Medical costs

How do the extreme frugality folks deal with medical costs? Do they just hope they never get very sick and if they do that they conveniently quickly die, or what? My family has faced several medical crises which could only be survived because of insurance. Extreme frugality does not accommodate medical insurance costs, so, what do frugal people do? If they get sick and need expensive care, do they beg for money, or what?

In the US, Medicare. Elsewhere, whatever is comparable.

Frugal folks minimizes sickness by:
diet (grow your own food, fermenting, etc),
exercising,
sleeping right,
drinking enough water,
proper body posture/kinetic
proper breating
weight lost (at least for the 62% overweight pop in USA)
active stress management
herbal medicine/probiotics.
Being cautious/skilled (Learning how to properly fall a tree so it doesn't fall on them and break a bone, etc).
Getting car insurance for car accidents.

When they do get sick they:
figure out if it is something the body can fix on it's own almost as fast without medicine/doctor. (Does the baby really need to go to the doctor for a temp of 100.5F).
figure out the root cause of the problem, is my breathing problems cause by mold, dust/dry air from heating system or me smoking too much or $100 for asthma meds every single 2week
figure out if some herb or combination of herbs can help.
figure out if farm animal med would be a safe, cheaper solution.
Pray, go to church/placebo effect
Beg, Gofundme, Public assistance
Go to the ER/Hospital for emergency and pay them back over 15yrs as money comes in.
Self-medicate

Move to Canada.

Health care is covered. Get insurance to cover what falls through the cracks like prescriptions and ambulance rides. Also have a job with good benefits.

Try incredibly hard not to get seriously injured or ill

Angie O'Connor wrote:Move to Canada.

I was going to say that.

Yesterday's drugs would have cost us about USD $3150.00 if we had to pay ourselves (not including doctors visits, specialist consults, &c.). We paid $99 for our yearly drug deductible, and the rest of the medicine was covered. It was a bad day yesterday.

It was a shock the first time I was injured while traveling and the doctor wouldn't see me without cash. Totally alien idea here.

R Ranson wrote:

Angie O'Connor wrote:Move to Canada.

I was going to say that.

Yesterday's drugs would have cost us about USD $3150.00 if we had to pay ourselves (not including doctors visits, specialist consults, &c.). We paid $99 for our yearly drug deductible, and the rest of the medicine was covered. It was a bad day yesterday.

It was a shock the first time I was injured while traveling and the doctor wouldn't see me without cash. Totally alien idea here.

Yup, I'd have no clue what to do if I couldn't just walk into a doctors office and then walk back out. It'd be more stressful seeing a doctor than it is already that's for sure!

Sorry you had a bad day yesterday. Hope the weekend improves!

That said, even in Canada we do have plenty of medical things we have to spend money for. Most of them subsidized, but still cost money.

Prevention is a huge part of saving money on medical expenses.

S Bengi has a good post above. I especially agree that it's important to educate oneself about when it's important to go to a doctor. When I do see a doctor about something, I always make certain I ask at the end "what symptoms do I need to keep an eye out for? At what stage do I need to call you again?" or something like that.

Then it's a matter of choice where I spend my money. Taking this medicine (because not all drugs are completely subsidized here) will mean I have to wait another three months before I can buy new shoes. Which is more important? Well, my current pair of shoes have holes, but its not rainy season for a while, so drugs it is. Or maybe it is rainy season, and having holy shoes would lead to worse than not taking the drugs. When one only has so much money, one has to make a choice where to spend it. I'm not willing to go into debt, so the shoes have to wait.

It sorta depends on income level and what state you're in.

In Oklahoma, which refused the free federal Obamacare medicaid expansion money, if you're poor enough that the feds think you should qualify for Medicaid, you're screwed, because no matter how poor you are you won't qualify for Medicaid if you're a single not-disabled adult, and you won't qualify for health insurance subsidies on the federal exchange because as far as the feds are concerned, you ought to be on Medicaid. I suspect Texas is similar.

