Business Plan, Step 1: My Health

A few days ago, I moved back from Colorado, the healthiest state in the US – but not for me. The stress of suppressing  forcing myself to fit into an unnecessary mold for 2 months took one helluva toll – daily migraines, back acne, weight gain, daily hiccup attacks, upper back pain, poor judgment, inability to stay asleep, and in the final stretch, heart palpitations. It was scary how I could feel myself deteriorate on a weekly basis. I spent over 5 months not knowing if there was an agenda to block my completion of the course, and in the end all I had was pure stubbornness to keep me going. This has left me in the worst physical condition of my life just as I’m supposed to be kicking off a career in alternative health.

Priority #1: Get healthy!

I can’t ‘sell’ health if I’m huffing and puffing while working on someone. I just can’t, it would be blatantly hypocritical. So my #1 priority for the next few months is to get below my “critical weight” (when my joints don’t hurt), which is about 20 lbs away, and build some core strength to make my future work easier on my body. I will still be chubby, but I’ll be stronger, more vital and a lot less self-conscious once my body is more manageable. As for the other aspects of my damaged health, I got nerve & fascial work from one of the top practitioners in the country 3x in 2 weeks, received acupuncture weekly for 5 weeks, and graduated. Everything but my weight is either gone or back to pre-Boulder levels.

But what about those expensive new skills??

To keep my new $19,000 skillset from withering away and to build some confidence in my actual skill level before I hang out my shingle, I’ll be taking two friends and maybe one family member through the 10-series – you know, people I can huff-and-puff over while I get back into fighting form. I’ll see some former massage clients, but I won’t be seeking out new massage business.

Sub-Priority: Find a new home

My bigger problem is where to live. I make great money at what was originally my side hustle, more than most of my classmates will make as structural integrators. But I can do that anywhere with high-speed internet, I don’t need to be in a $3K+ apartment in Manhattan. So the big question is, where do I live for the next few months that will support my health goal? I’m no doubt better off avoiding the nightmare that is the NYC real estate market in high season (May-Oct) because I’m a non-standard (read: self-employed work-from-home) tenant. Bearing in mind that I need privacy and quiet for both of my professions, I’ve come up with the following possible solutions:

  • Sublet in NYC – Upside: No moving furniture! Downside: Apparently very few places are legit AND not a dump, or cost more than they’re worth.
  • Apartment Share – Find someone with an apartment who lives there a few nights a week, so you never overlap.  Upside: Furnished; short-term commitment. Downside: It would never feel like home; seeing 4 massage clients a week might be problematic; where do I spend the other 2 nights.
  • Apartment on Wall Street – Upside: Possible clientele on my doorstep; 20% cheaper than midtown. Downside: The neighborhood is dead on weekends and after 4:30pm, it’s not convenient to the rest of the city; would need to deal with furniture moving, which I hate.
  • North Jersey – Upside: commutable to NYC in 15 mins ; no need for a car. Downside: a 1BR apartment is still $1500/month; no friends or old massage clients will visit. And it’s JERSEY.
  • Join a phone co-worker in London – Upside: short-term is fine, she knows what I do for a living, England is cooler in summer. Downside: Will it really further my goal to get healthy – to be in the country where I first developed a weight problem? And I’m not sure if the offer is real.
  • Live with Mom for a while – in a house that reeks of damp and old cigarettes? Where any route I pick to walk will be sidewalk-less for at least half the trip? Where my mother treats me like I’m a disorganized 14yo? Hrrmmm.

How are you going to “get healthy”?

WALK WALK WALK for the first 1-2 months – it’s truly all I need at this low level. Look for my #pfworkout tweets if you follow my Twitter feed! Then we’ll see where things are at come July and I might join a gym or add yoga for my crumbling core. As for diet, I’m going to focus on nutrient-dense foods and see if that keeps me from reaching for the empty calories; if not, I can do something else. My Starbucks addiction would involve a 700-calorie walk to get a 300-calorie drink…we’ll have to see how that turns out. So far, it’s a bit painful – not enough shade, and crossing the local highway feels like playing Frogger (I know, my 80s are showing).

So wish me luck – I’ve been back for a week and it’s been weird not having my own home or a scale or a whole bunch of other things I’m used to having control over.

