Jay Zigmont, CFP®: [00:00:00] Welcome to Childfree Life by Design. Today we’re talking about a massive financial drain that affects most everyone in our community, the weaponization of the medical industry. I’m Dr. Jay Zigmont, and I’m here in this episode, I’m joined by Dr. Jordan Grumet. We’re covering the corporate takeover of local medical practices, the truth behind soaring drug prices, and how you’ll fight back. It’s one of those topics that, just kind of caution for the audience, both of us have our own stories around this, and I am sure, they will all come out, and I’m sure you have your own stories around healthcare. So, eh, if nothing else, we’ll have a good conversation.
Intro: From Childfree Insights, this is Childfree Life by Design, the go-to resource for building the Childfree life you want. Every episode gives you practical guidance, clear direction, and meaningful conversations to help you live intentionally and design a future on your terms. This podcast is for educational and entertainment purposes only. Please consult your advisor before implementing any ideas heard on this [00:01:00] podcast.
Jay Zigmont, CFP®: So returning to the show today is a crowd favorite, Dr. Jordan Grumet, otherwise known as Doc G. He’s an internal medicine hospice doc, the host of the award-winning Earn & Invest podcast, and the author of the incredible new book, The Healthcare Heist: How Physicians and Patients Can Unite to Transform Healthcare. But before I welcome him back to the show, if you hadn’t gotten there, go back and listen to the one on The Purpose Code. I think The Purpose Code, which was the last book you were talking about, was and still is my top recommendation for any of my clients. So we’re just gonna pick up where we left off. So welcome back to the show.
Jordan Grumet, MD: Thank you so much for having me. I, I so appreciate it.
Jay Zigmont, CFP®: Yeah, and let’s be real. We’re gonna look at this, you know, you’ve looked at this as a doc, and I’ve been a healthcare administrator, been a paramedic, been on the other side of the healthcare system. And I don’t know about you, but at least I got burned out by a lot of the stuff you’re talking about in this story. Reading your book was kinda almost borderline PTSD of like, I know, the system’s broken. I mean, is that not real?
Jordan Grumet, MD: It, you know, it [00:02:00] is, and it’s funny because I often frame the burnout I had in medicine about an issue of purpose and identity, and I talk all about my financial independence journey. The reason why I actually wanted to write this book is ’cause there’s this whole other piece that I don’t talk about very often, which is this, the system is just broken. It is a divide and conquer system in which patients and physicians, patients and pretty much all healthcare providers are combating each other as opposed to working together. And there is a reason this has happened, and I think it surprises people to realize that there is a third party out there or a series of third parties who are stealing all the money out of the system. They’re not improving our healthcare at all, and we are all paying for it.
Jay Zigmont, CFP®: Yeah. I, I’m sure we had kinda similar origin stories. I entered healthcare because I wanted to help people. That was why I got in there. And then when I got in and saw the backside, I’m like, “It’s all about finance.” It is absolutely all about money. And I’m like, “If I’m gonna go do something on money, let’s go do [00:03:00] money. Let’s not hide it and pretend we’re taking care of patients.”
Jordan Grumet, MD: People don’t realize, like if you go back to colonial times, the beginning of our healthcare system was literally neighbors helping neighbors, people delivering each other’s babies ’cause there were no doctors. And so it was healthcare by the people, for the people, and pretty much it progressed that way. We started having basically an acceleration of medical services because of our world wars. We needed to treat our wounded. We needed better pain control. You ended up with pharmaceutical companies. But all of it in the beginning was really to treat our people. It was a public good. But starting around the 1950s, you really had the rise of corporations, insurance companies, pharmaceutical companies, where the idea was really to make money more than it was to provide this public good. And that’s where we get this acceleration of really healthcare being a huge business, a business where there are winners and losers. And believe it or not, the losers are mostly the patients and the [00:04:00] providers.
Jay Zigmont, CFP®: And just in case anyone’s wondering, we’re not just talking about for-profit healthcare organizations. So I come out of the nonprofit area, and the way they used to always say is no margin, no mission. You gotta make money to keep going even though you’re a nonprofit. So it’s not even like there’s like this separation between for-profit and nonprofit in the healthcare world. It’s all mixed together. Is that fair?
Jordan Grumet, MD: It is fair, and remember, non-for-profit status sometimes is something businesses use to pay less taxes, et cetera. So this idea that, oh, it’s a, a not-for-profit means that they’re not actually looking at the bottom of their line, they’re not looking at margins, just isn’t true. But we’re also seeing the rise of for-profit medicine, et cetera. So for instance, I work in the hospice field. Most hospices used to be not-for-profit, and a lot of them now are for-profit. And so you’ve seen an acceleration of the economics of these practices.