If you make enough money that you're not in abject poverty, you'll be eligible for a policy on the federal exchange, but if you're down near the "too poor to qualify for subsidies" line you can get a Silver plan (subsidized) for less than 40 bucks a month. Most of the Silver plans have thousands of dollars in deductibles, which makes them nearly useless, but in Oklahoma there has always been at least one zero-deductible plan available in each of the three years that the federal exchange has existed so far. These plans aren't awesome -- they typically don't pay more than half of emergency room visits for example, and likewise with respect to specialist visits or outpatient treatments -- but the one huge difference they make is that if you've got one, most medical providers will treat-and-bill you instead of turning you away if you can't pre-pay. The difference between getting treatment and not getting treatment can matter a lot (life and death), no matter what happens to your credit rating and net worth as a result of having large unpaid and unpayable medical bills. In some ways, it might help to view an Obamacare zero-deductible Silver plan as a guarantee that you can get medical credit. That's no small thing, and might appeal to even the most frugal among us.

Every state is different, both in its medicare-expansion stance and in the specific plans available on the state-run or federal-run exchange for that state. And I don't know enough about the "extreme frugality folks" to know where they tend to fall on the income scale that determines whether they are "purely screwed for being too poor for Obamacare" versus "making just enough to qualify for a subsidized plan".

Thank you for the realistic answers. "Don't get sick" is not a realistic answer to this problem. My dad is a quite healthy 85 year old who jogs every day and frequently enters 5K runs. A couple years ago he mysteriously contracted Necrotizing Fasciitis, which without modern antibiotics is fatal. Fortunately he has terrific insurance, got treatment, and was cured. Other family members have congenital problems which require ongoing care.

I hope more people who are frugal and dealing with medical issues in their family will post about how they are solving the problem of medical costs. Or perhaps most folks with medical problems can't choose the "luxury" of frugality, but must stay in the rat race in order to support their habit of staying alive.

My plan is that I'll be healthy until I'm not, and then I'll die; finally relieved of the burden of a miserable life...

In my opinion, modern medicine does an adequate job treating trauma: broken bones, deep gashes, etc... I would never even consider going to a doctor for any other reason.

I watch the people around me going to the doctor for self-inflicted harms... Primarily due to poor diet and bad judgment. It's particularly common to go to the doctor to get a pharmaceutical to counteract the horrid side effects of a different pharmaceutical. And then to go again to counteract the side effects of the side-effect countering pill. One time when I examined a family member's medicines, there was a primary medicine to treat a condition that really isn't a problem, and that only helps like 2% of the people that take it, and then there were 3 more medicines to treat side effects. Stupid!!! That's the same family member who's food, home, and garden are filled with industrialized poisons.

I am a member of a tribe that considers modern "health-care" to be akin to dealing with a corrupt mafia, so we adhere pretty closely to the list provided by S Bengi. We tend towards being thin. We don't eat industrialized food and it's associated poisons. We don't invite other types of poisons into our lives in the form of pharmaceuticals, cleaners, deodorants, shampoos, fragrances, agricultural poisons, dryer sheets, dyes, etc. We meet regularly and swap touch, food, herbs, massage, feelings, and ideas on how to be healthy. We are all healers, therapists, masseuses, yogists, herbalists, and cooks. Call us pragmatic stoics. We have a mutual assistance pack, that when it's time to die, we'll arrange transport to a remote place in the desert where we can camp long enough to die in a place where our bodies will never be found.

We believe that modern medicine is doomed by the impending bankruptcy of the national governments. Therefore, we consider it our duty to learn other modes of healing and healthy living.

Having been without medical insurance at various periods of our lives, we've found that working on preventing conditions, being creative and doing lots of research (nowadays via the Internet) is key. It's also important to know when you do need the medical system.

Prevention:
One of the biggest and best things we did was to lower our stress substantially by getting out of the rat race after too many years of high stress. Our income was greatly reduced but we found ways to keep going by full time RVing and working part time for three years. We saved the money from the sale of our previous home, then added a chunk out of a retirement account to buy a place in an area we love, so we no longer have mortgage stress. We made sure the property taxes were low. Imagine not having to earn $800 to $1,200 a month extra just to pay to live somewhere of your choosing! We like to hike and explore and are next to one of the biggest public lands areas in the U.S. (We could literally hike out of our neighborhood to the Pacific Crest Trail.) It is much easier to stay in shape without a gym membership than it was in the cities we lived in previously. At the same time, we can walk or bicycle just about anywhere in our town and do the majority of our errands and shopping that way. (Electric bikes made from kits added to regular bikes help when it is really windy or we go more than 3 miles.) We have a twentieth of an acre - enough to grow a good portion of food for the two of us, which I am working toward. We've changed our food shopping habits to include organic or non-GMO wherever possible - partly as a way to vote with our dollars. I am seeing more and more such products in the two stores where we shop. The farmer's market is really expensive so we don't buy much there - we usually have produce from our own garden when it's in operation anyway.

