Special Note: Random Topics

For those looking for a little of this, some of that, and the most accurate delegate stats around at the moment, Random Topics is the “go to” forum. The  admin has done a very good job sifting through the often confusing delegate picture and has some very nice updated pie charts that make the picture clear. The forum itself is well kept, well monitored, and often contains gems of information nort found elsewhere, so it’s well worth bookmarking.

In an age when you never know where the important bits of information may be hiding, having another source is quite helpful :-).

AZGOP Convention Continued: Part 2

Link To Part 1

As mentioned in part one, the slating process turned out to be problematic. It’s not unusual for slates–lists of recommended delegates–to be revised multiple times before the first vote. However, this slating apparently was out of the ordinary. Knowing something of how parties and conventions operate, I had deliberately made sure to grab seats for myself and several others from my district in the area where those with suits and fancy name tags typically sit, and was rewarded with some interesting information.

Quite a few of the old time middle level GOP operatives were rather “annoyed”. It was one thing for the AZGOP to cancel any notion of tabling delegates for slating “from the floor” (a time honored custom allowing “the little guys” a chance to play). It was another thing to prohibit delegates from “stumping” for votes at all–another staple of the delegate process, so the voters have a clue who they are voting for.

A Secret Star Chamber….

A “star chamber”, for those not familiar with the term, is an inner group of key players who meet to work out who gets certain perks or positions in the party, or who gets slated as the reps (open or secret) for the party. In THIS case, according a no less than 12 different mid level operatives, the “star chamber” was comprised of an anonymous group of power players that were chosen by some arcane process, by persons unknown. I could find none who would admit to being included. Quite literally NO ONE I SPOKE TO KNEW HOW THOSE SLATES HAD BEEN FINALLY CHOSEN. 

It should also be noted that a lot of names you would have expected to see on those slates,the mid level and upper level GOPers–were NOT on them. According to those I spoke to, the infighting in the local party right now is far more widespread, and serious, than the “outward” squabbling we have been seeing on the news. if you’re unsure why so many people want to go to Cleveland, read some of my earlier posts on why people fight for national delegate slots–it has nothing to do with voting or civic duty.

I did note that several of those slated for 3,3 on the final tally were also slated for Cruz,and one of the people on that slate hadn’t even been asked to be slated for either Trump or Cruz. As a matter of fact, he didn’t know he was slated until he saw his name. He was in a state of total jaw drop.

The mid level operatives I spoke with made it very clear that there is a serious level of infighting this election cycle within our state party. I also heard directly from more than one of them that they have been left out of the loop this cycle, and they are not happy campers.

Some Interesting Revelations:

The “Star Chamber” slating irritated quite a few people who had been excluded from any knowledge of who was being slated, and by whom. This represents a fairly radical departure from the norm, and when coupled with the absence of any opportunity to stump, or even meet the slated delegates and the ground teams insistence we vote our slate so we wouldn’t get “confused” is quite interesting, to say the least.

When you add in the large number of people reporting being uninformed (that would have been expected to be “in” on the game), one has to wonder exactly WHO chose the final slates in the first vote, and how/why….

Additionally, I had the chance to meet with the county chairs from over half of our counties in AZ–and the precinct situation here is far more dire than even I had suspected. At any given time, the party expects about 30% of those valuable precinct seats to be empty–they COUNT on it, as the precinct position is the power position. So while in one sense it’s desirable to have those seats manned with active volunteers to get out the vote and get the voters engaged, on the OTHER hand, you want to be sure those seats hold people who are in favor of preserving the GOPer power base, and the status quo. BECAUSE IT IS THE PRECINCT SEAT HOLDERS THAT VOTE IN THE PARTY SYSTEM. They are the people who, after the next general election, will be re-drawing our districts and voting on the state party rules and bylaws for the next cycle. And voting in the party leadership.

But from what I gathered in talking to the county chairs, and the precinct chairs,vacancies are at an all time high–with more than 1/2 the seats empty.