Jay Zigmont, CFP®: I was just at a conference and we’re talking about, CCRCs, long-term care communities, other things. And being nonprofit, actually they can get [00:05:00] more funding from a loan standpoint than for-profit. But the bottom line is they were talking about loans that they were giving out to these places at hundreds of millions of dollars. It’s still a business.
Jordan Grumet, MD: Mm-hmm. For sure. I mean, all of healthcare right now is a business, and it makes sense why in the US we generally pay about double per person for healthcare a year than what they pay in other civilized countries. We’re spending a lot of money, and those dollars aren’t going to our healthcare. They’re going to these third parties who are pocketing it, right? They’re paying their CEOs hundreds of millions of dollars. When you look at, for instance, pharmaceutical companies, their profit margins beat out most of the S&P 500. Now, of course, things have changed a little bit with AI, but generally these companies are doing really, really well.
Jay Zigmont, CFP®: I, I think there’s a challenge. So by the way, for listeners, you almost can’t talk about healthcare without talking about some of politics and Medicare and, the systems and the structure. So I apologize, gonna get a little political at times. I just… You, you can’t [00:06:00] separate it at this point. And there was a good discussion this, it was last week or the week before. They were like, “Oh, other countries are undercharging for drugs, so they should raise their prices to the other countries so it doesn’t look as bad in the US.” And that was a political solution. And I’m like, that is not a solution.
Jordan Grumet, MD: People don’t realize, so when people talk about what drugs cost in other countries, they kind of think, “Oh my God, there’s all these different pharmaceutical companies that are selling these drugs.” They don’t realize if you’re buying a drug in the US and it’s really expensive, that same company is selling that same drug to other countries for cheaper. Why? Because they make so much money in the US that anything they get extra in these other countries is fine. And why don’t they charge more in these other countries? Because unlike the US, these countries actually use collective bargaining. Their governments have universal systems, and their government will go to the pharmaceutical company and say, “You either give it to us at the price that’s reasonable or we’re not going to buy your medication.” And again, these companies are making [00:07:00] so much in the US, they’re willing to sell their drugs for pennies in other places. So why doesn’t it work in the US? Our government is also one of the biggest buyers of pharmaceuticals, right, with Medicare and Medicaid. Why don’t we do the same thing? Well, back in the Bush years when they passed the legislation that brought us Medicare Part D and the pharmaceutical benefit, part of that legislation was that the government was not allowed to negotiate for bulk drug buying. Which lobbying group got that one in, right? Obviously, and this is the problem with our healthcare system, we have these third parties that have lots of lobbying dollars and they own the politicians. And it just is what it is. If you wanna get elected today, you need a lot of money in your coffers, and the way they get money in their coffers is through these third parties who are basically paying off both sides to make sure that the legislation reflects their needs, just like it did during the Bush era, and it continues to do so.
Jay Zigmont, CFP®: It’s interesting. We, we talk a lot about, because of what we do at Childfree Trust, the [00:08:00] kinda long-term care and all the costs there and all the structures and, and the end of life stuff. And I was reading an article, this week and Medicare saying, “Hey, we need to do a better job at hospitals of understanding if people have advanced directives in place.” Which I agree. I think everybody should have one, and it should be, you know, written out. And I don’t know about you, but mine’s gonna say DNR, let’s kinda go that direction. But they’re not doing it ’cause it’s the right thing for the patient. They’re doing it because that, having that piece of paper in place saves Medicare about 10K per client because they can actually get decisions made. And I think the hard part is, part of me is I agree with that we should all have advanced directives, should all have them in place, and if you don’t, we can work at Childfree Trust to help you. But the reason they’re doing it is the money. So, it’s almost like to get these things done, you have to speak the money language. Is that fair?
Jordan Grumet, MD: It is. And, and don’t get me wrong, we need financial solutions to our healthcare problems. The issue is this: [00:09:00] we want the healthcare money to go to healthcare. It should either be paying for your care as a patient, or it should be paying for the providers who are giving you that care. But instead, we have a lot of these third parties who are putting their hands in the cookie jar, taking the money out, and they’re not really improving care. I’ll give you a perfect example, electronic medical records companies. We’ve spent billions and billions and billions of dollars implementing electronic medical records from third parties. Believe it or not, the government created one of the first medical records. It’s called VistA, and it’s used at VA systems, and it works fantastically well, and it’s really, really cheap. But that is not the system that we have in the US. For most of the US that’s non-VA, non-governmental, we have these private companies that give us electronic medical records like Epic, and those have cost us all billions of dollars to implement. And guess what? Most of the studies show that we’re no better off than we were 20 years ago. We don’t have less medical errors. We don’t have more efficient care. We don’t [00:10:00] have better quality of care. Basically, we are no different except that all those billions of dollars left the system and went into the hands of this corporation.
