Finding financial wellness in a very sick healthcare system with Dan Weissmann

 

Episode Description:  Dan Weissmann, host of the Arm and a Leg podcast shares his strategies on affordable healthcare, new legislation that can lower your healthcare bills and protect your credit score, how to negotiate medical debt and more.

Video Highlight: Dan speaks about the No Surprise Act.

Dan Weissman’s Bio:Dan Weissmann is a public-radio reporter and the host of An Arm and a Leg — a podcast about why health care costs so freaking much, and what we can maybe do about it.

Before launching An Arm and a Leg in 2018, Dan was a staff reporter for the public-radio show Marketplace, and for WBEZ in Chicago.

As a reporter, Dan likes a challenge. That’s why the job he’s chosen is to take one of the most enraging, terrifying, depressing parts of American life, and create something entertaining, empowering, and useful.

It’s a vital challenge: For instance, four in ten adults **with health insurance** report carrying medical debt.

An Arm and a Leg has built a loyal audience, won respect among journalists, and made an impact.

Now in its fifth year, with over 3 million downloads, the show was recently selected as one of “12 Health Podcasts Worth Listening To” by the New York Times. An Arm and a Leg show won an Ambie Award from the Podcast Academy in 2022 for Best Indie Podcast.

 
 

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Full Transcript:

Bobbi Rebell:

The other day I was watching our local news and there was a story that came on about using confetti- yes confetti- to de-stress. And I have to admit it was pretty appealing. By the way it's called the confetti project if you want to look it up. But guess what is the top thing that we stress about. Ok well given that you are listening to this you know the answer. It is money. According to the American Psychological Association, money continues to be the top source of stress for Americans. That’s where Financial Wellness Strategies comes in. We provide educational resources for companies employees to balance financial wealth with mental health. Financial literacy is important but we need to go beyond academics and learn how it all actually fits into our real lives- and what we want to accomplish with our hard earned money. Learn more about how you and your company can invest in peace of mind at FinancialWellnessStrategies.com

 

Welcome to the Wellness for Financial Grownups podcast. I’m your host Bobbi Rebell. So glad you are here with us for this unbelievable episode and I do mean unbelievable because we are talking about the high cost of medical care- and will be sharing some very specific ways we can control at least some of it. 

This weeks quote is from the NPR podcast Life and Debt:

“The Consumer Financial Protection Bureau reported last year that there's around $88 billion of medical debt in collections, and about 43 million Americans have medical debt on their credit report.”

 

Wow right? Well we’re going to get into why that happens so so many people It always shocks me how messed up our healthcare system is- and how much you can overpay if you don’t know what you are doing. I can pretty much guarantee the information this week’s guest is going to reveal will blow you away and save you not just money but really a lot of anxiety- truly financial wellness in its most literal form. 

Our guest is a wealth of information. Dan Weissman is the host of the arm and a leg podcast which is about why health care costs so much, and what we can maybe do about it.

Before launching An Arm and a Leg in 2018, Dan was a staff reporter for the public-radio show Marketplace, and for WBEZ in Chicago.

You will want to take notes but you can get them right on my bobbirebell.com website under the podcast tab where we have shownotes and transcripts so just sit back, listen and learn. 

Here is Dan Weissmann

Dan Weismann, you’re a financial grown-up. Welcome to the podcast!

So, Dan Weissmann, you're a financial grownup and host of the Arm in a Leg podcast. Welcome to this podcast.

 

Dan Weissmann:

Thank you so much. It's great to be here. Thanks for having me. Thanks for assuming I'm a financial grownup. I definitely do host this podcast though.

 

Bobbi Rebell:

Well, not only is our healthcare system terrible for our financial health, it can also do so much damage to so many different areas of our life. We focus on financial wellness here at the podcast

 

 

Dan Weissmann:

Oh, absolutely. I mean, yeah, it's certainly gotten worse in the last 15 years, despite, I mean, the Affordable Care Act has, did make some changes, I think, for the better for a lot of people, including for me in some ways. But, no, we're, everything, the systemic problem is it's a giant system that really allows people to make a lot of money. Even, even entities that are organized as nonprofits, kind of looking at their bottom line and. Wow, you've asked the great big question. How bad is this for us? It's terrible, right? As you said, we're all at risk of being in debt up to our eyeballs.

 

Bobbi Rebell:

So give us some examples of things that as consumers of healthcare, and healthcare is so frustrating because we usually go in, not always, but very often we go in, the biggest bills happen when we're in an urgent situation and not in a position to negotiate or even ask what things cost to me. Can you imagine shopping for anything other than healthcare, having no idea what the price is and having... really no choices about so many things that happen to you. So walk me through how this works and what's really going on here, because we thought with the ACA, we had different protections going on.

