Episode 498: The Healthcare Heist: Why Our System Is Broken & How to Protect Your Wealth w/ Jordan Grumet

Jordan Grumet 0:03

Look at all the mental gymnastics we're already talking about: affording healthcare before you're retired, affording it after you're retired, affording it if you need long-term care. We shouldn't have to do this. Like this isn't something we should have to work so hard for. There are plenty of countries around the world where none of this happens, they just go to the hospital, get the care. They just go to the nursing home, get the care, and it doesn't bankrupt anyone.

Intro 0:27

Welcome to the Journey to Launch podcast with your host Jamila Souffrant as a money expert who rocks her talk. She helps brave journeyers like you get out of debt, save, invest, and build real wealth. Join her on the journey to launch to financial freedom in

Speaker 1 0:47

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Jamila Souffrant 0:56

If you want the episode show notes for this episode, go to journeytolaunch.com or click the description of wherever you're listening to this episode. In the show notes, you'll get the transcribed version of the conversation, the links that we mentioned, and so much more. Also, whether you are an OG journeyer or brand new to the podcast, I've created a free jumpstart guide to help you on your financial freedom journey. It includes the top episodes to listen to, stages to go through to reach financial freedom, resources, and so much more. You can go to journeytolaunch.com/jumpstart to get your guide right now. Okay, let's hop into the episode. Hey, hey, hey, journeyers! Welcome to the Journey to Launch podcast today, we have returning guest Jordan Grummet, who is a hospice physician, author, and host of the Earn and Invest podcast. Who is known for exploring the intersections of medicine, personal finance, purpose, and well-being. He has been on the podcast a couple times. I noted it before our call, Jordan. You you were on episode 281, lessons about living from the dying and finding balance in between in 2022. Then you came back at the beginning of January, episode 407, building a life of purpose and finding meaning with everyday life. And you previously, Jordan, released two books, Taking Stock and The Purpose Code, which we talked about on the previous episodes, and now you have a new book, which is called The Healthcare Heist. And so I'm so excited to have you back.

Jordan Grumet 2:32

Thank you for having me. I'm excited for this conversation.

Jamila Souffrant 2:35

Yeah. So Jordan, I know some people may not have heard your backstory and kind of your origin of starting in this kind of field that you're in. Can you just give us like a quick story of how you came to where you are today?

Jordan Grumet 2:48

Certainly, it all started, believe it or not, when I was seven years old. My father, who was a physician, went around at the hospital. He got a severe headache and actually collapsed and died. He had a brain aneurysm, a blood vessel that burst in his brain. Being seven years old, I thought everything that happened in the world was because of me, because of the age I was. So I assumed that I was somehow responsible for his death. And after a few months of really thinking about it as a seven-year-old, I decided the way to make up for this horrible tragedy and my role in it was to become a doctor like him. And that was an incredibly purposeful thing for me. It was really exciting. I didn't care about money. I just wanted to be a doctor, and I worked my tail off to get there. Right, I had a learning disability when I was really young. I spent most of my college years in the law library studying. Eventually, I became a doctor, and instead of being Nirvana, I actually burned out really quickly. It didn't solve the problem. Like my father was still gone, and I realized I couldn't save every single patient, and that burnout really helped me start to think about personal finances. I'm like, well, I don't have any other skills, and I know I can't be a doctor forever because this is exhausting. What am I going to do? I actually eventually discovered personal finance, financial independence. A guy named Jim Dolly. I read his book, The White Coat Investor. I started to pursue financial independence. Realized I was there fairly quickly, and slowly left medicine. When I say slowly left medicine, I was a general internal medicine doctor. I left everything I did, but hospice work, taking care of the chronically and terminally ill patients at the end of life that kind of filled me up, but it allowed me to leave most of medicine and fill my time with other things that I thought were joyful, including writing, talking about personal finances, and that led to a deep dive of purpose. I often talk about personal finance and purpose. What I don't talk about is what caused so much frustration in medicine, and it wasn't just that I burned out because I couldn't bring my dad back. I was also burning out because it was a typically flawed system in which doctors and patients were moving farther and farther away from each other. It was a confrontational relationship, not one of allies, but of combatants. And I was watching all the money that was flowing in. The system, the economics of healthcare that we're supposed to pay for patient care. I was watching these third parties take all the money out, whether that is the government, or health insurers, or pharmaceutical companies, or venture capital and private equity. So, a lot of my frustration led me to leave the system and develop a world of financial independence and stability for myself. But now, as I get older, I realize that's not really a solution for everyone. Like we need to fix that system. I can't just walk away, especially with all that I know and all they have learned all these years. It makes sense that we talk about how can we fix this system so more people can stay within it. We can get people good healthcare, and doctors and nurses don't have to become financially independent, so they can escape. They can actually enjoy their careers,