Jay Zigmont, CFP®: And I happen to know quite a bit about EHRs ’cause my wife is an epidemiologist working in predictive medicine around EHRs and all that. There’s a lot of potential there where you can use them to make decisions, where you can use it to inform care. But I’m gonna be honest, it almost never works.
Jordan Grumet, MD: There’s a, reason too. Why does it work in the VA? So the VA system has this VistA, and if you go to any VA in the country, they can look up your records from a different VA. Well, here’s the problem. We’ve got five, 10 different medical records companies, and then we’ve got hundreds and hundreds of hospital systems, and they don’t wanna share data. So I, for instance, my hospital might use Epic, and then the hospital across the city may also use Epic, but guess what? They don’t interact with each other. If you go to one hospital, you can’t see the records from the other [00:11:00] hospital. Even though it’s the same medical records system, it’s been changed to fit that system, and no one wants to share information because, hey, if I make my information readily accessible to the hospital across the city, then you could go there and get your care there and give them your money instead of giving me the money. So these systems have potential, but right now they’re really serving the businesses, and therefore they’re not living up to their potential. And the other thing is a lot of businesses like hospitals are using them to upcode, right? So we can use electronic medical records to add in extra information, and how we code for a level of service or, you know, an episode of care is all based on how much documentation is. And these electronic medical records make it easy to document so you can upcode. And so all of these things, while they should make care safer and more efficient, they generally just don’t.
Jay Zigmont, CFP®: And by the way, for those that haven’t spent a whole lot of time in the healthcare system, the way people get [00:12:00] paid is by these codes that say, “Hey, this patient has X.” Well, how you code it could be different for everything. So great example, somebody was talking about, it was kind of at a life insurance example. They were talking about somebody who went in who had, you know, lost a family member, having a rough time, went into the ED, just having a, a grief reaction. Well, that gets paid very small. Now we start talking about diagnosed people with anxiety, depression, other things, and that’s the up-coding you’re talking about, which by the way, as a patient can hurt you, ’cause when you go to apply for life insurance, it’s seen differently. And these are the types of things people don’t think about, but there’s actually companies, they’re consultants that go into hospitals and teach people how to change the coding to get more money.
Jordan Grumet, MD: Well, the hospital hires like a huge number of coders who will look at your note, and this used to happen to me all the time when I was busy in clinical practice. I’d be in my office and I’d get a phone call or an email, and it would be some coder who said, “Can you please [00:13:00] add to your note this sentence so that we can fully code for this episode?” And so think about how much spinning of wheels is going on. How many people are being hired, how much time is being spent in order to generate this information so that they can bill the government more or bill the insurance company more? Again, none of this is improving care. None of me adding that little extra sentence that makes the coders happy but doesn’t really clinically matter. And I wanna be clear on this. We’re spinning our wheels and we’re wasting our money. These businesses are in the business of creating more work and generating more revenue, but not in giving better care. And I wanna be really clear about this. When a doctor goes to medical school, they take the Hippocratic Oath or the Oath of Geneva, which basically says they will swear to uphold the care and integrity of patient care. And then they start [00:14:00] to practice, and there’s something called the standard of care. There’s a standard of care in how you treat patients, and if you don’t live up to that standard of care, you can get sued. Here’s the thing. When a business changes the way a doctor practices, when they force them to see more patients or they change what drug the doctor’s giving because it needs to be pre-authorized or it’s not covered, basically these businesses are practicing medicine. But here’s the thing. The businesses haven’t taken the Hippocratic Oath. The businesses don’t have a standard of care. They have something very different. They have what’s called a fiduciary responsibility. What does fiduciary mean? It means that it is required to be as efficient as possible and make as much money as possible for its shareholders. We’re now talking money, and so these companies are practicing medicine to make money. Not for patient care, but to make money. And we are allowing it over and over again in our system.
Jay Zigmont, CFP®: Somebody we had online, I know you and I have a mutual friend, Dr. Bill Yount. His, one of big his things is, “Don’t call us providers,” ’cause that’s, that’s a pure commercial term. Like, that, you know, we’re here to help people. We’re not here to be providers. A- and I get his argument, by the way. I don’t know what term we use then. That’s k- part of the problem. But these terms are there because you’re providing a service. You’re not there to heal people. Is that fair?
