In February 2024 this website crashed for no apparent reason. Despite using professionals at GoDaddy.com it was impossible to restore anything after October 2021 (over 100 posts). I do have many of those post in draft form (no final edit or photos) and I have decided to repost them in that manner. I apologize for typos and other errors. How do I feel about losing all of my original work? Life goes on.

Years ago, we gave up cable TV and never looked back.  We have existed quite nicely with DVDs from the library, streaming services, and antenna TV.  

On Thanksgiving Friday, the family and I were re-experiencing our all-time favorite holiday movie, “A Christmas Story.”  Ralphie was cleverly placing an ad for a Red Ryder rifle (the one with the thing in the stock that tells time) in his mother’s “Look” magazine when something horrible happened.  The picture froze, and we sat in disbelief, staring at a buffering circle that went around and around our TV screen.  

We said a few choice words, but that didn’t help.  We unplugged and replugged the modem and the router, but that didn’t help.  We even checked the outage map, but it said that all service areas were green.  Things weren’t good in Kunaland.  We were suffering from the withdrawal of Christmas cheer.  Sucked away by a spinning circle that denied us knowledge of Ralphie’s fate.  OK, we knew that he was getting the rifle because we have watched this movie every year for decades, but it was devastating nonetheless.  

As I write this missive, our Internet is still out, and a Comcast technician is trying to beat the setting sun as he uncoils a giant spool of coaxial cable to reconnect us to the cyber world.  

We are not big TV watchers here in Kunaland, but deprivation is a powerful motivator.  I have found myself frantically searching terrestrial television stations for reruns of “New Gen” and “The Dick Van Dike Show.”  Thankfully, I have been successful in my endeavors, but at a high cost.  We are in open enrollment for Medicare, and at least 50% of the commercials have focused on getting me to dial various 1-800 numbers because “I could be missing out.”  Aging sports figures and ancient movie stars beckon me.  Slick commercials of happy seniors urge me to pick up the phone and dial NOW!

The following post has been researched but still represents my opinion.  If you are about to start Medicare or are on Medicare, you may find these writings helpful. Naturally, do your own research and come up with your own conclusions.

Medicare was established in 1965 by the then president, Lyndon Johnson, as part of his Great Society Program.  Before Medicare, only 50% of those 65 and over had health insurance, and very few had surgery or outpatient coverage.  The current US life expectancy is 77 years.  That is a long time to be without health insurance. Medicare is life-giving, but it isn’t comprehensive.  

The original Medicare consisted of Part A and Part B.  Part A is for hospitalization and has a deductible. The way that the deductible works can be confusing.  It involves a set deduction for every 60 days of hospitalization and a convoluted charge for skilled nursing care, which can add up.  Part B involves outpatient treatment, from doctor’s visits to diagnostics.  The recipient is responsible for 20% of all outpatient charges, with no limit.  That is not a big deal if you see your doctor once a year, but it could be catastrophic if you have to have regular expensive tests, for instance, MRI scans.  Treatments like chemotherapy and dialysis are also covered under this 20% rule.

In 2006, Medicare Part D was added as an option for Medicare recipients.  Part D covers prescription medications, and its payout is also very convoluted, having 4 phases: a deductible phase, a co-pay phase, a donut hole phase, and a catastrophic phase.  Most people are concerned with the donut hole phase, where their cash outlay for medications can increase dramatically.  

You will enter the donut hole when the total cost of all prescribed medications exceeds $5040 (including what insurance pays).  When your total out-of-pocket medication bills (NOT counting what your insurance paid) reach $7,400, you leave the donut hole and enter catastrophic coverage.  It is important to note that the $7,400 is the amount you paid, not your insurance, which can greatly burden financially strapped seniors.  However, Part D is better than what was available before 2006, which was nothing.   

Most seniors who stay with traditional Medicare will get private supplemental insurance for Part A and B (often called Medigap insurance).  This comes in various “flavors,” but many choose Plans G or N.  This will be an additional monthly cost beyond the normal Medicare B premium but will cover most of the charges that Part A and B miss.  The government sets Medigap coverage, so a Plan G from Company A will be identical to Company B.  However, companies set their monthly premium.  You may find an unknown company with a low premium for Medigap insurance.  They may do this to attract you but raise their rates more significantly than other carriers.  It is best to do a little research or use a broker to sort out a company’s history so you can determine its pricing behavior.

Part D requires its own supplemental policy.  In 2024, some Part D plans will have a zero monthly premium.  Part D plans can change yearly, so reviewing the documentation from your Part D insurer is important.  With Part D insurance, you are still subject to the donut hole and other limitations. 

What are the advantages of traditional Medicare?

-You can go to any doctor who accepts Medicare (most do).

-You can go to any hospital that accepts Medicare (most do).

-If your doctor thinks a test, treatment, or hospitalization is necessary, and if it meets Medicare guidelines, it will be covered, no questions asked.

-You can see any specialist without your primary’s approval or referral. 

