The easy hit behind second base turned out to be an impossibility as I am now an undesirable for most private insurances.

Since I know that most bankruptcies in the USA are healthcare related, I feel that I cannot be without healthcare insurance so I pay whatever I need to pay for the least coverage the insurance companies can get away with.  $10,000 out of pocket minimum?  Sure.  No coverage for any pre-existing condition? Bring it on.  Pay whatever they want and don’t expect anything in return?  Sign me up!

My thought was, let me at least be covered for any catastrophic situation, to prevent the bankruptcy, and I’ll pay for the preventive procedures out of pocket.  It could work, but be prepared to cover the first $10,000 until insurance kicks in, if they want. 

Last month, I went to test drive the latest private insurance that I bought after the salesperson sold me on the notion that this one would cover me for preventive healthcare procedures.  Because I purchased a new plan without leaving room for any “medical insurance gap”, I went to my primary physician with two insurance cards in hand.  Most of the visit was covered so I felt confident and went to schedule a suggested preventive treatment: A colonoscopy.

Overall health? OK. Weight? Blood pressure? Everything OK.  Let’s schedule your colonoscopy.  Oh, sorry did I mention that your last colonoscopy was 6 years ago and that they found one 2-mm polip? PRE-EXISTING CONDITION!!!!  My two insurance cards back to my pocket and a note written in my record that patient refused to schedule colonoscopy.  In a follow up phone call I found out that the physician fee would have been $550; anesthesiologist $450; clinic $695; and biopsy services if needed $450 for a potential total close to $2,000.00.   My insurance company is really concerned about my overall and long-term well-being, wouldn't you agree?