Episode three point fifty three Managing Money with Chronic Illness with doctor Andrea Figel.
Welcome to the Brugal Friends podcast, where you'll learn to save money, embrace simplicity, and live your life. Here your hosts Jen and Jill.
Welcome to Rugal Friends podcast. My name is Jen, my name is Jell. And today we are talking with doctor Andrea Figel, who is an expert in chronic illness and the economic burden and kind of closing the gap between that and accessing care for all of our listeners with chronic illnesses and all of our listeners who love someone or care about someone with a chronic illness. And this was just a great, great interview I'm so excited to share with.
You, really really beautiful. Please do stay with us because just heartfelt. You can sense it from doctor Feigel just the entire time of her understanding of chronic illness, all of the different layers and nuances associated the micro level, the macro level. So we're gonna we're gonna hear it all. And as we discovered through the episode, chances are every single one of us does have somebody, a friend, a
family member, or ourselves managing a chronic illness. So yeah, this episode really is for everybody.
Yeah, so for those who aren't familiar with like the term chronic illness, what we're talking about when we say that is stuff like heart disease, stroke, diabetes, cancer, obesity, arthritis. This is that's what how the CDC gives examples of it. There's also als Alzheimer's arthritis as much stuff that is ongoing and it is chrome in nature, not acute, So that could be anything, whether it's from childhood or developed
over time. We're going to cover. We're not talking about any specific illness, We're talking about it in a broader form. Anybody with any of these will hopefully get something out of today's episode. But before we get into this episode, this one is brought to you by forgetting. I press play on this episode without writing anything in this section because I forgot to, and once I realized it, it was too late. We were already recording and I was wondering, yes,
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Letter, Mike Drop. You do your best work on the spot. Look at you, I do. Look at you on the spot. For those of you who can't look at her, listen to her because it's a podcast. Yes, but you can look at her on Instagram.
Actually go follow us yes at Frugal Friends podcast if this is a topic that is of interest to you for any reason. We have another episode that is pretty in line with this one, Negotiating medical bills with doctor Vergie Bright Ellington.
She is a.
Doctor who now specializes in patient advocacy for We talk a little bit about negotiating medical debt but it's really about negotiating medical bills. That's episode two thirty and we will mention it later in the episode. But episode three thirty six, how to get health and self care services for free or low cost, that will be a good one to listen to after this one, because we mention it at a certain point. Let's do it, Doctor Feigel,
Welcome to Frugal Friends. We're so excited to have you here to talk about this topic.
Thanks so much for having me, and I'm just as excited as you are.
This is a really important conversation, I think, and one that Jen and I know we're not experts in, which is why we love to bring the experts on. So we are so thrilled to have you here and to learn from you. And just as we get started, I'm curious if we can begin here of talking about some of the extra expenses that might be associated with chronic illness.
I'm sure that those who are listening who have chronic illness kind of know of this, and so maybe just hearing someone name it for them is going to be helpful. But also for those of us who do not, but we may have friends and family, what can you say about some of the additional costs associated with having chronic illness.
Thanks so much, Jill for this really really important question. And so for those of you who are tuning in, I'm a health economist by training and one of the we focus at our Health Finance Institute. We focus on basically chronic conditions and the impact of the benefits of prevention, access and adherence, so which den can both safe health as well as expenses at the patient at the systems level.
So when we look at expenses overall at the systems level, if we don't engage early enough in terms of applying the evidence that we have and creating access for those who are faced with a precursor or already the full blown stages of a chronic condition, we are really losing a lot of direct and indirect costs. Some of my colleagues dita study and it's basically, the costs are so high at the societal level in the United States that it's like nine percent of the household budget of the US.
So it's kind of like saying, whatever revenue the government generates or the country generates, let's take nine percent off of that. And that's what we're dealing with. So if you said to anybody on the street, like, that's just going to give you an extra nine percent in taxes. Let's just taxi income an extra nine percent. Everybody would be like that's crazy, Like that's insane, nobody would go along with that. But that's what we're experiencing as a
country here in the States. And so what does it mean at the individual level. So from an economic perspective, we look at direct costs and indirect costs. So the direct costs are thus paying for your medical visits, the services, the diagnostics what we call consumable so like the landsets, the test strips for example, for glucose measurements and so on. And then they are also indirect expenses. So we're paying for ill health in two ways. We're not just paying
with our pocketbook. We're paying in terms of not being productive at work, having the miss time for doctor's appointments, having additional family members to like, you know, if we're all older, helping us, managing appointments, navigating the care system, and the list goes on basically as well early retirement for example. So when we look at what the costs
are as economists, we look at both. Back to your question, based on you know, often based on the job you have, and based on the economic status that allows you to basically buy different levels of insurance, right, and based on the insurance that you do have, certain things are or
aren't covered. So you can really be faced with a lot of both direct costs than the cost of navigating the system, and then the indirect cost of not being able to be the most productive version of yourself when you're faced with a chronic condition.
Yeah, I often forget that it's not just indirect costs for a person with chronic illness, but also for the person taking care of them. They also have to sometimes miswork, going to procedures and stuff like that. So even if you had a partner taking care of you that has income, the household income can't be as high. And that's something I didn't know until I talk to more people with chronic illness.
