Friday, February 29, 2008

Financial Politics

Many sites have begun to discuss the 2008 election. Many of the posts I've read on financial sites seem to have a flawed understanding of the two major issues that will directly impact households and consumers - tax cuts and bailouts.

McCain's position on the Bush tax cuts is pretty simple - make them permanent (they're set to expire in 2010.) The two Democrats are inclined to let the income tax cut on those making over $200,000 per year expire. Obama offers a tax credit for working families, for homeowners, and an increase in childcare credits. The merits of the respective positions can be debated, but to argue that the Democrats want to increase taxes on the majority of middle class Americans is false.

"Bailout" is a fairly loaded word. Opponents argue that the government should stay out of things like the subprime mortgage scandal because market forces will correct for the problem. An analogy might be the easiest way I have to explain the two major problems I have with this argument.

Take a company that makes "milk." Now, this substance isn't actually milk, it's a combination of toxins that will probably make you sick. But they label it as milk and sell it for half the cost of true milk. An awful lot of people are going to start buying this. Market forces can't account for this decision making, as the people buying the "milk" aren't making a true cost-benefit calculation, since they don't know the true cost. Market forces tell us that companies will live and die on the strength and cost of their product, but the model falls apart when deception is introduced. So now we have a whole bunch of really sick people who drank the "milk." As word starts to get out and people are able to see through the deception, the "milk" company goes under, because no one wants to buy a product that will make them sick. Market forces have corrected, the price of true milk goes back to normal, and harmony is restored. Except for those sick people. Those people go back to not having any milk and are now sick to boot. Market forces have prevented new people from getting sick from the "milk," but have nothing to offer those already affected.

This is certainly a trivial analogy, but it is at least illustrative. One can go further with how market forces might over correct (for instance, consumers stop buying milk en masse, resulting in collapse of legitimate industries and skyrocketing price of milk, meaning only the wealthiest can have milk, etc.) None of this is to suggest that government regulation and assistance doesn't sometimes go too far, or is inefficient, or without it's own problems. But I see posts like this one from NCN and it strikes me that while personal responsibility is certainly something to be emphasized, sometimes it isn't enough.

February Goals - review

At the end of each month, I will go through and evaluate the progress I made on the goals I post at the beginning of the month.

For February:

Find a new doctor to help with pain
I met this goal. I found a doctor that I am pleased with and who will act as a case manager for all the specialists I will see. I expect this to be a long lasting relationship.

Save $1000 in an emergency savings fund in a high interest savings account
Save $1000 towards the purchase of a car in a high interest savings account
I met one of these goals and struck the other. I am no longer saving for a car; instead, I am saving to move to a nicer apartment that will eliminate the short term need for a car. I did fully fund an emergency savings fund that I am keeping at ING.
Submit all paperwork to hospitals and doctors to reduce bills and work out a payment plan
I just need to drop this paperwork in the mail.

Overall, I think this was a successful month in terms of achieving my goals. I am making financial progress and keeping things under control.

Wednesday, February 27, 2008

A pleasant phone call with a doctor

I started my new prescriptions on Monday night. Throughout the night and all day Tuesday, I was plagued with hiccups and couldn't keep anything down. I called my doctor on Tuesday afternoon, and it was the first time I can remember that I was immediately able to speak with the doctor instead of leaving a message. He seemed genuinely pleased that I was calling him to discuss something that had come up.

So yet again, I'm pleased with the way this has gone so far.

Tuesday, February 26, 2008

Carnival of Personal Finance

My post on reviewing my debt and planning how to get out of it was included in this week's Carnival of Personal Finance. Some of my favourite posts talked about savings during your 20s and a post about additional income streams (I'm thinking about doing a small amount of peer to peer lending at some point.)