Jamila Souffrant 5:44

right? It's such a, I think, privileged position to pursue financial independence, to have the resources and the income and the access to be able to do it, and just to believe you can. And it's so, I think, a great point that a lot of our frustrations, whether it is you're in the medical field or for me, I was just in corporate America and I just wanted more autonomy. You know, we choose if we can to then exit the system by pursuing financial independence and having more control over our lives. But the system is still there, and it's a system that you know our family and our kids and just people, our community have to inherit. So it's very, I think, great that like people like yourself are, even though they have the ability to leave and not look back, maybe to come back and like shed some light and resources on navigating something as important as the healthcare system, because we all need it, we all eventually will need medical help if not already, and have people in our lives that are in the hospital or will go to doctors. And so, I just think it's such an important topic to explore.

Jordan Grumet 6:54

And you know, I love this framing. It really is a privilege to think about things like financial independence, a privilege that you and I have worked very hard to be able to exercise, but let's think about why it's a privilege. Well, we know about all the systemic factors that make it hard for your average person to pursue financial independence, but one of them is healthcare. Right? Healthcare is one of those things that's expensive that you could have a horrible thing happen to you, where if you don't have health insurance, it could bankrupt you. Both you and I had to face one of the same things when we decided we were going to escape the system and pursue lives that were more meaningful to us. We probably both had to sit there and go, "Okay, I'm going to leave my job. I'm going to leave my practice. You're going to leave corporate America, but how are we going to pay for health insurance. It was like a big question. I'm sure for you, it was for me for sure.

Jamila Souffrant 7:44

Yeah. Well, I was lucky and privileged to the fact that I my husband still worked, and so I that I had a partner, and that my partner had health insurance that I could stay on, and that was not an expense I had to worry about.

Jordan Grumet 7:56

And I think that's something that a lot of times you have a couple, and both couples will want to run. Both the people in the couple want to run the business, but one will be like, "No, no, no, no! I better stay so that we get our health insurance. And that's in the best of cases where you actually have one spouse who has health insurance. We know that there are lots of people, lots and lots, who it is a major stressor in their life.

Jamila Souffrant 8:19

Yeah, I think I would have definitely thought differently. Maybe had a different exit strategy. Just everything would have been different if I also had to consider healthcare for myself and family. And with that, let's talk a little bit about. I mean, when you when you think about financial freedom, whether you are pursuing early retirement or financial independence, or you just want to have your finances together and retire at the standard age. Healthy here is a big part of that, and I think for the decision for some people when we're on the journey, especially if you want to become entrepreneurs or quit early, is like we're talking about what do we do about healthcare? It's one of the biggest expenses, especially if you're sick and not healthy. So can we talk a bit about what that looks like on the financial independence journey and the things you've uncovered with your research and just experience?