 

Dan Weissmann:

Right, well, what the ACA does and did for me was it means that you kind of can't be uninsurable. Like I have a congenital heart defect and it doesn't affect my life too much, but I get checked up on once a year. But before the ACA, if I wasn't getting insurance from a job, I basically couldn't get health insurance, which was scary and horrible. So, you know, and the ACA put a floor essentially under what health insurance means. It means there's a list of like 10 or so kinds of things that it has to cover, including well-care visits once a year, coverage for mental health, all kinds of things. And those things didn't exist before. Like some state, your state might regulate insurance in a certain way, it might not. So the ACA put a floor under certain things, great. But it didn't change the basic system, which is, it's a non-system. It's just a bunch of things that people and companies do. And what companies do is they like to get the greatest financial advantage they possibly can. And one of the biggest problems in some ways is that all the entities that we see and interact with, one way or the other, pharma companies, insurance companies, hospitals and providers, see themselves and are in battle with each other. If I'm a hospital or a doctor, I'm thinking about the insurance company is gonna nickel and dime me over this. I gotta be sure. Like for instance, if I'm doing a well care visit, I'm doing a preventative visit, they're gonna pay me just a little bit for it. And I'm gonna spend half an hour with this person and I'm not gonna earn any money, right? How am I gonna fix that? Well, okay, here's what I can do. I know if I ask like, hey, do you need your meds renewed? Well, then like that was a separate service. That was a consultation. Did you ask me about some problem that we haven't talked about before? Oh. That now we've consulted on a brand new problem. And suddenly this wellness, this well visit that's supposed to be free for me is now loaded up with these other charges, which now we're on another side, right? I have insurance. Well, okay, great. But what does that insurance pay? Like, and what does it not pay? Like, okay, hopefully I've gone someplace where they take my insurance and I've done that homework. But most of us, our insurance has what's called a deductible. And now we pay out of pocket before that. insurance kicks in and pays anything. Um, you know, in my case, it's like $750 and that's not very much. I mean, it's a lot to me, but when we were looking at insurance plans, right. It was like, you want that $750 deductible. Well, we're paying a lot in our kind of monthly premium for that, right. The only pay every month. Like if we were to, if, but you know, to get lower monthly premium, we would have like a $2,000 deductible, a $5,000 deductible. These things, so this is $5,000 you're paying out of pocket before your insurance does anything for you. This is your insurance company saying, oh man, these providers are hitting us up for all this money. We got to make that up someplace. We can't pay out to providers more than we take in in premiums and we got to have a little profit for ourselves. So, you know, gosh, this premium sounds like a lot to you. How about a lower premium with a $5,000 deductible? Well, that's, you know, I happen to shop for insurance on my own like this, but if I'm running a company and I have employees, I'm also looking like, what am I paying every month to cover Dan and Bobbie and their families and all the things? And if I can't, and the insurance company says, it's gonna cost you 25% more to cover them this year, I'd be like, I can't afford that. They'll be like, well, how about this? They'll just have a higher deductible. And maybe higher co-pays and higher what's called co-insurance, which is where if they actually need a big service, they pay a percentage like, and I'm like, so all of this. So, so we get hit with these, we, we, as individuals get hit while these, while these other entities are kind of edging each other, trying not to kind of go out of business.

 

Bobbi Rebell:

Yeah. So I wanna get to some financial wellness strategies for the actual consumers, for our financial grownups that listen to this podcast. So you go to the doctor, you get the bill. What can you do? I'm gonna assume you don't like the bill.

 

Dan Weissmann:

I don't like it at all. Well, one thing I'm going to do, I actually had this story of like having a well visit. This was last week. I saw my doctor and afterwards I was like, oh, I let her ask me about stuff. I admitted that I'd been feeling under the weather that we could be bad. So I'm going to when that bill comes, I'm going to take a close look at it. If it doesn't have an itemized list of charges of every single thing, I'm going to call up. And I'm going to say I need what's called the super bill. or an itemized bill with every single charge. And I wanna make sure it has what's called the CPT code on it. And I was looking at it, I was like, what does that stand for? It stands for current procedural terminology. And I'm gonna look those up. What am I being charged for? Now, maybe I'm gonna like it fine. Maybe it's gonna be like you had a well visit that's covered under the ACA and under your plan. You don't know it's anything. I'll be like, great. But if not, I'm going to look and I'm going to ask like, did that one, did that really happen? And two, if I dig deep enough, a listener just tipped me off to this. I can, I can look up. Cause you, and basically you're Google, you're Googling things here. Like what is the CPT code for this mean? And you want to go a little deeper and digging in, I can find out how much time is that supposed to take? Cause that whole encounter was like 25 minutes. And if that bill is stacked up. to show that we were there for an hour and a half, I'm gonna have some things to say about that. I'm gonna call the billing office. I'm gonna call my insurance broker. I'm gonna call, and I mean, we'll see where things go from there. Sometimes you call and someone's like, oh yeah, I see what you're talking about. And they take care of it. Happens all the time. But sometimes you call and they're like, no, that's what happened. That's our charge. You're paying it. And then, and then. This is why this is so horrible, right? Because it's like when something goes wrong with your computer and you don't really know. Like, is this the thing where if I Google a little bit and try a couple things and invest 10 minutes in it, I can fix it? Or is this this kind of thing where if like I Google and I try a couple things, I'm gonna be here all day and at the end of the day, I'm gonna find out I need a new computer. Like you don't know.