-Precertification for procedures is not necessary.

What are the disadvantages of traditional Medicare?

If you are healthy, Medigap policies can be more expensive than Medicare Part C, also called Medicare Advantage. 

In 1997, Medicare developed Medicare Part C, originally called Medicare Choice and now called Medicare Advantage. Medicare Advantage is NOT Medicare. If you choose Part C, you leave Medicare and join a private insurance group. Your care will be managed like an HMO (or sometimes like a PPO).

Advantages of Medicare Advantage.

-You may have a low or no monthly Advantage premium (in addition, you still need to pay the standard Medicare Part B monthly premium).

-You will automatically get Medicare Part D, usually at no additional cost.

-You will possibly get many perks, such as:

Possible free gym membership.

Possible free dental checkups with selected dentists.

Possible additional dental coverage.

Free eye exams with selected eye clinics.

Possible allowance to pay for a portion of your eyeglasses.

Possible help with hearing aid costs.

Possible monies for over-the-counter medical items.

Disadvantages of Medicare Advantage programs

-You are limited to doctors who are members of your Advantage plan

-Those doctors may withdraw from your plan at any time.

-Your coverage is region-specific.  If you are traveling outside your hometown, you may not be covered.

-Your hospitals are limited to those that accept your Advantage plan.

-Seeing a specialist requires a referral.

-In practical terms, your care can be determined by a third party who may be less qualified than your doctor.  In some cases, your care is determined by a computer algorithm (AI).

-You may be denied care, even if your doctor feels it is medically necessary. 

-Many denials are reversed, but the process can be so arduous that you may not have the energy to constantly fight for what you need.

-There are reports of patients being denied necessary but expensive care.

-There are reports of patients having to wait long periods for life-saving treatments, for instance, expensive cancer treatments.

-Premier hospital systems, like Mayo Clinic, do not accept Medicare Advantage plans (but do accept traditional Medicare). 

-There are reports of patients being denied appropriate skilled nursing care for the needed time.

-Advantage programs can change their doctors, hospitals, and coverage annually.  You are responsible for determining if your treatment team and facility are still part of your plan yearly.

Why do brokers sometimes push patients toward Medicare Part C (Medicare Advantage)?

I can’t look into brokers’ minds, but I can list some documented facts.

-The broker receives a significant commission every time a patient is placed into an Advantage program. This commission is much larger than what they would make by referring someone to traditional Medicare.  

-There are undocumented reports that some Medicare Advantage companies offer brokers all sorts of additional perks that range from special trips, free training programs, and cash to market their businesses.

Why do private insurance companies like Medicare Advantage?

Again, I must speculate.

-It is a huge profit center for them.  They potentially gain millions of clients for whom the federal government pays a monthly premium.  In addition, some Advantage programs have a separate premium that the client pays.

Why does the government like Medicare Advantage?

-Technically, Medicare is neutral on the topic.  However, if you look at the Medicare website, it is easy to believe that Advantage programs are part of Medicare (they are not).  

-By pairing the word “Medicare” with “Advantage,” there is a clear suggestion that these programs are part of Medicare, yet better than traditional Medicare.  Why would the government allow this when it is not true? If I were making Rolex watches, would I allow a knockoff company to market an inferior watch and name it Rolex Deluxe?  

-Medicare Advantage was supposed to save the government money by using state-of-the-art models for delivering care.  It was supposed to provide care at the same or higher level than traditional Medicare.  It does neither, as it costs the government more than traditional Medicare, and many reports say it delivers poorer care.

Why would your pension plan want to change you to an Advantage plan from traditional Medicare?

-Government organizations, municipalities, and other groups offering pension plans may push Medicare Advantage as it eliminates their obligation to pay for Medigap insurance policies for their retirees (which can be stipulated in pension contracts). 

How can insurance companies profit when they give patients perks and pay brokers big commissions?  

Simple economics: take in more money than you pay out.  The more you do this, the more money you make.  Free dental exams are inexpensive, but a long stay in a skilled nursing facility is very expensive.  Limit the latter (even if deemed medically necessary), and you increase your bottom line.  There are documented cases of this. Insurance companies can squeeze profit from the other end by offering ridiculously low reimbursements to providers and care facilities.  There are cases of rural hospitals closing their doors because they couldn’t stay afloat due to the poor reimbursement they receive from Medicare Advantage companies. There are also cases of hospital chains dropping Advantage clients as they lost too much money providing care for them. 

As a physician, I have had some experiences with managed care.  Many HMOs offered such poor reimbursement that my group refused to join them.  Still, I could cite numerous examples where endless hours were spent trying to get care for a patient. Our office had a dedicated staff person whose job was to fight for medication coverage that insurance companies denied for often ridiculous reasons. These cases could return to the provider, forcing us to battle with an insurance reviewer. How many doctors can spend the time to do this?   Advantage must understand this quandary.