Add one to the masses of the uninsured

When I discovered that my $425/month Blue Cross Blue Shield health insurance plan added a deductible that essentially made it worthless to anyone without a condition or disease, I cancelled it. I checked around and found that insurance is 50% cheaper in Colorado across the board for similar coverage…what the hell does New York require that Colorado doesn’t that’s worth so much?? Geez. I had 63 days to decide whether or not I was going to buy back into a very broken system (health insurance – not healthcare), and when I found myself leaning very slightly towards “yes”, I discovered that since I’m not currently insured, I had to apply at least 10 days before I wanted coverage to start. Missed it by 1 day.

I hate to negotiate

Oh well. Not upset…in fact, it’s kind of freeing. My biggest headache will be negotiating fees with doctors and especially labs. I hate how the lab bills are like $140 but they accept $35 as full payment from insurance companies.  I can’t pick the lab the doctor sends to and I don’t know how flexible they are with individuals. I’m guessing not very. I’ll be googling advice on that.

Alternatives to Insurance?

I’ll also be looking at non-insurance like Aflac to mitigate the biggies. They don’t publish their rates online and I hate dealing with aggressive sales people so I’m not looking forward to this process. Plus I avoid buying insurance from companies that spend a lot on advertising – in other words, if I was shopping for car insurance, I’d be leery of Progressive and Geico.

My Version of Financial Responsibility for my Health

In the meantime, I set up a “Health Fund” within my ING Direct savings account. I transfer $250/month to it automatically. If I get some terrible diagnosis or another, I can always move back to the UK (I am a citizen – it’s legal!) with my internet telecom stuff and do my $50K/yr phone job from there while I get better.

So…got any advice for an uninsured 41-year-old that doesn’t involve marrying someone with amazing coverage?

Will Healthcare “Reform” Go the Same Route as Credit Card “Reform”?

It bugs the hell out of me that a law was just passed that won’t take effect for years. The government just gave private corporations a four-year window to do whatever they can get away with. When they gave credit card companies a 1-2 year warning, look what they did to us – limits are halved, interest rates have been doubled, some folks had their monthly balance repayment % increase by 150% with 30 days’ notice, new fees are being created out of thin air, annual fees for responsible cardholders are set to make a return, fixed rate cards have been unilaterally turned into variable rate ones which will allow CC companies to continue some of their mercenary antics, and I’m sure there’s plenty of other sneaky-bastard manoeuvring that I’ve missed.

So I’m wondering, what can health insurance companies do to us over the next four years? I can think of the obvious (increasing rates, limiting coverage, etc), but hey, those credit card companies got diabolically inventive. You know that insurance companies are even more capable of – and unapologetic about – an inhuman yet somehow legal lack of ethics and fairness.

Care to share any predictions?

Teeny tiny health scare (the C word)

This won’t be news to those of you who follow me on Twitter, but last week I got the results from some mole/mark biopsies and one of them came back as Basal Cell Carcinoma. Yeah, carcinoma, as in “cancer”. It’s benign, not the kind of cancer that kills you…I could have ignored it for the next 20 years and the only thing that would have happened is that it would have become bigger and uglier. My dad had it, assorted aunts and uncles have had it, and heck, there’s even some malignant melanoma in the family too (grandma, aunt, cousin). Is it genetic? I guess, but really I’d classify it as ethnic – damn celtic complexion.

I knew I wouldn’t be in any frame of mind to deal with insurance stuff if the diagnosis on the “pimple that wouldn’t go away for 6 months” turned out as it did, so I picked my dermatologist because the practice he’s with has a Mohs surgeon (minimal scarring) and I could be set up with that directly. My co-pay for specialist visits is $40, so I was trying to keep all that to a minimum. Sure enough, despite being totally prepared for the biopsy result, I barely remember the conversation with the doctor and the scheduler because I started to space out. I kept asking them to repeat things so that I wouldn’t forget – thankfully it was easy,  just no aspirin or ibuprofen, and show up at 1:30pm. That I could manage. I hung up the phone and cried for an hour solid, and then sporadically for the next hour or so. Um, I’m not really much of a cryer, so it gave me a terrible headache and, poetically, I couldn’t take anything for it.

Mohs involves local anesthetic and the removal of skin layer by layer until the microscope tells them there’s no more cancer. The assisting nurse said that most patients just need one layer, and I caught mine so freaking early that that’s what I’d prepared for. Well, they needed to take two. And so I type this post with 10 vertical black stitches under a ridiculously big band-aid on my forehead. Yes, I got the band-aids and Neosporin for free at Walgreens. Hey, c’mon, this a personal finance/frugality blog, I had to mention that!