 

Bobbi Rebell:

Right, but you do say, by the way, here's a little tip. You do say, if you don't like the person you get on the other end of the phone line, call back, you may get somebody else. I want to move on to something called the No Surprises Act that happened last year. Tell us about that.

 

Dan Weissmann:

Sure, the No Surprises Act was a response to something that was so horrible that Congress actually, a divided Congress actually had to do something about it, decided to do something about it. And this was what's called a surprise out-of-network bills. Because obviously, I'm anticipating the possibility of a really unpleasant surprise for this medical encounter I had last week. And that happens all the time. This is a somewhat more limited situation where you go someplace where you've checked it out. They take your insurance. Oh my gosh, I'm worried I'm going to go to the hospital. I'm going to go to the emergency room, for instance, or I need surgery. I'm going to go someplace where they're in network with my insurance. But then I get the bill and surprise. I get a SEP. I'm getting a separate bill from a provider I saw from the ER doc, or if there's surgery, like from the radiologist or the anesthesiologist, they're not in my insurance network, they're in business for themselves. They don't work. They're not employed by the hospital and they don't take my insurance. And they're sending me a bill for. whatever they want. And my insurance is like, well, that's out of network. Maybe we'll give them a few dollars depending and if you've met you're out of network deductible or whatever. And meanwhile, I'm on the look for whatever they're charging me. That's a really unpleasant surprise. And that was entirely legal until recently. The law took effect the beginning of 2022. And now the rule is you go someplace where it's in-network for your insurance. Basically. If you happen to see somebody who doesn't take your insurance, your insurance company is just supposed to work it out with that provider and make it so that you're not paying any more than you would if they were in your insurance network. And you're protected.

 

Bobbi Rebell:

Let's talk about medical debt. What rights do people have with medical, how do they deal with debt collectors? Put it that way. What do you do if you get to the point where you're disputing it, you're not happy, but you now have medical debt, which a lot of people have?

 

Dan Weissmann:

Tons of medical debt

Bobbi Rebell:

What are your rights?What do you do?

 

Dan Weissmann:

well, okay. So, so here's a couple of things very, very important to know. One, and maybe the most important is last year, the credit reporting bureaus said, you know what? We are no longer recording medical debts under $500. That's no longer going to hit your credit. So one thing that's really important to know, and when you say medical debt, like, well, who do you owe it to? Or who's asking you for it? Is the hospital the provider asking you for it? Have they hired a collection agency to go after you for it? Or they may have sold the debt to somebody else, to a third-party collection agency that's now after you for it. That's kind of important to know because if it's the hospital or the provider, you may be able to make a deal with them and say, hey, look, how about I give you half of this and make it go away? If it's a... If it's someone that they've hired, that person may be constrained and they may say, I can only cut you a deal for 20%. If you're dealing with somebody who bought the debt, they may be like, look, I paid 10 cents on the dollar for this. If you give me 30 cents on the dollar, I'm coming out way ahead. I mean, they won't say this to you, but you can ask them, what kind of  to discount you want. So there's many, I mean, those are, those are strategies. The one important, but the, the fact that. bills under $500 don't go in your credit report at all is important because one medical encounter could yield a bunch of bills that could stack up to thousands of dollars, but they may be individual bills of less than $500. That is, I mean, look, I'm not telling anybody just stiff people, but it does give you some leverage, especially if you're disputing something to say, look, you know, there's a limited amount of damage you're going to do to me. We all have our strategies in how we deal with people. And I don't necessarily recommend, I don't think it's that effective or that nice to kind of give someone a stiff arm. But to know that you're in a position where there's a limited amount of damage they can do to you is important. Similarly, those credit reporting bureaus aren't listing medical debts of any kind for, I think a year, which again means you have time. Even if, because what you're really trying to prevent, your credit getting hurt or getting sued, getting your wages garnished, that can happen. And those are scary and they do happen. So the thing to know is you have time to kind of pursue this.

