Health and Health Care
Health care spending accounts for 17 cents out of every dollar in our economy and it’s not slowing down anytime soon. We have an unfortunate system where there’s almost no transparency in pricing, so the one thing you usually can’t find out is what a doctor will charge for a given service.
But the promise of consumer-driven health care is coming. In this chapter, I’ll show you how to get the most for your money—whether it’s negotiating a bill, getting coverage when you have a preexisting condition, or finding the cheapest prices on expensive prescription medications.
SAVE MONEY ON PRESCRIPTIONS
Get free or discounted prescription drugs
Did you know that one in three prescriptions sits unfilled? People will go to their doctor, get the script, and even drop it off at the pharmacy. But when they’re told what the final cost will be, they let it just sit. Meanwhile, their condition can get worse, especially if they have a chronic illness.
A couple of years ago, my allergist wrote me a prescription for a sinus infection that contained ten pills at a total cost of $110. That was $11 a pill. After the pharmacist told me the total cost, I nearly needed to visit the emergency room because I fell down and hit my head!
When I saw my allergist again, I asked her about the expensive script. She explained that doctors have no idea what medications actually cost.
So what can you do to protect yourself from the high costs of medication? Shop retailers like Walmart and Target, which offer a wide range of generic drugs for $4 per month or $10 for a three-month supply. A popular southeastern grocer, Publix, and a northeastern supermarket chain, Wegmans, even offer fourteen-day supplies of select antibiotics for free!
When you’re at any of these stores, I suggest you grab a brochure detailing the discounted drugs (or print it out online). Then take it with you when you go to the doctor and ask if anything on the $4 list will work for your ailment. There might be a good reason why a $4 prescription won’t work for you. But if it will, why spend more?
My sister is a pharmacist and she taught me about prescription co-pay assistance cards that are available directly from the pharmaceutical companies.
I was seeing four specialists who all loved to pull out their prescription pads. But with these discount cards, my co-pay on my monthly meds went from $260 a month to $2.57.
When a generic drug isn’t available, check the medicine’s website for a co-pay coupon or ask your doctor because the drug reps usually give them to them. You can sign up online or by calling. It’s free, and you just show the card to the pharmacy.
I started by going to the website for each of my brand name prescriptions. With one, I completed an online form, and a savings card popped up for me to print.
Whenever I’m given a new prescription, I ask the doctor if they have a savings card for the drug. If they don’t, a quick Internet search tells me if (1) a generic is available, (2) if a savings card is available for the brand name drug, and (3) the approximate cost of the drug. If my final out-of-pocket cost is too much, I ask my doctor for a different prescription. The discount cards work with insurance and are usually available regardless of income. Other programs are available if you lose your job, insurance, or have low income.
Sarah E.H., TX
Cut pills in half and disregard expiration dates
If you know that expiration dates on drugs are really just conservative estimates of their shelf lives, you’ll save a lot of money in the drug market. Some twenty-five years ago, the military and the U.S. Food and Drug Administration (FDA) conducted an experiment and found that many expired drugs were still effective. The savings to the military as a result of not having to destroy and replace expired drug stocks was immense.
For example, the FDA found that Valium, Dilantin, and the antibiotics tetracycline and penicillin were all potent a full two years past their stated expiration date.
The Wall Street Journal, meanwhile, once reported that Bayer aspirin can be used effectively for four years, despite the manufacturer’s printing a two- or three-year expiration date on the bottles. Of course, I’d prefer that you buy a generic brand of aspirin to begin with instead of a name brand, but you get the idea!
According to what I’ve read, some medications used up to five years after their expiration dates retain 90 percent of their potency. Consult with your doctor if you’re in question. I want you to save money in the drug market and do it safely.
Another suggestion I have is to ask your doctor if your medication is cheaper in a higher-milligram dose and have them write the prescription accordingly. Then cut the tablet as needed for your proper dose.
For example, pill prescriptions that are 10 mg or 20 mg generally cost the same amount. So if you have a 10 mg prescription, you can instantly cut your drug costs if you purchase the 20 mg pills and chop them in half. It’s like getting twice the bang for your buck. Some drugstores even have devices that will split the pill in half.