Jordan Grumet 9:07

Well, the thing about it is, it's so much easier if you have a job. Now, that doesn't mean you're not going to be paying out of pocket. You're going to still have copays and deductibles and all those kind of things. But once you've decided that either I'm financially independent and I don't need the job anymore, or I'm going to go the entrepreneurship and buy my own insurance. You start to realize that insurance is not just expensive; it's prohibitive. I mean, think about that. I have a family of four people. If I and right now we are paying out of pocket, Cobra is about 3500 a month. Think about normal people in the financial independence realm talking about living off a million dollars net worth and spending $40,000 a year just health insurance. Nothing else can almost eat up that whole 40,000. So then the question becomes: Well, what do I do then? And it is true Obamacare. You can go to healthcare.gov, and there are subsidies. Those subsidies work, but only to some extent. So, if you have very low income, that will serve you. If you don't have very low income, the subsidies quickly fall off. And so, if you're making enough money, it actually is counterproductive because then you have to put it right back into healthcare, and so if you're not going to get it from your employer, and you're not going to get it from healthcare.gov, really your choices are pretty limited. There's health sharing ministries, so there's these private groups, often religious, that you can pay less into, and those big groups will then insure other people. So a lot of times they do this around religion. There are a lot of Christian groups, but those aren't technically insurance, and so there's a lot of questions about if you have any say if they decide not to pay for you. And there are also all sorts of rules about things like alcohol and other types of moral and ethical things that can disqualify you for care. Above and beyond that, there are a few other possibilities. There's something called farm bureau insurance, which again is very rare. But there's some places where you can apply to a farm bureau, or you can get expat insurance, right? You can go live in another country or geo arbitrage. All I'm saying is none of those things are easy. And even if you do have traditional insurance, there are limits to a lot of insurance policies, so that even if something catastrophic happens, and you end up with, you know, it's not uncommon when something catastrophic happens for someone to have a million dollar hospital bill. So what happens when you're responsible for 20% of that or 10% of it? Medical care still bankrupts people in America, and so the problem is there's no perfect solution. And a lot of people think, well, I will just wait till I get to Medicare. But even Medicare isn't perfect. If you make too much money, your Medicare premiums go up via something called Irma. But not only Medicare Part A and B, but people need supplemental insurance, right? Because you still have copays, you still have deductibles, and you still have the cost of pharmaceuticals, and so you have to get a Medigap plan, which is going to cost you through Blue Cross Blue Shield or United Healthcare, whoever. Or there's Medicare Advantage where you pay less, but it's run by these big companies, and most of the studies show that they actually don't deliver as high quality of care. And once you get Medicare Advantage, if you ever decide you want to go back to traditional Medicare and then buy a Medigap policy, it's actually almost impossible because then they can pre-qualify you and decide that you have too many pre-existing conditions. So when you first go on Medicare, all the Medigap plans have to take you regardless of your pre-existing conditions. But if you choose Medicare Advantage and then realize after two years it's no good and they're not giving you good service and want to go back to traditional Medicare and Medigap, they will evaluate you and a lot of times they'll either charge you a huge amount or they'll say you don't qualify.

Jamila Souffrant 12:54

Right now, I know based on your income, like for things like Obamacare and or even Medicare, Medicaid, Medicare. I was, you know, honestly, I Medicare and Medicaid. I get, I make sense.

Jordan Grumet 13:05

Medicare is based on age, and Medicaid is based on income.

Jamila Souffrant 13:09

Got it. But also, how do your assets factor in? Because I know that it is something within the financial independence community where you build up your assets because you don't want to be able to draw down on them. It doesn't necessarily mean you have a lot of income, though. But then your assets count against you for certain things, even if it's not cash flow.

Jordan Grumet 13:25

Correct. So there are a few different places where your assets matter. Generally, believe it or not, when it comes to Medicaid or when it comes to healthcare.gov, they're really looking at your income. Now, I will tell you, people who have a lot of assets tend to generate income whether they want to or not. I'm a perfect example of this. Like, I stopped working. I make a little bit with my podcasts and books, but make much less money than I used to. And my wife stopped working. So you think, oh boy, you guys have a lot less income. But the problem is, we actually need money to live off of. Well, where do we get that money to live off of? We sell equities. Well, we sell equities. You end up having capital gains and dividends, and those actually increase your income, which can then qualify you out of these subsidies. And so, even if you are wealthy, it is true if you really work it. If you're in a you know work with your accountant, really work it so that you have very low income, you can qualify for either Medicaid or Healthcare.gov with subsidies, but for most of us, that's not really possible because we want to actually spend that money we accumulated. In order to spend it, you're going to have to get it from somewhere. You're either going to have to get it from retirement funds, which is regular income, or you're going to have to get it from selling equities, which is capital gains and dividends.

Jamila Souffrant 14:39

Right, and then the other thing that I see that happens, especially for older people who do have assets, like a home where it's not liquid, and but in order to get the care that they need, they they they have to put it into a trust.

