The Expatriated Consumer

Imagining life without debt. Working to make it reality.

Archive for June, 2008

Doc, that hurts!

Posted by Maxwell Finklewicz on June 27, 2008

Never thought it would come to this. I’ve now had to start bargain hunting for medical care. Yep. That’s what I’m reduced to. The cost of medical care has skyrocketed, never mind that that my out-of-pocket costs increased dramatically when I relocated, what with a higher payroll deduction for insurance, to higher copays for services and prescriptions, and having to pay out of pocket for expenses that are not covered.

I find myself having to improvise, to stretch my dollar as much as possible. I am not going to skimp on my health, or my family’s because the cost is too much. I consider it a non-discressionary expenditure, so I work the system as much as I can to my advantage. Some things I do, in no particular order, to reduce my overall medical costs:

Shop around to get the best price on prescriptions and over-the-counter medications. My favorite is CVS’s ECB bonus program; at one time I was receiving a $5 off a $20 dollar purchase coupon for each new prescription I brought in. That paid dividends numerous times this year. You can also use those same coupons towards your copay. According to my local store, you can’t use ECB’s accrued from product promotions, though. Check with the pharmacy, too to see if your prescription qualifies for a discounted copay, as many are offering hundreds of prescriptions for as low as a $4 copay now.

I also shop at in-hospital pharmacies. Most hospitals have one, and oftentimes they offer many over-the-counter medications for retail sale, as well as prescriptions. One near me offers a bottle of 100 ibuprofen (same thing as Advil) for a mere $1.86. The generic version at the local big box retailer is upwards of $7. Children’s acetamenophen (Tylenol) & children’s ibuprofen are offered for 2-3 dollars less than the retail giants. I don’t get there often, but when I do, I stock up.

Find an “in plan” provider. Contact your health insurance company and ask them if they offer a list of doctors that are preferred providers for your plan. This can pay in a couple of ways, the most obvious being that often times there is a reduced copay for seeing those doctors on the list as opposed to one that is part of the “extended network,” or providers that accept your insurance, but aren’t part of the “inner circle” as I like to refer to it as. Weigh the pros & cons; for example, before I relocated halfway across the country, I continued to see the same doctor I had for the previous ten years despite higher copays with my last job’s insurance plan. This paid off because he knew me, knew what to expect of me, and tailored my care to that.

Ask the doctor if a recommended follow up appointment is truly necessary. She may put the decision in your hands. I’ve gone to the doctor for everything from broken ribs, to cuts, colds & sore holes and my previous doctor never recommended follow ups unless I felt like I needed it. He never blindly had me schedule another appointment simply so I could fork over a copay to be told the treatment worked, when I knew that already. Instead of having me come in to review lab work, he would call me, and council me over the phone, if say, my cholesterol was high, to remind me of the consequences, and encourage me to change my eating habits.

Conversely, I’ve been to a doctor who wanted to follow up every 4 months to evaluate a treatment I was receiving, when I knew the treatment was working for me, because I felt better, and was experiencing no side-effects. After the first 4 months I didn’t bother going back. I emphasize that I am comfortable with that decision because of the nature of the issue. Use your head, though, and don’t skip out on follow up appointments that are truly necessary – please don’t endanger your well being, or your life. Your doctor needs to monitor the effects of many therapeutic drugs, such as Coumadin, Depakote, and blood pressure medications, for example. Some of those medications, when not monitored properly can cause very serious problems. Carefully evaluate your circumstances, talk with your doctor, but most importantly, if you’re unsure, go to the appointment.

Utilize telephone triage services at your doctor’s office, your local hospital, or through your insurer. Don’t be afraid to call in and ask to speak to a nurse or a doctor over the phone to discuss health concerns. This can work well if your doctor knows you well, and especially if she knows your financial situation. You may have to leave a message with the office to call you back, but oftentimes they can tell you from your description of your concerns whether or not you should make the trip to town. The worst that will happen is they will recommend that you come in to be seen. All it cost you is a phone call, and it can save you copays & mileage, and even the entire office visit fee, as was my case a few years ago when I was uninsured.

Make sure that auxilliary services in your doctor’s office are covered by your insurance. I know here in Texas, insurance coverage is very fragmented, and I’ve received bills in the mail for laboratory services that I assumed were covered at my doctor’s office, only to find out after the fact that my insurance mandates that my labs be processed by one particular contractor, leaving me with a big ‘ol bill to add to the top of the pile.