I remember a case where I had treated a patient with severe depression with several antidepressants, with no success.  I switched him to venlafaxine, and he had a significant positive response.  Unfortunately, his insurance plan’s formulary did not cover that medication.  Our office spent an enormous amount of time trying to get it approved, and it finally ended in a doctor-to-doctor peer review.  After being placed on hold for a long time, I was connected to the reviewer. The smug MD on the other end of my phone call asked endless questions about the patient.  I explained his past treatment failures, his amazing response to venlafaxine, his need for long-term treatment, the fact that he had a job to keep and a family to support… and more.  I spent 45 minutes talking to the reviewer.  This was during a day when I had a full schedule of patients.  This patient needed to be on meds for at least six months (standard practice), likely longer.  Ultimately, the doctor said I was right, and that the patient should be on venlafaxine.  He approved TWO WEEKS OF MEDICATION!  He told me that I could appeal again if I wanted to extend his treatment. Yes, he was an asshole, but you can see how such systems prevent patients from getting the care that they deserve. On the books, appropriate checks and balances were in place; in reality, the barriers were made impossibly high.

My Personal Story.

Despite being a physician, I found it difficult and confusing to compare Medicare plans comprehensively.  Many “balls in the air” occupied my time when I was approaching retirement. Additionally, I was going into retirement as a high-income earner.  Everyone must pay monthly for their Medicare Part B (traditional Medicare and Advantage recipients alike).  However, if you are a high-income earner before retirement, you must pay additional IRMAA surcharges. This meant that my monthly Medicare Part B payment was pretty hefty. Additionally, I decided to wait until I was 70 before I started to collect Social Security payments, as this would maximize my monthly payout.  This meant no Social Security checks for years. I did this for my wife, who is ten years younger than me.  She comes from healthy stock, and she likely would outlive me.  I wanted to ensure a more comfortable lifestyle for her. Lastly, she owns her own business and has to pay a significant premium for her private health insurance.

I was on a fixed retirement income and was faced with significant outlays for health care so I had to explore cost effective options. I’m pretty healthy, and Advantage programs in my area offered many perks with zero additional premiums (again, you still have to pay the Part B premium on Advantage plans).  I use a large medical group (hundreds of doctors), and they as well as my local hospital accepted Advantage insurance. Using a broker, I signed up for a Humana Advantage plan.

My experience with Humana was good.  I’m on a couple of cheap generic meds, and they covered them.  Additionally, I needed to see a few specialists and also had a short course of physical therapy during the last few years.  Humana covered this, too, with co-pays from me.  Lastly, I had a simple outpatient surgery, which Humana also covered.  I never used the “perks” for a variety of reasons, including laziness on my part. 

This year, I decided to change to traditional Medicare despite having a good experience with Humana Advantage.  You are probably scratching your head and asking, “Why?”  There were three reasons:

1. I love to travel around the country in Violet the campervan.  In January 2023, I attended a large rally of van dwellers in Quartzite, Arizona, called the RTR.  This rally had many seminars, including one that discussed health insurance for seniors.  They noted that Nomades on Advantage plans are often not covered when traveling outside their plan’s catchment area.  There are exceptions to this rule; for instance, a large plan may have related plans in other regions.  However, it can be difficult in an urgent situation to find an affiliated doctor or hospital that may or may not be present at your locale. Using an out-of-network provider or hospital could be extremely expensive for the Nomad.  Agents may tell you that emergencies are easily covered when traveling, but that was not the message from the talk’s presenters.  This concerned me.
2. As the rally was ending, I got a call from my wife.  She was having medical issues, and it was eventually discovered that she had a large malignant mass in her pelvic region, which was pressing on a major nerve root.  She had standard BCBS insurance, which was a godsend.  She saw many specialists from our large group, but they couldn’t help.  She then saw a neurosurgeon outside our group, but he felt that her case was too complicated.  We then went to a major university hospital and saw another neurosurgeon, who referred us to a third neurosurgeon.  Her treatment eventually involved a 7-hour operation at a major university hospital with five specialist surgeons in attendance, including two department chairs (yes, it was that complicated).  She spent four days in the ICU, many more days on a general med/surg floor, and then she was transferred to a state-of-the-art rehab hospital.  She was hospitalized for around a month in total.  Post-hospitalization, she was scheduled for eight weeks of radiation using a very specialized (expensive) machine that used a CT scanner to position every treatment.  Additionally, she needed to have a custom leg brace made and she attended many weeks of physical therapy. She got an incredibly high level of care at a top facility with world-class doctors. She was able to go where she needed to go instead of being restricted by her health insurance. If we had to pay out-of-pocket, it would have bankrupted us as the costs were astronomical.  
3. My brother-in-law needed cardiac surgery, and it was a tricky operation.  He could have had it done locally, but he researched and found that the best place in the country for his surgery was at the Cleveland Clinic in Ohio.  Their success rates were the highest nationwide.  He had regular Medicare, so he was able to go where he wanted to for his complicated surgery. 