Together Rx Access card offers 25 to 40 percent discount
Since the middle of the last decade, several pharmaceutical companies have been offering a prescription savings program called the Together Rx Access card. You get a card that can save you between 25 and 40 percent if you have no other prescription-related discounts.
To be eligible, you must be under sixty-five and receive no prescription drug coverage from the government or an employer. Some income limitations do apply. If you’re single, you must make less than $45,000. If there are two people in your family, it moves up to $60,000. Add $15,000 for each additional household member up to eight people. As a side note, Arkansas and Hawaii are the only states with slightly higher income limitations.
Simply visit TogetherRxAccess.com to enroll or call 1-800-444-4106 for more information.
If you’re eligible, don’t assume the price is always the best in the marketplace. I also want you to check at whichever of the three warehouse clubs—Costco, BJ’s, and Sam’s Club—is convenient for you. You don’t have to have a membership to get prescriptions from these places. And remember that you can get many common prescriptions for $4 or even free from retailers and supermarket chains. (See “Get Free or Discounted Prescription Drugs” on page 103.)
GET THE MOST FOR YOUR HEALTH CARE DOLLAR
Negotiate the price for nonemergency medical care
We often hear about people who are uninsured, but we don’t hear about people who are underinsured. A lot of people have coverage, but it may be only minimal for some procedures. Figuring out what’s covered and what’s not is like reading hieroglyphics.
SmartMoney magazine says consumers can really benefit by negotiating up front for nonemergency care. The classic example of this is an uninsured pregnancy. The list price can be as much as 900 percent (!) above what an insurance company can negotiate. The key is to negotiate beforehand; after the fact, you’ll have no recourse.
Consumers need to know that the price difference from hospital to hospital is all over the map. So my advice is negotiate, negotiate, negotiate. About two-thirds of people who haggle do get a lower price.
Whenever I give this advice on air, a lot of medical professionals get hot under the collar. They often allege that I’m turning medicine into Walmart. But they need to understand that health care is the only thing we buy that we don’t know the cost of until after service is rendered. Doctors also need to know that a customer with a cash payment represents more money in their pocket than a negotiated insurance claim.
Use a nurse-in-a-box retail clinic instead of the ER
One of the most expensive places to get medical care is in the hospital emergency room. There’s a much better alternative if you need medical care when your doctor’s office isn’t open.
“Nurse-in-a-box” facilities, which are typically located in drugstores, discount stores, or supermarkets, offer the services of a nurse practitioner who administers basic medical care. They can be a great, cheap alternative to waiting forever in the emergency room. Customers love these kinds of “store within a store” operations because they’re open seven days a week for extended hours.
But what’s the quality of care you receive at a nurse-in-a-box facility? It’s actually very good. The September 2009 issue of the Annals of Internal Medicine published a study that examined the cost and quality of the care that people who had three common illnesses—otitis media (middle-ear infection), pharyngitis (sore throat), and urinary tract infection—received at a doctor’s office, at an urgent-care center, and in an emergency room at a hospital.
The study was done by a team of PhDs and MDs from the University of Pittsburgh working in conjunction with two health-related research foundations, and the results didn’t surprise me.
“Overall costs of care for episodes initiated at retail clinics were substantially lower than those of matched episodes initiated at physician offices, urgent care centers and emergency departments. ($110 versus $166, $156, and $570, respectively),” the journal reports.
And then there’s this conclusion from the study’s authors: “Retail clinics provide less costly treatment than physician offices or urgent care centers for three common illnesses, with no apparent adverse effect on quality of care or delivery of preventive care.”
That last phrase—“with no apparent adverse effect on quality of care or delivery of preventive care”—tells me everything I need to know!
My daughter is away at college earning a degree in drama, and if you don’t know anything about drama majors, let me just say, they tend to be a little . . . well, dramatic. So when she called on a Friday to say she fell and hurt her foot, I gave her the parental pep talk and told her she’d be fine.
Then she called on Saturday. Her foot is killing her but she’s too busy with rehearsals to go to the local urgent care center.
Finally, on Sunday night, after the urgent care center closed, she said she thought she should go to the emergency room.
