Tuesday, February 17, 2009

Economic Leverage in Hard Times: Part 5—Health

This is the fifth installment of my series on how everyone can get more out of the life they want while at the same time spending less money to make it happen. My motivation is that most folks today need to be more careful about their economic choices, and I have some good news.

Through what's been learned about cooperation and sharing in community living, it's possible for most of us to continue to enhance the quality of our life while at the same time cut back on cash outlays. To be sure, my suggestions will require some lifestyle changes. Yet what I'm offering is meant to be widely accessible, and does not involve a change in personality or altering one's core values. In Part 1 I focused on Housing; in Part 2 I looked at Food; Part 3 was about Transportation; Part 4 spotlight Energy. Today I'll tackle Health & Personal Care.

• • •
While Health & Personal Care comprise less than 10% of the typical American family’s budget, it occupies a larger space in people’s consciousness because of the spectre of illness (who doesn’t know heart-wrenching stories of people stricken in the prime of their life, incapacitated for months—or even years—with cancer, automobile accidents, or complications suffered from vicious falls?). It’s on our minds a lot.

For the purposes of this blog, I’m combining Health and Personal Care. While hospital fees for treating a ruptured appendix are light years different than outlays for mascara to look your best at the office Christmas party, I still want to talk about them at the same time. Before delving into my half dozen specific suggestions, I want to begin with some general prefatory comments.

When it comes to Health, there’s a lot of background anxiety about making the right choices. On the minor level, is it worth it to pay $2 for an organic orange, when it only cost $1 for one that's been conventionally-raised (isn’t that a nice euphemism for fruit grown on trees liberally hosed with organophosphates)? On the heavier end of the spectrum, should you pay $68,000 for a hip replacement performed in your home town hospital, or fly to The Netherlands and have the same operation done for $28,000? I know a woman who faced this very choice last year and opted for The Netherlands. While she was totally satisfied with her experience, it can be really tough price shopping for health care when you’re uncertain of the trade-offs. Under what circumstances, if any, are you willing to buy less than what you perceive to be the best (and isn’t there a little birdie inside your head constantly chirping the refrain: "The most expensive is probably the best")?

There’s a great story about this involving a gynecologist who was advancing in age and thinking ahead to his retirement. Not wanting to let down his steady patients, he decided on a strategy of doubling his rates. Given the law of downward sloping demand (that says demand will drop as price rises) he figured that the market place would winnow down his regular caseload while at the same time maintaining total income. Then, when he finally pulled the pin, fewer women would be inconvenienced with the need to shop for a new doctor.

However, it didn’t work that way. To his astonishment, he found that when he doubled his rates, his caseload increased! Apparently, his new clients figured that a doctor that expensive must be terrific, and everyone wanted the best when it came to personal health.

While there’s a certain coyness among health care providers about providing clear, up-front information about costs, problems in that regard are nothing compared with the challenge of obtaining reliable, neutral information about the quality of health care services. Mostly we’re making decisions with very imperfect information, and the higher the stakes, the scarier it is.

With Personal Care it tends to be a different picture, though perhaps no less muddy. First of all, where does basic hygiene drift into cosmetics and vanity? It’s a fuzzy line. In the same way that fashion is an exaggerated outgrowth (perversion?) of our genuine need to be clothed, a lot of what falls under the category of Personal Care is manufactured demand.

Take, for example, the expectation that women should shave their legs and armpits. You’re going to have to go a long way to convince me that this is anything other than a style choice and not a necessity (however much Madison Ave works to convince women that they’ll never get laid unless they’re hairless—in the right places). Still, it’s hard to fault a women functioning in public who makes the decision to shave, simply to avoid having her armpit and leg hair distract from what she really wants to accomplish. Who am I to get on their case for not tilting at that particular windmill?