Examining these three points, I realized I wanted to switch from an Advantage plan to traditional Medicare.  It is possible to do this, but there is a glitch.  When you initially sign up for Medicare, Medigap plans must accept you. However, after a grace period, if you want to switch from an Advantage plan back to traditional Medicare (and get a Medigap plan), you need to go through an underwriting process.  If you are deemed too high of a risk, Medigap insurers can reject you. You are asked many questions, including if you were hospitalized in the last three years or if you had been treated for cancer in the last five years.  It is possible that any “yes” answer will prevent you from getting Medigap insurance. There is also a central database that insurers can use that contains detailed patient information.  I have heard (not verified) that some Medigap companies will reject you for common problems, like being on more than two blood pressure meds simultaneously. 

Changing from an Advantage plan back to traditional Medicare on my own seemed impossible.  Letters needed to be sent, plans needed to be canceled, new plans needed to be applied for, and timeframes had to be honored in the complicated way that the government likes to do things. Luckily, I have a good insurance broker who made the transition easy, took all the steps to disenroll me from my Advantage plan, and set me up with a Part D insurance plan and Medigap for Parts A and B.  

If I stay healthy, I will pay more while losing the perks offered by my Advantage plan. However, I never used the perks anyway.  My dentist of 30 years wasn’t a Humana provider, so I continued to pay her out-of-pocket.  I thought about joining a health club but never did.  I didn’t even know about some perks, like having an allowance for over-the-counter meds. 

If needed, I will have better treatment options with traditional Medicare.  Additionally, most Advantage plans have added co-pays and deductions when you utilize more expensive treatments, like hospitalizations or ER visits.  If I ever had to seek expensive care, it is likely that regular Medicare would be less expensive overall. 

I suggest you use an honest insurance broker who specializes in working with seniors. If your broker pushes you towards an Advantage plan without discussing traditional Medicare, I would find a new one.  However, a good broker can make your life much easier as they are well-versed in this very complex topic.  

Do I think there are instances where an Advantage plan is better than traditional Medicare?  Yes, when the individual can’t afford the costs of paying for a Medigap and Part D premium. That may be a sizable percentage of the retired population. However, I don’t think the extra perks that Advantage programs offer should impact one’s choice. That is like choosing a mechanic because he gives out free car air fresheners. 

Although the above is my opinion, I hope it will get you thinking about the best option for you.

Cheers

Mike

In February 2024 this website crashed for no apparent reason. Despite using professionals at GoDaddy.com it was impossible to restore anything after October 2021 (over 100 posts). I do have many of those post in draft form (no final edit or photos) and I have decided to repost them in that manner. I apologize for typos and other errors. How do I feel about losing all of my original work? Life goes on.

Dr. Julie is the harbinger of Christmas cheer in Kunaland, with her first volley being the Christmas music that commences on Black Friday and plays in a continuous loop until the big day is over. She has a massive collection of Christmas CDs, which she oddly stores in our laundry room post season. I must admit that I have contributed to this collection in Christmas pasts, often finding one or two discs each season suitable as stocking stuffer fare. For those younger than 40, a CD is an former state-of-the-art device that stores digitally encoded music. Most have been destroyed or lost during the great Spotify war (the format war to end all format wars). A few remain among us old-guard types. Individuals clinging to the false belief that things were better in the old days.

Most of us in Kunaland enjoy this injection of Christmas cheer, at least for the first few weeks. I admit that there are only a finite number of times that I can rock around the Christmas tree and have a happy holiday. Thankfully, that inflection point is close to the end of the season. Just as I have had enough, it is time to take down the decorations and embrace the brutal reality that we call January in the upper Midwest.

Music is just the start of Julie’s efforts, which also include Christmas activities and, of course, the tree. My prior work life was replete with insane work hours, so Julie would always drag our artificial bush from the basement and set it up so the family could decorate it. This task has slowly shifted to me as a reward for my status as a retiree. In turn, I have shifted it to the entire family as my kids, with their supple bodies,  are now more suitable crawl space explorers.  

And so it was this season. Julie started the conversation a few weeks ago. “We need to get the tree up….We need to get the tree up…We need to get the tree up!” Finally, we got the tree up. Since her surgery, Julie’s ambulation has been… umm, compromised. “Don’t do anything; we will do it. Sit back and relax,” I said. However, she associates the season with many things, including reclaiming mildewy Christmas boxes from our crawl space. She needed to liberate at least a few of them. Naturally, I contributed, but the kids did the lion’s share of relocation work this year.  

I bought our fake tree decades ago. At the time, it was the latest in fake tree construction with odd hanging branches that clipped into a skirt base. Once assembled, a top completed the illusions in all its artificial goodness. At the end of the holiday, we place the tree into a custom tree body bag, and it transitions from a position of significance to a piece of basement clutter. Such is its life. Today a hero, tomorrow a discard.

Our tree’s days are numbered. Long ago, we lost several of the plug-in branches, which we craftily hid from the outside world by placing the bare parts towards the corner of the room. Don’t even get me started about the fake needles that I’ll still be vacuuming up in August. However, the biggest issue is that our tree no longer looks like a tree. There is only so much branch fluffing that one can do.