In other words, people of AZ–if we want to get this party working for us again, there is no better time to get to your local GOPer meeting, say the right words, and GET A PRECINCT SEAT.

Networking In GOPerLand….

I had my other half in the “guest section”, connecting with other guests and also engaging the various volunteers for candidates of all types and passing out my cards to my blog. His designated position was between a “balanced voice of reason” and a “concern troll”. I gave him very careful instruction on what buzzwords to use, and what NOT to get into discussions about, and went about my business–which was seeking out dissatisfied voters, angry voters, and inside party members whop want to get the system operating properly again.

As such, MY designated position was one of “the party is in trouble. If we want to bring back conservative, constitutional principles and insure we don’t have out of control candidates again, we need to get voters back into the party system, and engaged”. I was very careful to use language that is commonly used by inside operatives (not MY fault if they decided I was “for” their candidate of choice, of course). My purpose was quite simple–get a strong feel for what is going on in as many counties as possible, in what ways the heads of those counties felt they were weak, and to get a deeper picture of the precinct level feeling in the party.

As such, I was very happy to note that not only are there more than enough empty precinct seats to allow a reform movement to succeed, a higher percentage of precinct chairs and county level chairs were dissatisfied with the situation than I had estimated would be the case. Not surprisingly, the more rural/remote counties had the highest vacancies and the highest dissatisfaction level–rural areas typically do. Party members in counties other than my own are more than willing to network with me, and are also more than willing to be active members and contributors in the website I’m building.

In the next post, I’ll cover the infamous “second ballot/at large delegate” vote electronically.


Insider Report: The AZGOP Convention: Part 1

Arrival:  7:30 a.m.

After staying in a local Mesa hotel at 50% off (courtesy of the AZGOP) I arrived at the Convention Center promptly at 7:30 a.m. for credentialing. As a delegate from Congressional District 3, Legislative District 3, Pima County, I presented my voter registration card and picture ID, signed in and got the first ballot of the day (and my 10.00 lunch voucher). Our section was in the very front, and I took a seat in the 2nd row knowing full well the unwritten rules governing seating at conventions. I wanted to be among the higher ups to listen for valuable information, and along the way I hooked up with a Trump ground team member and some of my fellow 3,3 delegates.

We were given the “Trump Slate” by a representative and told to “just vote the slate, and don’t listen to anyone”. The problem inherent in this instruction became rather evident, in short order, as there were few names on the slate I could personally identify as vetted (by ME) Trump supporters–not to mention when we read the rules for this convention we discovered that the AZGOP had decided not to allow delegate candidates to speak for even three minutes each in our caucuses or canvas for votes for the at-large selection later in the day. The reason given was “time constraints due to an usually high number of delegate candidates”.

The Greatest GOPer Show On Earth Begins:

For those unfamiliar with this form of political theater, some background is in order. All the candidates of any type have table sat up and are passing out bumper stickers, signs, and information. The higher echelon party members have the fanciest name tags and are the most dressed up–in AZ’s case, big brushed gold badges in the shape of the state. Next are standard plastic name tags coupled with more casual attire, then simple lanyards with your delegate voting credential card. Typically, the groups will tend to separate while people are getting settled, but as I dragged some of my fellow 3,3’s to the front of our section, we got in among the intermediate name tags and a handful of “gold tags”.

The Convention opened with a dual invocation–the first gentleman giving a Hebrew Prayer for peace (properly sung with beautiful pronunciation, followed by the English translation), then an invocation by a middle of the road Christian. A trumpter/bugler then played the Stars Spangled Banner (we sang), and some children recited the Pledge of Allegiance, and the preamble to the Constitution. The Party head’s daughter Faith Graham did a Kid’s News report showing how uninformed the average voter attending the state fair is, accompanied by a well stated plea for us to elect the right people “for the kids, who do care”.

