Why I love concierge medicine

I had my physical done on Thursday, and came away with some new medications to try. Today, my doctor called with my lab results, even though there was nothing surprising on them. Then we discussed some additional thoughts I had on medications, and he offered to send me a new prescription. Maybe the most interesting thing, however, was that he expressed concern over how quickly my ankles have deteriorated recently and had done some research on the best specialist for me to see. The specialist he found is the foot/ankle consultant for the local NFL and MLB teams and a pioneer of new technologies and research in his area. I've never had a doctor be quite so conscientious about following up and following through.

Week 9 income/expense review

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

3/23/08-3/29/08

Income:
$1,156.83

Expenses:
$90.74

Total:
$1,606.09

Not too bad, all things considered. $15.00 went to transportation for my doctor's visit and work. $46.93 went to take care of my taxes (filing expenses and getting additional documents.) The remaining $28.81 went to medical expenses. Next week, being the first of the month, won't look nearly as good, since monthly expenses will come due.

Also, I received a $25 lending club referral bonus that went straight to funding a new loan. I have $100 invested over there now, and my first payments should start coming in next week.

How to climb up from the bottom or 6 months in review

6 months ago, I was at absolute rock bottom. I had no place to call my own, and the only roof over my head was at the mercy of a friend. I was pregnant, but I had to keep it hidden, and had no plans for what to do with my due date only four months away. I had no job, and consequently, not a single dime. I was in massive amounts of debt, but too scared to even take a look at my situation to figure out just how bad it was. I felt like I didn't even officially exist - no copy of my social security card or birth certificate, no photo ID or bank account.


I was seriously contemplating suicide; I had a plan and had even bought everything I would need to carry it out.


Now? I know that if I had to pick up and start all over, I'm in a position where I could do so. I can and will survive. I started by rectifying the paperwork problem. I went down and got my social security card. I had to have an attorney request my birth certificate, but I eventually got that. With that, I was able to take out a bank account. From there, I went and applied for jobs. I started with mostly administrative type positions - all those really require is a basic knowledge of computers. I was lucky with the job I found, but really, the primary consideration was getting some income. I house-sat for a month to save up a bit of money before moving into a basement apartment. This situation was ultimately untenable, but it was certainly better than nothing to start off.


That gave me the basics - food and shelter. Then I began evaluating the longer-term considerations. I made an adoption plan. Even though it ultimately turned out in ways I couldn't predict, I felt comforted knowing that there was a plan in place and that my child would have the best outcome I could give her. I pulled my credit reports to figure out how much I was in debt and started researching my options there. Ultimately, I hired a law firm to offer me some assistance. I started saving - having money stored away in an emergency fund made a lot of difference in my stress level.


Now I know that I'll never have to end up here. I'm making enough money to rent a place of my own, a place with a reputable management company and in a good neighborhood. I'm saving up enough money so that if I lost my job, I would have 2-3 months of living expenses put away, enough time to find a new job or obtain disability payments. I'm eliminating my old debt and not taking on any new debt for a while, and no unsecured debt at all.


I dug myself into a pretty deep hole. I was able to climb out of it, and now I'm working on filling it in so that I never end up there again.

Overall Financial Plans

You save for short-term goals and invest for long-term ones. It's a statement I read in a book review (but I can't seem to remember the actual book, otherwise I'd probably buy it) that has stuck with me.

Once I move and begin paying rent again, I'm going to have to pay quite a bit of attention to how I handle my money. I'm starting to think about how I want to allocate it as I begin to build up reserves and invesments while simultaneously paying down debt. These aren't necessarily goals in the SMART (specific, measurable, attainable, realistic and timely) sense. Instead, I'm trying to plan out an overall set of intentions for how to save and invest.

In order of priority:

1. Emergency Fund - $1,000. This will be my cash reserves in a high-interest savings account. I plan to keep this fund as a safety net for unplanned emergencies.

2. "Income" Investments - $3,000. This will be my second level safety net. This amount would enable me to get through 2 months of absolutely no income at all without much alteration. That would be enough time for me to find another job or obtain disability if there was a major disruption in my work status. I plan to keep this amount in an income or value index fund. I don't plan to need this, so I'll tolerate fluctuations in the value to get a better overall rate of return. I'll likely continue to invest a small amount ($50) in this fund per month after the initial investment.