Jordan Grumet 14:50

Yeah, what you're talking about is when you get older, the big killer we worry about is actually long term care insurance. So the problem is, if you need long-term care, either having someone come into your house and take care of you full-time, or living in an assisted living or a skilled nursing facility, those things are exceedingly expensive. I mean, you're talking 15, $20,000 a month, and guess what? Medicare nor health insurance pays for long-term care, and so the question is, how are you going to pay for that? But there is one entity that pays for long-term care. It's Medicaid. But to qualify for Medicaid, you have to be of low means, right? You have to have very little money. So when you have people are on Medicare, and all of a sudden something catastrophic happens, and they think, boy, we're going to need long-term care for three or four years. It's going to bankrupt us. It is true. If you have very few assets in your name, like let's say you're a couple and you have almost no assets in your name, you will qualify for Medicaid immediately. The problem is you were planning on living in retirement, so you have to have assets to pay for that retirement. So you end up spending. So if let's say you have a healthy wife and a husband who's sick. You put the husband into long-term care. The wife has to spend all of her money to pay for that long-term care. You know, 15 to 20,000 a month. She eventually spends everything down until she has nothing to pay for herself, her house. Then they qualify for Medicaid. So it is true if you think about it beforehand. And Medicaid has a five-year lookback period, so I can't just transfer all of our money into a trust once something happens. You've got to do it about five years before something happens, and so you have to actually be planning with a healthcare lawyer and an accountant like 1015, years before any of this happens to get your money somewhere safe, so that God forbid one of you needs long-term care, you won't get killed by the spend down, right? You don't want to get rid of all your assets, or the spouse who's left doesn't have anything to live on. Believe it or not, sadly as it is, people would get divorced for this reason. People who were married for 50 years and then one needs long-term care and they didn't want to spend on the other's assets. They would get what's called a Medicaid divorce, so that they could separate their finances, so that they would qualify for Medicaid faster and not mess up the other person's finances, which is really sad if you think about it.

Jamila Souffrant 17:16

Yeah, it is, and you know, again, this is if I often think, sure, yes. If someone has a home that's worth a lot of money, you know, in theory, they they are privileged in a sense that they have this asset, right, to fall back on if they need it. But usually, that that asset is not liquid; it's the home they lived in forever. And you know, so the workarounds to kind of get the help you need then causes people to create and be crafty around this, but it's like necessary.

Jordan Grumet 17:46

And let's talk about this. Look at all the mental gymnastics we're already talking about: affording healthcare before you're retired, affording it after you're retired, affording it if you need long-term care. Like we shouldn't have to work so hard. Our system shouldn't be so broken that you have to know 10 years before you're going to need long-term care to get a lawyer to set up a trust so that eventually you'll qualify for Medicaid. God forbid if something happens to you. This system is just broken, and so we, you, and I are part of a community who's very savvy about finding ways to get these things done, but a only a certain percentage of the population is going to be this savvy and have all this wherewithal to do this. Everyone else is going to suffer. But b we shouldn't have to do this. Like this isn't something we should have to work so hard for. There are plenty of countries around the world where none of this happens. They just go to the hospital, get the care. They just go to the nursing home, get the care, and it doesn't bankrupt anyone.

Jamila Souffrant 18:45

Yeah, just and I think too because I'm at the age, you know, I'm in my like 40s, and there's the older people in my family where that's becoming the reality, where you're thinking about long term care, or there things coming up, and I feel like this is like my audience too, as they're becoming of age, and whether they're 30s, 40s, that they have people who are in their lives that they're thinking about these things. They're getting sick, and or they're getting older, and they're trying to plan for their health.

Jordan Grumet 19:17

And I want to be really clear about this because there is a group of people say, you know what, healthcare isn't a right, and if you want healthcare, make your own money and buy it. And I get that they're like, why should I have to pay for everyone else who can't afford it? But here's the thing: you and I are paying for it already. Every time a patient goes on Medicaid, the government has to come up with that money and eventually gets it through us. Every time someone goes to a hospital and doesn't have enough money to pay for care, the hospital takes it as a loss, and then they increase prices, which increases prices for insurance companies, and then insurance companies just hand it right back to you and increases premiums. We are paying for all of this, whether you realize or not, and base. We pay more in taxes that cover these kind of things, and more in indigent care. It all comes back to us, and more in healthcare and health insurance premiums than people do in countries that get universal healthcare. We're actually already paying out of pocket each person as much as a lot of people do in these other countries, based on their taxation system, so it's not like we're saving ourselves any money. It's just everyone's getting worse, less efficient care, but we're still paying for it. I mean, look at healthcare premiums have gone up almost every year for the last 20 years, and now it's getting even worse. I mean, with the passage of the one big beautiful bill, and people coming off Medicaid, and the subsidies being drawn back. I mean, basically, our healthcare costs are just going to explode. We're paying for it, whether we call it universal or not. We're still paying for it.