An emergency room on a Sunday night? After a weekend of rehearsals? I had visions of huge hospital bills. Knowing my daughter’s flair for drama (and most importantly knowing that at the urgent care center I’d only be out a co-pay of $35) I told her to hang on one more day. Emergency rooms are for people with broken bones, not bruised feet.
So she waited. Then she called on Monday. She has a broken foot. She also has a story she’ll never let me forget about her cheapskate mother. Yes, I’m a little embarrassed, but when I think about the cost of an emergency room visit (easily $1,000) I figure I will happily pay the price of one more “cheap mom” story!
Patti D., KS
Read user reviews of doctors online
We hear a lot about “consumer-driven health care” these days. But what does that really mean? One facet involves consumers helping each other out by putting up user-generated reviews of doctors or medical facilities that allow you to make an educated decision about your health care.
RateMDs.com is one of the most popular sites for doctor reviews. It allows customers to rate doctors based on the friendliness of their staff, punctuality of appointment time, helpfulness, and knowledge. I think it’s especially important to vet a potential doctor whenever you get a referral to a specialist. That’s where a site like RateMDs can come in handy.
Because there’s almost no transparency in medicine today, the one thing you usually can’t find out online is what a doctor will charge for a given service. That’s why I prefer nurse-in-a-box facilities, where all the prices are clearly disclosed. But I digress.
Some doctors who have a bad bedside manner are getting their feelings hurt because patients are acting like any normal consumer and rating them in cyberspace. Recently, a San Francisco man who posted a negative review of a chiropractor on Yelp.com was sued after claiming the doc cheats insurance companies. That case was quietly settled out of court just days later, according to the San Francisco Chronicle. It’s important to note that Yelp is a user-review site that’s not specifically geared toward the medical field.
So far we haven’t seen enough litigation to create any chilling effect on user-generated reviews of doctors online. If you’re reviewing a doctor online, remember to stick to the truth and not jump to crazy conclusions.
Take advantage of health care advocates
Navigating the health care maze can be an exhausting process if you or your family members are sick. Employers are starting to understand this and make health care advocates available to their employees as a free benefit.
Health care advocates are usually former medical professionals who help people get what they need from the medical system. Right now about three thousand employers offer health care advocate access. But very few workers even know they’re entitled to such a benefit. Check with your insurer to see if one is available to you.
I think of the health care advocacy phenomenon like I do expeditors. When you live in a city, sometimes you can hire an expeditor who knows the right people to contact to expedite any request. In the same way, health care advocates can assist you in getting to doctors and certain facilities that you might not be able to get to on your own.
Of course, it goes without saying that health care should not be this difficult. Yet that’s the reality.
Set up a health savings account
Health care in the United States is outrageously expensive, as you well know. The problem started in the 1960s when companies offered to provide health coverage in lieu of pay raises and other benefits. That’s when people began not caring what health care cost because they weren’t paying for it themselves. The whole thing has been upside down and backward ever since.
Well, fast-forward to today and there is a possible solution. As a key part of consumer-driven health care, health savings accounts (HSAs) allow people to squirrel away money tax-free in interest-bearing accounts for qualified current and future medical expenses.
HSAs work in conjunction with high-deductible health plans. A high-deductible health plan offers rock-bottom premiums, but you typically have to pay a minimum of the first $1,200 out of pocket for an individual or $2,400 for a family. You essentially act as your own insurer, paying minor expenses until you have met your deductible.
In practice, that means you are the one bankrolling a doctor’s visit for the sniffles or an annual checkup. The money in your account that you don’t use over time grows with interest and can be tapped for future health expenses or moved into an investment account for retirement. In that sense, it’s different than a flexible-spending account because there’s no “use it or lose it” deadline to beat every year.
If you see the doctor frequently, an HSA is probably not a good idea for you. But if you don’t, you can end up with a big pile of cash that grows with interest if you remain fairly healthy.
Individuals looking for HSAs and companies looking to start HSA enrollment for their employees can get quotes and other info online at HSAFinder.com and HSAAdministrators.info. Be particularly wary of any bank that wants to charge exorbitant fees to open an HSA. I heard of one that wanted to charge an annual fee of $235!