With that said, I wasn’t about to go out last Sunday night to buy a new one. This tree would have to do until I could find an excellent post-Christmas bargain. Our fix was simple: cover the tree with enough decoration so no one would know that our tree resembled a used green pipe cleaner.

Christmas means many different things to different people. It is the day to celebrate the birth of Christ, despite the reality that Jesus was born in the spring. Others focus on Santa Christmas, still others holiday parties, and for some, Christmas represents the agony of aloneness, or the sting of credit card debt.

Here in Kunaland, we do a little of this and that, but one of our favorite things is decorating the tree as a family.

I already mentioned that our fake bush is in sorry condition, but I’m here to inform you that our decorations don’t fare much better. However, we have no intention of ever changing this latter category. There will be no Swarovski crystal or Disney-themed trees in our future. Each of our ornaments tells a story. Torn, worn, faded, it makes no difference to us. Every decoration has a place of honor on our tree. Gently placed, then carefully removed and packed away for the next season in a solid Rubbermaid box. Our old Christmas tree is the frame that holds these cherished objects, some of which I will share with you today.

In February 2024 this website crashed for no apparent reason. Despite using professionals at GoDaddy.com it was impossible to restore anything after October 2021 (over 100 posts). I do have many of those post in draft form (no final edit or photos) and I have decided to repost them in that manner. I apologize for typos and other errors. How do I feel about losing all of my original work? Life goes on.

Was I poor growing up? Yes! Wait, No! Honestly, I don’t know, but whichever I was, it may be helping me now. 

Growing up in a Chicago bungalow, I didn’t have much.I often tell others that I grew up in a blue-collar household, but that isn’t exactly true. My father had worked his way up from a blue-collar job at CPS to becoming the chief operating engineer of one of its largest high schools. He made a good salary. However, money was always a struggle at home.

Our house was in disrepair and outdated. Our cheap furniture was falling apart, and we lived a very conservative life. We never went out to eat or went on expensive vacations. The only vacations that I remember were some camping trips. In that case, we borrowed an Army surplus tent from my Uncle Nick and traveled only 50 miles from our home. I had only one pair of pants during much of my freshman year in high school. I didn’t have any sort of a bedroom until I was in my teens.

My dad sat me down when I was finishing 8th grade and told me that I had to attend our local and dangerous public high school despite the fact that teachers told him I was gifted. Likewise, I was told that I had to attend a junior college even though education was a strong emphasis in our family.

The reason for our lack of money was always “medical bills.” Yet, my dad had excellent union-level health insurance. My mother suffered from diabetes, so I suppose that that was a financial drain, but I was never taken to the doctor and finally used my own earnings to get my teeth filled when I was 18.  

I am writing the above not to incur sympathy but rather to set the stage and emphasize a theme. Things are not good or bad; they just are. It is how we approach our life experiences that matters.

Over the years, I have become a success. I’m not bragging; I think most who would look at my accomplishments would agree. I became an adult during a time of consumerism in America, which helped fuel my obsessive need to compare things. I love doing creative work, and one of my passions is photography. If I wanted a particular camera, I would buy it, so I have a number of cameras. This comparison compulsion goes beyond photography equipment. For instance, I have three stand mixers. I’ll stop revealing my purchase history so I don’t appear completely crazy to you, dear reader; you get the point. Does having those things make me happy? Yes! Does having a bunch of stuff also stress me? Yes! Things are neither good nor bad; they just are.

Over the last few years, my purchasing has slowed, and my willingness to spend money frivolously has been curtailed. There are a number of reasons for this change. I have a fixed income now that I’m retired. Three of my four adult children have returned home as they pursue adult life and more advanced degrees. And the economy; this last point is the most impactful to my current situation.

The prices of everything are almost unbelievable to me. Despite my above buying confession, I have been conservative in my spending, so the hounds are not at my door, but I genuinely wonder how many are surviving during this period of escalation.

Years ago, it was common to take my family out to dinner, often weekly. Not anymore. Taking Julie out to a very average breakfast can cost $55 with a tip. My family recently went to dinner at a local restaurant to celebrate a major achievement of my daughter’s. We ordered the cheapest bottle of wine on the menu. Three of us had  small portioned pasta dishes with no sides or salads. One ordered a burger, and one ordered an appetizer as her meal. In addition, we ordered a single appetizer for the table. The bill with tip was $240. My sister recently went to an average restaurant and ordered meatloaf. It came with instant potatoes and canned gravy. There were no sides. Her bill, including tip, was $35. My friend, Tom, ordered a carrot cake from a restaurant chain (famous for cheesecakes). He went into the store, and they handed him the cake, which was $75 with a suggested 20-25% tip. That is almost $100 for a 10″ cake! Now there is a “suggested tip” when someone hands you an overpriced ice cream cone or frosted donut.