Jamila Souffrant 20:56

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Jordan Grumet 22:42

So what I talk about in the healthcare heist actually is about how third parties have leveraged the doctor-patient relationship to extract money from the system. So this is everything from health insurers to pharmaceutical companies to electronic medical records companies to the medical malpractice conglomerate to private equity and venture capital, all these third parties are coming into our system. They're taking money out, and they're rarely actually improving the system. So they're leveraging the system and using their vast economics to basically change our political system, to basically change our laws. These are entrenched interests, moneyed interests who do a lot of lobbying, and they've created a system that is just fundamentally broken. Here's the thing: I would love to say that we could fix this solution by just electing the right politician. I'd love to say we could fix this system by passing the right laws, but we are way past that. The entrenched interests are too great. What we need, honestly, is a revolution. And when I say revolution, I'm not talking about pitchforks and guns. But what I'm talking about is you get a revolution when the main stakeholders come together and fight together for change. So who are the stakeholders in our system? They're basically all of us who need care, and then they're the people who give care, not electronic medical records companies, not health insurances, not pharmaceutical people, not venture capital people? It's pretty much you and I, those who give care and those who need care. Basically, these third parties have turned us into enemies, right? Basically, doctors don't trust patients, patients don't trust doctors, doctors are worried about being sued, patients are worried about medical mistakes. All I find is that instead of being allies, which we need to come together as the main stakeholders and push for change, we're actually on opposite sides of the spectrum while all the money is being pulled from the system. And so, how do we fix this? We need a revolution. And believe it or not, again, these are big pie in the sky ideas. Why? Because all the basic, simple ideas have all failed. It's really hard when the political system is controlled by the people who have the money and who don't want things to change. So, how do we change the system? Doctors and patients have to come together and change the world. We have to. Become allies because right now we're basically combating each other, and so we have to come together. This is not an uncommon problem, and if you look throughout world history as well as U.S. history, when things get bad enough, whatever it is, the main stakeholders come together and fight for change, and it usually centers around storytelling. And I know that sounds a little strange, but bear with me. Let's talk about Rosa Parks. The story of Rosa Parks on the bus was basically a sentinel moment in our history that pulled the shared stakeholders together, that forced change, change from entrenched interests that didn't want to change. Right, hundreds of years of politics, of society, and culture. We needed these stories to gather around, pull people together, and force change. But that's just one example. Believe it or not, storytelling has changed the world and caused revolution often. I have a talk about the early 1900s. There was this guy named Upton Sinclair. Upton Sinclair was a writer and he was an avowed socialist. And he looked at the meatpacking industry and he saw how horrible all the workers were being treated. He was a socialist, so he wanted to help the workers. So he wrote a book called *The Jungle* a fictional tale about the atrocities of what was happening to the workers and about the meatpacking industry. Now, believe it or not, this book caused an uproar, but not for what he thought it would. So Upton Sinclair was hoping to improve the lot of workers, but actually, when people read the book, they started worrying about their food supply and how horrible the food was being treated. So the first thing that happened is legislation occurred that basically changed how we handle food and meat and improved the system quite a bit.

Jordan Grumet 26:53

You could say that was where the end was, but actually, within 20 to 30 years, we had our first collective bargaining laws and we had our first unions, and so it's a great example, just like Rosa Parks, where when we gather around a story, we can actually change systems. Often, when entrenched interests don't want those systems to be changed, I'll give you one more example, which actually is right on the nose. In the United Kingdom in the early 1900s, there was a doctor named A.J. Cronin, and he wrote a fictional tale called *The Citadel* And so, this book he wrote was about all the bad things that were happening in a healthcare system and how people couldn't get what they needed and how it just wasn't working. Believe it or not, they had been trying to pass universal healthcare in the UK for years, and it kept on hitting roadblocks. But after the publication of that book, public sentiment changed to such an extent that they've actually given credit to the book *The Citadel* with getting the passage of the NHS, the largest universal healthcare system at the time, and UK's first universal healthcare system in which every single citizen could get care. So stories change the world, and right now patients come into the doctor's office all the time, and they tell all of their stories. They pretty much are very intimate with their doctors and caregivers, right? They not only tell them all the problems, they take off their clothes in front of them. On the other hand, doctors have always been trained to be detached. We don't really tell them about us or what our lives are like, and so that's appropriate. Like when you go into the emergency room and you have chest pain, you don't want the doctor to be like, "Well, listen to the day I had. But that doesn't mean that out in the world, healthcare practitioners shouldn't be telling everyone else what it feels like to be them, we do a great job of telling people what we know, like how do you treat high cholesterol, how do you avoid heart disease, but we do a horrible job of telling people who we are. And if we really want to come together as allies to break the system to cause revolution, we need to gather around better stories. And I really feel like those stories need to come from healthcare providers. I think that's where we start, and we're seeing this in little ways. I'll give you one last example. Atul Gawande wrote a book called *Being Mortal* *Being Mortal* was about kind of how poorly we were treating people at the end of life and our elderly. And after he wrote that book and told all sorts of stories about patient care. We had the rise of palliative care and hospice. It actually increased the number of people who signed up for hospice. Increased so telling stories changes the world, and I think that's what we're going to need if we truly want revolution because everything else has failed.