Robert Graham, Head GOPer, gave a rah-rah speech, and explained the basic process, then it was hurry up–and wait. And wait some more, while the credentialing team made sure we had a quorum. Graham turned the floor over to a professional parliamentarian, causing a minor ruckus as people pointed out “the rules” shouldn’t allow that, and the point was not well taken.

The First Vote:

The Trump slate was updated twice while we were waiting, then we went to cast our paper ballots–one for delegates, one for party chair people for Cleveland. Bruce Ash was running unopposed, with three women vying for the chairwoman slot–so that contest ended in a run off. As we had no opportunity to talk to anyone except fot one gentleman who introduced himself to all of us in 3,3, (Thank you Mr. Ortiz, Sr.!), I had to rely on my notes from the meeting where we all got picked to go to Mesa. On that first ballot, out of the 6 of us 4 were know Trump supporters in my area, two weren’t.

HOW these people got slated will be in Post 2, as it was a very odd series of events all the way around. By now it was lunch time, and long lines formed at the food trucks in the 90 degree cloudy weather, and after eating people were making the rounds of the local candidates’ tables. I disposed of my trash and began making connections, starting with the gold badges and working my way down the line.

I began the day with about 150 business cards, and bought home less than 10, so a decent day–the type of networking that I did and others were doing will also be in the second post. When we went back in, we found we had a run off to deal with when it came to our chair women for Cleveland, and we had to go back out for the 2nd credentialing. The voting process is extremely tightly controlled, as you have to re-credential and get your badge initialed to participate in the second vote. And it was on the second vote of the day things got interesting in GOPerland.

So They Misplaced My Entire Group–Things Happen LOL.

Everyone was outside at once, and it was badly controlled mayhem. The Cruz ground team had their second slates already to go, and I grabbed one (to insure I wouldn’t accidentally vote for a Cruz supporter). And Lo and Behold–no sign for 3,3. So we were milling around, and half of the other delegates couldn’t find their credential people either. According to my local chairman, they accidentally left him off the voting lists in the January meeting–they seem to always mess up something about my district *sigh*.

After almost twenty minutes, we were directed back inside, and finally got some spare paper ballots for the second vote and the runoff–plus a sealed plain envelope, with a slip of paper in it. When everyone was finally back in the main hall, we were then directed to pass the paper ballots to the center of our rows–as we would be voting electronically. At that point, we STILL didn’t have an at-large Trump delegate slate in hand.

Coming Next: GOPers On Parade…..

ZAAZ Results, Week 1

For the first week, I deliberately didn’t alter my food intake, though I did keep a food diary and count calories. I found that my estimates of my caloric intake (around 1200 a day or so) were accurate. When I went to see my GP, he pointed out a couple of interesting things:

  1. The “2000 calorie” recommendation, upon which all our vitamins and mineral requirements are based, derives originally from studies done by the U.S. Government on navy members during the 1970’s–not exactly a long term “representative study” that a benchmark should be, as navy seamen don’t have the same activity levels as civilians, even when averaged out.
  2. Civilians at the time, no matter what their occupations, got at least three times as much physical activity i the average day than we do now, and microwave meals and pre-packaged meals weren’t the norm either.

So, the “recommended daily allowance” isn’t necessarily applicable any more. And given that the almost 2 pounds per month I have been gaining equates to about 200 calories a day at my normal exercise level, we settled on a 1000 calorie a day limit, with slightly high protein, moderate low glycemic carbs, and near zero fat as a starting point. I’ll be getting into that along with the recipes I use in other posts.

Week One: Observation And Experimentation

I settled on using my ZAAZ 4 times per day, 12 minutes at a time, and doing gentle stretching and isometric exercises as a benchmark. I found that even when doing only simple stretches and running through some of the few Yoga postures I am capable of contorting myself into, I could definitely “feel the burn” at times. The machine came with a nice big chart of stretches, and I found that using them allowed me to tightly focus the majority of the vibration in selected muscle areas.

