What’s concerning in America is that almost everyone is overweight, obese, or borderline overweight. The pandemic has greatly highlighted how dangerous it can be to be overweight or obese.

As I grow older and now have two kids to raise, I’ve found myself slowly gaining weight as well. As a result, I’d like to use this post as motivation for all of us to get in better shape!

Besides going through my new year financial checklist every year, I also like to see a doctor at the beginning of the year as well. I figure worst case, if I get extremely unlucky and get cancer, the most I’ll live with the disease untreated is 364 days.

I also spend about $9,120 a year on insurance premiums for a “silver plan.” $760/month seems like a lot for a guy who is relatively healthy. So I figure I might as well get at least something out of it while helping subsidize some of my brothers and sisters who pay less.

Recently I had the pleasure of participating in a Conquer Cancer Foundation event at the home of my friend, Dr. Thomas Roberts and his beautiful wife Susan. Tom used to be an attending staff oncologist at Massachusetts General Hospital and an instructor of medicine at Harvard Medical School before joining Farallon, one of the first hedge funds in the world to manage university endowments.

My favorite thing about Tom is not that he’s a very smart and successful guy. The thing that stands out most about Tom is how nice and thoughtful he is. You might think a man of his stature wouldn’t bother hanging around with someone like me, yet he’s been nothing but kind and magnanimous with his time. We met on the tennis court several years ago and have been good friends ever since.

Tom is on the board of the Conquer Cancer Foundation and I’ve promised to help him spread the word about this devastating disease that has affected so many. Although I cannot match the funds that many generous benefactors have offered, I do have an online platform to help raise awareness. My grandfather died of skin cancer before the age of 65 and my good friend’s father was recently diagnosed with bladder cancer. It seems like everybody I know has been affected by cancer to some degree, whether it be a family member, close friend, neighbor, or colleague.

Here are some cancer statistics:

* One out of every two men and one out of every three women will be diagnosed with cancer in their lifetime.

* There will be over 1.6 million new cancer cases diagnosed and nearly 600,000 cancer deaths in the US in 2014.

* Cancer remains the second most common cause of death in the US, accounting for nearly 1 of every 4 deaths.

* There are nearly 14.4 million survivors worldwide.

The following is a guest post by reader Dave Scott who shares his experience of taking care of elderly family, specifically, his 97 year old grandmother.

I’m thoroughly impressed with Dave’s sense of duty and attitude throughout this entire article. You can tell he feels it’s an honor to take care of his grandmother and he’s looking for more insights on how to be a better caregiver.

I’d like to have an open discussion during the holidays addressing the issues of cost, environment, emotions, responsibility and estate planning. 

Taking Care Of Elderly Family

It can be a great honor and a huge sense of responsibility to manage all the aspects of a aging family member’s affairs when they are in need of your help. For approximately 20 years, I have been managing my grandmother’s investment portfolio. All other aspects of her life were managed by her with a little bit of help from my father.

In late 2010, all that changed. At the age of 97, my grandmother needed to move into assisted living and was no longer capable of fully taking care of herself. During the same time period, her relationship with my father, her only living child, began to become strained and my father was battling his own health issues. As a result, I made the decision to move my grandmother from her current independent living home in Arizona to reside near me in Texas.

The responsibility dynamic changed, almost overnight, whereby I had just agreed to manage 98% of all of my grandmother’s affairs. I was definitely up for the challenge and thought I was the best suited to take it on. However, it doesn’t diminish the fact that this is not a trivial  undertaking.

Managing all aspects of a family members’ life

This is not about a ‘power grab’ to control all aspects of a family member’s life. For me, it is only about effective management. I approached this as just another offshoot of managing my own affairs.

If you are going to effectively take on such a role, it is prudent that you do it in an all  inclusive, non piece meal, way. You are the quarterback for their team and, as such, you need  to ensure that their life is being managed to maximize their well being and quality of life.

When I  am referring to managing all aspects of their affairs, I mean everything from ensuring they have an ample amount of household supplies, to insurance, to utilities, to doctors, to dealing with management at their assisted living facility, to managing their investment portfolio.

While it may be obvious, the most important thing is having someone that is willing and able to take on this role. Some family members may be willing but are clearly not capable. It takes a large amount of organization to ‘operationalize’ all the aspects of another person’s life. However, I have found  that once a good set of processes are established, everything generally runs on autopilot.

