@Psyksis: I'm happy to hear you are enjoying the journal. Pursuers of FI/ERE are few and far between, so we have to find any way we can to support each other. This journal is my way of giving back to the community, to provide a datapoint that people can look at.
Thanks for the tip about Nicaragua. I had some Nicaraguan friends in college, I'm sure I would get along with people there. Costa Rica tends to outshine most countries in the region, so I think there are some good opportunities to be had in an undiscovered country like Nicaragua.
I wish you good luck with the accumulation stage!
spoonman's Journal
Re: spoonman's Journal
#034 03/20/2014 -- My Rant About the Ridiculous Cost of Healthcare in the US
Normally I try to keep the vibes positive in this journal, but today I need to vent a little.
A couple of months ago during a normal weekend of activity my wife got very sick. She tried to get well on her own, but the next day her condition was the same or even worse, so we decided she needed to see a doctor. I quickly logged onto our medical insurer’s website and was recommended to an In-Network urgent care clinic not far from our home. At the doctor’s office, a Physician’s Assistant had a look at her, and promptly diagnosed her with the stomach virus, a bug that has been going around a lot lately (similar to the virus on the recent cruise ship in Florida). Upon her advice, the wife was given a shot to mitigate her nausea. After getting the shot, slowly my wife was able to hold down food and fluids again. Eventually she fully recovered. So all in all, the clinic’s services did make the difference in allowing my wife to recover with a modicum of comfort, and equally as important, provided the mental peace of mind that it wasn’t anything more serious than that.
Having said all that, here comes my rant. The cost breakdown for our visit (of which we are currently 100% liable for, as I’ll explain later) goes as follows: $375 for the visit, $200 additional fee, $60 for the nausea shot, and a $45 fee for administering the shot. That’s a total of $680 bucks! Are you fucking kidding me?!? I think this is complete BS because that sort of cost is simply not commensurate with the gravity of the problem and the level of service we received. And $45 bucks just to administer the shot? Get the hell out of here! The dude that administered the shot just walked in and did it in about 9 seconds. The needle wasn’t made of gold, and he didn’t administer the shot in a particularly graceful way. In fact, my wife’s backside was sore in that spot for an unusually long three-weeks afterwards. So for this they get to charge $375+200 bucks? This is totally ludicrous. Don’t even ask me what the extra $200 fee was for...cause I still have no idea.
No wonder it costs tens of thousands of dollars to hospitalize someone, and no wonder why people can get financially decimated if they get seriously sick.
Why oh why do these services cost so much? I’m sure people can point to plenty of political reasons, but I just feel that medical facilities are unjustly billing too much. Had my wife’s condition been less urgent, we could have taken a quick trip to Mexico and gotten treatment there. The cost of the treatment would have been literally two orders of magnitude less.
Now, to add insult to injury, our insurance provider came back and told us we are 100% liable for the cost because the clinic we visited was Out-of-Network at the time. We have a high deductible plan, so it’s understandable we’re gonna pay a high fraction of the cost, but it is supposed to be discounted (at least 30%) if we use In-Network providers. I called the insurance provider and got them to admit that their website clearly said the clinic was in our network. The representative said they would adjust the claim to appear as in network, but three weeks later I found that the claim had not been adjusted properly, and because the representative did not document our conversation we now have to go through the pain of filing a formal appeal with all the hassle and bureaucracy that it entails. For those that are curious, they will be pulling the recorded tape of my initial phone call to review the rep’s confirmation.
So the provider is sticking us with a huge cost while the insurer is (through incompetence or intent) trying not to hold their end of the bargain. Between my employer and myself we pay thousands of dollars a year to the insurer, only to receive mediocre service.
Thankfully, we can easily afford the medical bill, so it’s not the end of the world. But it’s still aggravating to know that these people are able to get away with so much. The easy thing is to pay the bill, walk away, and vow never to use the insurer. However, I’m gonna continue to fight this to the end and make sure they hold their end of the bargain.
Normally I try to keep the vibes positive in this journal, but today I need to vent a little.
A couple of months ago during a normal weekend of activity my wife got very sick. She tried to get well on her own, but the next day her condition was the same or even worse, so we decided she needed to see a doctor. I quickly logged onto our medical insurer’s website and was recommended to an In-Network urgent care clinic not far from our home. At the doctor’s office, a Physician’s Assistant had a look at her, and promptly diagnosed her with the stomach virus, a bug that has been going around a lot lately (similar to the virus on the recent cruise ship in Florida). Upon her advice, the wife was given a shot to mitigate her nausea. After getting the shot, slowly my wife was able to hold down food and fluids again. Eventually she fully recovered. So all in all, the clinic’s services did make the difference in allowing my wife to recover with a modicum of comfort, and equally as important, provided the mental peace of mind that it wasn’t anything more serious than that.