By the third day, I had not only gotten more adventurous, I got my first indications that the ZAAZ does, in some way, provide extra muscle stimulus; I was “stiff” when I woke up in the morning. Typically, before the ZAAZ, when I woke up I would be extremely stiff, and often couldn’t move comfortably for some time. Now, I am able to roll out of bed easily (something I haven’t done in literally a decade), and the “stiffness” is very like the residual effect you have the morning after a typical exercise workout in a gym or Yoga class, tightness but not pain.

I have also noted a noticeable improvement in my range of motion, and my lower back spasms have significantly decreased as well.

The Final Takeaway From Week One:

Yes, the ZAAZ has made a definite difference in the type of pain I experience, as well as pain level and inflammation level. I have noted also that my digestive system is working much better than normal, in that I haven’t had any diverticulitis, very little bloating despite a dramatic increase in fiber, and very little discomfort.

I have also noticed that my fluid output his increased in relation to my fluid intake. When I do sleep, I’m not sleeping longer than usual, but I am falling asleep more easily, and waking more rested than in the past, and ANY improvement in my severe sleep disorder is cause for celebration. When I weighed myself, I found I had lost about 2 pounds, which I am assuming is water weight.

One of the most interesting side effects from a physical standpoint was something the literature on the ZAAZ had touted as a benefit, that I had completely dismissed as hype; cellulite reduction. For those who don’t have cellulite or aren’t chicks, the degree of cellulite you have is measured against the fruit scale–minimal cellulite is typically lemon or lime peel consistency and appearance, mild is orange, moderate is grapefruit, severe is cantaloupe or cottage cheese (small, medium or large curd).

You gauge your level three ways–standing at rest and shining a flashlight at an angle along the skin looking for ripples and dimples, seated doing the same, then you pinch a few inches and squeeze lightly. A young woman or boy will show nearly perfectly smooth skin with tests one and two, and lime or lemon with the pinch. Girls typically have more cellulite in general than males of the same weight, as we have higher body fat percentages.

I was a large curd cottage cheese for one and two, and also for the pinch test. Having tried every cream, nostrum, exercise, and homemade remedy for the condition for years, I have found no permanent fix–even when I weighed 125 instead of 200, it was pretty bad as I got older. Now, after one week, I am a grapefruit in many areas of my thighs sitting and standing, and a small curd cottage cheese to cantaloupe with the pinch test. Even the worst areas show an objectively noticeable difference after a week, and the actual reduction of visible cellulite is probably around 25-30%.

I have also noticed that my overall skin appearance is “different”, but I can’t quantify how it’s different. My other half tells me I’m getting a glow :-). I have also noticed that I am removing a lot more dead skin cells with my three times weekly whole body exfoliation than in the past, and that my feet aren’t cold all the time any more either. Nor are my lower legs and feel at swollen as they had been, though I still wear my compression socks, and will continue to do so.

Week Two Plans

This week, I’m sticking with the 1000 calorie diet plan, and increasing the types of stretches and exercises I do while using the ZAAZ, and we shall see what happens. While the ZAAZ does have a “calorie counter” on board, I don’t necessarily consider it an accurate measure at this point, and so only note the numbers for comparison with any actual weight loss. In theory, the amount of food I am eating should, at this point, equal my body’s needs–which means any weight loss would derive from water weight being lost or the actual exercise value of the ZAAZ.

My plan at the moment is to keep full intake and output documentation of fluids for a week or two and see how much more output than intake I have, so I can determine how much of my weight loss, if any, is coming from exercising on the ZAAZ in the form of interstitial fluid released from my fat layer by the intense vibration, and how much is my expected output based on intake.

In theory, the ZAAZ, like any whole body vibration machine, liberates interstitial fluid built up in the fat layer and in cellulite (thus decreasing the appearance of the cellulite), and the constant micro movements of the musculoskeletal system to stay in balance burn extra calories above and beyond any calories burned in natural body functions–so even if you just stand on one and don’t move around at all, you’re supposed to lose weight. According to the calorie counter, each 12 minute session provides a base calorie usage of 75 calories, give or take a calorie or two–which would amount to that 1.2 pounds a week.