Managing Cash Flow 

My main goal is to ensure that my grandmother will not outlive her assets and that she will maintain a healthy, active lifestyle. She is thriving in assisted living and I want to ensure that his remains for as long as possible. As such, I have paid careful attention to the balance between maximizing income and reducing expenses where feasible.

Lets start with income. As many of you know, assisted living can cost ~$5K/month or more (depending on the level of care needed and the location in the country). While my grandmother has a reasonably sized portfolio for her age, it doesn’t generate enough cash flow to only enable her to live off the dividends / interest without touching the principal.

Managing Investments

I have structured her portfolio in a conservative manner so as to generate reasonable cash flow while ensuring it isn’t too negatively impacted by a market downturn. I try to keep her portfolio as simple and consolidated as possible through the use of only a few funds and ETFs. For example, Vanguard Wellesley Income Fund has worked well for her for many years. It provides a conservative balance of equities and bonds with a low expense ratio.

I was a bit concerned about her bond exposure earlier this year so I lightened up on any bonds that were too far out on the yield curve in favor of shorter term ETFs. While her portfolio was negatively impacted during this year’s downturn in bonds, it wasn’t enough to cause significant concerns.

As you would expect, if you estimate an approximate 4% return on  a conservative portfolio and account for an average 7% increase in the annual cost of assisted living (and associated expenses), it doesn’t take too long to identify when the portfolio will be exhausted. However, interest rates have gone so much post-pandemic, that a 4% return may be too aggressive.

Managing Expenses

It is a bit scary to think that the seniors in our society who are fortunate enough to live to be 80+ and live in assisted living are still confronted with the possibility of outliving their nest egg in their final years. One aspect of maximizing her income that I gathered information, but didn’t pursue, was the option of having my grandmother take advantage of spousal veterans benefits.

The government currently doesn’t have a look back period on veterans benefits unlike Medicaid which does have a 5 year look back period. Your loved one could theoretically gift away all of their assets today and apply for veterans benefits tomorrow with no impact on the amount they would receive as a result of their recent gifting.

While there are a lot of people that have taken this route to curb the costs of assisted living, and there is pending legislation in congress to close this loophole and implement a look back period on VA benefits, it just wasn’t the right course of action for my grandmother at this time.

From the expense side, there are several things that can be done to minimize unnecessary expenses. This is an iterative process as your loved ones needs change or circumstances change.

Note: In order to be eligible to receive Medicaid coverage while in a nursing home, an individual can have no more than $14,400 in countable resources. Certain assets, such as the home and retirement accounts, may be exempt in some circumstances. The idea is to give away your assets to loved ones to qualify for government assistance before the five-year look back period begins, or else you will be disqualified. 

A few expense reductions I implemented are:

1. Evaluate Medicare Prescription Drug Plan (PDP) options on an annual basis – identify if there is a more cost effective plan in my area based on the latest medications that my grandmother is taking.

2. Purchase grandma a big button cell phone with a basic $10/month plan – tether it toher wheelchair so that she is always available for a call. Cancelled her land line thus saving her $20-$40/month in unnecessary phone costs.

3. Eliminate all monetary gifting to family members – this one could be a bit more controversial. My grandmother has always been very generous to her family during birthdays & holidays. However, this was adding up to be several thousand dollars per year that could be used for her care. Therefore, I set the expectation with the family through a message that started something like this: “I think we would all agree that grandma’s assets should be, first and foremost, used to benefit grandma….”. Everyone agreed and there has been no discussion since.

4. Negotiate with Assisted Living – this is not always effective but I try to have the assisted living facility reduce the annual increase as much as possible. If I can get them to reduce the increase from 7% to 5%, that can make a marked impact.

Maintaining Your Loved Ones Quality of Life for as Long as Possible 

When deciding on a location of an assisted living home, there are the expected tradeoffs of  location, quality and cost. For my grandmother’s situation, I wanted her to be close to me  such that I could be seen a lot. I wanted to get to know the staff and the daily workings of my  grandmother’s assisted living facility. I have found that this is invaluable when first taking on such an endeavor.

Just as no one cares about your money more than you, no one cares about your loved one more than you. Therefore, if you are visible and the staff knows you, you can get a lot done, immediately course correct if something is not to your liking, and ensure that your family member’s quality of care is maximized. I was fortunate as the assisted living facility close to my home has a great reputation for quality.