An example of when prevention would likely have been better than the cure.
I recently had a Facebook friend die after a multi-year battle with cancer at age 59. She was a lawyer who trusted the conventional medical system to help her. She said it started out as breast cancer due to environmental causes. She'd always been somewhat stout and I suspect not eating the healthiest of diets. She made it sound like she was overcoming things and it wasn't until 9 months before she died that I messaged her and asked if any of the oncologists or medical staff had mentioned nutrition or other alternatives to her. She said no. I also sent her a link to the Truth About Cancer website but think she was by then too tired to keep fighting. I feel that if she had not had insurance, she would have been avidly researching for other alternatives and chances are good she would still be alive today.

Being creative:
Hubby and I delivered Christmas trees one year and at the end of the month, he had a back attack and started throwing up. He'd never had any back trouble before so we were afraid it might be his appendix. I got on the computer to research appendicitis symptoms and they didn't match. He mentioned back pain so I crushed up some Vicodin (left over from another ailment) and put it under his tongue so he wouldn't throw it up. This did relax the back muscles and stopped the vomiting so we figured it was back spasms from him having too much fun tossing trees around. Result - a valuable experience for both of us and we avoided the expense and discomfort of an ER visit, which would likely have included unnecessary tests.

Another example is ear infections - I simply take a bit of gel from a garlic pill, put it in the ear, and that works within a couple of days every time.
If I feel a cold coming on - and sometimes even after my nose has started running - I start on garlic pills (could also use fresh garlic but there's an associated odor) and rest as soon as possible. I make sure to tell myself, "I don't want to be sick" or "I don't want this cold, go away" (rather than, "Oh no, I've got a cold" with the implication that there's now nothing to be done about it). I look at it as a cold trying to catch me rather than me trying to catch a cold. This has prevented/turned around at least twenty colds in the past 10 years. Only got caught by one, a real doozy, recently - and then I figured it probably gave my immune system a good workout.

Research and knowing when to seek medical advice:
Currently we are on Medicaid and I've been having foot problems for the last 6 months. Did a lot of research and tried a bunch of things but they didn't match my symptoms and I didn't get relief (although I'm happy to say I didn't make things worse). I finally was able to see my primary care guy who immediately prescribed two different types of drugs because he wasn't sure what the problem was either - I tried one medication but refused the other after reading the side effects. Since the problem continued, I was sent to a physical therapy office and saw four different PTs over six visits. Each had a different idea of what might be the problem and a different set of exercises for me to follow - they did not coordinate care. Don't know if it was because I didn't have standard (i.e. "non-poverty") insurance or just the way this office operated. Podiatrists aren't covered in our state by Medicaid so I paid a sports injury chiropractor who immediately diagnosed the issue as "pronation syndrome" which was something I'd not come across in my research on foot pain. It was worth spending $99 to get help with understanding the problem since I can now do further research - everyone else was trying to tell me I had plantar fasciitis, which was not matched by my symptoms.

Other times when we paid for medical emergency care: My hubby broke his wrist and went to the ER - we didn't have the $200 they charged and they let us pay off over time. Our daughter tripped and split her chin and we also ended up paying over time to another ER for the stitches. That was when ER visits were cheap - if that happened these days and we weren't insured, we'd go to Urgent Care. Note: Supposedly hospitals cannot refuse to treat you if you have life threatening symptoms regardless of insurance - I think it helps to have a persistent, squeaky wheel type person with you if they are reluctant to take you in.

So, bottom line, do what's right for your body as much as possible, be your own advocate (or find someone who will advocate for you) and educate yourself about what is going on rather than turning it all over to the "experts," regardless of whether you have insurance or not. It is a real chore sometimes to spend time on doing so rather than recreating, but it does pay dividends in my opinion.