Having said all that, here comes my rant. The cost breakdown for our visit (of which we are currently 100% liable for, as I’ll explain later) goes as follows: $375 for the visit, $200 additional fee, $60 for the nausea shot, and a $45 fee for administering the shot. That’s a total of $680 bucks! Are you fucking kidding me?!? I think this is complete BS because that sort of cost is simply not commensurate with the gravity of the problem and the level of service we received. And $45 bucks just to administer the shot? Get the hell out of here! The dude that administered the shot just walked in and did it in about 9 seconds. The needle wasn’t made of gold, and he didn’t administer the shot in a particularly graceful way. In fact, my wife’s backside was sore in that spot for an unusually long three-weeks afterwards. So for this they get to charge $375+200 bucks? This is totally ludicrous. Don’t even ask me what the extra $200 fee was for...cause I still have no idea.
No wonder it costs tens of thousands of dollars to hospitalize someone, and no wonder why people can get financially decimated if they get seriously sick.
Why oh why do these services cost so much? I’m sure people can point to plenty of political reasons, but I just feel that medical facilities are unjustly billing too much. Had my wife’s condition been less urgent, we could have taken a quick trip to Mexico and gotten treatment there. The cost of the treatment would have been literally two orders of magnitude less.
Now, to add insult to injury, our insurance provider came back and told us we are 100% liable for the cost because the clinic we visited was Out-of-Network at the time. We have a high deductible plan, so it’s understandable we’re gonna pay a high fraction of the cost, but it is supposed to be discounted (at least 30%) if we use In-Network providers. I called the insurance provider and got them to admit that their website clearly said the clinic was in our network. The representative said they would adjust the claim to appear as in network, but three weeks later I found that the claim had not been adjusted properly, and because the representative did not document our conversation we now have to go through the pain of filing a formal appeal with all the hassle and bureaucracy that it entails. For those that are curious, they will be pulling the recorded tape of my initial phone call to review the rep’s confirmation.
So the provider is sticking us with a huge cost while the insurer is (through incompetence or intent) trying not to hold their end of the bargain. Between my employer and myself we pay thousands of dollars a year to the insurer, only to receive mediocre service.
Thankfully, we can easily afford the medical bill, so it’s not the end of the world. But it’s still aggravating to know that these people are able to get away with so much. The easy thing is to pay the bill, walk away, and vow never to use the insurer. However, I’m gonna continue to fight this to the end and make sure they hold their end of the bargain.
Re: spoonman's Journal
The urgent care center billed you their full price,which is a BS price they use to negotiate with insurance companies. They, of course, wouldn't pay that price. Some times you can negotiate yourself, sometimes not.
Re: spoonman's Journal
@Chad: yeah, I'm guessing it's a total BS price because I have reason to suspect that they classified the expenses as coming from a regular doctor visit, which is normally higher than urgent care. I have to call the provider and inquire about that.
The question is, are they screwing up on purpose or through plain incompetence? It might be both, and I think they're doing it because they think they can get away with it.
Stay tuned.
The question is, are they screwing up on purpose or through plain incompetence? It might be both, and I think they're doing it because they think they can get away with it.
Stay tuned.
Re: spoonman's Journal
Sorry, that's not what I meant by BS. They aren't screwing up. Well, they maybe, but I doubt it. They create these prices as negotiating tools with insurance companies. These astronomical prices are the real prices. The urgent care center will then use these prices in negotiations with an insurance company about how much to pay. They then agree on a contract lasting a certain time period and that's the price for that insurance company for that time period. Since this urgent care center is not part of your insurance network (the negotiated prices are why there is a "network") the urgent care center automatically defaults to their non-negotiated price, which is generally astronomical. You could negotiate directly with the center, but it will be more difficult being that you are alone...but it's possible.spoonman wrote:@Chad: yeah, I'm guessing it's a total BS price because I have reason to suspect that they classified the expenses as coming from a regular doctor visit, which is normally higher than urgent care. I have to call the provider and inquire about that.
The question is, are they screwing up on purpose or through plain incompetence? It might be both, and I think they're doing it because they think they can get away with it.
Stay tuned.
Re: spoonman's Journal
Thanks for clearing things up, I think I get it now. I think I have some leverage to negotiate because I think they are billing me for the wrong type of service.