I would like to take this opportunity to bitch about one thing that really shouldn’t be difficult with our healthcare system: why can’t you get a ballpark figure for office procedures? I’m with a major insurance carrier, shouldn’t they be able to look up the code and say “it’ll be $__ for the first layer and $__ for each additional layer removed if all goes the way it normally does.” How are we supposed to be financially responsible if we don’t know whether to expect a $500 bill or a $5000 bill?

And here’s a real kick in the head – this practice (and I understand this is becoming quite common) will not do anything beyond a co-pay consultation unless you have a credit card on file. If you don’t pay your bill within 30 days, they charge your card. I was planning to unofficially finance it @ $200/month until it was all paid off, but now that’s not an option. I can only hope it takes ages to process the bill while I save up. Normally I could take a $1000 hit without touching my savings account, but that hasn’t been the case for a year now.

Finally, Weight Watchers has gotten $mart

So I’m way better with my money than I am with my weight. But I’m not here to whine about my having a beached whale body rather than a beach body. I’ve tried quite a number of thing over the years … a few fads, a gimmick, a bunch of books, a few meeting-type deals, self-hypnosis CDs, totally on my own, with a one-on-one dietician, and I’ve lost track what else. My greatest success was doing it on my own, but mentally I was in a pretty good place for 3 years and then I hit the skids about 18 months ago. I can’t do it alone now, but I also can’t afford to experiment the way I have done in the past — and I really can’t afford to mess with my health. So I’ve gone back to the tried-and-true…

Not sure why, but when I don’t have the  – hm, not sure what to call it, strength? motivation? inclination? sticktoitiveness? – to do it on my own, I can still do it with Weight Watchers. I have always found WW to be a very thorough, healthy and at times even clever approach, but I never agreed with their payment system. Historically, you paid per meeting and if you missed a meeting, you had to pay for it anyway. Well, the weekly fee and the registration fee (waived 2-3x a year during promotions) were about the same, so a lot of folks would either postpone their return to make the extra fee “worth it”, or they’d just wait for the next free sign-up deal. Not only was WW missing out on all those fees because of this policy, but their lapsed members were regaining. Talk about a lose-lose scenario, right?

Just before I left for Colorado, I opened one of their many email newsletters, which I’ve been automatically deleting for years. Apparently they now have a monthly membership deal, which works out to be the equivalent of 3 weeks’ dues and allows “unlimited” meeting attendance, and until 10/17, it’s a “BOGO”, as in Buy the first month, Get the second month free. It’s also set up as an automatic payment that needs to be cancelled, so you have to make a conscious decision to quit or just throw away $39.95 every month…so maybe you’ll just keep going even through a plateau or other bad patch because, heck, you’ve already paid for it. Weight Watchers gets more consistency to their bottom line, and we get a decent deal in terms of both value and support. Now that’s a win-win scenario!

I’m not a big fan of throwing money at a “solution” so I’ll feel committed to making the change. Although I have always stuck with the really pricey things I’ve tried (e.g. personal training), the Return on Investment was never satisfactory. At some point I’ll do a whole post about weight loss on a budget, but I want to leave my lady readers with this quick nugget of wisdom: if you’ve got limited funds for weight management, spend it on solving the input (food) side of the equation rather than the output (exercise) side. Eating and eating behavior are 75% of the problem, so hit that first and hit it hard. For the other 25%, just walk more.

Would you want to know if you had a ticking health bomb?

As I may have mentioned, Bridezilla was diagnosed with Rheumatoid Arthritis a few months ago. She just saw a specialist and found out she’s got the worst possible case – something to do with blood markers (genetics?) that indicate she will never experience remission. Eventually, she will end up on Enbrel – a $1200/month prescription.

I’ve asked two Real World people if I should have my doc include a test for RA in my next batch of annual check-up labs. One said no, she would not want to know, it would change how she lived her life. The other said yes, he’d want to know so he could plan for the possibility. I realized that since RA hits the hands the worst and those are my moneymakers, I should get tested. It doesn’t mean I’ll definitely develop it, and if I do, there’s no way of knowing whether it will be in 2 months or 2 decades. But this not only affects my livelihood – it also influences future changes in health insurance providers. Right now I have a policy that doesn’t cover prescriptions, and if I end up needing a drug like this before a generic is permitted…yeah, you know where I’m going with that.