The first condo that I bought was 29K. It had two bedrooms, its own laundry room, and a balcony. What could you buy for that price now? My friend recently bought a pickup truck that cost well over $100,000.00. I took my car in for minor repairs, which were not only exorbitant, but they also tacked on a random “service charge.” There was a time when repairing an old car made sense. Now you have to think about it, but what are the options when new cars are so expensive?

Package sizes are shrinking while grocery prices continue to go up. I went to Costco to buy groceries and left with a bill that exceeded $450. I’ll still need to go to a “regular” grocery store to buy the things that Costco doesn’t stock.

We will stay at a hotel when we visit Julie’s family over Christmas. Julie made the reservations, so I don’t know the cost. However, I know that a mid-level hotel has become very expensive over the last few years.

I could rant about other costs, like gas prices, but you get the point. The cost of a former average lifestyle is now beyond what many can afford.

We have grown up with the expectation of plenty. Some of the first YouTube videos that I made centered around practical things like packing a lunch and setting up a simple kitchen. Those videos were directed to recently divorced men that I was seeing in my practice. They were used to spending without thinking. Now, they couldn’t afford to eat out every meal but didn’t have the skills to make their own food.

Growing up the way that I did has made me comfortable with changing my spending patterns. Years ago, we dramatically reduced restaurant visits, and we now almost always cook at home. I have made the transition back to the 1960s when casserole meals were king. Additionally, I’m now making more meatless meals and shopping “the sales” when I go grocery shopping (the Costco trip was an aberration).  

I’m trying to fix household appliances instead of buying a new one. I’m trying to extend the life of our cars. I’m conscious of costs when on vacation. I clean our house instead of paying someone to do it. I concoct my own household cleaning chemicals that are environmentally friendly while being more economical instead of buying overpriced cleansers.  

Could I lead a more extravagant lifestyle if I wanted to? I suppose I could, but my current lifestyle doesn’t feel like a hardship. I have everything that I want or need. I’m not going hungry. My kids continue to have our emotional and economic support as they advance into adulthood. I find many things that make me happy. I am enjoying life. I don’t have FOMO.

Part of the reason for the above paragraph is that I grew up with less, and that taught me how to live with less. I don’t want to appear Pollyannaish when it comes to the escalating cost of life. I know that there are many whose life situation is so dire that dealing with an inflationary economy isn’t an exercise in frugality; it is life-crushing. I don’t have a solution for those poor souls.

However, for others, there are many options and perhaps even a silver lining. Our economy has been structured on a consumer model. We don’t manufacture as much as we used to. Instead, our economy has become a service economy that can only be fueled by having people use services and buy products. We have been taught that last year’s clothing fashion is unacceptable. That we need to redecorate our homes every three years. That we will be judged by the expense of the cars that we drive. That we deserve to go on exotic vacations. We have been told that if we follow these rules, we will be happy. Unfortunately, the opposite is often the case. These spending commandments were not established by psychologists or psychiatrists; they were established by economists and industry. Those folks see profit as their guiding light, not other’s happiness.

For many, this has led to extending themselves past their means. They are trapped by debt. Excessive mortgages, car loans, payment plans, credit cards. They spend excessively on things that promise but don’t deliver a higher quality of life. They have been programmed to believe that they must acquire expensive “experiences” to be happy. They have been led to believe that they can no longer learn on their own. They need to hire an expert to teach us how to bake a cake or organize a closet. All of these things fuel our economy, but they don’t necessarily make lives any better.  

Half of my career had been spent working with the underserved. However, the other half had been working with the privileged. These folks had everything on the surface. They could buy anything, go anywhere, do anything. Many were very unhappy. They took the consumerism pill, but it didn’t give the cure of fulfillment that it promised.

I have talked in the past about the importance of connection with others. This means different things to different people. However, people who are connected with others in a healthy way live longer and happier lives.

Another aspect of happiness that I would like to highlight is a person’s core needs. We all have basic parts of our lives that satisfy us. Those parts can be different for different individuals. Once you understand your core needs, it is possible to find ways to satisfy them. One of mine is to be creative, another is to learn, and another is to teach. I can be creative in an endless variety of ways, from cooking dinner for my family, to writing, to coming up with novel solutions to things. Likewise, there are learning opportunities everywhere, as there are opportunities for me to pass on information to others.  

Yes, I did the above in my former doctor role, but I also can achieve these goals in my retirement life. For instance, I can encourage non-cooks to cook by posting simple recipes on my Facebook page. I can learn about any obscure topic that interests me by opening my computer. I can help others to view things differently by writing this blog. 

It makes sense to discover those core things that lead to life’s satisfaction. To start, I would suggest reflecting on events and situations that made you feel happy and fulfilled. Then strip the situations down to their basic elements.  It is through this exercise that you can find the core things that satisfy and fulfill your life. 

As economic times stress us, it can be easy to say that these are bad times. However, they can be good times. We can use these stresses to move us in new directions. Things are neither good nor bad. They just are. It is what we do with them that matters.