Monday, February 25, 2008

The verdict on my new concierge doctor

I had my first medical appointment with the concierge doctor today. I have to say, I'm feeling very good about that expense. When I walked in, it was immediately clear that he remembered me, remembered our discussion, and had spent time before my appointment doing research on my condition. That impressed me a lot - not only did I see him for an hour, but he took his own time to make sure that the hour we had would be productive. He repeatedly emphasized that the treatment program would be *our* decisions, not just him passing down judgments from on high. I walked out feeling like he truly is interested in making a difference in my life, which is a great feeling to have.

He performed a physical exam (though not the annual physical covered by the program, we'll do that in a few weeks) and blood/urine labs. He sent me home with trazodone for sleep, lyrica and oxycontin for pain, and a handful of free samples of rozeram (a sleeping pill) to evaluate and use as needed. This isn't expected to be the final solution, but hopefully it will make for a good starting point. We also agreed to focus specifically on my jaws and ankles at the moment, as those are the two joints that are most affecting my quality of life (my jaws severely limit what and when I can eat, my ankles cause a lot of pretty bad falls.) He's going to look into what specialists I should see for those.

I don't think concierge medicine necessarily makes sense for everyone, but I think this was the right decision for me.

Sunday, February 24, 2008

Pain Scales

WhiteCoat Rants has a post discussing the 1-10 scale that doctors use to gauge a patient's pain. He discusses the different ways that doctors attempt to convey level 10 pain. Personally, I've found that patients need to be proactive as well in communicating what they mean with a specific number. Chronic pain is different from acute pain and individuals experience pain differently, so patients and doctors don't need to add miscommunication to the mix when treating pain. I tend to describe pain in terms of how it affects my daily life.

0 - no pain
1 - small, ignorable pain
2 - pain noticable when aggravated
3 - pain only noticable when I'm paying attention to it
4 - noticable pain, but I forget about it when I concentrate
5 - I fight to focus through the pain, but win
6 - I fight to focus through the pain, but begin to lose
7 - pain is the major focus, but I can accomplish things with effort
8 - Accomplishing basic tasks becomes difficult (i.e., going to the bathroom)
9 - unable to perform basic tasks without major problems
10 - unable to do anything, entirely consumed by pain

Many of the commenters referred to a "10" pain as being labor/childbirth without anesthesia...I had back labor with no medication whatsoever, and it would be a real choice for me to decide whether to undergo that again or to suffer my current level of pain. Chronic and acute pains are very different.

I haven't been below a 4 in over a decade, but my goal in seeing doctors is to have 4 be my day-to-day average.

Week 3 income/expense review

Every week, I'll be posting my expenses and income for review and analysis.





I didn't get paid this week, and brought in no extra income. The vast majority of my expenses this week came from a $375 payment for my enrollment in a concierge medicine service; this will be a quarterly expense. $22.00 went to transportation and the remaining $10 was a donation to a political candidate. I'm going to focus on trying to save as much as possible between now and my planned move date of April 15th, so my goal for next week is to spend no more than $20 on all categories except transportation and medical.

A change in circumstances

I posted a while ago about the lack of heat in my basement apartment. The good thing about the apartment was that it's $650 a month. The bad part is...everything else. It's cold, which is really having a negative affect on my health, and it's cold even when the heat is on. It's full of other people's stuff. I have no privacy, which stirs up my anxiety. I have no true kitchen, just a refridgerator and microwave, so I can't do much about reducing my grocery or dining expenses. Going anywhere, even just to work, takes 2 hours one way.

So the plan is for me to move back in with friends for a couple of months and then move into an apartment. I found a really nice apartment complex...the rent is nearly twice as much, which I'm not looking forward to, but it's better in every other way. This will be a major expense and will certainly increase my monthly expenses (increase in rent, utilities, and insurance, though I'll be able to decrease dining, transportation, and grocery expenses.) Because I'm moving much closer to a metro stop, my commute will be significantly reduced (to about 30 minutes, max) and so I'm going to postpone buying a car. For the next couple of months, since I'll be living with friends, I'll be able to put the money I would have used on rent and groceries towards saving up for the move. I'll also be getting some increases to my income - a raise, possibly a bonus, and the tax rebate check. All of these should help to blunt the financial impact.