3. "Growth" Investments - $?. Here's where I plan to keep the majority of my savings. This will be invested in a growth index fund. I intend to leave this in here for long-term purchases, such as a house, and as my general "building my net worth" account. Because I intend to keep this investment as a long-term solution, I can tolerate larger fluctuations in value for a greater expected rate of return. I'll need $3,000 to capitalize this fund with Vanguard initially, and then will continue to put as much as possible into this fund, but at least $100/month.

4. Savings. I'll use this account for my shorter term purchases that I need to save for, and things that may blur the line between needs and wants. I'll put $100 per month into a separate, high interest savings account and withdraw it as necessary to make purchases. Things such as furniture, a new computer, a new wardrobe, a new car, etc. will fall into this category.

2007 Taxes

I've finished up my 2007 taxes and put them in the mail today. I only began working in November, and I had very little income during that time. Between that and being single, my taxes should have been a quick, simple process. Unfortunately, because I had a child that died, they were much more complicated. I had to attach a copy of the certificate of live birth and subsequent death to the taxes, so I wasn't able to e-file. But between that and filing as head of household, my refund will be fairly significant this year. I'm expecting about $2,000 from federal/state refunds and another $600 from my stimulus check.

I expect my 2008 taxes to be fairly simple. I'll be filing as single, with (hopefully) only one W-2 to report. My liability or refund amount should be fairly small.

Carnival of Personal Finance

My post on Spending Control was accepted into this week's Carnival of Personal Finance, hosted at Million Dollar Journey. There were a lot of good posts this week that I found interesting and relevant to me.

• I've Paid For This Twice Already - How Small a Transaction Before Plastic Seems Absurd? Personally, I would use my debit card for absolutely everything if possible. There are two scenarios when it is difficult. First, I sometimes have to take cabs (and will continue to have to do so until I move again) and cab drivers are extremely reluctant to take them, though some will. Second, the cafe at my office only takes cash (a good incentive to take my lunch, I suppose) so if I want lunch, I have to pay cash. Sometimes this is enough of a motivation for me to just skip it entirely.
• Millionaire Mommy Next Door - Is the Perfect Financial Storm Brewing? I'm not really ready to make a call on whether the economy is going to be terrible for a while or for a long while - I think there will be a big shakeup in November of this year and the results of the election will have a large impact (not a total one, the economy doesn't respond all that quickly, but I do think it will shape the direction and length of the current state.) However, there is a point made in this article. Millionaire Mommy says that she isn't a buy and hold investor and so is playing defense. Personally, I am - I'd like to keep some "cash" on hand in an emergency savings fund, but given current interest rates, I'd prefer to put anything more than 2 months living expenses into something where I can look forward to better return rates over the long haul. I'm planning on building up my portfolio as much as possible while the downturn is occurring with an eye towards a few years down the road.
• Money Under 30 - Asset Allocation for Investors Under Thirty. I'm just starting to explore what I want to do with the money I save, so I'm enjoying reading all posts on allocation right now. Currently, I'm investing 50-50 in a "growth" fund and an "income" fund, with nothing held in bonds/ETFs. As I get more savings to do a lump sum investment at a place like Vanguard, I'll likely adjust this allocation to better reflect a long term strategy for my age (23.)
• The Honest Dollar - 11 Ways to Trigger an IRS Audit. I just finished up my taxes this year. They're fairly simple, but I did have one "flag" that was listed - I'll be claming the earned income credit (EIC.) I do have all the required documentation and I'm pretty clearly eligible, so I'm not worried.

One of the many reasons I like participating in carnivals is that they truly do make me think. I've gotten inspiration for two posts, one on my taxes from this year and one on my long term plans for my money. Look for those in the next few days.

Week 7 income/expense review

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

3/16/08-3/21/08

Income:

$0

Expenses:

$172.30

Total:

($172.30)

This looks like a big week for expenses, but there were some annual things that came due. $49.95 was spent on things related to my taxes (filing expenses, obtaining documents.) $24.00 went to utilities, renewing my telephone number for another 13 months. The remaining amount was discretionary. $58.36 was a combination political donation/clothing purchase. I needed a lightweight outer layer, which I bought from a political candidate. $39.99 was entertainment - I signed up for a fantasy baseball league which will run through the end of September. I think this is fairly good value for my dollar. There's also a possibility of winning $200, though I'm looking at it as a sunk cost and not counting on getting any monetary benefit.