Yeah, and it's both for persons with illnesses the caretaking, but also as people are aging and most often not Actually also that burden can fall on women, the daughters and the sisters and their moms, and that actually can
also lead to women dropping out of the workforce. For example, we saw that during the pandemic that premininly moms were taking care of the children or sick family members, and the labor breaforce participation rate dropped to a level not seen for decades because again of the toll of caretaking.
And I don't have the exact numbers, but sometimes we see really like twenty to thirty percent depression in income because of these caretaking activities, and also like the health toll as well, like the mental illness, not mental illness, but the mental burden that comes along, the mental health burden that comes with these caretaking activities and the burnout. And it's something again that's kind of like a silent partner of the chronic disease burden that we see in
the United States. And there was a big, actually front page coverage of the life expectancy is dropping in the United States for yet another year in a row.
And the reason is not just.
Inequalities, but really like the chronic disease burden, the massively chronic disease burden, and social inequalities, and also just a lot of the issues around access to care, the affordability of care, and the accompaniment of that care by either healthcare workers, social workers or family members so you can actually adhere, because again, the cost isn't just it is you know, it costs you directly, but it also costs you on other levels, like socially and in terms of your time.
Yeah, I so appreciate what you're saying, and I don't necessarily have a question in what I'm about to say, but I think it's worth underscoring that indirect cost that what your labeling and helping us to be able to identify, I think isn't Hopefully we can kind of come to some version of solutions, but I think in some ways it's just this empathy and freedom and recognition that life is not the same for someone managing chronic illness, or the caretakers or the partners or the family and the
friends of those who are managing chronic illness because we can't expect the same things. I think sometimes we talk in life seasons on this show of sometimes we go in and out of seasons where this thing is happening
or this overwhelming burden has taken place. But what is being underlined for me and what you're describing is that for someone with chronic illness, it's not just a season, it's a lifetime, and I think so much more so just space and flexibility and managing of expectations when so much of the mainstream conversation about personal finance is going to be hustle and get the better job and do the side business and meal prep for an entire day on a Sunday, and it's just like none of this
is going to be possible for somebody where there's these heavy direct costs, heavy indirect costs. I'm just wanting to underscore the importance of what you've just laid out for us, because it's it's hitting me hard in this WHOA Okay, then then a lot of other things need to shift and we can't expect the same things when when the circumstances aren't the same.
Yeah, no, I I I appreciate you pointing this out.
And just a complete side note, even in the best of days, I've never meal prepped on a Sunday, so.
We can normalize that across the board.
We don't need to do that.
So just if everyone was listening, even in the best
of times, don't real prep. So but yeah, I mean, I think and this is really like a system's response, right, And I think that I'm sorry if I come back to the systems, I always think about, you know, if this affects me so deeply, like, how can I make sure that we create solutions that if others are in the situations And this goes to the empathy our face with better options and choices, right, And I think flexible work environments right that allow you, like, for example, one
of our workers, she's managing the care of two people in her family. We've created a working environment where as long as the work gets done, and there's obviously a couple of non negotiables, right that can be integrated, And of course we're not a perfect workplace and whatsoever, but we're trying to basically say, okay, we understand that this amazingly performing individual is also a caretaker of two family members that have chronic conditions, So how can we accommodate that.
So we're not just going out there saying, well, you know, look at this crazy chronic disease burden. But actually, like for people who are faced with family members who's care they are coresponsible.
Off that they have the ability and I don't.
Know, you know, I'm sure there's other workplaces to do even better things. But I think generally that awareness is say, it's okay that we are human beings, and how can we still achieve our common goals notwithstanding the fact that we're actually in these types of situations or like you know, some of our family members maybe in these types of situations.
I think that you know, if we look at the social network, and this is also like, so when I start my class in health financing with my students in Georgdown, I basically say, like eighty to ninety percent of health isn't created in a healthcare system. So we are a sickness system, right. The healthcare system takes care of sick people, right, So what produces a healthy versus a sick individual? And that has a lot to do with the socio economic
status that a person finds themselves in. So by investing in better support structures, and that includes the ability to take that walk over lunch, to have access to that healthy food, to have coverage to pay for preventative expenses and primary care expenses and check ins so that you don't just basically start interacting with the healthcare system when you're like completely sick, and the cost to just you know, it's it's a life or death situation, so we focus
a lot on what can we invest now person at a personal and a societal level, so that we then can save in the longer run.
Yes, I love that point.
It's a notion of frugality but applied to not just the individual, but you know, really because and it's you know, the funny thing is, if we were frugal about this, right, if you say, okay, let's just spend this money on these preventative services, private care and the check ins and then all that kind of stuff, we would not just save money, we would actually help the economy grow over time too. So it's kind of this like, why would
you invest this is what? Actually it's not just good for your pocketbook, it's actually good for your economic growth in many fold ways.
Yes, I love what you're describing about just a workplace. What we can be aiming for in workplaces at a systemic level, what types of workplaces we can even be looking for, whether we are managing chronic illness or not just advocating for it or creating I mean, I know we've got a lot of listeners who are starting their own businesses. And one of the reasons Jen and I have begun frugal friends and have sought to grow it
is for that flexibility. And I think that conversation can even expand into the much larger population just from parenthood perspective and then people caring for their elderly parents. I mean pretty much this conversation does hit a lot of people in wanting greater flexibility with their work, and so I think there could be a lot of reasons to look for that or create it in what we're talking about here.