The ZAAZ is also supposed to create a synergistic effect, if you exercise while on it, so you burn more calories exercising on it than you would doing them standing still. Once I have determined how much of the weight I’m losing is pure water weight, I can begin to chart other weight loss, and figure out what is causing it.

In the meantime–2 pounds less weight, sleeping better, and the cellulite reduction is amazing! As to the chronic pain, the decrease is about 50% or more, coup-led with greater range of motion and less inflammation. So far, a resounding success.



Direct Pay Health Care Part 3

In the last article, we took a basic look at concierge medicine, and why it’s worth exploring. But where concierge plans aren’t available or are too costly, there is always basic direct pay. The American Association of Private Physicians has a growing network of physicians listed that are straight cash doctors. And paying cash doesn’t cost nearly as much as you would think, either.

Why Pay Cash?

First of all, most of these physicians won’t take any form of insurance, government program or otherwise. As such, they avoid one of the largest cost drivers in medicine, the paperwork burden to get reimbursed for the work they do. In addition, you’re in charge. You have a much greater say in which tests you take, and why, and you never have to worry about a medical visit being “denied” by your insurance company either. Cash payers also get scheduled for appointments far more easily, and faster, than is otherwise the case.

There can be tax advantages as well. Most people completely overlook the line in their tax forms about “allowed medical expenses”, but if you’re close to moving from one tax bracket to another, those deductions can make a real difference. By using an online tax filing program and checking out both the itemized and non-itemized tax burden, you might find you save a good chunk of taxes by paying cash and taking the allowed deductions.

With many direct pay doctors, you have negotiating room. All of the cash only doctors I know in my area have discount rates available for seniors and the working poor, and many also do a great deal of pro bono work. Quite a few take barter, credit cards, checks, cash, debit, Paypal, and precious metals. Five doctors I know also take Bitcoin.

In many states, there are now medical barter networks, and in my area, there are over one hundred medical professionals of all types willing to barter their services for everything from janitorial services to car care. You might even find doctors advertising barter deals on Craigslist. Other places to look would be a general search for “barter networks” in your area, or freecycle. If you are a professional or have a marketable skill of any kind, joining some of the larger barter networks can also help you grow your business.

Barter networks are the best way to get into trading, as they keep all the paperwork in order for tax purposes, and offer you the widest variety of ways to use your “trade credits”  efficiently. This also offers the “safest” introduction to the wide world of barter, as the people and businesses that belong to such networks tend to be highly reputable.

When Cash Is A Good Idea

Cash is a great idea if you’re young and healthy. In Tucson AZ, an annual physical and a complete blood screening will cost about 150-200.00. If you use one of the nine different ways to get out of paying the fine for not having obamacare, and you take the money you would have paid in insurance premiums and invest it in precious metals, then you have a stash of cash handy if you do have a real emergency at some point.

As a typical example, a 26 year old male who has to buy insurance through his job at a local school district is paying just over 100.00 a month for that insurance. Were he able to “opt out” of the employer’s health insurance program, he’d have on average an extra 1000.00 a year to invest in precious metals for emergencies, or pay off old debts. If his girlfriend did the same, between the 2 of them they’d have 2000.00 a year more than they do now.

Many employers will be happy to get off the hook for your insurance also. Several local companies give their employees an extra 10-15% in their paychecks if they opt out of company insurance, as long as they can document they are either in compliance with obamacare, or have been waived. This translates into an extra 90 cents to 1.35 per hour at our local minimum wage. When you combine that extra money with paying cash or bartering, the financial advantage can be significant.

But What About Emergencies?

This is where things can get interesting. Most people don’t realize that hospitals will negotiate bills. In some cases, if you have your own direct paid doctor that has hospital privileges, you can have your doc take care of you, for starters. And if you’re willing to be direct and persistent with the hospital billing department, it’s not uncommon to get a hospital stay cost reduced by 50-60%, or more, before you even start paying, and when you do start paying, you’ll have low monthly payments with no interest.