And the issues are more confusing than that. While shaving is rarely a Health issue, how much do we need vitamin supplements, or sun screen? Vitamin deficiencies and skin cancer are real things, yet, at any given time, we're often engaging in so many would-be helpful practices that's it's hard to isolate the efficacy of each one.
Worse, it varies widely by person. In many cases, we simply start doing something because others around us are (or our parents did). For example, when I first entered puberty I automatically started using deodorant (didn't everyone?). It took me until I was 19 and half-way through college to question it. No one had told me I had offensive body odor; I was mostly using Right Guard because I didn't want to have someone tell me I had BO. Holding my breath, so to speak, I stop spraying my armpits and have never used deodorant since. How many more superfluous Personal Care practices do I engage in unwittingly? Hopefully, fewer all the time.

Finally, many products are more expensive because they are preparations that save the user time—even though it would be a relatively simple matter to concoct your own at a fraction of the cost.

OK, enough with the preamble. Here's today's half dozen specific suggestions for containing costs in the category of Health & Personal Care:

1. Toothpaste
This is a great example of a product that straddles the fence between Health and Personal Care. On the one hand, it’s fairly firmly established that brushing one’s teeth daily is a good Health practice. In addition to preventing decay, it’s also essential, along with flossing, in dislodging harmful plaque related to gum disease. Essentially if you want to keep your teeth, you need to brush.

However, brushing doesn’t necessary mean you need toothpaste. The health claims for the medicinal properties of toothpaste are less clearly established. Mostly, I think, it's used to freshen the breath, which starts to tilt things more in the direction of Personal Care choices and away from Health needs. While I'm all in favor of sweet breath, and halitosis is not much fun to be around, bad breath is neither contagious nor fatal.

In my early 20s I read The Tooth Trip (1972) by the renegade dentist, Tom McGuire. He thought the world of brushing regularly and using dental floss, but considered toothpaste an optional extravagance. For deacdes I ceased using toothpaste and never had a cavity. That's how much I needed Crest.

I'm using toothpaste as my first example to illuminate the issue of unexamined assumptions in how we relate to Health & Personal Care expenses—not because there is that much potential savings in expunging toothpaste from our household budget.

2. Do It Yourself
Let’s suppose that you don’t think it’s wise or are otherwise unwilling to do without a product or service. What are your options? In almost all cases, you can move in the direction of doing more yourself and foregoing convenience in exchange for savings in the pocketbook.

Take lawn mowing as an example. While I tried to convince you in an earlier blog (Feb 9) to take up gardening instead lawn care, let’s suppose I failed. Instead of hiring out the mowing to the neighbor’s teenager (or worse—from a community building perspective—a lawn care service) you could mow your own lawn. You’d be trading your time for dollars, and getting a bit of exercise into the bargain.

But don’t stop there, consider using a push mower instead of a power mower. It’ll lower your capital expense, be less noisy, eliminate the fuel costs, and now you’re starting to get some aerobic exercise—especially if you have any slope to your yard.

Wondering why I’m talking about lawn mowers in a blog about Health & Personal Care? First of all, exercise is definitely related to Health and in today’s sedentary lifestyle we can’t count on getting adequate exercise merely by doing life (as people could 100 years ago). Ours is a convenience world where not moving is considered the epitome of having “made it.” Thus, it takes conscious thought to reverse engines, and to start valuing physical exertion instead of hiring it out.

Further, because of the desire to “look good” mentioned in my rambling preamble, there will be even more resistance to going back to simpler ways—for fear it will appear to others that we’ve failed to "make it." There is probably nothing in the lifestyle we’ve created at Sandhill that encapsulates this better than our conscious choice to eschew flush toilets. Not only have we not built any into the three residences we’ve constructed in our 35 years, we’ve taken out the one we had in the original farmhouse.

Instead, we have two composting toilets, simultaneously saving on water usage and capturing the nutrients in our own shit, which we use to replenish the soil. Despite what I consider sound reasoning, it is highly challenging to many people's sensibilities that they won't have access to "normal" plumbing when visiting. There are folks (relatives, in particular) who will not visit us for more than 10 hours simply to avoid navigating the natural process of elimination without the comfort of seeing potable water whisk away the evidence at the touch of a handle. Talk about the power of conditioning!