There are some people who don’t like HSAs, of course. They think all of the money is being funneled to the healthy and rich. But it’s better than our current system. Of all the economic output in the United States, 17 cents of every dollar goes to health care. That’s about 50 percent higher in than any other developed country. We are basically sapping our nation’s economic growth with the enormous amount of money going to health care.
DEALING WITH INSURANCE ISSUES
Get price quotes from area doctors when battling your insurer
For more than twenty years, I’ve been receiving calls from people who are in dispute with their health insurers about “usual and customary” charges. This is a tactic used by insurers to shift costs away from themselves and onto consumers.
Say, for example, an out-of-network doctor bills your insurer $100 for a procedure. Typically the insurer might cover 80 percent and you would pay 20 percent after meeting a deductible. But using the guise of usual and customary charges, the insurer goes back to the doctor and says it’s only reasonable for the doctor to have charged $50 for the procedure.
Well, the bill is still $100 despite what the insurer says. But now the insurer is paying only $40 (80 percent of $50) and you get stuck picking up the remaining $60 tab.
In a massive conflict of interest, insurers were using an internal database to calculate what level of reimbursement they would give out-of-network providers for usual and customary charges. At the end of the last decade, a settlement between the attorney general of New York and UnitedHealth Group Inc., which owned the database, changed all that.
When brought to task by the attorney general, UnitedHealth admitted no wrongdoing whatsoever. But under the terms of the settlement, UnitedHealth will pay $50 million to a nonprofit group to build, own, and operate a more transparent database.
If you’re locked in an ongoing dispute with your insurer, I advise the following: Go to other doctors in your area and ask them what they charge for the procedure in question. This will give you a consensus to show your insurer that the charge should be closer to what your doctor says instead of what your insurer says—and that gives you leverage to negotiate.
Remember, though, that prevention is the best medicine. You can completely avoid the hassle of usual and customary charges by using in-network providers only. They’ve already set negotiated rates in place.
Monitor your health credit report
Almost everyone knows that you have a credit report that monitors the health of your finances. But do you know you have a “health credit report” that insurers check when deciding whether or not to take you on as a new customer?
In the era of electronic medical records, Ingenix and Milliman are a couple of large organizations that make billions of dollars compiling information about prescriptions on an estimated 200 million Americans and selling that information to insurers. Ingenix even crunches a “pharmacy risk score” on you to tell insurers the risk level you pose as a potential customer.
Both of these companies obtain their information from pharmacy benefits managers (PBMs), which are third parties that administer prescriptions through free-market insurance, Medicare Part D, and the Federal Employees Health Benefits Program. PBMs are a very popular option because they offer cheaper prices when you get your drugs online or through the mail instead of at a retail pharmacy.
If you have privacy concerns, you can always be proactive about the whole thing and opt out of information sharing under the terms of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). But some of us might already have active dossiers on file. Fortunately, you are allowed to see your health credit report once each year from both Ingenix and Milliman for free.
To obtain your Ingenix report, call MedPoint Compliance at 888-206-0335. To obtain your Milliman report, call 877-211-4816.
Another even broader credit report–style dossier is compiled by an organization called MIB Group. MIB tracks anyone who has applied for individually underwritten life, health, or disability income insurance during the past seven years. As with Ingenix and Milliman, you are allowed a free copy of your consumer file annually through MIB. Simply call 1-866-692-6901 to request yours.
Know what your insurer has on you!
Get written insurance approval before radiological tests
If you’re like most people, chances are you’ve had an MRI, CAT scan, or other radiological test at some point in your life. The use of such tests has surged by 50 percent in the last five years, partly because they’re potentially lifesaving tests. But they’re also overprescribed by doctors who are afraid of being hit with a malpractice suit for not running the tests. In doctorspeak, they’re practicing “defensive medicine.”
To complicate matters, the big insurers are now using radiology benefits managers (RBMs) to assess whether they want to cover the procedures or not. A Wall Street Journal reporter found case after case where an insurer would precertify a radiological test and then, after the fact, turn around and deny payment based on the recommendation of their RBMs.
So what can you do? Before you proceed with any radiological test, get approval in writing—even if preauthorization isn’t necessary. Don’t settle for approval over the phone; you must get it in black and white.