Mike

In February 2024 this website crashed for no apparent reason. Despite using professionals at GoDaddy.com it was impossible to restore anything after October 2021 (over 100 posts). I do have many of those post in draft form (no final edit or photos) and I have decided to repost them in that manner. I apologize for typos and other errors. How do I feel about losing all of my original work? Life goes on.

When I was growing up, Norman Rockwell prints were a big thing. They seemed genuine, yet unattainable. The holiday prints were incredibly engaging. Dad carving a turkey on Thanksgiving, or a family bursting through Grandpa and Grandma’s front door on Christmas Day, arms full of beautifully wrapped presents. These were familiar scenes, but they didn’t resonate with my reality. They represented what I thought the holidays should be, and I wondered why my holidays were not like that. 

My expectations of life went beyond “Saturday Evening Post” covers. I was obsessed with the TV show, “Leave It To Beaver.” I looked at the Cleaver’s immaculate home that had the kid’s bedroom I wanted. I slept on the back porch growing up. They lived in the fictionalized town of Mayfield; I wanted to live on that backlot. I wished that Beaver’s brother, Wally, was my older brother.  Father, Ward Cleaver, was so wise and caring. Mother June Cleaver was stylish and sophisticated. Why couldn’t my mom wear pearls when mixing meatloaf for family dinner?

Years passed, I married, and then I divorced. I lived in a basement apartment euphemistically called a garden apartment many miles away from my family and my daughter. Combine this geography with my introverted nature, and holidays and special occasions were spent alone.

I can’t say I felt sorry for myself during those times, but I admit there was an emptiness. I don’t want to exaggerate. I did travel to see my family on Christmas; I would get invited to parties. However, I was alone when I woke up and returned to my little apartment with its asphalt tile floors in the evening. Norman Rockwell was not going to paint my life for a magazine cover.

Initially, I took a “soldier on” attitude to this situation, but that stance only went so far. Eventually, I decided on a new strategy. I would establish my traditions and customize them to improve them. If I could do anything without traditional restrictions, what would that be?

Some of my initial attempts were very simple. I realized that if I let people know my birthday was coming up, they would recognize it: a card, a piece of cake at work, or a Happy Birthday telephone call would come my way.

I started to expand that concept to minor holidays. I love corned beef and cabbage, but I wasn’t going to make an entire corned beef dinner just for me. I called a local restaurant and asked if I could carry out a corned beef dinner. They said yes, and I started the tradition of picking up one on my way home from work.

After many years, I remarried and had more children (I had my last child when I was 48!). During our early marriage, my wife, Julie would take the kids to Minnesota to see her father on Father’s Day. I couldn’t go as I was working. I felt sorry for myself, but then I created a new tradition. I picked up my sister Carol on Father’s Day (her husband had passed, and her kids were grown), and we would go on an adventure. We would choose a random road and drive off into the country, exploring small towns until dinner. Then, we would find an interesting restaurant and celebrate the day. I have fond memories of those times.

My life has been “traditional” for many years, but bending traditional expectations is still necessary.

We had a lovely Christmas this year but it wasn’t a Norman Rockwell one. On Christmas Eve, we drove 400 miles to see Julie’s family, and on Christmas Day, we returned to Illinois. Most of the holiday was spent driving. Naturally, we were treated to a Christmas Eve dinner and a Christmas Day brunch. However, our Christmas Eve lunch was at Culver’s (a regional burger joint), and our Christmas Day dinner consisted of gas station food. We celebrated our own family Christmas the day after Christmas, and will celebrate with our oldest daughter and her family tomorrow. Hardly classic, but still wonderful.

When I was growing up, I wanted a Leave It To Beaver life filled with Norman Rockwell holidays. I negated my ethnic urban life for an unrealistic fantasy. As time and maturity went on, I understood that my happiness was my responsibility. My reality was neither good nor bad; it was up to me to accept it or charge it to my liking. Longing for a fantasy life was not only unrealistic, it was harmful.

I tried to impart some of that knowledge to my patients during my working years. I had folks who would spend the holidays year after year with relatives who would demean them. Why did they have to do that? Others had estranged children who would reject them during the holidays. How could they focus on those who loved them instead of grieving those who didn’t?   Some were alone. What could they do to build their connections? Others were jealous of their friend’s holiday trips or expensive presents. How could they celebrate what they did have? And so it went.

Holidays are never perfect; no one lives in an Instagram world. We are all flawed and vulnerable. However, we are not helpless. We can accept the things we can not change. We often have the power to improve our situation. However, we can’t live in a fantasy. After all, that is why they are called fantasies.

Merry Christmas and Happy Holidays!

Mike

In February 2024 this website crashed for no apparent reason. Despite using professionals at GoDaddy.com it was impossible to restore anything after October 2021 (over 100 posts). I do have many of those post in draft form (no final edit or photos) and I have decided to repost them in that manner. I apologize for typos and other errors. How do I feel about losing all of my original work? Life goes on.