One key aspect of quality that you can look for is how long has the staff worked there. In the case of my grandmother’s place, the same  management team has been together for 15+ years. This demonstrates a continuity of care and  dedication that I think is critical. In the short term, I was willing to tradeoff the slightly higher cost of this facility in favor of its great reputation and location.

A practice run for retirement

If you are fortunate enough to have the experience of caring for all the aspects of a loved one’s affairs, it will give you a new appreciation for what we all will face when we hopefully are there as well.

For me, I feel like this is a practice run for when I retire and certainly a reality check on the costs associated with maintaining a balanced, high quality of life. In hindsight, we probably should have established some type of long term care insurance for my grandmother years ago. While it wouldn’t have addressed all the cost concerns, it would probably have helped to alleviate some of them.

There are other financial options that I continue to explore in the event that her health deteriorates and she needs skilled nursing care.

The changing role of grandchildren in caring for aging grandparents

In the past few years, I have been fortunate to have the opportunity to deepen my relationship with my grandmother. If it wasn’t for a set of unique circumstances, I may never have been given this opportunity – and for that, I am grateful. My situation has enabled me to reflect on the possibility that grandchildren may play an increasing role in helping to manage their grandparents affairs in the future.

Besides the opportunity to deepen your relationship with your grandparent, the relationship is different than a parent/child relationship, and thus may be better suited, for these types of situations.

Grandchildren don’t carry the same ‘baggage’ that children do when dealing with an aging parent. In my experience, where my grandmother may have given more pushback to my father in a decision he may have made on her behalf, she doesn’t question me, her grandson, in the decisions that I make on her behalf (well, maybe she  questions me sometimes).

Once my grandmother realized that I had everything under control, she was willing to let go and enjoy her days without worrying about the details. Taking care of a elderly family member is an honor and responsibility none of us should take lightly.

Recommendations For Taking Care Of Elderly Family

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PolicyGenius helps you compare the best quotes all in one place. Check out their free life insurance rate quotes with PolicyGenius today. When insurance companies compete, you win!

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Updated for 2021 and beyond.

Obamacare is also known as Universal Healthcare. Unfortunately, as of 2021, Obamacare is still very expensive without employer subsidies.

However, Obamacare is a net positive for early retirees and the underemployed. If you make less than 400% of the Federal Poverty Limit for your household, you will get tremendous Obamacare subsidies.

Obamacare For Early Retirees And The Underemployed

We appreciate our health the most when we are sick. I certainly appreciate my health now because I’ve currently got a sore throat from probably too much sailing in the Bay this past weekend. The wind regularly picks up to 25 mph and makes the temperature on the water feel like 50 degrees instead of 70-80 degrees.

The Affordable Care Act (Obamacare) goes into effect October 1, 2013 if Republicans in the House fail to block the movement. Republicans will probably fail since Obamacare has already been given a thumbs up by the Supreme Court, but hold on for some potentially massive pain as I indicated in my newsletter the other week, recommending readers reduce stock positions and buy bonds when the 10-year yield was at 2.85%-2.9%.

As someone who retired 31 years before being able to receive Medicare at the age of 65, you might think I’m worried about health insurance. Health related problems is the number one reason for bankruptcies in America after all.

But I wrote a thorough post in the spring of 2013 entitled, “Cheap Health Insurance Options For The Unemployed, Self-Employed, Or Early Retiree” that goes on to explain our options: COBRA, Spousal Health Insurance, Parental Health Insurance, and AgileHealthInsurance, an easy way to get affordable term coverage for as little as $1.50/day with premiums up to 50% less than Obamacare (ACA) plans.

I’m as skeptical about the government as anyone, but now that Obamacare is going into effect, the options for heathcare are theoretically even better. For those who are seeking financial independence, who are early retirees, or who are just trying to save money to get by, let me argue why Obamacare is a net positive for America.

Healthcare For All Sounds Nice

The fundamental premise for the Affordable Care Act is that no person should suffer catastrophic financial loss or die just because he or she cannot afford healthcare. Genetic diseases and car accidents don’t discriminate between rich or poor.

Those with pre-existing medical conditions will now be able to get coverage. Young adults are able to stay on their parent’s insurance plan through their 26th birthday. Insurance companies cover preventative care such as flu shots, physicals, mammograms, and vaccines. These are all good things.