Price shop for procedures. We had a recent non-emergency surgery in our house, to take place in an outpatient setting. We received a call from the anesthesiologist’s office letting us know that we had to pay an additional $500 for their services that were not covered by our insurance (instant headache & nausea…) After pow-wow’ing with our doctor, we discovered that it was cheaper for the procedure to occur in the hospital surgical center next door, than it was going to cost in the doctor’s office. Why? Because our insurance is directly associated with the hospital, and the anesthesiologist was not. The doctor’s office explained that for most folks, it’s less expensive in the outpatient setting, and oftentimes more convenient, so they had blindly assumed that was the case for us. The icing on the cake: we even saved on the office visit copay, since hospital procedures are covered in their entirety. Work with your doctor & insurance to find out what works best for you.

Utilize your healthcare spending account (HSA) benefits at work. May as well pay for as much of your healthcare as possible with pre-tax dollars. That can equal as much as a 30% savings on all of your healthcare expenditures up to $1500 annually. Watch yourself though, because once you commit a particular amount to the HSA, you’re locked in, and whatever you don’t use, you lose. There is a myriad of things you can use it for, so familiarize yourself with it to get the most out of it. Don’t be afraid to talk to the folks in your human resources department if you have questions.

Healthcare costs keep growing and growing, with out of pocket contributions from patients increasing annually. Get the most bang for your buck, by knowing what’s covered by your insurance, and familiarizing yourself with the in’s & out’s of healthcare in your area. Ask questions. It’s your right to know all the alternatives, and you have the final say in what happens to you. Hopefully, with a little bit of work, and utilizing some of the ideas above, you can get the healthcare you need, without finding yourself in the poor house.


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I’ve been living a lie…

Posted by Maxwell Finklewicz on June 24, 2008

I’m relatively new to managing my budget. I’m still figuring out the in’s and out’s of proper money management. I look at the numbers, little gears whir and spin in my head, something computes, panic hits, and then I remember that we have some little chunk of money coming in that I hadn’t previously accounted for. Then I know we can make it for another month, and I can worry about next month when the time comes.

I have regular panic attacks about money, because I fear losing all the hard work I’ve invested along with my wife, in building a comfortable life for our family. We certainly don’t live like kings, by any means. We also don’t live like paupers. But I discovered that we do live beyond our means. Very hard reality to accept.

It feels like we should have enough money, but at the end of every two weeks, when I’m done paying the bills, I notice the tank running close to empty.

I’ve read that most people don’t realize how out of whack their finances are until they actually see it on paper. Authors always recommend writing down your budget. So, being smug, I read that, then read onto the next chapter, because I know in my head what was coming in and what is going out. “Thankfully, that doesn’t apply to me,” I think. I meticulously track our expendatures in Quicken, so that I can print off some nice looking reports that don’t make any sense to me at the end of the month. At least I know what my monthly payments are, and what my income is. Then after all that hard work being meticulous, I have a panic attack because DOOM looms ahead. Why? Because of the stuff not in the accounting software in my head. Like the $40 in medical costs to bring the baby to the doctor. Tack on another $80 for the two prescriptions that my insurance won’t cover, and there goes the money I had earmarked in my head for the car payment.

Where does all our money go? For some reason, looking at the numbers that Quicken compiles for me doesn’t ring any bells for me. Perhaps it’s because I’m not watching the math in real time, or doing the work myself. Perhaps it’s something in the software, I don’t know. But, I discovered quite rudely, after finally reading it for the umpteenth time, that you need to sit and actually take the time to WRITE DOWN a budget.

Now, I hate pen and paper, I’m rather a perfectionist in my own mind, (upon close observation of me in action, many would argue vehemently otherwise, but I digress…) so I hunted around for some budget templates for spreadsheet programs on the Web. I discovered the one that fit my needs quite well right at Microsoft’s Office site. I like that I can change catagory names on the fly and that it does the actual math for me, and I just watch the numbers change after data entry in each catagory. There are a couple columns near the top, one that indicates income, the other indicates output. Guess which number is higher?

To the tune of $1000 – $1500 a month, our expendatures outpace our income on a regular basis, in case you didn’t guess correctly. That puts me square in the middle of one of the popular statistics among personal finance advisors – that the average American family spends between $1000 – $1500 MORE a month than they earn. That makes me hoppin’ mad, because I hate being a statistic. Needless to say, I hate the idea that I actually have been so obtuse to believe that I was immune to such egregious tendencies, as well.

Consequently, my wife has had to go back to work sooner than we had anticipated after our move, I’m in the process of looking for additional work, and our spending plans are getting a big ol’ makeover. We are struggling to rework the numbers so that they are in line with reality. Man, oh man, it ain’t easy, but we’re plugging away at it.

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Zippity Doo Dah Day!

Posted by Maxwell Finklewicz on June 15, 2008

Fathers Day is here, and just in case there was a chance anybody would forget, the newspaper has been packed to the gills with sales fliers from all of the usual suspects declaring, “It’s here! If you love Dad, get him something good! …And remember, we have the best prices for Fathers Day gifts!