I have to confess something, but I bet you already know it. I’m a compulsive person who loves to compare things. If I have an interest in something, it is unlikely that I will own just one of those things. I’m compulsive, and I spent my professional career helping people recover from alcohol and drug addiction, so you may think that I have addictive problems. The two fit together like a hand in a glove.

However, the answer to the above question is no. I don’t like being out of control, and so drugs never appealed to me. I enjoy having a drink of alcohol or maybe even two at times. However, I tend to get hot and flushed with alcohol, and anything more than a small amount makes me feel queasy. Thankfully, drugs and alcohol have never been an issue in my life.  

Some may identify my compulsive behaviors as an addiction in its own right. However, most addictions have consequences: health problems, social problems, financial problems, or legal problems. My compulsion to compare things has added junk to my home. I am forever removing and adding more stuff to my collections, but stuff hasn’t caused me any of the above problems.  

If you have read my past posts, you know that I have struggled with my weight since grade school and have lost significant amounts of weight many times, only to gain it back again slowly. For many years, my problem was that I liked to eat. I was never a binge eater; I was always a grazer. A sandwich snack, then a few hours later, some crackers, and so it went.  

After chronically being on diets, I thought that I could no longer lose weight. However, circumstances combined around eight years ago, and once again, I lost a large amount of weight, and I kept it off for quite a while. However, COVID hit, and slowly, I regained it.  

Here is a piece of information: food no longer interests me; my weight gain was due to another factor. Let me clarify this first point. There are some foods that I like more than others, but none of them drives me to eat. I usually consume an average amount of food at a given meal, and I typically eat less than those around me. Even when genuinely hungry, I’ll quickly satiate before I finish my plate. I cook meals for my family, but I make the easiest foods when I only have to cook for myself. In those situations, I commonly have a can of soup or a bowl of Cream of Wheat for dinner, even when other foods are available. Why? Because they are easy to make, and frankly, I don’t care.  

You may be saying to yourself, “So you don’t like to eat, but you are gaining weight? Bull hockey!” Honestly, it is true. However, I haven’t told you the whole story. I do have one type of food that I compulsively eat, almost to the level that I would call an addiction.

When I lost weight the last time, I made many changes. Some, like exercise, I keep to this very day. However, when COVID hit, I started to return to my food nemesis-sugar. You see, I had given up concentrated forms of sugar for years. However, it was frequently on my mind despite the reality that not eating it made me feel physically better. I won’t sidetrack about sugar and inflammation at this point. Just let me say that sugar has very little nutritional value; in excessive amounts, it packs a damaging punch. This is despite what Harvard researchers Dr. Fredrick Stare and Mark Hegsted said. They promoted the idea that a calorie is just a calorie. After their deaths, it was discovered that they were shills of the sugar industry. Those little tricksters messed up an entire generation!

When I returned to sugar, I did it carefully, eating a small sweet after dinner. However, over time, sugar has become a bigger and bigger problem for me. If you gave me the option of a fabulous dinner at a highly-rated restaurant or a bowl of grocery store ice cream, I would likely go for the latter. Bacon and eggs for breakfast? I would rather have a slice of coffee cake. A burger and fries for lunch? No, give me a piece of pie. My drive to eat sugar borders on addiction as I clearly will give up more nutritious food choices for sugar choices, and at times, I feel powerless to do otherwise. I continue to eat sugar even though I know it is contributing to my weight gain and likely other problems.

I do not typically make New Year’s resolutions, but sometimes fate intervenes. Yesterday was New Year’s Eve, and I played games with my family. I don’t like playing games, which makes my family highly committed to having me do so. It must be a challenge for them. I often submit to their requests because it makes them happy. Oh, I just digressed, sorry.

The topic of New Year resolutions came up, and I mentioned that I would like to stop eating concentrated forms of sugar. Kathryn suggested that I give up sugar for the new year. I panicked and said that would be impossible. Grace offered some logical suggestions, as she often does. None of them resonated with me, as I felt I could not commit long-term. Giving up sugar forever felt like losing a best friend. Julie chimed in, and something she said clicked. She suggested that I give up concentrated forms of sugar for the month of January. That would be hard, but setting a time limit made it seem possible. Doing such would be like the “One day at a time” philosophy that alcoholics use. I will give up sugar for a month; beyond that, I’m making no further commitment at this time.

It begins today, January 1, 2024. I successfully avoided coffee cake while making my morning coffee. Still, Julie had some Rhodes cinnamon rolls rising on the counter. I love cinnamon rolls, so this will be another test. Thousands of tests will follow in the next 31 days. I think the “One day at a time” philosophy may be good for me to adopt.  

I find it fascinating that there are still ways that I can improve myself, even during retirement. I may be able to go past January with this commitment. I’ll have to re-evaluate it when that time comes. I’ll consider this resolution a success if I make it to February. Prayers and positive thoughts for this endeavor are happily accepted. Lord, grant me the wisdom to change the things that I can.

Happy New Year, everyone!

Mike