Yeah, what you were saying made me think about, like, so in work, Yes, that's one place where like you can advocate for yourself as a person with chronic illness. Are there any other ways that you have seen people or recommend people advocate for themselves to create more flexibility in their schedule or to save that money in the long run, or like anything people with chronic illness can do to advocate for themselves, either in those direct or indirect expenses.
Yeah, I noticed this is such a powerful question. So what we see, like, I think it's understanding what makes you adhere to certain treatment schedules and things like that. And when you look at, for example, fifty percent of persons who have prescribed a drug like met foreman or GLP one on what not to, which basically regulates to glucose levels, a couple of outo mechanisms when you're time.
When you have primarily type two diabetes, which again a high percentage of Americans are faced with, over fifty percent actually drop off their treatment regimen within two years. Right, and the question is why and what does this mean? Right? It could be financial, Right, people could say, well, this is so expensive, I can't afford it, and that needs to be looked into and we need to find ways
to make sure that people can afford it. But there's sometimes also like just factors like you know, they're too busy, they can't get to the pharmacy on time, they can't do this. But even though it might make sense in the short run, in the long run, what does this mean. It will cost them in terms of health, It will it will exacerbate the conditions, It will cost them in terms of their productivity. So just try not to be penny wise pound foolish. And also I think understanding that
you know what can help you stick as an individual. Right, it's really chronic conditions. The chronicity term of the term implies it's over time, it's like, you know, it becomes part of your life if it's a lifestyle, and simply as you know, if I know I need to go to bed on time to perform my best, what helps me do that?
Right? If I know I.
Need to exercise in order not to get anxiety, then what helps me do that? Like I love group exercise classes, I love workout buddies, right, And what we have seen is that person's with a social network, and we actually did studies on like social networks of diabetes and weight loss management, they stick much much more strongly to that regimen and that actually benefits, you know, the bottom line, both for the payer like the assurance, but also for persons. So it's in a sense it is frue goal to
take care of yourself. And I think that is something that we see We think we save because we don't want to spend on ourselves, but if we actually allow ourselves to keep investing in the day to day and what's necessary. Again, of course if we can't afford it, it makes so much more sense for our health in the long run. And I think that in terms of like in our person that's faced with having certain prescription drugs and a person have certain workout plans and an advocacy.
I think it's finding a understanding how you're ticking right, like what makes your healthy choice the easy choice? And maybe we should add what makes the healthy choice the cheap choice so you would choose it? So maybe you know we need to think about that. How can we make health the healthy choice to easy and the cheap choice.
I love what you're describing.
I wish this podcast had video like the whole time, because Jill and I are just nodding our heads like yes, yeah.
Well yeah, because we describe frugality as being good stewards of all of our resources, and so you're describing our own physical resources or resources of whatever medications are available to us and beyond and stewarding it well and there can be, and not stewarding it well by not making use of it, by not taking advantage of it, by not investing some of that money to avoid some of the higher costs to both our bodies and our wallets
if we're not doing those things. So I appreciate so much of what you're describing in what people can be considering for advocacy. I'm also curious if what your knowledge is, and recommendations are regarding just other financial assistance that people may or may not be aware of, whether government programs or other maybe foundations that people might be able to access to assist and supplement maybe that beyond what they can afford.
Yeah, again, such an important question is Again like with twenty eight million people uninsured in the United States and you know, personal bankruptcy, the main reason for it still being medical co expenses, you know, And we see healthcare as a human rights in our organization, so we really absolutely, you know, we feel for them, but we also think
it's an injustice. But what I've come across recently is actually that a lot of pharmaceutical companies have assistance programs for accessing their drugs, and I think that maybe something that doesn't you know, it's not maybe front page news or something like that, but several of the top ten
pharma companies they actually also assist patients. And that goes beyond you know, the pharmacy prescription programs and the couponds and this, and that you actually can apply to their programs directly if you're showing certain means testing basically showing you certain below a certain income thresholder you're uninsuredag this or that, because they want to basically show that they're making their programs accessible. I mean, I can't speak for them.
I don't know exactly if they're good motives or not. I'm sure they're all.
Across the spectrum, right.
But I was actually surprised and see that there is actually direct consumer assistance for those who prescribe these specific drugs in in a chronic disease space, and that goes for cancer drugs who can which can be very very expensive. That goes for diabetes related drugs and others as well, So encourage listeners to maybe look into that as well.
And then I think there's also a notion sometimes that, oh, you know, what does it mean that I have to basically be on you know, on medicaid or or things like that. And I think there's no shame in that, because I think by taking advantage of these programs and taking care of your own health that over time can actually pay dividends in terms of you remaining healthy and you staying healthy. And then there are sometimes also like
cash assistance programs or like we have. I live in a very very fortunate I live in a very relatively affluent community. But there are programs you know, through you know, the mayor's office and our community centers that it can actually where people can apply for assistance as well when they have issues with their medical bills. Again, not every community offers these types of programs, but I would just not be afraid to just ask within one social network.
And if there's not specific enough, I apologize. Were constantly arguing with governments about how five percent of their GDP can be saved if they just offer better primary care. So sometimes sometimes we don't focus so much on the you know, on the individual. How the person who should be at the center of this, who is at the center of this, can make ends me, then their medical bills stay manageable.
No, I mean that's great information. I have listened to these ads on TV for the drugs and they say if you can't afford your drug, reach out to that. But I never like thought about it. I never realized, like, oh, these drug companies are actually offering assistance. I just assumed they wouldn't. So I like never put two and two together that that's what they were doing because I just assumed they would not.