Re: spoonman's Journal
#035 03/28/2014 -- March Dividend Income Update
This was a relatively quiet month for our dividend income. We had a massive tax bill to pay, due to an increase in earned (and passive) income and because we sold our condo and no longer have that tax write off. Despite these setbacks, we managed to increase our passive income by $205 this month. It could have been lower had it not been for the fact that several companies increased their dividends this month, which contributed $132 to the total (the other $73 came from the few contributions we were able to make this month). If you stop and think about it, that’s the equivalent of us plowing several thousand dollars into those companies to increase the dividend income by a similar amount. I think this marks the first month where the organic dividend increases actually exceeded the increase from our contributions! I [heart] awesome dividend companies!
Our passive income now stands at $15,774, which is very close to our notional goal of $16K for unlocking the PNW from possibility space. Although it’s very likely that we’ll cross the PNW threshold in the next month or two, we will continue to invest as much as possible until August. As we approach August, we will examine where we stand with our passive income and auxiliary funds (i.e. the escape fund of 25K to help us cover unforeseen expenses and serve as a crutch while we get our new budget in order). As I write this, I hope we can pull the trigger even earlier than late August, but we may very well have to work an extra month or two if we deem it necessary.
I almost forgot to mention (yet again, I don’t know why) that we received $1,317 in dividends this month, which were strategically reinvested and contributed to the $205 increase this month. This was one of the few months where I checked my brokerage account often to see if there were any available dividends to reinvest. Normally, when I get ready to make a purchase, I just grab whatever is there and combine it with regular contributions. This month’s received dividends really felt like the “fourth man in the field” (my wife and I being the first and second, and the natural dividend increases being the third =) ).
This was a relatively quiet month for our dividend income. We had a massive tax bill to pay, due to an increase in earned (and passive) income and because we sold our condo and no longer have that tax write off. Despite these setbacks, we managed to increase our passive income by $205 this month. It could have been lower had it not been for the fact that several companies increased their dividends this month, which contributed $132 to the total (the other $73 came from the few contributions we were able to make this month). If you stop and think about it, that’s the equivalent of us plowing several thousand dollars into those companies to increase the dividend income by a similar amount. I think this marks the first month where the organic dividend increases actually exceeded the increase from our contributions! I [heart] awesome dividend companies!
Our passive income now stands at $15,774, which is very close to our notional goal of $16K for unlocking the PNW from possibility space. Although it’s very likely that we’ll cross the PNW threshold in the next month or two, we will continue to invest as much as possible until August. As we approach August, we will examine where we stand with our passive income and auxiliary funds (i.e. the escape fund of 25K to help us cover unforeseen expenses and serve as a crutch while we get our new budget in order). As I write this, I hope we can pull the trigger even earlier than late August, but we may very well have to work an extra month or two if we deem it necessary.
I almost forgot to mention (yet again, I don’t know why) that we received $1,317 in dividends this month, which were strategically reinvested and contributed to the $205 increase this month. This was one of the few months where I checked my brokerage account often to see if there were any available dividends to reinvest. Normally, when I get ready to make a purchase, I just grab whatever is there and combine it with regular contributions. This month’s received dividends really felt like the “fourth man in the field” (my wife and I being the first and second, and the natural dividend increases being the third =) ).
Last edited by spoonman on Thu Sep 18, 2014 1:11 pm, edited 1 time in total.
Re: spoonman's Journal
#036 04/01/2014 -- Medical Bill Situation Update
In entry #034 I ranted about a ridiculous medical bill that we got back in January. I actually submitted an appeal, which would have taken several weeks to resolve, but would have forced the insurance company to pay their fair share.
I decided to call the provider directly and see if they could throw me a bone. Well, they were very sympathetic to our plight and actually reduced the bill from $680 to $255! That’s far better than the amount I would have had to pay if the appeal was actually successful. I am grateful that the provider was able to play ball with us. We went ahead and cancelled the appeal.
However, I just can’t help but think about how arbitrary this whole thing is. They can send a ridiculously high bill to the insurance company and score a ton of money even though they very well know that they are grossly overcharging for their services. Of course, the insurance company is gonna have to make money so those costs eventually get passed on to all of their customers. The whole thing is incredibly perverse.
We still have to be infinitely more careful in the future, these sort of charges can totally kill the buzz in retirement.
In entry #034 I ranted about a ridiculous medical bill that we got back in January. I actually submitted an appeal, which would have taken several weeks to resolve, but would have forced the insurance company to pay their fair share.