I am 100% behind health insurance for all even if it costs me more to help subsidize someone else. Unlike trying harder to make more money, it’s very difficult to try harder to fight a drunk driver who runs you off the road and breaks your legs.

The main concerns about the Affordable Care Act are several fold: 1) Rising premium costs for healthy individuals to support less healthy individuals, 2) Overcrowding and longer wait times, and 3) A distaste for the government forcing individuals to get insurance even if they don’t want insurance.

The Bright Side Of Obamacare

1) Eat More Of What We Love.

I’ve got a safety net to eat more unhealthy food I love such as steak, lemon meringue pie, chocolate fudge sundaes and cheeseburgers. I also won’t feel as bad for not working out 3-4X a week anymore. For the past 12 years since leaving NYC, I’ve been trying to stay in shape because the stress of working on Wall St. was already high enough. I needed to be in the best shape physically and mentally to do my job.

Now that I’ve got Obamacare, I can definitely let myself go more. The bonus is that maybe I get to save money on premiums because I slide into the average fitness category, or I get more of my money’s worth because I’ll be seeing the doctor more for checkups and drugs.

2) The Market Is Efficient.

People are fooling themselves if they think people who really need or want the best healthcare are going to accept overcrowding. The free market will kick in where doctors will charge more for concierge service to meet demand for better care.

My own doctor I’ve seen for 13 years started his concierge service where he provides 24/7 consultation (gives members his private mobile phone number for off hours) and weekend visitations (normally shut on the weekends) for an extra $1,500 a year.

Meanwhile, it’s better to wait to see a doctor if you have a problem than not be able to see the doctor at all for those who were once without health insurance.

3) The Government Already Controls Everything.

Paying monthly health insurance premiums when you are just trying to make ends meet is painful. I have numerous friends in the food, art and online business industries who don’t have health insurance because they are young, feel healthy, and don’t want to pay an extra $200-$300 a month since they are making less than $2,000 a month.

The problem is that it is vital for all of us to at least get disaster prevention insurance because these are the people who enter an unending cycle of poverty if something bad happens.

The Affordable Care Act offers discounted premiums for individuals making less than $28,725 a year and families of eight (!) or less who make under $99,075 a year. The government already throws us in jail if we don’t pay tax rates that are unilaterally decided by them, so we might as well pay for something that might save us from poverty.

You can choose to look at the negatives of Obamacare, or you can choose to embrace the inevitability. You’ll be much happier in the long run if you do because fighting omnipotence will only get you squashed.

NEW HEALTH EXCHANGES STARTING: BRONZE, SILVER, GOLD, PLATINUM

Americans under 65 can now elect to buy their health insurance through health exchanges online in their state come October 1, 2013 (see healthcare.gov). Californians, for example, can get a Bronze monthly plan for $278/month, while folks in Wyoming have to pay the most at around $425/month according to the US Department of Health And Human Services. If you happen to live in Kansas, Oklahoma, Minnesota, Tennessee or Maryland, you’re paying less than $200/month on average per person. Not bad at all!

But again, if you are one of the millions of Americans who never had to pay health insurance premiums because you elected not to have health insurance, you might not necessarily be happy now that health insurance is the law. At least you’re getting something, unlike taxes which go to a black hole that funds wars and shady infrastructure projects.

Economics-wise, we are theoretically improving the fiscal health of our health care system by forcing the uninsured to pay health insurance premiums. 30 million Americans paying $200 a month equals an extra $72 billion dollars a year which can be used to cover emergency care that’s already being provided. However, who knows how much more abuse or moral health hazards will result from everybody now having more insurance.

Obamacare Needs To Get More Affordable

It’s always scary to have the government mandate and meddle in our lives, especially when it comes to our health. Their intentions may be perfectly good, but they always find a way to mess things up due to bureaucracy, greed, and red-tape.

A great example is the government regulating Wall St bonuses. By limiting the amount of bonus money that could be paid out in cash, Wall St. simply raised base salaries by 70-100%!

I’m scared of the inefficiencies of Obamacare, but I believe the free market will help blunt inevitable problems. Health insurance companies will have to compete on price and quality with these new exchanges or die.

