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Medical Costs and Choices

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I’m not a bad father.

Last spring, we noticed my son had a wandering eye. One of his eyes would just drift when he was looking at something. It was happening consistently, so we brought him to the eye doctor. After an exam, we found out that his eyes were 20/100. The doctor said that getting him classes may be enough to fix the wandering eye problem. The theory was that his eye was drifting because his eyes weren’t able to focus. Bringing the world into focus could have let his eyes train themselves to work right.

Nine months with glasses later, the problem hasn’t gone away, so we went back to the eye doctor.

He’s got alternating exotropia. His eyes aren’t working well together. One eye will focus, and the other will drift. So now we’re looking into vision therapists.

A friend went through something similar with his kid, so I asked him for the name of the doctor he used. He gave it to me and told me the clinic was the best in the business, and I would be paying for that. I asked about the cost and was handed the doctor’s spiel about how sad it is that parents focus more on the cost of care than getting the best possible care.

What a load of crap.

First of all, that’s a sales pitch. Of course the doctor is going to defend his prices. If his prices are exorbitant(I don’t have a basis for comparison) and he can’t defend them, people will go elsewhere. $3000 isn’t pocket change. That’s a significant chunk of change. Refusing to look at your options is irresponsible.

Second, price does not equal quality. There are a ton of things that are overpriced garbage. Not only do scam artists abound, but some legitimate things are are horribly overpriced at one location and reasonably priced at others. To stay on the vision theme, my $10 glasses are every bit as high quality as any $400 pair I’ve ever owned. The difference between generic and brand-name drugs? The label and the price. The FDA requires they be chemically identical to be sold. If you insist on the brand name because it’s “better”, you are flushing your money down the toilet. If you live by “you get what you pay for” you are guaranteed to get ripped off.

Third, balancing cost and treatment doesn’t mean I care less. Yes, I am killing my debt as fast as I can right now. Even when I was willing to use a credit card, I wouldn’t drop $3000 without considering my options. I have an entire family to consider, not one problem that my kid doesn’t even notice. Grr. I hate getting told–implicitly or otherwise–that I am a bad parent because I don’t choose to waste my money the way other people do. I’ll check out my options first, thank you.

Now, I will pay for the best when it is warranted. My wife wants Lasik and mentioned some sale some company was having. No. The guy sticking a laser and a scalpel in my eye will not be the lowest bidder. When I left the gene pool, I went to one of the top guys in the state for the procedure. When those things screw up, it’s permanent.

Vision therapy? Not so much. If it comes to surgery, we’ll go with the best. But it’s not there, yet. My kid is going to get a series of eye exercises, no matter where we go. Even if I go to some back alley vision therapist with a degree from a Nigeria U, what’s the worst case scenario? We may have to try someone else. Since I will be doing a bit more research than that, odds are better that my kid will get exactly the same therapy regimen for 1/4 of the cost. That’s the difference between a perfectly competent doctor and a perfectly competent doctor who convinced some trade magazine to write him up as the best in the business.

What do you think? Am I neglecting my kid by wanting to save some money for his braces, too?

Sunday Roundup: Ice Fishing

Misc

Ice Fishing in Portland, Maine — Image by Captain Kimo via Flickr

Update: Something wonky’s happening with this post. If you’re seeing it in your reader again, just ignore it.

Twenty years ago, my grandparents were living in Arizona. They went to see Grumpy Old Men in the theater and, during an ice-fishing scene, they overheard the people next to them talking about how impossible it was. You can’t walk on the ice, let alone drive there! Naturally, my grandparents corrected them.

For the uninitiated, in the land of 10,000 frozen lakes, ice fishing is an actual pastime. The ice on a lake can reach 36 inches, which is more than enough to drive on by 24 inches. Ice-fishing aficionados will drill a hole through that frozen mess, drop a line through the hole and find dinner. Last night, I went ice fishing for the first time in at least 10 years, probably 15. On the lake we were on, they actually plow roads across the ice. It sounds cold, but we were in a 20-foot fish house with a generator, a couch, and a TV. The neatest thing was the underwater radar thingy that turns ice-fishing into a video game.

30 Day Project Update

This month, I am trying to establish the Slow Carb Diet as a habit. At the end of the month, I’ll see what the results were and decide if it’s worth continuing. For those who don’t know, the Slow Carb Diet involves cutting out potatoes, rice, flour, sugar, and dairy in all their forms. My meals consist of 40% proteins, 30% vegetables, and 30% legumes(beans or lentils). There is no calorie counting, just some specific rules, accompanied by a timed supplement regimen and some timed exercises to manipulate my metabolism. The supplements are NOT effedrin-based diet pills, or, in fact, uppers of any kind. There is also a weekly cheat day, to cut the impulse to cheat and to avoid letting my body go into famine mode.

I’m measuring two metrics, my weight and the total inches of my waist , hips, biceps, and thighs. Between the two, I should have an accurate assessment of my progress.

Weight: I have lost 29 pounds since January 2nd! That’s 4 pounds since last week. 13 more to meet my goal for February.

Total Inches: I have lost 15 inches in the same time frame, down 1 since last week.

Best Posts

Thinkgeek has a new high-protein, low-carb snack. Did you know that toasted ants taste like bacon? I’m far more tempted than I should be.

On the off chance that somebody has missed the memo over the years, tax protesting–the art of ignoring your taxes because you don’t like them–will not end well for you.

I’ve been fighting an urge to get a Kindle. Over the last few weeks, the itch has been getting harder to ignore. Money Crashers has a list of resources for free ebooks, making the itch that much worse.