Yeah, and found not about it. We're actually we're working on an index called Health Impact Credit, where we're actually ranking the health impact the companies are having. And one of the things is that we're looking at do they give priority to the worst off and do they make their medicines affordable and accessible? And then you know, we comb through like a lot of data and we realize
that they have these assistance programs. Again, I have never personally applied to one of them, but I was surprised to find that every single major drug company actually offers these programs. And I wonder if they're under subscribe because both of us here who are in this field are like, actually, this is news to us, right.
Yeah, that's amazing.
A lot of a follow up but peripheral question, and this was not given to you in the outlines, so no worries. You're like, I'm not I don't know, that's not me. But you mentioned how the workplace you've created is creating flexibility in the work that you're doing. And for someone who maybe is able and desirous of holding a job while managing chronic illness, are there specific ways that people can look for jobs that are offering this level of flexibility.
I mean, I'm not imagining that there's a database, Although that would be great, but are you aware of how people can find that type of work?
I mean, I think it's an excellent question. I mean there are sort of like company rankings, right, like which companies have very good employee wellness programs. There are companies that offer programs through wellness linked insurance and that's one such program is called Vitality and it's started in South Africa. But what they do is basically they incentivize employees to engage in both fitness behavior and their health checkups to manage this a black local hypertension to wait and so on.
And what we found is that even participation of members just by once a month can both save employees over one thousand dollars in their expenses over a year, not to get the rewards from the company, but it also saves the insurance company and the employer there for a lot in medical expenses. So it's literally like a win win win situation. So if I were in the job market, I'm like, I really want to make sure that you know, my employer.
Is promotes health.
I would really look at these types of programs and if they're being offered, I think that there is sometimes a risk great if you're going in and saying, well, you know, you don't want to come across as somebody who can't manage the regular nine to five. But I think if there is sort of a if there's an organization already works in a health space and you know, maybe maybe there is a conversation that can be had.
And what was really eye opening to me was there was like there's a called Global Week of Action on Chronic Diseases and it's usually the second week of September each year, and we did like a series I think it was about two years ago on chronic illnesses and we're, you know, we were relatively young and healthy and we had I think fifteen employees at that time and we did that and what's very surprising to me is that almost everyone had a story of how they're either having
their own history with chronic illnesses or an immediate family member.
And I think it's.
Almost we just almost have to assume that it's the norm. So if we can be part of that conversation saying like, look like I mean, it could almost be like a what chronic disease accommodations do you need? As opposed to like I think the norm should be like, you know, the same thing when you like with the pronouns, right, you just want to be like I was, like, you know, at the beginning, I was very ignorant and said, why
do I need to share my pronouns? It's like, well, so that those who have specific preferences that may not be obvious don't feel the onus is on them, right, very shared pronouns. But then like the same thing with this is like maybe we just assume that everyone is having some sort of help, like what are your you know, like what is it?
And how can we accommodate it?
Right? What's the non negotiable that the employer needs and can just be met? You know, this morning, eight thirty am or on my way to work, the school nurse called and she ran through it.
She didn't even ask.
If I had time. She just assumed I had time because I'm the mom, right, So Jenny's laughing. I love it. It's like, yeah, it's like you're the mom. You have to ask health questions when I call you because you know, and I'm like, never mind that I'm running into a meeting and I'm running a whole like I'm running a company. You're like, no, mom has to be responsible for the health questionnaire of the nurse right now, you know, which
I was able to accommodate. But I'm just saying, like, I guess what I'm trying to say in a very long winded way, if those of us who employ can basically create a space where we acknowledge that it's more likely than not that everyone has either a chronic condition or someone with a chronic condition that they're partially responsible for, and you say, what's the plan, right, what's the care plan?
And just accommodate for that. And I think that so again, the one employee that we had, I mean, she two three weeks and she was doing already fantastic work. She she know, she was in tears, and she's like, I'm gonna have to you know, I think I have to resign because, like you know, I have this this chronic disease in my family and a person with a chronic disease, and I, you know, I need to manage the care and say, like, hold on a second, what is it
that you're doing. Is the universe where we can actually come to an agreement, And we were able to come to an agreement, you know, on that basically saying okay, this is this net and you need to let us know what information is key and she does fantastic work, Like I'm so glad she was able to stay with us.
And obviously that can't be the outcome in every situation, but I think that openness and I think that has to I mean, obviously advocacy of chronic disease groups and stuff like it is key, but I think it also makes a difference from the top right where those who can make those changes and accommodations can find empathy and say, well, you know, we're working with people. You know, we're not talking. You know, it's not an AI machine that's doing that work.
It's actually not a person. And I might be in that person's shoes one day as well. I'm giving you a way too long reply here.
So it's it's beautiful because and it's opening my eyes even more so to how the workplaces in the States set up in such a way as if our personal life doesn't exist in the Monday through Friday nine to five, and again, as you're identifying for pretty much all of us, it's just not true and kind of advocating for there to be space for all of us to be able to work parents, people with chronic illness, caretakers and having
greater levels of flexibility, whether we're finding that, we're creating that, if we are in a position of the ability to do that, to create spaces that provide that degree of flexibility and honoring of personhood. I think it's such an important thing to highlight.
Yeah.