The more competition there is, the lower the price and better the service all else being equal. If people want to pay for better access and service, then there will be options that allow people to pay more and vice versa. If competition gets too fierce, insurance companies will go out of business and new subsidies will come into play.

Just look at “Communist” China. The free markets have overwhelmingly crushed the ideology of Communism by producing the fastest number of new millionaires and billionaires in the world.

I’ve been to China over a dozen times since 1997 and I can tell you first hand the wealthy are living large. We cannot squash the desire for more, nor can we eradicate rational people. Have faith things will work out for the better.

Recommendation For All Parents

Although Obamacare is extremely expensive, life insurance is not. At the end of the day, if you don’t have good health insurance or are unhealthy in general, you increase your chances of death.

If there’s one thing the pandemic has taught us, it’s that life is not guaranteed. We must do everything we can to protect our children while they are still dependents.

As a result, please get life insurance. Not only should you get enough life insurance to cover your liabilities, your life insurance term should last long enough to get them through college.

The best place to get life insurance is through PolicyGenius. PolicyGenius will help you find the best plan for the lowest price tailored to your needs. PolicyGenius provides free, no-obligation quotes so you can get the best rate. 

In the past, you would have to get a life insurance quote by applying to individual carriers – the process was completely opaque. Now, you can have multiple qualified life insurance carriers compete for your business after applying on PolicyGenius. It’s so much more efficient! 

After eight years of owning life insurance, my wife decided to check on PolicyGenius for free to see if should could do better. Lo and behold, my wife was able to double her life insurance coverage for less money. All this time, she thought she was getting the best deal with her existing carrier.

If you don’t have life insurance, please get life insurance before you need to. Life insurance gets more expensive the older you get. If you get sick, depending on the severity of your sickness, you might not be able to qualify.

If you do have life insurance, I highly recommend checking PolicyGenius to try and get a better deal. Chances are high you’re not getting the best terms. 

Physical fitness and financial health go hand in hand. If you don’t have, it’s hard to have the other.

I don’t care how rich you are. If you don’t have your health, you might as well have nothing. This is why I have a whole Health & Fitness section. Think back to the times when you were sick. Every time, I’m sure you were willing to give up everything just to feel better again.

I’ve got to admit something that’s bumming me out. I’m disappointed so many readers proved my derivative theory correct when I wrote, “Proof Your Weight Is Not Your Fault.”

The post is about a convicted killer on death row who is asking to get his sentence commuted due to his weight. If you are 475 lbs and have spent the last 27 years in prison where there are no buffet lines, don’t tell me that genetics doesn’t have anything to do with this person’s weight.

Physical Fitness Is Huge

My derivative theory hypothesized many readers would be vehemently against the statement that one’s weight is largely determined by genetics because it takes away people’s illusion of control. In financial speak, “How dare you say my wealth was not of my own doing?” or the now famous Obama mis-quote, “If you’ve got a business, you didn’t build that. Somebody else made that happen.” Readers of personal finance sites are generally fiscally conservative. Spend less than you make right?

I also hypothesized most dissenters would be fit and under 35, the median age of Americans. Have you ever seen those gossip magazines with some beautiful spokeswoman showing the efficacy of their latest anti-aging product? Well shit, of course it works if your model is 22 years old!

In other words, there’s an annoying belief that if you’re fit, everybody else should also be fit. Otherwise, you’re just lazy. It’s like the 18 year old kid who eats all he wants and never gains weight, making fun of a 45 year old mother of three for not looking like Jessica Biel. Nice job punk.

Stay Motivated To Keep Fit

The genetics post is meant to motivate folks who are struggling with their weight to stop beating themselves up so much. Don’t hate yourself for not looking like folks we see in magazines or on TV because they are anomalies magnified by the power of media to make it seem like they are ubiquitous. If we can love ourselves more, we can snap out of our funk and climb back up those stairs.

Another goal of the post is to break down stereotypes against those who are obese. I don’t know anybody who is out of shape who is happy to be out of shape, just like I don’t know anybody who is struggling financially who doesn’t want to be wealthier. The post was not directed at fit people. Yet for some curious reason, so many fit folks lashed out. Dear fit people, why does my post concern you so much? Compassion is a part of our humanity.

Now that you know the furtive reasons for my genetics post, it’s time to answer the most logical next question: Is there a positive correlation between physical fitness and financial health? To answer the question, I need your support.

Taking Action For Physical Fitness