If you’ve already had a test done, and you’re getting a referral to another doctor who is suggesting another test, take your films with you instead of undergoing a duplicate test.
Challenge a hospital’s tax-exempt status when denied charity care
Hospitals across America are doing covert “wallet biopsies” to deny lifesaving treatment for patients, according to BusinessWeek. This is even happening to patients who have insurance!
In a wallet biopsy, hospitals take a separately purchased health credit report, as I just mentioned, and factor in your income, insurance, and level of debt. The goal is to gain a profitability index score on you so they can determine how to handle your individual case.
If your index score is too low—meaning that your insurer is unlikely to pay and you’re unlikely to meet your out-of-pocket expenses—they won’t treat you, according to the patients BusinessWeek quoted that were in this situation. The article went on to say that hospital billing departments are looking at your credit score, available space on your credit cards, and what’s in your 401(k) at work for a reason to deny you charitable care.
But there is a way to fight back. Many hospitals have nonprofit status, which means that they receive massive subsidies from taxpayers in return for the promise to provide charitable care. If you truly believe you qualify for charity care, have a family member go directly to the hospital’s administrator and threaten to challenge its tax-exempt status with the IRS if it doesn’t deliver.
Hire a medical billing advocate
I’ve had two surgeries in the past few years. Both were pretty painful but not nearly as painful as the bills I received in the mail.
Not only were the bills outrageously expensive, they were impossible to understand. According to Money magazine, roughly eight in ten hospital bills have multiple errors. So almost always the bill will be wrong, and it won’t be in your favor.
It’s hard to blame hospitals for the mistakes because they are so difficult to run. Should you just roll over and pay the bills? No way!
My advice is to document everything that goes on in the hospital. Keep a log and ask a friend or relative to write down every medication you are taking and every procedure you have. Then when the time comes to get the bill, ask for it to be itemized. You can then compare everything you have written down to everything on the list. It’s up to you to be on your toes in the hospital.
You can also hire claims assistance professionals or medical billing advocates to look over your bill and vet it for errors. They’re available in more than half of all the states. Visit Claims.org (Alliance of Claims Assistance Professionals) or BillAdvocates.com (Medical Billing Advocates of America) to locate one near you, and expect to pay between $65 and $125 per hour for their services, depending on the geographic location.
While you might balk at that price, I recently spoke with Claims.org’s co-president Katalin Goencz, who told me that a claims assistance professional (CAP) can usually tell if there is a mistake on a physician’s bill in less than 15 minutes. About eighty percent of the CAPs in her organization will offer fifteen or thirty minutes of free consultation time to assess your situation and see if they can help you. So I strongly recommend that anyone who is uninsured and paying retail for expensive medical services go this route.
DIET, FITNESS, AND HEALTH
Be cautious of weakened organic food labeling standards
My wife loves buying organic food. She routinely shops at Whole Foods—a store that I jokingly like to call Whole Paycheck because it’s so expensive. But are consumers really getting their money’s worth when they pay extra for organic food?
The Washington Post has reported that food producers have been able to convince the U.S. Department of Agriculture to lessen its organic labeling standards over time. The result is that there are currently 245 products (up from just 77 in 2002) labeled as organic that contain nonorganic ingredients.
At the end of the last decade, organics were a $23 billion business and the fastest-growing segment of the food market. Customers like my wife are often willing to pay up to twice as much for that organic label.
However, the newspaper estimates that 90 percent of organic baby formula is not truly organic. Other organic products singled out by The Washington Post because they contain nonorganic ingredients include cheese, beer, and duck. In fact, Consumers Union—the publisher of Consumer Reports—claims that some supposedly organic foods even contain mercury and polychlorinated biphenyls (PCBs)!
If you insist on buying organic, you have to make sure the label reads “100% organic.” Just seeing the word “organic” by itself is not enough. You should also look for an ingredient list, the name and address of the handler, and the name and seal of the organic certifier.
Try buying your store’s in-house brand of organic food to dial back the price. Most retailers in the food business have private-label organic food available. You can also try shopping at Walmart. Yes, I know the monster mega-retailer is anathema to a lot of “green” shoppers. But the reality is that it offers better deals on organic food than other places and can help you save that other kind of green!