Essentially, I spent about 17% of my bonus. The rest of it is going towards reducing debt and savings.

Next week, I'll be going to the doctor's office, so I'll have various additional transportation and medical expenses. I don't expect any other significant spending next week.

Good financial news

My consumer debt is down to just a touch over $23,000. One practice offered to zero out my balance and one of the hospitals believes they can get it through my insurance, so some of that debt is gone as well. My net worth should get a boost with those updates.

Spending control

I've found that blogging about my finances has really encouraged me to think about what I spend. It hasn't necessarily stopped me from spending money, in fact, this week (as you'll see,) I spent nearly $90 that wasn't required. But it wasn't idle spending or impulse purchases - I knew that I would be accountable twice over, once to myself when I entered the information in Quicken and once to the world at large when I did my weekly listing of expenses. I thought about the value to myself, not in monetary terms, but in personal satisfaction, and decided that they were worthy expenditures.

There are some people who simply don't have any money for discretionary purchases. But for the vast majority of us, we get into trouble because we spend money on things that don't truly matter to our lives. Happiness is worth spending money on, and sometimes I think personal finance bloggers forget this. However, if we don't stop to evaluate the happiness that will result from our spending, we keep buying more and more things that are meaningless and worthless.

I take away two lessons from the past 3 months.

First, tracking my expenses is fundamentally important. I track them both in Quicken and on my blog. In Quicken, I keep track of every single cent I have coming in or going out, and I do so daily. If I'm at the computer, where most of my expenses occur, I enter them immediately afterwards. If I'm not, I enter them that day. Some people find this tedious and painful - that pain should be telling you something. If you're feeling uncomfortable about your expenditures, you have to get control of them, because finances, more than anything else, cannot simply be ignored and wished away. I did it for nearly two years, and I truly hit rock bottom - no money in my pocket, no credit, no chance to obtain credit, no income, no savings, NOTHING. I went from being 21 years old with a $50k+/year job to nothing - a bit of discomfort felt while seeing expenses in black and white is worth not having to go through that. I use my blog to keep myself honest. If I have to post a weekly report, I can't just lie to myself and "forget" to keep track of my expenses.

Second, I've found that I can replace an urge to spend. Sometimes I go play with my financial outlook in Quicken. Quicken 2008, at least, has a home screen with a calendar showing expected available cash for every day. I've got my paycheck set up as expected income, so I can see my available cash growing and look forward to my net worth increasing. I don't like seeing it drop, so that's an incentive to not spend. If that's not enough, sometimes playing with my money can help. I set up an investment account. My personality is such that I'm not too worried about blips and dips in the stock market, so buying into index funds is similar to "shopping" for me - I'm purchasing something, but it's something that helps my future. Plus, it's fun to watch my investments. If you're the type who panics at the slightest drop in value, this probably isn't for you, but seeing an investment gain money for the first time ever sent a definite thrill through me.

I'll never cut out discretionary spending entirely for my life, and honestly, I'll never want to do so. But I want money to make my life better, and I'm thinking more about how to make that happen.

When reading blogs makes you feel bad...

I sometimes enjoy going through and reading nurses' blogs. But they always make me wonder how the nurses I've had felt about me. I try to be a good patient when I'm in the hospital. But after I gave birth, I felt like I was requesting something to drink every hour. And the big one - at one point, I lost control of my bladder on the bed. Actually, that's not entirely correct, I didn't have any control, and didn't notice it for a little while. But I felt insanely guilty and couldn't stop apologizing. Blogs have really enabled me to "walk a mile" though, and I hope it makes me a better patient (and person.)

Pain

Days like this are difficult. The pain is nearly blinding in it's intensity. These are the days that I try to avoid drinking much, so that I don't need to go to the bathroom...when I finally do need to go, I put it off as long as is humanly possible because it hurts so much to get up and walk the few feet to get there.