That’s two posts on spending money. Here’s one to balance that with making money. Do you know the best time to post an eBay auction?

LRN Timewarp

This is where I review the posts I wrote a year ago. Did you miss them then?

Have you ever participated in a financial binge & purge? Budgeting and planning can help you avoid the purge, but you’ll have to forgo most of the binges.

Everybody gets caught by life’s ups and downs occasionally. When that happens, how can you fix the damage to your budget and finances?

Finally, I explained my plan for shopping quickly.

Carnivals I’ve Rocked and Guest Posts I’ve Rolled

Brown Bagging Your Way to Savings was included in the Festival of Frugality.

Debt Burnout was included in the Carnival of Personal Finance.

Thank you! If I missed anyone, please let me know.

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Have a great week!

Cutting Healthcare Costs

Finance

It’s not a secret that health care can be expensive. Many people pay two and three digit bills for their prescriptions. A visit to the doctor’s office can hurt the budget. Glasses cost hundreds of dollars? How can you cut this cost?

Drugs

If possible, go generic*. There is no difference between Trazorel and trazadone, aside from the cost. Wal-mart, Target, and many other stores offer common generic prescriptions for $4-5. When you are talking to your doctor, ask if there is an drug option that has an available generic. When you are talking to your pharmacist, ask if there is a generic alternative available.

Get the price match. The Cub Foods pharmacy near me matches the Target generic drug price, giving us $4 generics for the asking. This is often an unpublicized deal, so make sure you ask. If your pharmacy will not match nearby prices, consider going elsewhere.

See if there is a 90 day plan. Many insurance companies sponsor a 90 day prescription plan that gives you a 90 supply of drugs for the 60 costs as long as you are willing to accept the drugs by mail. For expensive prescriptions, this 33% discount can be a substantial savings.

Physician

Does your clinic offer online consultations with your doctor or nurses? Some clinics offer a chat or email option to talk to your doctor without requiring a visit that will add fees and copays to your expense sheet. Most clinics and hospitals have a free nurse line for basic questions, like “When is my baby‘s fever dangerous?” It’s a great chance to save some money. I know, from personal experience, that they won’t be shy if they feel you need to come in, but they generally won’t try to convince you to come in if aspirin will fix the problem.

Stay in-network. Check with your insurance company to make sure the doctor you want to see if in your network and therefore, available at the cheapest out-of-pocket price. If not, and you really want that doctor, ask your insurance company if they accept nominations for the network and ask your doctor if he’d be interested in being nominated.

Stay home for your cold. Don’t go to the doctor for every minor problem. The best remedy a doctor can give your for your cold will reduce it to a seven day malady. On the other hand, if you do nothing, it will go away in about a week. Why waste the money? This counts double for the emergency room and urgent care. Strep throat is not an emergency. Wait until morning and go to the clinic, paying the lower fees instead of the large ER costs. Make an appointment for a doctor visit, if possible. Urgent care is billed the same as a regular visit, but most insurance plans double or triple the copay for urgent care visits.

Cash Flow

A Health Savings Account(HSA) is a pre-tax account to save for qualifying medical expenses similar to a Flexible Savings Account(FSA). The main differences are that HSAs are only available for people with high-deductible insurance plans and do not have to be spent on medical expenses. Non-qualifying expenses move from pre-tax to post-tax, meaning you will be charged federal income tax for non-qualifying withdrawals. FSAs are “use it or lose it” plans. If you don’t use it, it will go away, usually at the end of the year. That makes December a great time to stock up on over-the-counter medicines and possibly replace your eyeglasses, as both of those are qualifying expenses. Find out if you have either option available. If you use either one, set aside a place to store every imaginable medical receipt, so you can be reimbursed. Make sure you understand the FSA-eligible expenses.

An Ounce of Prevention

Get routine checkups. The earlier you find a problem, the more options you have. This goes for everything from cancer screenings to blood tests. Get a physical every year and know what is happening with your body. We may be living in the future, but replacement parts are still hard to come by.

Maintain Your Health

It’s cheaper to be healthy. Eat right, exercise, quit smoking.

I enjoy a good meal. It’s one of my favorite things. I won’t cut rich foods out of my diet, so we reduced portions. Beyond the first few bites, the flavor isn’t nearly as enjoyable or even noticeable. There’s no more enjoyment for huge servings than small ones.

Get more exercise, even if it’s just a 2o minute walks twice a week parking on the far side of the parking lot, or taking the stairs instead of the elevator.

Vision

Go online. This one is worth a write-up all by itself. I have 6 pairs of prescription glasses–all varieties of frames and coatings–that have cost a grand total of about $150. There is no noticeable difference between my cheapies and the designer alternatives. While I work on the write-up, the best site to introduce you to the concept of online glasses is GlassyEyes. Reviews, coupons, and discount likes. They have step-by-step instructions on turning an intimidating idea into a simple and cheap solution to an expensive problem.

How do you save money on health care?

* There are no generics available on new drugs until the initial patent expires. This gives the pharmaceutical companies a change to recoup their research and development costs. Without this patent period, new private drug research would evaporate. Don’t hate the brand names, but don’t show undue loyalty.

Sunday Roundup: Outta Town

Misc

Scrapbooking Cupcakes! — Image by clevercupcakes via Flickr

This weekend, my wife is off scrapbooking with my mother and sister-in-law. Instead of hanging around the house trying to keep three kids entertained, I’m at my brother’s house, since his wife abandoned him with their kids, too. I’ll let his kids keep mine entertained, and vice versa. Woo!