Thanks for these replies.

I hope some people with chronic or acute conditions* will post about how they deal with the costs as a frugal person.

*but maybe they would post, if they could, "I had a heart attack, so I died."

If you need an operation think about going to another country to get operated - Spain or Cuba both have inexpensive healthcare .
Or vote for a candidate that is going to fix your system

@Joe L.: "We believe that modern medicine is doomed by the impending bankruptcy of the national governments. Therefore, we consider it our duty to learn other modes of healing and healthy living."

I'm pretty much in sync with everything you said and am on the same track of thinking, even if a different track of behavior. Which I will address along with Tyler L.'s "I hope some people with chronic or acute conditions will post about how they deal with the costs as a frugal person."

I've got pretty good insurance, but unlike my co-workers on the same plan, am not at the docter's office each week with a sniffle or hangnail. Between the fact that one co-worker in particular uses her sick leave for everything from spa visits to hangover recovery to a bonafide heart condition (some of which fall under insurance and some of which don't), much of her chiropractic and doctor's visits seem highly stress-related.....not from the job per se, but from an apparently shitty personal life that she continues to feed.

With that out of the way, and coming from a family of "health care providers" (loosely used), it's pretty clear in the US that things are bad. But one thing that it seems *all* modern health care systems will have is a need to stoke the oven...to keep it fueled with enough "throughput" so that money can exchange hands and the practitioners from the doctor to the CEO all can keep up their skills of the trade. Along with all of the other horror stories one might come across is the observation that, more and more, the general population serves as the lab rats for "beta testing" new procedures and new drugs well after the real lab rats have served their purpose.

...And with *that* of the way, my main peeve these days is that I can't seem to establish the idea with my doctor that "when I feel sick I will come and see you". Cuz that doesn't fuel the furnace.....doesn't provide enough throughput for the hospital system. So in one case, I presented with joint pain some years ago. Was pretty surprised when, after doctor recommendations for physical therapy and increased ibuprofen, I suggested he check my uric acid level. "Why?" he asked...."Cuz hyperuricemia (gout) runs in the family???....I noted that on my chart when I started with you." Prescription of allopurinol did the trick....but along the way it was decided the blood pressure was getting too high......and blood sugar levels were getting too high....and.....and..... you get the idea. It's a systemic problem. Throughput is needed for cash-flow, monitoring is needed to avoid lawsuits. Blood pressure and blood sugar both can in many, even if not all, cases be adequately handled dietarily, only minimally suggested by my doctor. It was always the prescription drugs.... but this is not news to most.

The clincher: "Well......I'm not sure why we didn't get your allopurinol prescription filled on time recently....maybe it's because you didn't come back in for your blood tests when we asked....". Hmmmmm ..... that kind of felt like blackmail and extortion all wrapped into one.

1) Stay as healthy as possible.
2) At least *try* to stay out of hospitals (speaking from US perspective)
3) Keep eyes and ears scanning for new changes, developments, and programs.....and not least, good physicians.

My husband and I haven't had any insurance ever, until the last two years. This year we both turned 65 so we have medicare.

We have relied on local clinics and payment plans for the forty five years before that. We paid $5 a month for our son's broken arm until the surgeon himself said that's enough and forgave our bill. I think there are more options (in the US anyway) for the very low income, as we were, that make it unfair, really, for those trying to earn enough to afford insurance payments.

We've been able to go to a local clinic when necessary that has a sliding scale payment plan...and a few ER visits for stitches for the boys, again paid off on time.....

I was diagnosed with glaucoma and at the same time cataracts just two years ago at a routine eye exam. As much as I would like to think I'll just go with whatever happens I really didn't want to go blind. Fortunately, our insurance had kicked in and it covered surgery to remove the cataracts and lens implants for both eyes and my drops for glaucoma that are running a few hundred a month.
If I hadn't had insurance there are groups, like the Lions Club, who provide help for cataract removal. I'm not sure about pharmaceuticals though.

My plan is that I'll be healthy until I'm not, and then I'll die; finally relieved of the burden of a miserable life...