Thursday, February 21, 2008

Doctor shopping, of sorts

Yesterday I had an "interview" meeting with a new doctor. This doctor is affiliated with the concierge medicine trend. Essentially, I would pay $1500 annually, and, in turn, I see a doctor who is limited to 600 patients (down from the 2,800 he had before) with 24 hour, 7 day a week accessibility. Plus, he would manage my care across all specialists, which, when you have a chronic disease, is something incredibly valuable. They also include a detailed physical, full lab work, etc., but I'm not placing a priority on that.

I arrived around 1:45 pm for a 2 pm appointment and was immediately taken from the public waiting room to a private waiting room. The doctor came in right on time (a first!) and we spoke for about 45 minutes. I really liked him, surprisingly enough. He's not inclined recommend homeopathic medicine, he understands that patients don't particularly want to feel like a freak show, to be paraded around for everyone's interest, and is interested in establishing a long term relationship with a two way street of communication.

Long story short, I think I'm going to sign up. It's an expense I didn't particularly want, but one that I think will make a huge difference in the quality of my life.

Tuesday, February 19, 2008

Additional income sources

Every personal finance blog out there says the same thing - spend less than you earn. The two ways to do that are to reduce expenses and increase income. I'm attempting to do both. The reviews of my spending that I post here are helping me to identify areas where I can cut back, and I already watch several (groceries, entertainment expenses, etc.) I'm also attempting to increase my income. My upcoming promotion should help that. Additionally, here are some other thoughts I have.

The mint contest - if I could win, that would provide $5000 directly towards paying off my debt.

FusionCash - I try to complete offers from here every so often. The link is a referral link, for every person that signs up, I receive $1 when they confirm their email address, $2 when they complete an offer, and $5 when they cash out. I've gotten a $25 check from them once already.

ING referrals - If anyone is looking to open a high interest, online only savings or checking account with at least $250, contact me and I'll send you a link. The offer gives you a $25 bonus in your account, and I get $10 for each referral. I signed up through a referral link for my emergency savings fund.

I'm always trying to increase my income, even if just by a little bit per month. Every little bit helps.

Some good job-related news

I've been working at my job since the middle of November. Our annual performance reviews are coming up, and due to the way my company handles the bonus/raise system, they wanted to go ahead and get me on the schedule, even though I've only been there a few months.

While I'd normally be a little worried by the prospect of a performance review, this time around I'm pretty confident. I sent an email to my boss mentioning that I'd like to learn more about a different job within the company. We had a meeting, and I'll be getting a promotion and moving down that career path. It should bring along additional responsibilities and additional compensation, plus it will provide me with some good skills to add to my resume.

Monday, February 18, 2008

Week 2 income/expense review

Every week, I'll be posting my expenses and income for review and analysis.








The expenses came from:

  • $30 on personal

  • $150.53 on medical

  • $39.00 on transportation

  • $17 on dining

  • $4.50 in fees

The personal expense was getting my brows waxed. Pricy, but it's a once a year expense that makes me pretty happy. Transportation was about twice as much as usual this week, but I went to see Barack Obama speak, which was worth it. The medical was just payment for my ob/gyn visits that wasn't covered by insurance. So if I exclude that expense, I met my spending goal for the week and then some.

Friday, February 15, 2008

Debt Review and Plan

My debt breaks down into two categories.

I have $24,946.00 in charged off debt from a couple of years ago. I need to pay it off, but for now, it's not the highest priority. I'm not sure where 20% of this debt came from, my suspicion is that it's a duplicate listing. I'll be sending a letter to find out where that came from. More than half the rest came from my losing my apartment and car when I had the major medical problems. The remaining portion is from credit card debt, some of which I accumulated from standard consumer purchases (I did spend somewhat frivolously) and some from trying to pay medical bills that insurance didn't cover. All totaled, there are between 8-9 oustanding accounts (depending on the one I'm unsure of the origin.)