Yeah, so these are things that we can do directly to advocate for ourselves and our friends and family. Let's look on like a macro level, like how can hand people with chronic illness and we the people who love them? How can we advocate for a better future? Like what's something I can do without a PhD or a lot of time to invest in in like dedicating my life to this.
Yeah, I think it's a great question, and I think just I think generally just being saying that health is a given, and health health needs to be given and
a rate rather than a benefit. Without health, neither of us would be on this podcast right now, right, So we again we see it as something an afterthoughts sometimes as opposed to something that comes at the beginning, right, and in a sense, that from a system's perspective, making sure that if people get sick or have to take care of an immediate family member that is sick, that
person can do so without losing their job. Right, So basically like labor laws, employment rights, those kind of what we describe benefits here, but really is sort of at a core of us taking care of each other but then being able to come back to our job. So I think being vocal about that is very important that if you can advocate for them at a policy level, also looking at like, you know, what are the main drivers of ill health and just you know, encouraging each
other to be aware about that. That's everything from you know, if your mom and you have time and you advocate for you know, no vending machines in school, because thirty times forty years down down the road, you know, the people with more ven unhealthier vending machines are going to be the one suffering from obesity and diabetes and excessive
costs of insulin. Like we know all that, right, So what are the small things in which we can actually ways that we can advocate for These small changes that then over time impact accumulate in their impact. So we then avert that spending in the long run. You know, my mind always jumps to, like what are the policy changes,
like what saves us the most money? Right, and what saves us the most money is really like access to you know, as the five drivers, like making sure we can you know, our kids can exercise, making sure that we have places where people can exercise for free, that it's encouraged, smoking, vaping, making sure that that is really reduced, making sure that people can access their primary care provider at reasonable rates, and that our medical system is incentivized
to not you know more often a patient with that chronic disease is see no more building can happen. But we actually don't reward physicians or healthcare workers that keep people healthy.
Right, what about that?
What if we promoted that and made them examples and heroes of our society or the heroes of the medical system.
So ultraprocessed foods, really.
Thinking about how can we make sure that we have dialogues and we hold corporations accountable, that we deserve better foods and the policies that allow us to eat less processed food, less salt, content, less high proples. Concert that's added above and beyond what we need on a daily basis if any. Also, like air quality, indoor and outer air qualities is highly important. And then just the basic conditions around mental health, like mental health.
I'm shaking my head right now.
I mean it's thirty to forty percent our healthcare costs are related, both direct and indirect, are related to mental health conditions. Right. We all have the between depression. I think of one quarter or more of women in the United States adult women are on some sort of form of antidepressant or anti anxiety medication. Right, And that's a
huge cost, right, I mean that's a massive cost. I mean in terms of the financially time productivity everyone in their immediate environment, and like, how can we create these places of empathy, empathy, these healthier ways of the day to day. And again that's a frugal decision, right.
Making sure that people can get enough sleep, that.
They're not overly stressed, they're not equally anxious, actually will reduce premature mortality, will increase labor force participation, It will do so many good things for us also financially, that on all these fronts we can actually encourage the health but also the well being of for individual pocketbooks as.
Well, yeah, room on both the micro and macro level to advocate for changes.
Yeah, I think what I'm hearing is like investing in the cost to take care of yourself now won't solve the problem, but it'll save money on the larger problem. And taking the time to invest in when it's time to advocate by your vote, taking the time to make sure that you are learning about the labor laws and stuff like that, and advocating for even if you don't have a chronic illness, for advocating for those around you who do, just assuming that everybody does have someone around them with it.
And just as a footnote, like I mean, I know that one of my insurances, like I mean, they kind of reimburse you if you check in on healthy behaviors and things like that. And you know, sometimes that can be again that won't enrich one to like by thousands of dollars, but it can be at least ways that
you feel like at least some not financially rewarded. So if anyone you know is part of these types of programs, sometimes you can actually you know, or if you're quitting, there's like smoking cessation programs and you pay you three hundred dollars at the end if you actually quit smoking, and but you pay with your diligence for debts for unlocking that that money. M hmm.
I have one more of a curveball question for you, y'all.
Jill's loving these today.
I know I am, because I feel like you can handle them of person handing them doctor Andrew and Figel. So for somebody listening who maybe even going back to the beginning of this episode, might be really resonating with the because of this chronic illness that I'm managing, the advice that's given financially just can't totally work for me. I've got to do a lot of individualizing here. Or maybe the person who's feeling a little bit deflated in
managing their personal finances while managing their money. Is there anything this isn't tips necessarily, just do you have any encouragement for them, For the person feeling deflated because of their chronic illness or as they care for someone with a chronic illness feeling as though the typical advice doesn't work for me, what might you say to them?
Yeah, I think that's such an important question. And again, you know, this is just an attempt and what's worked for me as well?
Right?
I mean it can be so daunting both from like you know, if you stuck with you know, large bills, or like just a long journey ahead of you or like a forever journey, right, And I think that people are I think we need to learn to rejoice in small steps and also think about what am I so a the things that I do on my sort of personal health journeys is what are the small things that can change? And am I doing better today than I did yesterday?
Right?
Did I whatever? Did I go to sleep a bit earlier? Did I manage my stress a little bit more?
That kind of stuff?
Because that accumulates over time, So chronic conditions come into play. Obviously there's genetic predispositions, but very often they emerge from very long term standing patterns and so managing them will take time. Getting better will take time, and also getting better financially will take time as well. And again I'm not trying to minimize the very acute obviously physical pain,
physical stress, and often a financial pain and stress. However, you know, I look at it also so it's basically am I better today?