We're talking about embodying what Duane Elgin styled Voluntary Simplicity into everyday life. The low tech solution is often healthier as well as cheaper—you just may look a bit odd in the practice.

3. Grow Your Own Herbs
This is a natural extension of my previous DIY example, spotlighting to how you can cut costs for both food (my next point) and many other health care products by establishing an herb garden—both for culinaries and medicinals.

Focusing here strictly on the Health side of things, at Sandhill we grow hypericum (St John's wort), calendula, and echinacea for making tinctures. We harvest borage, red clover blossom, raspberry leaf, and all manner of mints for teas. We also keep bees, which yields local honey (said to help with allergies), pollen, and propolis.

Most of these things are simple to grow (in fact, it's down right difficult to get rid of mint once it's established), and lovely to smell and look at.

4. High Quality Food
I wrote about gardening in a previous blog in this series, and now we're starting to see how these categories overlap with reinforcing suggestions. Look at the mutlplying benefits of gardening:
o You can't eat any healthier than when relying on fresh, local, minimally processed food.
o You're getting fresh air and sunshine (natural vitamin D—no need for the supplements) tending the garden, putting yourself more in touch with natural circadian rhythms (read you'll sleep better).
o You're getting some of that much-needed exercise I spoke about earlier—much superior to more time in front of ye olde keyboard.
o Sharing home-grown food is a terrific way to break the ice with neighbors (Warning: be careful not to overdo it with the zuchinis; they can get out of hand in a blink, and the neighbors may start to lock the door if you take this particular form of sharing-the-joy too far).

5. Trade Massages
How about exchanging massages with friends and neighbors—instead of just trading text messages. It's way cheaper than paying for a masseuse, and it's likely you won't have to schedule it so far in advance.

Sure, amateurs are not likely to be as skillful in finding just the right spot or applying just the right amount of pressure, yet touch itself is healing and it's getting to know one another in another way—kinesthetcially, not just intellectually or emotionally.

Taking this a step further, there is a wealth of low risk health practices you could do as a neighborhood or interest group: yoga, tai chi, qigong, or even fast walking. Heck, take up shuffleboard together. As long as it involves movement and doing it with others, you're on the right track and it's easy on the wallet.

6. Community
Homo sapiens is hard-wired as a species to be social. We crave our kind. While that doesn't (unfortunately) mean that we always behave well in the company of others, we're predisposed to want it. There are reputable studies which show that vibrant social connections are a definite aid in living longer and better. (In fact, we devoted Communities magazine issue #102 [spring 1999] to that premise.)

Taken in its broadest sense, this last suggestion is to look back over the previous five suggestions, and think how each provides the potential for synergistically boosting your Health yield by doing it with others. When you brush without toothpaste or tear out your flush toilet, it may not lead to a conversion, but it'll certainly lead to a conversation. Build on it!

DIY is not necessarily DIABY—Do It All By Yourself. You can do your own as a group or as a neighborhood. The same goes for the herb patch or the food garden. Maybe you can do the medicinals, the person on your right side can take on the culinaries, and the dude on your left side can grow tomatoes for everyone. Be creative!

Involve your friends, your neighbors, your housemates... anyone you're willing to play with. Emphasize relationship over control and owenrship. You'll live longer and can probably save money into the bargain.


Anonymous said...

It was unheard of when I grew up for anyone to go banckrupt because of medical costs. All you say makes sense but there is still the unreal costs for medical treatment when you need it. I lived in Japan for 7 years and there was high quality medical and dental care for a reasonable cost not so here in CA.

sitamckay said...

Hi Laird,

I know your name and your face...now I'm trying to figure out if I know you from thinking of joining Sandhill, or whether you were once part of U & I Ranch, which I was in '73...back when Jubal was king... I would love to find some of the old folks that used to live there...please let me know if that's how I know you and get in touch!...