I also have $40,391.31 in hospital/medical bills from medical care given to my daughter (I have insurance, but it doesn't cover dependents, the adoptive parents would have done so if she had survived.)

My goal is to be completely debt free by 9/5/2014. I don't think it will necessarily take that long, but I want to enter my 30s without debt.

So how am I getting there? First, I am contacting all the hospitals and doctors about the medical bills. They have all sent me forms that I am filling out to request assistance, reductions, and payment plans. I am also including a letter explaining my situation. Second, I will verify and validate all the consumer debt - confirm how much I owe and to whom. This will allow me to form a completely accurate and up to date calculation of what I owe. Third, I will begin putting at least $500 to paying off debt every month starting in March. I expect to be able to pay off 4 of the 8 or 9 consumer debt accounts within 2 months. I am hoping between working with the hospitals and paying off those small debts, I will reduce my debt to $30,000.

Thursday, February 14, 2008

Some health thoughts

WhiteCoat Rants was kind enough to link back to my site based on a comment I made on one of his posts. It's refreshing to see doctors like him, ones who sincerely care about their patients and do what they can to respond to their patients' concerns, even when they have nagging doubts. Between that and the comments on my last post, I'm not giving up on my search for a doctor just yet.

So with that bit of inspiration, today I set up an "interview" of sorts set up for a new doctor for next Wednesday. He's part of the "concierge" medicine trend, where I'll pay an annual fee but get 24 hour access for him to essentially manage my entire care. The initial meeting will be free, and won't be a diagnostic or treatment session, but will hopefully allow me to explain my condition, what I'm hoping for in terms of treatment, and see if this is an appropriate choice. $1,500/year is quite a bit, but I'm rather desperate at this point. If he turns out the way the last appointment turned out, at least I won't have spent any money for it.

Monday, February 11, 2008

I'm not looking for drugs, really!

I'm not a good patient. I know this. I have an insanely rare, genetic, congential disorder. It's not curable. It brings along a whole host of secondary conditions, most of them degenerative. I have chronic pain. I'm young enough that joint replacement surgery is a bad idea, I've got enough problems that surgery is it's own problem, and yet my joints are mostly destroyed. But still, finding a doctor shouldn't be this hard.

I stopped seeing doctors regularly about a year and a half ago. I was frustrated, depressed, and they weren't helping, so I just stopped going. Then I got pregnant, and I went to my ob/gyn for that, but wasn't doing anything for my own problems. But now I'm finding that I won't be able to continue to function if I don't take care of my own health, so I'm in the market for a doctor who can help me manage my joint issues, my chronic pain, and whatever else happens to pop up.

I'm finding though that doctors are falling into one of three camps. The first won't see me because I'm too complicated. The second only wants to prescribe the drug du jour, regardless of it's efficacy. The third kind assumes I'm just a drug seeker because I'm in pain and would like to manage that pain.

I don't have unrealistic expectations. I don't expect to be pain free. I haven't been pain free since I was 12, I wouldn't know what it felt like. But I don't think I fit the profile of a drug seeker - I've not taken any prescription drugs in over a year, I voluntarily quit methadone and oxycontin because of the side effects, I've never gone doctor shopping to get more drugs, etc.

Beyond all that, though, my experience is that people who will decide that I'm drug-seeking before ever meeting me demonstrate a worse problem. In my last visit, the doctor informs me the minute I walk in that she doesn't believe in drugs for pain. I'm fine with that, if she can offer me non-pharmacological relief, that's fantastic. She repeats this several times throughout the visit. At the end of it...she writes me out two prescriptions. One is for an extremely mild narcotic, one is for a drug that won't address my real problem and is a drug I've already taken before and had a bad reaction to (and I discussed this with her!) So for all her self-congratulating speech on not using drugs for pain, her only solution is for drugs that won't do anything for me. Great. I paid $495 for that visit. I didn't even bother to fill the prescriptions.