I decided to call the provider directly and see if they could throw me a bone. Well, they were very sympathetic to our plight and actually reduced the bill from $680 to $255! That’s far better than the amount I would have had to pay if the appeal was actually successful. I am grateful that the provider was able to play ball with us. We went ahead and cancelled the appeal.
However, I just can’t help but think about how arbitrary this whole thing is. They can send a ridiculously high bill to the insurance company and score a ton of money even though they very well know that they are grossly overcharging for their services. Of course, the insurance company is gonna have to make money so those costs eventually get passed on to all of their customers. The whole thing is incredibly perverse.
We still have to be infinitely more careful in the future, these sort of charges can totally kill the buzz in retirement.
Re: spoonman's Journal
#037 04/08/2014 -- Final course corrections
The wife and I are pulling the trigger sometime in August of this year. In the last dividend income update, I stated that I wanted to keep investing as much as possible after reaching our $16K/year goal, perhaps pushing it to $16.5K/year, but we’ve decided to take a slightly different approach. Since we are only a few months away from saying Adios to the fast lane, we’ve decided to channel the rest of our savings into bolstering our escape fund and making sure we have enough cash for other expenses that we’re anticipating this year. We’ve determined that a proper size for our escape fund is $20K, because that corresponds to about one year’s expenses* under the budget I outlined in post number 33. Among the expenses that we are expecting this year are three domestic trips and maybe one international trip to visit some family. In one of the domestic trips we will scope out the city we’ll move to and decide what sort of apartment is good for us. In addition to travel expenses, we need to put some money away to cover that last two months of rent because we will pull the trigger before our apartment lease expires. We’re also trying to anticipate moving expenses and other odds and ends.
I should note that we’ve been in the accumulation stage of our journey for 4 or 5 years now, so making these final plans feels surreal. My wife and I are beginning to experience a wonderful elation. Making these final course adjustments is challenging but also incredibly exciting. Entering FI by accumulating income generating assets and placing ourselves in a low COL situation has been a somewhat theoretical exercise. We have been trying to unlock different regions of a possibility space for years, but now it is all converging on something real. Now I look at the “PNW” green line in our possibility space charts and tell myself, holy shit, it’s coming together! We’re eager to enter this new chapter in our lives and all the wonderful adventures ahead of us.
*I think I may have mentioned this in previous journal entries, but our projected annual income from our IRA SEPPs will be approximately $4K. That should supplement our dividend income and push the total to about $21K/year, which should cover both our annual needs and our annual wants.
The wife and I are pulling the trigger sometime in August of this year. In the last dividend income update, I stated that I wanted to keep investing as much as possible after reaching our $16K/year goal, perhaps pushing it to $16.5K/year, but we’ve decided to take a slightly different approach. Since we are only a few months away from saying Adios to the fast lane, we’ve decided to channel the rest of our savings into bolstering our escape fund and making sure we have enough cash for other expenses that we’re anticipating this year. We’ve determined that a proper size for our escape fund is $20K, because that corresponds to about one year’s expenses* under the budget I outlined in post number 33. Among the expenses that we are expecting this year are three domestic trips and maybe one international trip to visit some family. In one of the domestic trips we will scope out the city we’ll move to and decide what sort of apartment is good for us. In addition to travel expenses, we need to put some money away to cover that last two months of rent because we will pull the trigger before our apartment lease expires. We’re also trying to anticipate moving expenses and other odds and ends.
I should note that we’ve been in the accumulation stage of our journey for 4 or 5 years now, so making these final plans feels surreal. My wife and I are beginning to experience a wonderful elation. Making these final course adjustments is challenging but also incredibly exciting. Entering FI by accumulating income generating assets and placing ourselves in a low COL situation has been a somewhat theoretical exercise. We have been trying to unlock different regions of a possibility space for years, but now it is all converging on something real. Now I look at the “PNW” green line in our possibility space charts and tell myself, holy shit, it’s coming together! We’re eager to enter this new chapter in our lives and all the wonderful adventures ahead of us.
*I think I may have mentioned this in previous journal entries, but our projected annual income from our IRA SEPPs will be approximately $4K. That should supplement our dividend income and push the total to about $21K/year, which should cover both our annual needs and our annual wants.
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saving-10-years
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Re: spoonman's Journal
From my experience its even more exciting when you get to the other side.... making these final plans feels surreal. My wife and I are beginning to experience a wonderful elation. Making these final course adjustments is challenging but also incredibly exciting.
Best of luck with these final adjustments. Get used to the feeling of elation (and surreallism). Congratulations - your story is one which I have followed with interest in the months I have been reading so carry on posting please.Re: spoonman's Journal
Wow! Very exciting!