Am I making small things? Small? Changes that in the end will get me there.
And this is also like when you, for example, on a fitness journey or a weight loss journey, for example, when will I be fit? Right? I don't know when I will be fit, but I know that if I keep sticking to this plan, there will be a day in the future where I'm.
Like, I guess I did it.
But I need to keep going on that journey, right, Because it's not like you're not going to be all of a sudden in better financial shape like overnight. You're not going to be like, all of a sudden completely cured overnight, unless some sort of miracle happens. But for most of us, it's a journey. And I think that kind of like looking at the what's better today than yesterday and realizing that I need to let go of
that immediate need for feeling immediately better. But I just if I stick to the planet, it will be one day where I look back, I'm like, yes, I'm better than I was, Like I feel better financially, I feel better physically than I was three months ago or four months ago.
You did it. Thanks for that message from gentleness that is definitely above and beyond what I was hoping for to go for speaking in the way that you did out of your expertise and years of experience and caring for others in this space, speaking of consistency, and just one day at a time, and we don't know where it's gonna lean, but we're gonna keep doing it.
And I think you're fully capable of this one.
The bill of the week.
That's right, It's time for the best minute of your entire week. Maybe a baby was born and his name is William. Maybe you've paid off your mortgage, maybe your car died and you're happy to not have to pay that bill anymore. That bills, Buffalo bills, Bill Clinton, this.
Is the bill of the week. I have so many of those. You have way too many of those. All right, I'm so excited. Yes, so, doctor Andrea. Every week we invite our guests or our listeners to share with us their bill for the week, and we are excited to hear yours.
Yeah.
So I got into a little car accident last weekend. Somebody bumped me. Thankfully none of us were injured, so knock on wood, and thankfully I have good insurance. But basically I chose a rental car and even though it insurance covers it, I was like, you know, I don't like, I think there's value and not overspending, right, being frugal
and mind full of resources periods. So I chose like a very cheap rental car, and then it came and brought me just massive as UV, and I thought usually they honored the original price, right, and so I was really upset that they then like basically snug me or my actually my insurance company with a bigger price tag. And I was like, that's all not cool, Like even if I'm not paying for it, I don't think that, you know, they're basically abusing the system, and I just
hate that. I hate the notion of, well, somebody else is paying for it, I can just stick them with the bill, because I think it comes back to you and I think it's a part of honesty and integrity.
So I took it upon myself to be on hold for or three hours of this car company and they never picked up, and then they're like and then I was like going on literally like reddits and like online searches because I'm like, I am not having them build whoever they're billing more than they should, and I found this like corporate email address, and I basically forwarded a complaint and ce seed my insurance and I said, this is the contract that's enough for but this is the
bill you stuck with me, with me with and that's not okay. And then they escalated it and they're fixing the issue.
So even though I'm a.
Personal benefiting from it, I feel I did the right thing. But I just hate it when, like you know, like I just hate it when there's this over billing issue and things like that and I take, you know, I on my company. I like, even though I don't have to, I check out bank account every single day, and I just also like, sorry, one more bill, like two years
ago around Thanksgiving somebody. It's always around Thanksgiving because that's when the tax to do for nonprofits and then basically we always have to say how much is in a bank account. So basically, like I hope no scammeras listening to this, but basically, like nonprofits have to basically report how much money is in their bank each year, which
companies for profits don't have to do that. And so around the busy shopping time is when people try to take advantage of organizations like hours that tries to do good work, and it's very hard to raise money for nonprofits, and so they started racking up a credit card and I was able to reverse that. And then two last year they tried to steal sixty thousand dollars from our bank account by breaking into our expensify and changing your spending limit on our cards, and again I was thankfully
able to stop that and reverse that. But you know, sixty thousand dollars for a nonprofit that tries to help people with chronic conditions. I mean, how crazy and annoying do you have to be to try and stiff us with that?
You know, so annoying is not the word I would.
It's been crazy any right, Yeah, expensive, I said, this is a little spending car that was created by these cameras and it says like easy money.
And I'm like, you gotta be kidding me.
So yeah, I go.
I go full in, Like if I feel that there's an unchest bill, there's an overbuilding, there's something, I go and I'm like, not with me.
I'm very I'm like, no, not with me.
So I love this question.
By a way, Wow, you've got advocacy in your veins. I'm loving everything that you're saying. And what a beautiful marker of integrity like you're saying. Because the more and more we let, even at these smaller levels the system be taken advantage of, we eventually are the ones taken advantage of. I think we see it so much in the medical world, and you're identifying it then just in this other insurance space. So man, well, thank you. I resume given your time to do all that.
Yes, I love it.
Wow. If you all listening, have a bill about advocacy for justice, if it doesn't even benefit you, but it benefits the nation and the world, we'd love to hear it. Visit Frugal friendspodcast dot com slash Bill. Or if your name is Bill and we don't care what you've done, call us too because we love that too. Frugal Friends podcast dot com slash Bill. And now it's time for the und all right, now we have more animated as the episode coast.
I know we do our own stunts. So this week's question in the Vulnerability round is how do you personally budget and or save for like regular non emergency medical expenses that regular self care that's going to cost us a little bit in the short term, but save us in the long run. So Andrea, you can.
Go first shout out to goodl Excel.