The idea of going to the ER for pain meds amuses me, in a dark sort of way. I'd much rather sit in a comfortable chair at home, trying not to scream from the pain, than sit in an uncomfortable chair in the ER trying not to scream from the pain, all for a few pills. I'm not sure any pills could touch this pain anyway, though I wouldn't mind something that could just knock me unconscious for a while. I'm sure my doctor would be happy to prescribe more medications, but the mere thought of the effort it would take to actually go into the office sends spasms through my body.

Week 6 income/expense review

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

3/9/08-3/15/08
Income:

$1,738.70

Expenses:

$29.95


Total:

$1,708.75


Pretty good week! I got paid and my bonus came through this week. My salary will increase by about $250/month. I'm going to take $100 of that and invest it in a mutual (index) fund. I know dollar cost averaging isn't the way to go in order to maximize profits, but I simply don't have the $3,000 lump sum to open up a Vanguard fund at the moment. I'll have a post on this once the account is verified. For my expenses, $2 went to dining, $13 to transportation, and $14.95 to a credit monitoring service - now that I'm actively watching my credit reports and trying to fix them, I need this service.

Bouncing off the walls

The past few weeks have been really stressful. Between the pain flareups and the corresponding drug mess, moving, being ill, and being busy at work, I've felt overwhelmed at times. Today in fact, I got a ton of stuff dumped on my plate and was a bit stretched.

However, the night got a lot better. One of the documents that came across my desk was a document from the #2 guy in my company. He made a point of sending me a note of praise for the work I did and CC'ed it to my boss. Then, I had my "performance review" as a spur of the moment phone call. Turns out it wasn't a performance review at all, but the president of my company calling to tell me that my boss and co-workers had spoken very highly of me, and he informed me that I'm getting a cash bonus (2% of my salary) and a 15% raise. Not too bad for 4 months on the job! He said I should see the raise on Friday's paycheck.

Plus, I'll be able to negotiate my salary upwards as I continue to take on more responsibilities within the company and continue to get promotions, but for right now, I couldn't be happier.

$45,000 worth of letters

I spent $2.05 on stamps, and $45,000 hangs in the balance because of it.

First, I sent a letter to my ex-landlord. This was my written notice of vacating the premises. The place I was renting violated the city code in a good two dozen different ways, the most notable of which was not keeping the apartment at 68 degrees or warmer at all times. I didn't even need a fridge in the place, anything left out would usually freeze and then stay frozen. But the final straw was when I showered before bed and woke up in the middle of the night with ice coating my hair. That was a terrifying experience. So that letter, and a subsequent complaint to the appropriate authorities could result in around $5,000 in refunds, damages, etc. What I asked for in the letter, however, was merely the return of my security deposit ($650) and the mail that she's holding hostage. If I don't have it by the 14th, then I'll file the complaint and take her to court.

Then I sent off letters and forms to the 5 different places wanting money for my daughter's treatment - two hospitals, two doctor bills (one for each hospital), and the emergency helicopter transport. Those added up to over $40,000. Now all I can do is wait on their replies.

Week 5 income/expense review

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

3/2/08-3/8/08

Income:
$27.20

Expenses:
$161.05

Total:
($133.85)

Even though I'm negative on the week, this was a pretty good week. The income came from interest from my online savings account ($1.97) and from online sources ($27.20). I'm going to endeavour to make an additional $25/month on top of my salary, so I'm off to a good start. None of my expenses were particularly discretionary. $45 went to transportation this week. $99 went to debt. $15 went to the MVA to get my photo ID, and $2.05 went to stamps. Next week, I'll get paid, and I'm not expecting any major expenses (transportation, medical, maybe a little on dining.) I'm also hoping that sometime this month I'll receive a raise and possibly a bonus.

Drug reactions

I've been taking my new prescriptions for a couple of weeks now. I'm not sure any of them are working out very well. I actually stopped taking Lyrica entirely - every time I take it, I get the hiccups for 5 or 6 hours, plus vomiting for 12 or so. Pretty bad side effects for a completely ineffective drug. The oxycontin does take the edge off the day to day pain (my Guitar Hero skills have improved on it!) but does very little, if anything, for the "breakthrough" pain. It hasn't had many side effects though, mostly just a little bit of itching. The trazadone...this one is weird. I'm supposed to be taking it for sleep, but it doesn't help me get to sleep. In fact, since I've been taking it, I've slept a lot worse. I get really, really sleepy, but can't actually descend all the way down into sleep, so I lie awake for several hours in a haze.