So given your own circumstances, would you want to know if you had a significant probability of a debilitating but not deadly disease looming in your future? If so, why, and what would you start doing differently?

Back from Florida – Worth Every Penny

Monday afternoon I got back from my trip to the Florida panhandle for a 3-day seminar in Myoskeletal Alignment. Even if I never use the material or just can’t develop a talent for it, it was worth it because ohmygod, I am pain-free. All that Rolfing I had early this year fixed the new acute pain, but not the chronic old pain – I didn’t even think it was possible. However, the last few months I’ve had increasingly persistent daily headaches, and the neck discomfort I was waking up with was getting worse.

To make a short story long, I twittered about registering for this course, and one of the teaching assistants found me and we started “following” each other. I felt a little silly because my Twitter identity is related to this, my hobby, and not my profession. In other words, he gets to read fascinating things like “Delivered 15 boxes of cereal and 15 deodorants to the teen shelter” and “Got $84 worth of stuff at CVS for $1.78”. Anyway, about 2 weeks ago, he sent out a tweet looking for someone local to do some typing in exchange for a 30-minute session with him. I did it, and collected on Sunday morning before class. He got about 15 minutes into it and called over a fellow teaching assistant to take over, because the other guy had moves he didn’t. Well, this bodywork tag team worked what so far appears to be lasting magic.

I honestly did not realize how much discomfort I was in every waking moment. Taking a sip of coffee, opening the microwave door, turning my head, putting on my sneakers…I was constantly expecting pain, bracing against it, moving to avoid it. I could get relief from a chiropractic adjustment, but that only lasts for about 6 hours. I used to get awesome, enduring treatment from my osteopath in Scotland, but not here, and it’s been 9+ years since I’ve had access to him.

My Myoskeletal Alignment treatment was 84 hours ago and is still holding. 84 pain-free hours. Now I’ve got to either find someone local who does this or become a groupie and follow these two pairs of golden hands around the country getting treatment wherever they teach. Because if I’ve learned nothing else from this line of work, I know that 16-year-old problems don’t get solved in 40 minutes. But no matter what, it was worth every penny I spent on course fees, airfare, hotel, etc. just to find this out. Heck, I may even take the course again in November to solidify my knowledge and tweak my technique.

On the business side of all this, I’m trying to line up people with specific problems/joints that I’ve learned to treat so I can practice and get things to the point where I feel comfortable stating that yes, I can fix plantar fasciitis/IT band syndrome/frozen shoulder/neck cricks/etc. I’ve successfully talked my cousin into letting me whale on his hip this Sunday – he’s 38 and in the past 5 years or so has been suffering terribly from pain related to being hit by a car when he was 7. However, I had tentatively lined up a few financially-strapped clients for 30-minute freebies on their major pain centers and no one has replied to my emails in 2 days despite their initial enthusiasm. Just further proof that no one values “free”.

State of the MMK Union

According to the talking heads at CNBC (my commercial break channel surfing destination of choice before 4pm), that whole downturn thing is over and happy days are here again. So let’s pretend for a moment that I believe them and look at how it has affected my year thus far, as I sit here on the eve of my 39th birthday…

Income:  My income has taken a 20% hit, based on a year-on-year comparison for the Jan-April period. I predicted a percentage closer to 50%, so this is GREAT!!! I suspect it would have been higher if Feb 2008 hadn’t been so frighteningly dire in the immediate aftermath of the Bear Stearns collapse. Anyway, this means I’m making my expenses and a bit more, but not a whole lot more. And I’m hoarding it.

Career:  Looks like there will be a 2-day Rolfing workshop in June. Given the complexity of Rolfing, I suspect it’s an intro deal to market the big 300+ hour course, which bodes well for my financial future!

Investments:  GE is down 30% since I purchased it, and AIG is up 180%. And if business continues to show recovery, I just might be able to make that Whole Life premium in September (I’ll go monthly if I have to, but I feel like that’s just postponing the inevitable).

Health:  Still fighting to get my minor vascular procedure done – pain in the ass doctor won’t schedule a surgery date (it’s not just me). My weight is way up but, I think, no longer increasing…with Bridezilla’s big day looming, I really need to re-establish my good habits pronto. And thank whatever powers that be, I finally resolved the neck-shoulder-elbow pain in February…ahhh!