Cook double portions at home and freeze them
Cooking can mean many different things to different people. To my mind, it simply means putting something in the microwave—preferably frozen—and changing the temperature of it! But at the peak of the recession, the Los Angeles Times reported that many recipe bloggers saw their page views more than double. These are the kinds of sites that were routinely being ignored during better economic times. Somehow it wasn’t deemed worthy enough to know how to cook easy meals from ultra-cheap ingredients.
Christa DiBiase, the executive producer of my radio show, has long used sites like Recipe. com and Epicurious.com to figure out how to fix simple and nourishing meals for her family. But now there’s a huge network of family cooks who share their money-saving ideas in a whole new generation of blogs dedicated to the art of budget food preparation.
Some of the ones I’ve seen are HopefulHousewife.com, TheFamilyHomestead.com, HillbillyHousewife.com, and AllRecipes.com.
In addition to the money you can save, cooking at home can also be a real time-saver if done correctly. My recommendation is to dedicate a few hours on a Saturday or Sunday to making double portions. You can have a home-cooked meal on the spot and freeze the leftovers for use later in the week when you’re too busy to cook.
Even if you can’t figure out how to make a masterpiece worthy of Julia Child, simply making food at home costs a fraction of what it costs to eat out. For those who can’t cook, you can always be like me and buy your favorite frozen meals on sale.
Food fraud a problem for some high-end products
Fancy food products such as sheep’s milk cheese and sturgeon caviar that are sold at higher prices because of their content might not be the real deal, according to a Washington Post report I read about what’s being called “food fraud.”
Two New York City high school students, working in conjunction with scientists, tested sixty-six foods and found that eleven did not contain what the label promised. For example, some samples of sheep’s milk cheese were made from cow’s milk and some sturgeon caviar was sourced from the lowly Mississippi paddlefish!
In other examples of food fraud, manufacturers themselves have sometimes been scammed by suppliers. California winemaker E. & J. Gallo sold 18 million bottles of Red Bicyclette Pinot Noir (vintage 2006–2008) that were later discovered to have been made from cheaper Merlot and Syrah grapes in France. It’s been dubbed the “Pinotgate” scam.
The FDA has long been charged with ensuring that food contains what it promises, but the organization can’t keep up with the task in light of more pressing cases of dangerous food contamination. They’ve just trusted the marketplace not to lie.
My solution is either buy plain generic food that makes no promises about fancy ingredients or buy fresh and local so you can actually meet the grower or manufacturer. Until the industry comes up with a self-regulating body to ensure you get what you pay for, know that it may not be worth the extra money to pay for the label with the fancy promises.
Be careful with supplements and herbal remedies
I am among the two-thirds of Americans who take a dietary supplement—as in vitamins, herbal products, or those miracle remedies you see on bad late-night TV. For me, it’s two chewable vitamins every day. But my executive radio producer, Christa DiBiase, takes supplements, including magnesium and others.
The scary news is that a recent Dow Jones report suggested that people can experience kidney failure and liver failure because the contents of some dietary supplements are not regulated closely enough. Meanwhile, a survey from the National Institute of Diabetes and Digestive and Kidney Diseases found that roughly 10 percent of people with liver problems developed them from taking herbal remedies.
The claims made by herbal remedies are generally not verifiable. The U.S. Government Accountability Office has found there’s a real problem here: Companies are not required to tell the Food and Drug Administration what ingredients they use; they’re required to report only if someone is hospitalized or dies as a result of using their product—after the fact!
So now there’s a big fight about whether or not the feds should have stricter standards for dietary supplements. The Center for Science in the Public Interest has been vocal in wanting manufacturers to verify what’s in their products.
The closest thing to any kind of oversight is an accredited body called the United States Pharmacopeia (USP). If there’s a particular product you’re questioning the safety of, try visiting USP.org and searching for info about it there.
This stuff is the Wild West of medicine. You’ve got to be careful with what you put in your body—especially with the claims you see on late-night TV. I’m stunned by the number of ads I see for what I’ll euphemistically call “evening activities.” Know that you are being conned by the actors. The product might not harm you, but it will harm your wallet.
Finally, be sure to tell your doctor about any dietary supplements you take. That information will help him or her be aware of any possible drug interactions with traditional medications you might be taking.