Joseph, are you speaking of a 'miserable life' in the Buddhist sense, meaning 'suffering' ?
I think good ergonomics and a healthy diet....clean living all play a part in a doctor free future.
I just don't think we can predict how we will feel when faced with a surprise illness or diagnosis that could be life changing for ourselves or another family member.
Depending on the diagnosis, I don't think I'll be philosophical enough to go willingly without intervention.

I have always seen looking after my health as my number one job. When I was about 7, my dad explained very clearly that Whiskey Joe and another drunk named Albert, were no good to themselves or their families and that they were a terrible drain on the public purse.

There have been a few minor injuries, but I have always eaten well and abstained from cigarettes and alcohol. My weight hasn't ever been an issue. I wear a full face asbestos mask whenever I work with dangerous substances. I'm in far better shape than most men my age.

This doesn't guarantee lifelong good health, but my chances are good.

That's my strategy -healthy eating without vices and overall physical strength. Injury is probably my greatest risk. I've demolished about 250 buildings by hand and I regularly use a chainsaw etc.

I don't expect to ever be a broken down old guy who suffers from the effects of decades of bad choices. Still, there is a huge luck factor to maintaining good health. Constant vigilance and money in the bank are more important as we age. No one is more vulnerable than those who are old and poor.

I know people with chronic health problems, that will never go to the doctor for any reason. They manage the pain with alcohol, or marijuana.

How do the extreme frugality folks deal with medical costs?

Mike Cantrell wrote:In the US, Medicare. Elsewhere, whatever is comparable.

Medicaid is income related for any age group, I believe......Medicare is only age related...it kicks in at 65yrs.

Being frugal is not the same thing as being poor, and I'm not sure why so many of the responses are equating the two.

We are NOT exactly frugal, but we have been moving that way for a few years. The reason we are doing so is so we will have the funds to pay our own way INSTEAD of begging and/or borrowing when we face a crisis. My son got pneumonia and was hospitalized for five days a couple of years ago, running up medical bills of over 10,000. We paid it. I think that is the responsible thing to do.

PS After writing the above, I saw that you were specifically talking about "extreme frugality", which I assume refers to Jacob Fisker's Early Retirement Extreme. I will note that he specifically mentions having a health insurance plan, PLUS liability insurance:

Early Retirement Extreme Day 13: Insurance

Obamacare managed to make the insurance industry even worse, in that the high deductible plans he recommends have been pretty much phased out, because they "weren't good enough".

Jim Thomas wrote: I saw that you were specifically talking about "extreme frugality", which I assume refers to Jacob Fisker's Early Retirement Extreme.

It doesn't. I'm referring to people who are frugal either by necessity, because they are poor, or by choice, because they are sick of working for money, or for some other reason.

I think that I spoke a bit too forcefully in my earlier post, and would edit it, but the time limit has apparently passed. If a moderator would be so kind as to delete this part of my earlier comment, I would appreciate it:

, instead of taking the money from other people (AKA "move to Canada" or "get subsidies")

Prevention and self medication is a realistic answer for many. Up to a point.

We have a medical sharing account, one of the few exceptions to the ObamaCare mandate. It is not cheap, but much more frugal than any other option I found.

We also have a concierge doctor. We pay a yearly membership and then small cash visit fees beyond a yearly physical. He doesn't accept insurance, so he doesn't have that extra 50% overhead of dealing with bill collection.

I have many Amish friends, when they get a big bill like ER or a baby, they do any private income assistance from the hospital (many have bill forgiveness for low income) and then they make payments as they can.

As others have said, self medication and prevention are two biggies.

For our self medicating we do not go to the hospital if all we have are cold/flu symptoms. I drink quite a few drinks that are high in natural sugars and Vitamin C whenever I get sick, in addition to spicy foods (to help clear out my system). I also "shut down" and do nothing but rest for 24 hours. I have been doing this regimen for over a decade now and have not been sick enough to miss more than a single day of work each time I get sick (which only happens ever two or three years). I work in a position that interacts a lot with people from all over the world (lots of hand shaking) and even being that exposed to germs I find myself getting sick less often than most people.

For prevention, I try to just be careful and safe. I wear chaps when I use my chainsaw and scrap wood to guide wood on table saws when I use them.