Jamila Souffrant 29:36

Right. Well, I think it's an interesting point bringing up the story and and coming together for like a common cause, eliminating the middleman who has now become the puppeteer and the controller of everything. So, is there are there organizations or ways in which people can start doing this? Has this started already and not made as much of a you. Bang! Or

Jordan Grumet 30:01

so here's the fantastic thing. Actually, it totally has started already, and social media has been a huge way in which it has happened. An example I give in the book is Sherwin Newland, who is a famous surgeon who suffered with depression, and he was about to get a frontal lobotomy because none of the meds worked. He was going to literally go and have them take out a piece of his brain, and then one of his residents said, "Hey, have you tried electroconvulsive therapy? It was something that in the 1970s and 80s was actually frowned upon, but in a last-ditch effort, Sherwin Newland went and got electroconvulsive therapy. It actually pretty much cured his depression with almost no side effects, and he went on to have a very storied career as a very well-known surgeon at the time. I don't know if you ever saw the the movie One Flew Over the Cuckoo's Nest, but pop culture was showing electroconvulsive therapy as something that was ancient and harmful to patients. And if you watch the movie, someone gets electroconvulsive therapy and they're frothing at the mouth and they're shaking, and it's almost done as a punishment. Pop culture really frowned on ECT. Sherwin Newland became the voice of telling the stories about how it was beneficial. In fact, he did a TED talk in the early 2000s before he died, which got millions and millions of views. Again, this is a simple way in which a story changed things. Now, electroconvulsive therapy is still one of the standards of care for hard-to-treat depression, even though it was very much frowned upon in the 70s and 80s. And so it's happening already. It's happening through Instagram and X. It's happening through pop culture. I don't watch The Pit because it would give me way too much PTSD, but I've heard that it does a really good job of telling physician stories, to a lesser extent, the the show ER that ran for for I think a decade or two, to some extent Grey's Anatomy, but that's a little bit over the top. But these stories are being told in small ways, but we haven't got to the point where we've got that. You know, again, in every major movement, you get to the point where there's so many voices yelling together. You get to the tipping point, and we just haven't got there with the whole system. We're we're getting close, but we just haven't got there yet.

Jamila Souffrant 32:14

Yeah, and I think that's the thing with the system. Or when we're talking about systemic issues, is that it can take a while. It may not happen, you know, in our lifetime. Hopefully, our kids or our grandkids. But I think that's what's frustrating: is you need to work on both ends. You need to fix the system so top down, and then also where the self responsibility comes in of how do what do we do, like as individuals, as humans, as families, to help protect ourselves in situations like this, is there anything that we can be doing to to maybe insulate us from the healthcare cost and bankruptcy that may occur?

Jordan Grumet 32:53

Yes, tons of things we can do. Let me break down a few easy ones: preauthorizations and denials. Health insurers make a huge amount of money by pre-authorizing certain meds and procedures, and then denying them, even if your doctor suggests it. So, you as a patient, first of all, if you get a denial on a medication or procedure, fight it, appeal it. So few people appeal these things, and a lot of them get overturned. So, first and foremost, don't just accept it. When you go to the doctor and you get a medicine, see if you can get a generic. Pharmaceutical companies slap tons of patents on their medications. Your average blockbuster medication is protected for 38 years. 38 years. Pharmaceutical companies are making more than ever. Every time you use a generic, you are improving the system. Try to find a practice that is not owned by venture capital, private equity. Back in I think it was 2018 or 2019. For the first time ever, we were more physician-owned practice than private equity, venture capital, or hospital-owned practices. That switched over in about 2019, 2020, these systems run by private equity and venture capital make more mistakes, cost people more, and don't give better outcomes.

Jamila Souffrant 34:10

How do you find those? How do you do that? Is there a way to search?