I have an appointment with another doctor on the 13th. Maybe eventually I'll find one. In the meantime, I'll take those prescription forms to the new offices, invite them to call the prescribing doctor, and hope they'll believe that I'm not looking for more pills. I just want help.

Sunday, February 10, 2008

Debt versus Pain

Dealing with chronic pain is an area that seeps over into all aspects of my life. Tonight, my living arrangements are the problem. I'm renting a basement in a townhouse. It's $650 a month and right on the bus stop, which is about 2/3s the cost of what everything else in the area is. The problem is that my landlord doesn't like keeping the heat on. I've talked to her and asked her to do so, but she turns it off except for a couple of hours in the evening. It's 25 degrees outside and the cold is killing me. I have circulatory issues, so my fingers are currently blue and numb (typing is an experience when you can't feel your hands!) and my joints are on fire.

I don't know that I can afford to move, or that I could find a place that would rent to me if I did do so. But I don't know that I can continue staying here.

Mint Contest entry

Mint, an online financial site similar to Quicken is holding a contest, inviting entrants to submit a video or story about getting into debt. The winners will get $5000 towards paying off their debt. My entry is here:

Saturday, February 9, 2008

Week 1 income/expense review

Every week, I'll be posting my expenses and income for review and analysis. Since this is the first week, I'm doing a little bit of an extension to capture the first of the month.





Obviously not the best week. Where did the money go?
  • $650 to rent
  • $88.42 to dining
  • $35 to entertainment
  • $23.43 to household
  • $35 to transportation
  • $580.06 to medical

$161.85, or 11.5% of this week's spending was purely discretionary. I went out twice. Had I not done that, I would have saved $85 the first night and $43 the second night. The first night was a planned expense, I had not gone out in several months, and I wanted to do something nice for a friend as a thank you, so I combined those two choices. The second night was unplanned, but it was work related and semi-obligatory. I also bought a headset (the household expense) to use with my VOIP service. While technically this wasn't a required expense, using my computer to make phone calls will be significantly cheaper in the long run than using my prepaid cell phone.

$670 (47.7%) was mandatory, $650 in monthly rent, and $20 in transportation costs to get to and from work.

The rest, entirely consumed by medical expenses, were for lab tests, X-Rays, and one doctor's visit. Depending on how my insurance company evaluates my deductable, I may receive $396 of that back. I'm not counting on it, however.

So looking ahead to next week, I will be paid again on the 15th, and should not have the vast majority of these expenses. I will have some transportation costs and some dining costs. However, I intend to try to keep my spending to under $100 for the week.

Tuesday, February 5, 2008

A background, part II

I was due to give birth on January 19th.

2 days before Christmas, I noticed that the contractions I had been feeling were stronger and slightly painful. They were irregular though, and subsided after a few hours.

3 days after Christmas, I woke up around 3 AM to go to the bathroom. It was a weird, painful sort of experience, but I didn't think too much of it - pregnancy had been full of weird, painful experiences, so I went back to bed. Around 7:30 AM, I woke up with painful contractions. They were extremely irregular, but fairly strong, so I had a feeling that I wasn't going to make it to my due date. I decided to start getting things ready while I waited for them to come a bit faster and more regularly.

An hour and a half later, I found myself on my hands and knees, calling 911. The contractions were still irregular, but they were extremely painful, and all of the sudden I could feel the baby trying to crown. 10 minutes later, I was being raced to the hospital. My daughter was born as we pulled into the emergency room. The entire process had taken less than two hours.

I was raced into the ER, while they took my daughter up to the NICU. I was in shock, bleeding badly, and surrounded by a whirlwind of activity. I could only get that my daughter was alive, but wasn't doing well, and they weren't sure why.