Many states require hospitals to accept whatever good faith payment a patient makes, even if it is as little as 20.00 a month. And most hospitals are more than willing to work out payment plans, if you show them what you can afford and stick with it. Some hospitals also have private accounts that are funded by benefactors to partially cover medical care for those who can’t afford it as well.

Instead of an ER visit, it’s also a good idea to look into the urgent care clinics in your area. Many of these are open on average 18 hours a day, and a typical visit is around 100-150.00. The wait times are also considerably shorter in most cases than an ER visit, and also significantly cheaper. Many direct pay physicians, like their concierge care associates, will  make house calls if you’re actually sick as well.

Direct Pay And Diagnostic Testing

Another thing many people don’t know is that you can pay cash for diagnostic testing, and in many places you can even order simple blood work, like complete blood counts, without a doctor’s referral. This varies from state to state, but it’s worth checking into so you know your options should you need tests. Imaging centers have basic cash fee schedules, and many also offer discounts for seniors, cash payers, and the working poor.

If your employer doesn’t offer an HSA and you want to go the cash medical care route, then it’s a good idea to open a savings account, and deposit anything you can afford into it at least once a month, if not more often. Whether it’s a “keep the change” savings account at your local bank or credit union, or a traditional savings account, setting aside money starting right now for those emergencies is the wisest option.

Saving For Your Medical Independence

The best way to save for medical expenses is actually precious metals. With the price of gold and silver artificially low right now, you can easily buy a few silver dollars or 1/20th of an ounce of gold once a week, and put it aside. Make arrangements with friends or family to have them buy the metal from you privately at market value should you need to cash it in for bills, to avoid having to declare the sale on taxes. Different coin shops will charge different “premiums” on your purchase, so shop around for the best deals.

Precious metals are the savings of choice because they actually do appreciate in value, effectively earning “interest” in excess of what a savings account would pay, and as long as you sell them privately, they are essentially not tracked by the government. At current prices, a few silver quarters will cost about 20-30.00, and are easily stored in a small fireproof safe or even a change bowl on the top shelf of the closet. Just be sure that any real silver coins are kept totally separate from household change. When buying silver for savings purposes, you’ll want to ask for “junk silver”, and steer clear of “numismatic coins”. Junk silver coins are very worn, or very common (like Roosevelt dimes), and so they sell at or very near “melt value”.

It’s also a good idea to check your change when you get it, especially dimes, and half dollars. There are a very large number of 1964 and earlier Roosevelt dimes still in circulation, and they are silver. You can check a large pile of dimes quickly by stacking them and looking at the edges–one or two without the copper stripe really stand out that way. This is especially good if you run a small business and get a lot of change. We have found quite a few silver coins among the change we get from customers over the years.

As for half dollars, the 1965-1970 Kennedy Half dollars were 1/2 silver, and all pre-1965 were full silver. Nickels minted during the WW2 years are also silver, and sometimes show up in change. It doesn’t hurt to ask your doctor if he or she will take gold and silver coins at market value, either. As a rule, direct pay doctors tend to be independent minded people, and often very flexible when it comes to forms of payment.



Direct Pay Health Care Part 2

When people think of “direct pay health care”, they think of the 1% paying cash. But direct pay health care is available to everyone, and you don’t have to be “rich” to use it, either. In this article, we’ll focus on one common type of direct pay health care that is often viewed as for the rich only–concierge care.

Concierge Health Care

In “concierge care” the patient pays an annual “retainer”, which can be as low as 100.00 a month for an individual. This retainer gives you the services of a group of doctors and specialists, on an unlimited basis, for a small co-pay when you schedule appointments. The average concierge medical network will also include inpatient and outpatient medical care for surgeries, and emergency room services and even ambulance/transport services at a discount.