Home:  Re-upped in March for 18 months at an acceptable rent. In retrospect, I wish I’d shot for 20-24 months, ugh, what was I thinking. I do need to replace some dying items in here though, like a shelf unit that’s getting awfully rickety. But I tend not to get around to such things until they completely fall to pieces, which is really not a great plan when clients come to your home.

Travel:  No plans in the making, except for the non-negotiable trip to Colorado in September for the wedding. I really should do something the first week of July though, because I know I’ll be wasting my time waiting around for clients to call.

Charity::  I’ve funded several microloans at Kiva with money that had been repaid from other loans. I’ve made weekly deliveries of cereal, dairy products, condiments, toiletries and first aid items to a teen shelter and also cooked dinner there twice. My new shopping-for-free hobby has been fantastic in this respect! I’ve made one delivery, with another in preparation, of toiletries and beauty products to Bottomless Closet. I’ve done 4 ThaiForGood massages for $$ for my little charity projects. I sent a check for $80 to Thai Freedom House in February, with plans to send another $50 within the next 10 days.

CONCLUSION:  Despite the year’s craziness on a macro level (volatile markets, new president, Craigslist Killer, swine flu panic, etc), I’m doing just fine on a micro level. And you too can come to this conclusion if you restrict your news viewing to Comedy Central 🙂

Monday Migraine edition

Business picked up for me these last few days – and I find myself slammed with migraines, hence the lack of posts over the last week. I worked through Thursday’s pain, had a “headache hangover” on Friday and even a bit on Satuday. Along comes Monday and I get another monster migraine — all the free Excedrin in my stockpile didn’t make one bit of difference.

On Friday, I transferred the final $1K of my 2008 Roth IRA allowance into my account — haven’t decided what to buy, and will wait for another dip in the Dow before buying anyway. What can I say, I don’t buy into the “happy days are here again” nonsense on CNBC. I personally don’t take any encouragement in hearing that the market just had its best week or month since 1933. Ahem, there was more Great Depression ahead of that moment than behind it.

The never-ending headache that is health insurance

This morning I saw my pain-in-the-ass vascular surgeon about the final surgery on a stubborn varicose vein. I won’t get too much into why he’s a pain because it has nothing to  do with money…well, I guess it does because if he hadn’t pretended that he did the procedure we decided on, it would have saved me at least $100 in co-pays. Anyway, before I had the first two procedures in January 2008, I asked him once and his admin staff twice if everything was good to go with the insurance company and they all said yes. Then the bill came and because it wasn’t pre-certified, the insurance company only paid 40% instead of the 80% they would/should have. BCBS of Illinois has been giving my doctor the runaround for a year, and the admin assistant who deals with that stuff had a stack of files going back two years of billing cases with similar issues. Apparently they always pay up, but they’re counting on frustrating the hell out of accounts receivable staff to the point where they give up trying.

The doctor started off with an apology for discussing billing issues with me, but said that what the insurance company had paid so far (and might only ever pay) didn’t even cover the pre-profit overheads for the surgery. Apparently the surgery that he officially bills @ $8300 per leg gets a Blue Cross Blue Shield approved fee of about $2200, of which $950 is the barebones cost of materials and staff costs for everyone but him. Well, I can do the math for the two days per week that he does this and only this office surgery, and BCBS pays some of the lowest fees out there…so for those procedures alone, he makes a minimum personal profit of $20,000 a week. I soooo don’t feel bad for him. 

On the way out, I told the assistant to bill me for the 20% co-insurance that I owed no matter what the insurance company did about their portion of the fees. So when I go in for an ultrasound of my leg tomorrow morning, I’ll be slapped with a bill for $870 – expected, but I hate the timing. Then it also turned out that there were smaller co-pay/co-insurance bits and pieces that I’ve owed for a year and that they claim to have been sending me bills for monthly (I honestly haven’t received a single one of them), so that’s another $130 I’ll be coughing up. Add another $85 for my portion of today’s and tomorrow’s appointments, and BLECH.

Let’s harken back to my credit score of 805, where I was penalized for not having any installment payment debt (e.g. car loan, student loan). I wonder…if I arrange to pay that bill in monthly chunks, will that do the trick, or is that such an unofficial arrangement that it won’t count? I can pay the whole thing up front, but if I can get some personal benefit out of it somehow, I’ll take it.