 

Bobbi Rebell:

Yeah. Before we wrap up, I want to get your number one financial wellness strategy when it comes to healthcare and health insurance and dealing with the system that we have here in the United States. For the average person who has the average amount of healthcare in a year, you know, not necessarily with a huge illness, let's hope. What can people do to not get themselves into these debacles?

 

Dan Weissmann:

It's super a Good question. I think the first thing to do is to know how to shop for insurance and to understand insurance, understand what you're getting into. An insurance contract, you know, when you, I mean, you're getting insurance benefits, like that is designed by at least as big a team, probably bigger, of financial experts and legal experts as if you were buying a derivatives contract. It's the kind of financial instrument that most of us as individuals wouldn't be qualified to get on the other side of if we were like an investment deal. It's that complicated. There's a lot to know. So I would say learn what you can. I have some resources. We have a newsletter called First Aid Kit. We did a kind of three-part series about understanding insurance because there's a lot of terminology, a lot of math to understand. And again, it's not... It's not made for us. It's made for professionals. So we have some there's a guy he's in our newsletter and he's in our podcast, he made an incredible 30 minute video about understanding health insurance. It's hilarious and it's horrifying and it's accurate. And so if you prefer this in YouTube form, he's got you. And there are other places to learn this but understand what you're getting into. How much are you likely to be on the hook for? If there's a deductible. What is it? When there probably is, you know, what are your obligations? Where, what's your insurance network? If they tell you these are the doctors you can see, fact check it. Call anybody you're thinking you're gonna see before you go. Hopefully, if you think you're gonna see them this year, like as the year begins and say like, I'm gonna read you what's on my insurance card. Tell me if you actually take my insurance. Don't tell me if you take Blue Cross, because there's a million different little variations of Blue Cross. Do you take XYZ, Blue Cross, blah, blah, blah, and they'll tell you and then call them again before you actually show up. It changes all the time and the list your insurance company gives you may not be accurate.

Bobbi Rebell:

Okay, Dan, so where can we catch up with you? I know you've got the newsletter, you've got the podcast. Give me all your socials.

 

Dan Weissmann:

Oh, thank you so much. The podcast is called An Arm and a Leg. You can find it wherever you get podcasts. You can find it also on our website, which is armandaleggshow.com. We are on Twitter and Facebook and Instagram @Arm and a Leg Show. That's us.

 

Bobbi Rebell:

Perfect, thanks Dan.

 

Dan Weissmann:

Thank you so much.

 

Bobbi Rebell:

We all want to live our best financial grownup lives and one way to do that is to know that the people we care about are also in a good place when it comes to their money. That might mean our kids, our grandkids and yes- even our friends. But how. Its’ awkward. You see them struggling- pretending to know more than they do- or making bad money decisions but don’t know what to say- and even if you say something supportive- then what? That’s why I wrote Launching Financial Grownups. In Launching Financial Grownups I share the tools and strategies so you know what to say to take the pressure off and give those you love the confidence they need. It's about giving those we care about the right amount of help, at the right time- so they can not only learn what they need to know about being financial grownups- but also be confident they can do it- and that you will be there to cheer them on. Pick up a copy of Launching Financial Grownups - I promise you will be so happy you did.

So much quality intel in that interview. Huge thanks to Dan and I’m now a dedicated listener to the arm and a leg podcast. 

Extra credit assignment for all you grownup friends: Watch the PBS report Critical Care America VS the world on why the US Healthcare system is so much more expensive- and yet somehow seems less effective than the rest of the world. We will leave a link in the show notes. And while you are on the website be sure to sign up for our free newsletter where we share more ways to be financial grownups. 

Big thanks to Dan Weissman for helping us all be financial grownups and invest in peace of  mind

 

Wellness for Financial Grownups is a production of BRK Media. Editing and production by Steve Stewart, guest coordination, social media support, and show notes by Alliee Borbon. Artwork by Chelsea Perez. You can find the podcast show notes, which include links to resources mentioned in the show, as well as show transcripts by going to my website, bobbirebell.com. 

To get even more out of this podcast, make sure you are also on our newsletter list to get more free content to live your best financial lives. There is a link in the show notes but you can also sign up at bobbirebell.com or at financialwellnessstrategies.com. And be a friend- share the podcast with your friends by taking a screenshot and sharing it on social media. Make sure to tag me on instagram at bobbirebell1. And while your there- follow me- and if you DM me that you listen to the podcast I will follow you back. You can also leave a review on Apple Podcasts. Reading each one means the world to me. You can also support our merch shop, grownupgear.com by picking up fun gifts for your grownup friends and treating yourself as well. And finally my grownup friends, don’t forget to invest in peace of mind. Thanks everyone. 

 

 

 
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