Re: spoonman's Journal
$20k combined seems like a nice comfortable number for the two of you. And very doable! I was going to say that $16k sounds a little on the "pushing it" side compared to how you're used to living. Doable, sure, but there would he a lot of sacrifices I feel. I think ~$20k is almost perfect for two people.
Do you plan on reinvesting once pulling the plug or completely deplete the 4%? I find for myself it would be extremely hard to just stop investing. If I don't reinvest some of my profits it just feels wrong haha. Wondering about your thoughts on this.
Do you plan on reinvesting once pulling the plug or completely deplete the 4%? I find for myself it would be extremely hard to just stop investing. If I don't reinvest some of my profits it just feels wrong haha. Wondering about your thoughts on this.
Re: spoonman's Journal
You know, after investing for many years it will be difficult for us not to keep investing, but the truth is I don't think we'll reinvest any money. I would need to throw 25K into the portfolio to match the increase in income from the organic dividend growth. If I reinvest $500 or even $1000, the increase in annual income would only be around $40, so we're better off using that money to travel, visit family, go to concerts, and buy ice cream =).
If we make extra income from side gigs, then I would first max out an HSA account (if we have one), and then try to maybe max out a ROTH.
If we make extra income from side gigs, then I would first max out an HSA account (if we have one), and then try to maybe max out a ROTH.
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FI Fighter
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Re: spoonman's Journal
Exciting times indeed! Congrats on all the tremendous progress. I hope to pull the plug from corporate in the next year or so...
Time to slow down life and enjoy! Hope you have a blast!
Time to slow down life and enjoy! Hope you have a blast!
Re: spoonman's Journal
Thanks for swinging by, FIF!
You said it, it's time to slow down and enjoy things. I'm starting to gather a series of techniques and activities that help us "slow down" time. Hanging out at the beach is one of them!
You said it, it's time to slow down and enjoy things. I'm starting to gather a series of techniques and activities that help us "slow down" time. Hanging out at the beach is one of them!
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IlliniDave
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Re: spoonman's Journal
Sounds like you're in a great place. I like the idea of an "escape fund". My investment strategy is more on the total return side (sounds like yours is a dividend strategy) but either way, the cash/cash-like buffer is a nice transient absorber. Good luck slowing down time!! I am in pursuit of the same thing, I think, although I have never heard it expressed quite that way. The best thing I've found, even now while I'm still working, is to get in the habit of just checking in with my senses on a regular basis as a way to corral my mind and return it to where I am. There's a Zen saying, paraphrased: "When you sit, sit. When you sweep, sweep." that expresses that idea of mindfulness in the typical stark style they use. Not that I'm suggesting anyone spend all their time sitting or sweeping! I'm looking forward to hearing your journey as you complete the transition.
Re: spoonman's Journal
IlliniDave, I've been reading quite a bit about mindfulness lately and I am starting to practice some breathing exercises. I'm hoping to make mindfulness a more central part of my life in the coming months.
This week I've been trying to be more present while riding the bus, it has been a challenge to say the least!
This week I've been trying to be more present while riding the bus, it has been a challenge to say the least!
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IlliniDave
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Re: spoonman's Journal
For me it's been an impressive thing. I'm both a worrier and a reminisce-er, by habit if not by nature. Both have served me well in some ways, but if you overdo them you wander through life in sort of a fog. Life happens now. If your head is always stuck in the past or lost in the future, you can go through life and essentially miss most of it for not paying attention! I still have many lapses into my thinking-dominated mode, so it's a work in progress. I think a daily busride would be quite a challenge!spoonman wrote:IlliniDave, I've been reading quite a bit about mindfulness lately and I am starting to practice some breathing exercises. I'm hoping to make mindfulness a more central part of my life in the coming months.
This week I've been trying to be more present while riding the bus, it has been a challenge to say the least!
Re: spoonman's Journal
Me too!IlliniDave wrote:I'm both a worrier and a reminisce-er, by habit if not by nature.
I have the legendary ability to space out and live in the past, the future, or some other hypothetical reality. It has proven to be useful for ERE purposes, but I can get carried away as well. I'm happy to hear that mindfulness working out for you, I hope I can achieve the same results.
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Hankaroundtheworld
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Re: spoonman's Journal
I had to respond, as this is so typical me as well, and funny, my wife is the complete opposite, she can fully live in the "now" and enjoy it, and has actually problems looking into the future well enough, while I always look ahead (more than looking back), dreaming about the future. My sister told me abt mindfulness, and via another couple (that went ERE 5 years ago), meditation (breathing techniques, etc..), so a lot to learn to be in the "now"