Don’t buy bottled water
The master marketers at Coke and Pepsi did a phenomenal job of converting soda drinkers into drinkers of overpriced bottled waters like Dasani and Aquafina throughout much of the 1990s and the last decade. They convinced us we were doing something good for ourselves by buying and drinking bottled water.
But just read those labels closely and you’ll see the water is sourced directly from municipal supplies before it’s processed. In essence, it’s glorified tap water!
The Great Recession did a lot to involuntarily quench America’s thirst for bottled water. People who lost their jobs or had hours cut realized the folly of paying big bucks for the stuff when tap water is available for nearly free.
Meanwhile, the green movement has taught us that bottled water is actually harmful for the environment—because of the gas used to ship it to stores and the plastic that ends up in landfills. These have been factors in its sales decline.
Here’s my favorite angle: Over the course of a year, bottled water can cost you more than one thousand times what tap water costs. Committed bottled-water drinkers can spend $1,400 in a year on the stuff according to one estimate I’ve seen. Tap water can run you about $1 annually, if even that much. Wouldn’t you rather put that $1,400 back in your wallet?
Some people who want to give bottled water the boot say they’re not comfortable with the taste of tap water. The compromise is to filter your tap water at home. You can get a cheap external filtration system for around $10 or $15 and a reusable bottle for well under $20.
Test your tap water on the cheap
After years of my prodding, my executive radio producer, Christa DiBiase, finally made the switch from bottled water to tap water. So what made her cross over from the dark side? She got hold of something called the Watersafe All-In-One test kit, which is one of the recommended picks of Consumer Reports in this field. Visit DiscoverTesting.com for more information.
For about $20, she was able to test her family’s tap water for bacteria, lead, pesticides, nitrates, chlorine, pH, and hardness. Well, the water passed with flying colors, and her brood has been drinking from the tap ever since.
Buying a home-testing kit is also a great way to avoid the marketing push from water-testing companies. A few years ago, Christa got a call from a company claiming she had missed her appointment to test the water quality at her home. At first she thought it was a scam marketer. But it turned out that her sweet but absentminded husband, Mike, had scheduled an appointment without telling her!
Mike is a marketer’s dream. He doesn’t like to say no and once even signed up for a credit card the family already had—just because someone asked him to! Christa later reminded Mike that she had bought the Watersafe All-In-One test kit several months before.
The complimentary water test the marketer was offering Christa likely would have involved a hard sell in the home. These companies practically convince you that if you love your children and want them to stay healthy, you must buy their product.
Stay away from toning shoes
Are toning shoes the real deal? This popular new type of footwear is supposed to tone muscles, promote weight loss, and improve posture just by wearing these shoes and walking as you normally do throughout your day.
Toning shoes sell for $100 to $250 and appeal almost strictly to women. That’s prompted Skechers, the leading toning-shoe company, to hire former football star Joe Montana to pitch them to men.
But the claims that you’ll derive some kind of exercise-related benefit from wearing toning shoes are “utter nonsense,” according to Barbara de Lateur, a professor of physical medicine and rehabilitation at Johns Hopkins University’s School of Medicine in Baltimore, who was quoted in a USA Today article. In fact, people are suffering injuries as result of wearing these shoes.
The professor worries that toning shoes can destabilize how a person walks and that wearing this kind of footwear can give you strained Achilles tendons. The shoes might be especially problematic for seniors and equilibrium-challenged adults.
So steer clear of toning shoes, ladies (and gentlemen)! Save the money and don’t believe the hype. If you’ve already bought a pair and love them, just read what has been posted online about the potential dangers. Then make an educated decision about whether you want to continue wearing them.
Beware of at-home genetic testing
For years, the ability to identify genetic health risks for common diseases and discover your ancestral roots was out of the price range of most people. But that has changed in recent years.
I remember discussing on my radio show an early leader in the at-home genetic testing field called 23andMe.com in the early 2000s. At that time, their services started at around $1,000. Now, they offer their services starting at less than $400.
The costs just keep going lower and lower as more and more competitors enter the field. But should you spend your hard-earned money on at-home genetic testing?