As concierge physicians focus on wellness–keeping you healthy–the average plan will include basic health services annually in the retainer fee, and also offer a wide range of alternative medical treatments, from acupuncture and chiropractors to massage therapy, yoga, and even Tai Chi. Many plans also allow you to add ancillary services like dental and optical to a standard package, and arrange to keep accounts similar to HSAs, so you can have some money set aside for unexpected medical expenses within the practice itself.

Many concierge plans also offer house calls, and 24/7 on call nurses for general questions in addition to 24/7 access to your primary doctors, and some also offer telemedicine, online visits with your doctor. The advantage of a good concierge plan over insurance at comparable rates is simple–you not only get more for your money, the good concierge plans often have reciprocating services with medical teams in dozens of states and cities. Some plans have nationwide coverage, so your medical care and records go wherever you go, and there are also international plans available.

Is A Concierge Plan For Me?

Concierge plans are the best choice for young, healthy people who don’t need to see doctors often at all. The savings over insurance premiums can be substantial on an annual basis, and if you choose a large network, your health care is very portable. It is also a good choice for older patients with stable, chronic conditions, as many concierge plans offer reduced rates for seniors as well as offering some pro bono care.

For those with families and young children, the financial benefit may be small, but the benefit of your child being able to develop a long term relationship with one group of doctors more than outweighs the financial angle, just as it does for adults. Concierge doctors have smaller patient loads, and because they have the same patients for years and in some cases decades, they know their patients, and can often spot changes in a patient that other doctors would miss.

Choosing A Concierge Plan

Concierge plans range from simple to complex, from as little as 100.00 a month to 1000.000 a month or more, for the luxury, worldwide programs. All of them tend to focus on promoting wellness proactively, as such you’ll find an emphasis on diet, exercise, and a holistic approach to being healthy that is an important part of the system. As an example of one of the best ones for “boomers”, you can check out MDVIP, one that is a popular choice and has been in operation since the very early 2000’s. I highly recommend subscribing to the newsletter.

Another good resource is American Academy of Private Physicians , and in certain states, you can also check out Concierge Choice Physicians. Contacting your state’s Medical Board, or local hospitals, can also be a good place to start.

Important Things To Keep In Mind

It’s not only OK to “shop around”–it’s highly advisable. You’re paying for a service, not just “insurance”, so finding the right doctor or team is worth the time it can take. Also keep in mind that it’s a good idea to still have basic catastrophic coverage–and some concierge plans require you to have insurance available in case something big comes up.

Also, if you have an HSA option available at work, you can typically use HSA funds to pay for your concierge service retainer fees, and in many cases your concierge related medical costs will be tax deductible–so whether you go a standard “direct pay” route and just pay your doctors cash or you go the concierge route, you’ll want to keep all your receipts and take the extra few minutes to figure out whether filing an itemized tax return is “worth it”.

While Medicare  doesn’t cover concierge costs in most states (California has exceptions to this), if you have to be hospitalized or require diagnostic services you can typically arrange to have those billed through your Medicare, at the standard rates. And in some states, a concierge plan that covers all that is required by obamacare is accepted as being on obamacare.

If the idea of a full concierge plan doesn’t work for you financially or otherwise–then shop around for direct pay doctors outside of concierge networks. Most people don’t realize that just about every doctor will take cash–and that many doctors will also negotiate their fees with you, as will hospitals and in some cases diagnostic testing centers.

We’ll be covering other ways to lower your medical bills in the next several articles, including barter. But it never hurts to call your current doctor and ask them what their cash fees are if you don’t file an insurance claim–the answer might surprise you.

As we said before–concierge medicine isn’t for “everyone”. But if you’re someone with chronic conditions, someone who is a believer in proactive wellness, or someone who rarely needs more than the typical annual checkup, a reasonably priced concierge plan can make a difference financially, especially if you take the money you would have been shelling out for insurance and either invest it prudently, or buy precious metals.