I just have like an Excel sheet and try to have like slacken in.
What I'm doing. And I do overspend in.
Healthy foods and personal trainers.
Hey, it's not overspending. If that's what you value, I value it a lot.
I also recently got divorced, and some of my friends call me like, you, no, you don't have a revenge dress, you have a revenge body.
I gladly take that compliment.
Seems way more sustainable and there's a lot more longevity and that for sure.
I love a revenge I know, right.
Yeah.
No.
I tried to budget, and I was always very good with numbers and even budgeted for my parents when I was young. I grew up very poor, and I actually sometimes my grocery shopping for them because my mom would always spend something extra, and I was like, no, no, no, no, you got to stick to the budget. So I had to basically just intrinsically know like what's over and underspending, and then you know, I try to like get my stuff together of like making sure I have a couple
of months' worth of savings and stuff like that. So but again, I grew up very poor, but I'm now in a very privileged position, and I thankfully I'm able to put some money aside and to have a little
bit of slack. But yeah, I've been on thirty five dollars a week food budgets and literally like no savings when I was in my university program and I had these issues with my teeth and all of a sudden, seven thousand dollars in expenses and I was working sixty five hours a week while I was doing my master's program. So I know how it feels, and I'm just like, when you're stuck in this position, I just honestly did what I could and prayed and bleaned on some friends.
So you know.
Yes, sometimes that's how we get unexpected things covered.
There's those seasons exist in illness and regular illness.
So yeah, we don't want go fund me to be the plan, but sometimes it's what ends up being what's needed. And so I'm glad that it does exactly because we don't. We don't always have backup for whatever life throws at us. So good to have friends and community.
Jill, is that your plan? Is that your answer? That's how you say for regular There was.
A really fun there was a really fun study that looked at like what makes people live long? And it's basically the amount of friends you have, the amount of exercise you do, the amount of beans and lentils you eat. So exercise, sleep friends, and beans.
Are so I sleep friends, and I'm gonna live forever. If I am gonna live forever, because I would love interest, my children are gonna live even longer because basically that's all Kai eats it.
And the young a bean salad. Lately, I didn't even know I was investing in longevity.
We're gonna live forever together, Jill, together the old day. Okay, what is your actual answer?
Oh? No, one's gonna like this. Well, who knows. I can't say that you're saying non emergency. I do have a sinking fund for medical expenses, and it's the amount of my deductible, which is quite high. So if I can't pay routine expenses out of just like my miscellaneous money,
then I'll dip into that sinking fund. But as far as preventative care goes, I am not a person living with chronic illness, and so I'm as focused as much as possible on just how can I maintain health in my day to day and how can I do it for free? So I'm really not spending on medical things. I do free YouTube exercise. I make a veggie smoothie every morning with my VitaminX. I invested in that three years ago on a Black Friday. I recommend it.
Everybody knows she loves her vitamins.
I drink a lot of water. I love sleep, That's what I do. What about you, Jen?
So I am not getting a ton of sleep right now still, But as you know, Atlas is like what seven almost eight months old at this point, so it's getting better for sure. And I'm actually like in this right now. I didn't plan this around this episode, but I had a back injury two weeks ago, so I don't regularly have medical expenses, but I have been spending more than usual right now just because of this lower back illness injury. And I have a half marathon in a week and a half, so like there's like a
time crunch to getting it. So I am spending a lot of money on chiropractic care and acupuncture to try and heal it quickly. And two things I will recommend on those like community acupuncture just googling community acupuncture in your city is low cost, sliding scale acupuncture. And then the joint chiropractors, like I had never been, but it's like essentially a franchise that just makes chiropractic care affordable and accessible, and I was like, Yay, they're doing great work.
So I think finding those community they're not nonprofits, they are for profit companies, but with a goal to make quality for profit care accessible and they just change up the way they do it. It's in a it's not private room, it's not exclusive, it's you know, one big room. So looking for things like that when I do need care, but then it really just comes out of our miscellaneous fund because I don't use it very often. I work
out very frequently. So I've been struggling with postpartum depression in this postpartum experience. I didn't with my last one, and so I have personally decided to try and just use exercising to get through it, and that has really
worked well. And the biggest cost to that has been my personal guilt for choosing to exercise rather than like if I should be working, or feeling like I should be working, or maybe feeling guilty for having my kid in daycare, but knowing that this is that is the highest cost I pay for this like type of self care. So that is my medical expense is in a nutshell right now.
Thanks for sharing very quick foot note to this, just because you spark my brain. I don't so back when I was in Canada, and I don't know if they have this here so for me, like chiropractor, like I used to be a dancer, and again like a student, so they used to have these colleges of massage therapy and you could basically get students to give you massages. And I also hacked the system because they had eight semesters, so I started to know that I needed to ask for level seven level eight students.
To get scheduled from a massages.
So pretty much I got a almost fully baked massage therapist as opposed to like a novice, and you know, you got like massages for twenty or twenty five dollars.
That's also how I got my haircuts and like all this kind of stuff again not medical, but whatever, So I don't know if that exists in the States, but that it might as well, you know, so things like that just about exercise, you know, like exercise releases actually like happiness hormones, like from your muscles when you compress your muscles, and I find it's so fascinating, but it's
such aally therapy. And then the other thing I did because again like it's so like mental healthcare, even with the apps and whatnot.
Can't be so expensive.