I'm going to try to get back into the doctor's office next week, so we'll see what his thoughts are.

Free money

I just received $25.00 free. I signed up with Revolution Money Exchange, a site that seems similar to PayPal, via a referral, and they credited my account with $25, no strings attached. If you'd like a referral (you receive $25, I get $10), send me an email from the account you want to sign up with and I'll send you a link.

Grand Rounds carnival

I was included in this week's Grand Rounds, hosted at chronicbabe. My post, "I'm not looking for drugs...really!" made it in.

I thought there were some good posts included this week. My favourites were about prescribing benzos and a post about couples dealing with one person's chronic pain.

My start with Lending Club

I took a chance and got started with Lending Club* last week. It's a peer-to-peer lending site similar to Prosper. I signed up and received a $25 bonus in my account and deposited $50 (money that I had acquired through various additional income sources) for a total of $75.95 (the $0.95 was a verification withdrawal.) This will allow me to fund 3 separate loans to experiment. I'm not investing any money that I can't afford to lose at this point, because it's risky, but I think this could be a good way to diversify investments, particularly before I'm able to invest in the stock market.

The process was quite simple. I signed up, verified my identity, and waited for the verification withdrawal from my bank account. A day later, I was able to deposit funds and received my $25 bonus. I manually chose the loans I wanted to fund (you have to deposit $500+ to create an automatic portfolio) and funded each with the minimum of $25. LendingClub allows you to view FICO scores, debt-to-income ratio, history of deliquencies, and number of credit lines to aid in making the decisions.

Currently, I have one loan that is actually funded, and 2 more in processing. One is a "B" rated loan, giving a 9.76% interest rate, and the other two are "E" rated, giving 14.18% interest rates.

All in all, giving out the money was a very easy and painless process. I expect my first payment to start coming in on April 1st. If this works out, I'll look at putting a total of $825 on the site over time, allowing me to reinvest the monthly payments into a new loan, making the entire thing self-sustaining.

*This is an affiliate link. If you sign up via that link, you'll get the $25 bonus, and $10 is deposited into my account.

March Goals

My goals for March:


Health

1. Get full physical and lab work done
2. Arrange to see specialist for my ankles

Financial

1. Have at least $3,500 in savings for move
2. Finish taxes

Debt

1. Finalize debt amounts and payment plans for medical bills
2. Begin working with debt agency regarding consumer debt

Week 4 income/expense review

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



2/24/08-3/1/08



Income:

$1023.37


Expenses:

$83.84


Total:

$939.53



I did well with my spending for this week. $51.84 went to medical expenses (prescriptions) and $30 went to transportation. $2 went to dining, my only discretionary expense this week.



Next week will be a bit up in the air, depending on how my apartment search goes. However, transportation and application fees should be my only major expense.

February 2008 review

My net worth as of Feb. 29th, 2008:

($63,051.34)

Assets:

Liquid assets: $2,210.02

Investments: $75.95

Total: $2,285.97



Liabilities:

Consumer Debt: $24,946.00

Hospital Bills: $40,391.31

Total: $65,337.31



My liquid assets increased by 68%, and my overall assets increased by 73%. My liabilities didn't change, however, I have made progress to negotiate debt reduction and payment plans regarding both my hospital bills and my consumer debt. I expect these to begin decreasing sharply over the next 2 months. Thus, my overall networth increased 1.5%



Monthly Income and Expenses:



Income:

Uncategorized: $3.56

Interest: $1.92

Salary: $3100.11

Total: $3105.59



Expenses:

Bank Charge: $4.00
Dining: $97.42
Entertainment: $35.00
Gifts: $10.00
Health & Fitness: $30.00
Household: $23.44
Medical: $1,157.43
Rent: $650.00
Transportation: $126.00
TO Lending Club: $50.95
Total: $2,184.24



Overall total: $889.43



I spent less than I earned this month, which is what I was aiming for. About 9% of my spending this month was purely discretionary. Over 50% was medical, that category should be drastically reduced next month. I'm not unhappy with the way the month went.