Jordan Grumet 34:12

Oh yeah, I don't know. I certainly think you could probably use AI and Google to search, and it can be the first thing you ask when you go to make an appointment, especially if you call, is you know who owns this practice? Is this owned by the physician? The other way, if you have some money, so there's two versions of practice out there, especially for primary care, that avoid a lot of these problems. One is for the wealthy, and one is for more middle class. The wealthy one is called concierge medicine. So if you're willing to pay extra money, that doctor doesn't use insurance. They collect a yearly fee from you. Sometimes it's as low as $1,000 a year. Sometimes it's as high as 20,000 for like the really top grade concierge medicine. Getting concierge medicine, if you have the money, basically takes you out a lot of these systems. It takes you out of a lot of the problems with electronic medical records. Can take you out of a lot of the problems with insurance companies, etc. If you can't afford concierge medicine, there's something called direct practice care, which is a cheaper version of monthly payments for care. Where these doctors also, the doctors because they receive extra payments, basically have less patients, don't spend all their time with insurances trying to get pre-authorization to do those kind of things, so they're more present. You have more access to them, and just by choosing a direct primary care doctor or a concierge doctor, you're helping improve the system. The other thing to do is we all need to talk to each other. Like when your doctor rushes into your room and they're 10 minutes late and they're rude to you and you leave. The first thing you're going to think is, "What an a hole! Right? What I found is a lot of patients don't realize that some doctors are a holes, but a lot of them are dealing with a crisis somewhere else and are just treading water to keep alive. And it's true they came in late because maybe they're sitting with a husband and wife and talking about the terminal illness that one of them has, it is complicated, and we as doctors have done a horrible job of telling our stories. So our patients just don't realize all the stressors and problems we deal with unless we start talking to each other, unless patients start trying to learn about what their doctor's life is like, and doctors, unless they keep on listening to all the problems the patients are having, we're never going to come together as allies.

Jamila Souffrant 36:24

Right, right. I actually think those are great just insights and and tips. Are there any other things that we should be thinking about? Maybe as we're on our financial journey, listeners thinking about saving for early retirement or just retirement, should they be investing and saving more with the idea of I do need a separate kind of bucket within my investment accounts for retirement accounts just for healthcare? Should they go above and beyond the you know what they think they need? What do you what What are your ideas for planning?

Jordan Grumet 36:56

I think anyone who's contemplating retirement or early retirement really has to have a real thoughtful discussion with their loved ones, their insurance agents, everyone about long-term care. And there's lots of ways to think about long-term care, and you have to figure out what is most comfortable for you. So some people will self fund. They'll take a certain amount of money, they'll put it in a separate place, they'll have it invested, and they'll let it compound over the next 20 or 30 years to hopefully come up with the 100 to $200,000 that's expected that your average person might need at the end of life. That's one way. Another is to buy long-term care insurance. The cost can be prohibitive. Occasionally, there still are ways you can buy it. There are also a lot of non-term life insurances that have long-term care riders, so they're whole life insurance policies that you don't buy because you don't want the whole life because whole life sucks, but they do have long-term care riders, and sometimes that actually can be beneficial. So when my wife and I both turned 40, we actually plunked down a one-time sum for each of us to get long-term care, and you never have to pay a premium again. You pay it all at once, and as long as that insurance company doesn't go out of business, if anything happens, you'll have long-term care. There are some other really interesting ways to look at it, even if that doesn't work. So, when you get older, if you live in a community of people who supports each other, if you need long-term care, let's say you break your hip and you're going to be home and you need someone to do the dishes and the laundry and cook for you. Well, some people actually move into communities where they do that for each other, and so you have a building of 100 people or 200 people, and you take turns helping each other when other people need it. It's very communal, but some people actually do that. There's also something called continuity of care. So as you get older, there are places that are independent living facilities that you either buy a unit in or you pay monthly for it, but also have assisted living and skilled living attached to them. And once you are part of that community, you can move from one to the other to the other and only pay slightly more. And so it could be like a long-term care policy because you're not paying these abundant fees. You're already paid into the system. You're already living in this continuity of care place, and so to go to a higher skill level of care is not that much. So there are a few different ways to really think about it. You just got to think about what looks right to you.

Jamila Souffrant 39:20

Right, right, and sometimes again, just like I think people feel about their finances and the future, it's so far away. I'll just get there when I get there, and to be able to think about it in advance and plan can save so much time, money, and grief for whether it's a loved one you're thinking about or yourself.