Well, consider this. The Food and Drug Administration is looking to tighten the reins on companies that offer these kinds of services after 23andMe.com mailed the wrong test results to the wrong people. The Financial Times of London reported that nearly one hundred clients got incorrect test results because of sloppy record keeping on the company’s part.
“The mistake left one client believing that her son was not her own, while another was led to understand that she was of African origin while the rest of her family is Caucasian,” the newspaper noted.
In May 2010, a competing service called Pathway.com was supposed to begin selling over-the-counter testing kits starting at $250 through Walgreens stores across the country. But the FDA interceded and has suspended that effort for the time being.
In theory, genetic testing at home is supposed to help people. The idea is that disease management will be greatly improved when medical providers can offer guidelines for patients who know they’re genetically predisposed to certain diseases.
However, some researchers are worried that if someone gets a report that indicates susceptibility to certain genetic illnesses, they’ll go into full freak-out zone. As the head of one research center told The Washington Post: “Information is powerful, but misunderstood information can be powerfully bad.”
Following the 23andMe.com debacle, the FDA contacted the company and four others in the field—Knome COMPLETE, deCODE Genetics, Illumina, Inc., and Navigenics—asking that they submit test results for approval before sending them to clients.
It will certainly be nice to have some oversight to avoid the kind of clerical errors that tripped up 23andMe.com. Yet I’m not naive enough to believe that you can put the genie of at-home genetic testing back in the bottle. This is one option in the marketplace that’s not going away.
So if you’re the kind of person who would worry yourself sick about a bad genetic report, then you should have the foresight to stay away from these services—even if you are tempted by the increasingly low price.
ELDER ISSUES
Opt out of mandatory arbitration in nursing home contracts
Several years ago, The Wall Street Journal did a story about nursing homes that harm or kill people through negligence. Surviving family members had no recourse because they signed mandatory arbitration clauses when they were admitting their loved ones that locked them into bogus stacked-deck dispute resolution.
It’s getting to the point that nursing homes have no incentive to not kill people; there’s nothing families can do after the fact. Some nursing homes have even been using multiple holding companies behind the scenes to limit their liability, according to what I’ve read. There are a lot of things going on in this industry that are unacceptable in a decent society!
Now, The Wall Street Journal is not exactly a bleeding-heart liberal-publication—but even they were very angry about mandatory arbitration being written into nursing home contracts.
Before you put a loved one in a nursing home, I want you to carefully vet the admission contract and see if you can opt out of any mandatory arbitration clause. If you can’t avoid it, try writing the following next to the clause: “I’m signing this because I was told that I have to.” That creates the possibility that you can potentially get out of mandatory arbitration and seek justice in the court system in the event your loved one is harmed or killed while in their care.
Corporations like banks bullying you into mandatory arbitration is bad enough. But it’s a whole different story if someone kills your mother.
Interestingly, the demand for beds in nursing homes has been far lower than what demographers anticipated. That’s because more families are choosing in-home care options for their elders.
You need to feel confident about who’s caring for your senior loved ones.
Plan for the unexpected with an advance directive
Very few people like to think about the end, but there’s an uncontested 100 percent chance that we’re all going to die someday. A little preplanning can go a long way in alleviating the burdens both financial and emotional on your loved ones.
Today we’re at a point where medical technology can keep people alive even though they are not really functioning. But that may not be the right choice for everyone. For me, I’ve told my family to pull the plug if I ever enter a vegetative state and have very little chance of coming out. So I’ve written that down in what’s called a “living will” or “advance directive.”
A living will is a legal document in which you state your wishes about certain kinds of medical treatments and life-prolonging procedures. The document takes effect if you can’t communicate your own health care decisions.
Obtaining the appropriate living will form is easy, and you don’t have to pay the $30 or more some lawyers charge. You can obtain your state’s form from a local doctor, hospital, or medical clinic. Or you can visit CaringInfo.org (National Hospice and Palliative Care Organization) to download the advance directive free of charge.
This document must be signed by you in the presence of two or more witnesses, but those witnesses cannot be a health care provider or a person who would stand to receive a share of your property in the event of your death.
Once you complete the living will, you can even upload it and have it stored virtually by Google Health, which is another free service. Full details of how to do that are available at CaringInfo.org.