I suspect an important aspect of self medicating is to have a good diagnosis. Some things are simple to diagnose at home, but others are easy to get wrong. Knowing when to go to the doctor and getting a medical diagnosis can be a huge money saver.

Just diagnosed with Sjogren's syndrome at the end of February. Just got my bill from the lab... Over $2,500 of which insurance paid $14 because I have not met my deductible.
I have rarely ever had a cold, eat healthier than most, gardener, ex-fitness instructor and now I have an incurable disease. I'll have to deal with IT and insurance companies for the rest of my life. I'm at the halfway point of feeling sorry for myself and pissed off. Which way it swings depends on the moment.
I read a lot (here and on Sjogren's forums) about gluten and haven't had any for 11 days now. Didn't realize how many nonsuspect foods (and nonfood items) it is in until I went grocery shopping. While there I met an elderly lady who was also label reading. She said she has diabetes and just wished God would take her. Then I felt worse for her than myself.

Karen, that's exactly the kind of example I'd like to see discussed. It sucks so hard. I empathize with the "sorry-for-self alternating with pissed" response.

$2500 would go a long way towards paying for alternate modes of healing/coping.

I understand that a lot of autoimmune disorders, including Sjogren's syndrome, respond well to Terry Wahl's protocol, which is mostly diet. She is currently conducting clinical trials using the diet.

Here is her website - http://terrywahls.com/

I'd strongly recommend watching this video and listening carefully to what she has to say.

Joseph Lofthouse wrote:
$2500 would go a long way towards paying for alternate modes of healing/coping.

Unfortunately, often one figures that out after the stupid expensive lab tests and "official diagnosis." So many conditions have similar symptoms, and often seem equally incurable by Modern Medicine. I could go off on a rant against the Illness Industry (not "health care" - it sure isn't that!) but I'm going to try to resist....

Most autoimmune diseases respond to anti inflammatory diet and supplements--turmeric, currant, etc.

But yeah. Hindsight isn't always 20/20, but it is much better than foresight.

Karen Layne wrote:While there I met an elderly lady who was also label reading. She said she has diabetes and just wished God would take her. Then I felt worse for her than myself.

Oh, that's so sad. Especially since - ironically - there's a good chance she could experience complete control of her diabetes by focusing on foods with no labels to read (veggies).

Burra, Thank you for the Terry Wahl's video. What a story of recovery. I've read about her in the past... incredible!
I consider myself and partner to be more sportsmen/women than hunter - gatherers. We fish alot. He hunts most anything. We grow way too many vegetables (provide for friends and family, food bank). I do, of course, have my luxury items: mixed nuts and "cheap champagne" I'm sure I could do so much better but what fun is living if you can't enjoy a few naughty things.

R Scott wrote:Most autoimmune diseases respond to anti inflammatory diet and supplements--turmeric, currant, etc.

But yeah. Hindsight isn't always 20/20, but it is much better than foresight.

A big part of autoimmune diseases is inflammation. The doctor said I even have it in my ears. Gave me 10 days worth of Prednisone and wants me to take prescription Ibuprofen (800 mg 3X day). I started with 2 a day, now I will only do 1 at night.
I take a multi, another Cal/mag/D/zinc 3x day, 500 mg turmeric 3x day, drink 1C. tart cherry juice daily and ginger green tea often. I hadn't heard about currants being a good choice. Thanks!
Wish my hind sight had been clearer, I have had symptoms for 20+ years. Chalked most up to age, genes, environment, etc. Didn't know that they were connected to each other in the big picture or that collectively they signalled disease.
I'm hating that "D word". Things that are diseased aren't even worthy of the compost pile.

Dan Boone wrote:
... there's a good chance she could experience complete control of her diabetes by focusing on foods with no labels to read (veggies).

Agreed. If you spend much time in grocery store line ups, it becomes evident that many choose poor health, one silly purchase at a time. Those people consume health care resources that could help those who struggle with incurable diseases that were not brought on by poor choices.

This sweet little lady reminded me of my grandma. She was reading on a can of peaches and told me that even canned in water or their own juice, they contained too many carbohydrates for her diet. She has diabetes. I tried to explain to her that they ARE a carbohydrate. It's not what was added to them necessarily.