Jordan Grumet 39:38

Remember, though, my goal is revolution, so we don't have to think about these things. My goal is that we fix healthcare so that we don't have to think about it. But until then, you're going to need people like me and you to talk about it on podcasts so people can figure out how they're going to afford this. But what I really would love to see is to get that grassroots change going, so that we can relieve ourselves and the. People less savvy than us from these heart rendering decisions. I mean, it's it's complicated. It's difficult.

Jamila Souffrant 40:07

Yeah. So Jordan, I know. So this book, The Healthcare Heist, it's out now. You're still doing your podcast and your other work. Can you tell me what what you're thinking about? What's next, or are you happy with just the way life is now? I I think it's always interesting to really talk to people who are financially independent and choose to work, and what that looks like because I think that just a glimpse of what people can look forward to when they truly have options to pursue passions and or things that actually help society right at at large.

Jordan Grumet 40:39

I feel so incredibly lucky to have discovered the financial independence community, and the reason why is it gave me the financial tools that I just didn't understand. That solved one big problem. It didn't solve all my problems, but it solved one big problem of how to free myself from at that time a job that wasn't working for me. I was lucky enough to have a bunch of free time and to delve into things like podcasts and writing and thinking about financial independence and personal finance, and that led me to having some very distinct ideas about purpose. What makes us happy? What should we pursue? These last few years are happier than I ever imagined I'd be a decade ago, but that's because I've been lucky to be able to pursue things that light me up. So, what do I love? What have I been able to do because of my financial independence? Well, I do a podcast, which I absolutely love, and I absolutely love interviewing people. And I would do it. You know, I get paid just enough, pretty much, to pay for the podcast. But I do it even if I had to pay to do it because it really is exciting to me. I love to write books. I could spend maybe the rest of my life writing books. I hope to you know five years ago I said I'm going to write books for five years and see how it goes. It's now coming up on five years, and I'm looking and saying I'd like to continue doing that for five more years. I also still like doing my hospice work, so I do it about 10 to 15 hours a week. It's another job I do, even if you didn't pay me for it, and so I feel at the age of 53. I'm turning 53 in a few weeks. I feel at the age of 53 that I have a way fuller life than I ever thought I would have, full of exciting things to do, but kind of calmer than it used to be. Right when I was young, had all this fear of succeeding and proving myself, and every achievement was exciting until I needed another achievement. And really, at this point in my life, I just find myself doing lots of things I like to do. And sometimes they go spectacularly, other times they don't. But I feel happy to to use the language from your you know from your platform, I feel really happy to be on the journey.

Jamila Souffrant 42:43

I love that. Okay, Jordan, please let everyone know where they can find the book, more about you and your other work.

Jordan Grumet 42:50

Easiest way is to go to jordangrammett.com. That's J-O-R-D-A-N-G-R-U-M-E-T. There, you can basically find all the content I produce. So that's books, Taking Stock, The Purpose code and the healthcare heist. That's my podcast, Earn and Invest, and that's my writing, including my Substack, also titled The Purpose Code. I pretty much put out three posts a week. Some of them are summaries of my podcasts; other of them are just blog posts. But if you go to JordanGrummett.com, you can find all of that.

Jamila Souffrant 43:18

All right, Jordan, thank you so much for joining the podcast again.

Jordan Grumet 43:21

Thank you so much for having me.

Jamila Souffrant 43:23

Don't forget, you can get the episode show notes for this episode by going to journeytolaunch.com or click the description of wherever you're listening to this. And you can still grab your Jumpstart guide for free to help you on your journey to financial freedom by going to journeytolaunch.com/jumpstart. you want to support me and the podcast, and love the free content and information that you get here, here are four ways that you can support me and the show. One, make sure you're subscribed to the podcast wherever you listen, whether that's Apple Podcasts, that purple app on your phone, your Android device, YouTube, Spotify, wherever it is that you happen to listen, just subscribe so you are not missing an episode. And if you're happening to listen to this in Apple Podcasts, rate, review, and subscribe there. I appreciate and read every single review. Number two, follow me on my social media accounts. I'm at Journey to Launch on Facebook, Instagram, and Twitter, and I love love love interacting with journeyers there. Three support and check out the sponsors of this show if you hear something that interests you. Sponsors are the main ways we keep the podcast lights on here, so show them some love for supporting your girl. Four and last but not least, share this episode, this podcast with a friend or family member or coworker so that we can spread the message of journey to launch. All right, that's it. Until next week, keep on journeying, journeyers.

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