Well, I took a look at the calender, wondering when we’d have a break from it all. Next month is Independence Day, and then, August. Wait! Do mine eyes deceive me? Is there no national celebration or marketing extravaganza excuse scheduled? Those poor, poor retailers. Whatever shall they do? There certainly must be something they can do to stimulate sales in the forgotten month in the dog days of summer.

Well, there is the “Just Because Day” on August 27, “Race Your Mouse Day” on August 28, & “More Herbs, Less Salt Day” on August 29 if you’re really searching for an excuse to celebrate. Yes, someone has actually delegated those dates as days of celebration. I’m not sure how marketers, in general, can devise effective sales slogans around “More Herbs, Less Salt Day.” There’s just no ring to it. There’s no significant history behind it, no emotional attachment. And the name certainly doesn’t stop you in your tracks and grab your attention.

So to help out those hapless retailers, and to do my part to help save the faltering economy, I propose that we celebrate a new holiday in August, the new national celebration sensation. Zippity Doo Dah Day. It’s got “zip” in it, it’ll grab people’s attention, and kids especially, will love just saying it.

Retailers rejoice! Another excuse to push out glorious sales fliers chock full of amazing deals & television spots showcasing the best ways to celebrate the stifling heat of the summer. To get those consumers to part with their money perhaps we bill it as the new patriotic holiday. Developed for the sole purpose encouraging spending, they could market the idea that it’s your patriotic duty to keep the economy flowing by buying good junk to fill your spare closet space and empty drawers with. So spend, spend spend!!!

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What’s in YOUR bottle?

Posted by Maxwell Finklewicz on June 4, 2008

One of the keys to achieving financial success is knowing what you’re buying. Name brands are not always better, the most expensive is not always better. Oftentimes, price is the marketing point. It’s expensive, so it must be good, right? Not necessarily. Case in point:

I worked in a liquor store for many years not so long ago. Being interested in all things beer at the time, I stumbled onto an article in the local industry beverage journal regarding Rolling Rock beer. I had not-so-fond memories of hairy next-morning experiences in relation to that beer brand, given that it was the beer of choice as a fresh 21 year old on a limited budget.

For those who may not remember, Rolling Rock was infamous for their longneck import bottles. They came in reusable flip top case boxes that could be purchased for as little as $10 a case. In addition there was a $1.50 deposit to ensure safe return of the empties so they could be reused by the brewer. It was always a glorious weekend when the stack of empties was large enough to net us a “free” case of beer after bottle redemption.

There was a slight ache in my heart when suddenly the price of Rolling Rock sky-rocketed to close to $20 a case, and they started to phase out those glorious longneck import bottles. They had upgraded their packaging, now retailing the beer in boxes and six pack racks featuring crisp images of Rolling Rock bottles sporting beads of sweat, indicating they were ice-cold and ready for the thirsty. The old packaging was a dull green, with the most interesting feature being the “33” on the back of the bottle, that everyone saw, but no one wondered about.

At the time the article was written, Rolling Rock was running full tilt with their ad campaign “Same as it ever was.” Little did I understand when the commercials started airing that it was a bit of a tongue in cheek statement. What was really going on was pure marketing genius.

In the late 1980’s and early 1990’s the brewer was on the verge of going under. Sales were dropping precipitously, and corporate knew something had to happen, and fast. They decided to bring in a new marketing exec.

He came along, looked at numbers, reviewed their promotional history, and furrowed his brow. “You need to raise the price,” he finally decided.

“You’re nuts,” corporate retorted, “We can’t sell the beer now, at the current prices.” And they prepared to tar and feather him for wasting their time. They were expecting recommendations for prize promotions or a new recipe.

“Hold your horses,” he replied, “Consider this: Budweiser is the standard by which all beer is held in this country. Folks see Rolling Rock at budget prices, and think: Cheap. Cheap = not as good as Bud. Raise the price to a tier just above Bud, put on your Galoshes and watch the cash flow tidal wave.”

Corporate considered the logic, and without changing a thing in the recipe, took the leap, raised prices, launched the “Same As It Ever Was” campaign, and suddenly Rolling Rock went from being the darling of the college frat houses to the bell of the ball for the yuppie crowd. Sales skyrocketed, and they found themselves rolling in piles and piles of cash.

Many consumers actually believe that Rolling Rock is a better beer today than it was yesterday simply because the price went up. I have an occasional one just to reminisce about the old days, but I don’t buy it simply because it’s a “Premium” beer now.

Every time you make a purchase consider why you chose that particular product. Price is a consideration, but should not be the only criteria by which you make a particular buying decision. Oftentimes, the less expensive options can be as good or sometimes even better than the more expensive ones. Let the marketers spend their money, keep as much of yours in your pocket as you can by seeing past their schemes.

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