And like that's not just radios, it's internationally. So just one program I loved and it's called fifteen Minutes for Me dot Com and they just I think it's like fifty bucks per month or something like that, but it has like baby check ins and things like that. And when I was traveling a lot and really like you know, distressed and sleep deprived, I was like, I just need something, but I couldn't see my therapist, and I couldn't afford
to see my therapist, you know. I was like totally like this is again it's not free, but it's comparatively affordable and also really like you know, science based and helpful.
Yeah, well we actually see these additional tips at the end.
I know, I love and we actually did an episode about getting those like services from different schools episode three thirty six. I just looked it up, but yes, so I haven't. There's a massage school actually very close to where we live that I have gotten massage at before, but I haven't done one lately. Yeah, thank you for those additional tips.
Speaking of more, doctor Andrea, where can people get more from you?
I'm quite active on LinkedIn. So this my name, Andrea Feigel. I'm LinkedIn and you'll find me obviously hopefully you know people who listen to this podcast. And uh yeah, so our website is health Finance Institute dot org, or you can email me. It's Andrea at Health Finance Institute dot org.
Awesome, thank you so much for coming on, Andrea. Thank you for everything you've spoken. It's been enlightening and we've both just are next are tired from nodding so much, so thank you so much.
No, it's been an absolute pleasure, and thank you so much for what you do. It's absolutely needed. And you guys are fantastic, You ladies are fantastic. So what a pleasure.
Thank you, Thanks Andrea.
Sometimes you leave an interview saying like that was a good one, and I left thinking that's a good one. I think people are going to get something out of it, because I did at least, so if I can, you can.
I'm not gonna lie. There was a few moments where I felt on the verge of tears, and that may just be where I am today and whatever I'm experiencing inside myself today Tuesday. I think the extra focus and acknowledgment of what those managing chronic illnesses are facing day in and day out can, just as I look at it, can feel so weighty, and so I think, even to hear doctor Figel's messaging of one day at a time,
be gentle with yourself. Yeah, there was just a lot in there that felt so intensive, but in a good way. And I'm so glad that we've got the space to look at what are the circumstances that many of our listeners are experiencing and our friends and family. I mean, you know that I lived with my grandmother who has Alzheimer's for a year to take care of her and met those indirect costs of it, interrupting some work, and yeah, just the toll that it takes on life. And that
was just a year. So Andrea, I appreciate this podcast and I don't know. I love our community and the people who even message us asking hey, what about me? Can you help the community to see people like me who's managing mental health concerns, chronic physical ailments. Can we make sure that all of us are seen and acknowledged. So lots of feels going on for me over here, and grateful for experts like doctor Andrea, and grateful for all of you who are listening. Many of you know
that we also have a newsletter. It's called the Friend Letter, and we send it out three times a week where we talk about freebies and savings tips and life hacks and actually so many were mentioned by doctor Andrea this week. I think this week we're talking about beauty schools and how to save in that regard, and just lots of different savings tips and hacks that are in this newsletter.
So if you want those reminders, you want to know what's available, you want something in your inbox weekly that's helping you to save and get free things, please get that. We want to also shout out a friend for replying to one of our emails who said I love this and how finances relate to our hierarchy of needs filing this away to glance back at forever. Thank you not just in the future, but a glance back for forever
from Rachel. And that's been a special unexpected treat too, is seeing the response emails, because you can you can get the newsletter, the friend letter and then respond to us and we see it and so that's also amazing.
It comes straight to our inbox. There's no like public forum for these emails, but we love to read them and it is special for us. So thank you for your email, Rachel.
So if you want these freebees, savings tips, values based spending hacks to your inbox every week so that you can even earmark them for forever, Frugal friendspodcast dot com slash friend letter, or you could just go to our website Frugal Friendspodcasts dot com. You can also follow us on Instagram because we love it when you can engage with us there and the link is in our bio, so tons of ways to get at us.
See you next time. Frugal Friends is produced by Eric Siriani. So I was at FINCN this past week. For those of you who don't know, finn Con is a financial media convention and expo. It is where all of your favorite money podcasters, bloggers, YouTubers, and a lot of influencers converge on each other for a week, converge on a city for a week. Sorry, that was a bad way to say that. And this year was New Orleans, and
I'd never been to New Orleans. And this might be a little TMI, but I had a checklist of things that I wanted to eat in New Orleans and I made the whole checklist. I did all of them, and by the end of the week, I had consumed so much sodium that my feet swelled like I was nine months pregnant, so painful. I don't eat a lot of sodium, like even in the takeout. I guess, like I'm I don't know if my body just wasn't accustomed to it
or what. But I was told after I told somebody like how much, not how much I'd eaten, but like what I'd eaten, They're like, oh, yes, all of those things have a lot of salt.
And I was like, oh, can you give us like a quick snapshot of what what?
Yes? I started with Bignet's, but I don't think those were the salty, you know, the things with the salt. I had jambalaya, gumbo, shrimp, po boys, many sasaaks, which is a local delicacy drink. Also don't think those were the salt givers. But I had the other things multiple times, and while all delicious, probably consumerated to the demid eyes of my ankles.
Too much of a good thing.
My ankles left me and I just had a leg, just had leg all the way down.
So well, what did you learn, jen H?
Everything in moderation.
Yes, fin CON's dangerous. Thin Con is dangerous.
That's what I learned. I'll be back next year in
Atlanta with moderation in tow maybe