A few hours later, they had me stable and in a room when I found out more. My daughter was doing very badly - her blood was too acidic, and it was destroying her from the inside. The doctors did everything they could, including flying her to a nearby hospital and trying an experimental treatment. After only 6 short hours of life, they asked me to make the decision to stop treatment. She died only a few minutes afterwards.

Sunday, February 3, 2008

A background, part I

I've often started and abandoned blogs, for one reason or another. However, I am determined to get out of the hole I've found myself in, and a place to write about my progress and my setbacks will help hold me accountable to myself. Plus, maybe some others will find this useful.

So what is this hole? 2 years ago, I had a nice apartment, a new car, a good job, and was doing fine. Then I started having health setbacks - fatigue, chronic pain, organ damage. At one point, I slipped into a coma for three days. I lost my job and sank into a deep depression that spiraled out of control fairly quickly. I ended up losing my car and my apartment. I stopped getting medical treatment. I cut off all contact with the outside world, except for living on a friend's couch. I stopped paying my bills, leaving me with $16,000 in debt that ended up going to collection agencies.

For the next year, I lived in sort of a fog, depressed and afraid of both dying and living; most days I wouldn't even get out of bed. When I thought things couldn't get any worse, they did. I was raped by a stranger. I thought I could just ignore it and pretend it never happened.

Unfortunately, that wasn't possible. 4 months later, I discovered that I was pregnant. I looked into abortion, but I was too far along for any doctors around my area to perform the procedure. I had no idea what to do. I spent the next 3 months trying to pretend that nothing was wrong, that I could just go on as before. Finally though, I sat down and took a long look at myself and my life and decided that I wasn't going to just wait around to die any longer.

So I got a job. I moved off of my friend's couch and into my own apartment. I researched placing my child for adoption, selected a family, and completed all of the paperwork. I was well on my way, I thought.

Friday, February 1, 2008

February Goals

My goals for February:


  1. Find a new doctor to help with pain


  1. Save $1000 in an emergency savings fund in a high interest savings account
  2. Save $1000 towards the purchase of a car in a high interest savings account


  1. Submit all paperwork to hospitals and doctors to reduce bills and work out a payment plan

January 2008 review

My net worth as of Jan. 31st, 2008:


Liquid Assets: $1,318.67
Other: $0
Total: $1,318.67

Consumer Debt: $24,946.00
Hospital Bills: $40,391.31*
Total: $65,337.31

*I am negotiating with the various doctors and hospitals to try to reduce the hospital bills amount.

Obviously, the net worth looks pretty bad, and it is. I took a big hit at the end of December with the hospital bills.

Monthly Income and Expenses:
Uncategorized: $0.50
Interest: $0.40
Other: $25.00
Salary: $1701.61
Total: $1717.51


Bank Charge: $4.50
Debt Repayment: $825.00
Dining: $51.11
Groceries: $178.79
Household: $9.15
Misc: $15.00
Rent: $1300.00
Transportation: $78.25
Utilities: $36.00
Total: $2497.80

Overall Total: -$780.29

Looking at it, it appears that I spent more than I earned, as well. However, it's not as bad as it looks. My paycheck for the first half of January was incorrect, about $350 short. $650 of the rent bill is actually a security deposit, and that's a one time expense that I will eventually recoup. Factoring in those two issues, I spent less than I earned.

$14.50 of my expenses came from poor decision-making on my part, I lost $10 and didn't plan ahead and had to go to the ATM at my office, which is from another bank, resulting in the $4.50 bank charge. The $825 debt repayment was a personal loan from before I had my bank account set up, so that reflects expenses occurred in a prior month. I spent quite a bit on groceries, but a lot of that came from having to buy several things to get settled into my apartment. Those won't be regular expenses, and I'll be looking to keep my grocery bill around $100/month.