Jordan Grumet, MD: It is. And I, I wanna be clear also on this. It’s not just that these third parties are coming in and taking all the money out, but they’re also pitting doctors and patients against each other, and that divide keeps us from coming together and pushing for change, right? So it’s kinda like the divide and conquer. The stakeholders are pretty much the patients and the people who are providing care. And if those two ever come together, maybe we’ll get revolutionary change where people stand up and say, “Hey, I’m not gonna put up with this.” So what do they do? They basically pit them against each other to divide and conquer, [00:16:00] keep, keeping them so busy being angry with each other that they don’t realize they’re being robbed blind. And so here’s where you see things like the medical malpractice conglomeration of companies and lawyers, et cetera, that basically is pushing data that suggests that doctors are making errors all the time. There was a study called To Err Is Human. It came out in, 1997. It basically said that 98,000 people a year die from in-hospital accidents. It was a horrible study. It was extrapolated. They took a small number of incidences and extrapolated it to the whole country. It would basically suggest, like, one in two people who die in the hospital die from an error, which we all know is not true. But it made it seem like doctors were careless. Again, pitting doctors against patients. Never mind the fact that two-thirds of medical malpractice cases never make it to court because they’re thrown out, and that once you get into court, eight out of 10 cases find for the doctor and not for the plaintiff, right? So we’re talking about only a small number of cases when litigated actually [00:17:00] show medical malpractice. But the lines have been already drawn, and people have been convinced that the doctors make a lot of mistakes. Electronic medical records. Now we have this physical barrier to our patients. Our patient used to come into the office, and we’d look him in the eye, and we’d, you know, examine them, and we’d be very present and very close. But now we have this computer in between us, and we don’t even make eye contact with our patients anymore because we’re so busy looking at our computers. And then last but not least, insurance companies like HMOs have decided that the doctor is the gatekeeper, right? So the primary care doctor is the one who decides what tests get ordered and what referrals get made, and if you don’t like it, talk to your primary care doctor. Primary care doctors became gatekeepers, but they were never trained to do that. And remember, us doctors have a responsibility to our patients, not a fiduciary responsibility or even a public health responsibility to make healthcare cheap. That is not our job. Our job is [00:18:00] to order what’s necessary for our patients, even if it’s expensive, because that is our oath that we took. And so all of these things are pitting doctors and patients against each other. They’re uncaring. They make lots of mistakes. They’re withholding care as a gatekeeper, and they’re not even making eye contact with you. All of these things actually come from these third parties who have been inserting all these things into our lives. You know, go back 100 years ago, none of this existed.
Jay Zigmont, CFP®: I’ve got a whole clients who are docs and both of, actually the two of them I’m thinking of, both have decided they’re gonna go do concierge medicine and leave the healthcare system and just cash basis. And by the way, it’s actually cheaper for the clients in a lot of cases. They get the doc’s personal phone number. The doc actually gets to care for the person. They have to keep some records just, you know, for CYA, but it doesn’t have all the red tape, and it’s, to me, so much better care because you actually can spend time. There’s one locally here, and what they’ve done, it- it’s 10K a year, so it’s not cheap, but [00:19:00] when you go to visit the doctor, the doctor does have a nurse, you’re the only one in the practice, and they get to spend as much time as you need. That just seems insane.
Jordan Grumet, MD: And let’s talk about that model. So people ask, “What can I do?” Well, one thing, if you have enough money, you can do either concierge medicine or direct primary care, and you’re directly cutting out one of those third parties, which is the insurance company. So why does this work? Well, the doctor doesn’t take insurance anymore, so no pre-authorizations, no coding hassles, none of this. And so they charge a monthly or yearly fee, but because of that, they can see a lot less patients. They can give you a lot more access. And so one of the ways we can buck this system… Now, let me tell you, I think it’s a cop-out. I think we have to tear the system down and rebuild it. I think we need revolution. I’m not talking about pitchforks and guns, but I’m talking about the main stakeholders coming together and pushing for revolutionary change, just like they did during the Civil Rights Movement, right? 1965 Civil Rights Movement, we finally [00:20:00] got legislation because the stakeholders came together and pushed past the enmeshed parties that were keeping it from happening. I think we have to do the same thing in medicine. So that’s the answer. But if you’re not going to do that or if we’re not gonna get to that point yet, then there’s some more simple things we could do. We can go to concierge doctors. We can go to direct primary care doctors. Or better yet, even if you can’t afford all those, you can at least try to find out if your doctor owns his practice or if it’s owned by a third party like private equity or venture capital or even a hospital system. We can even start trying to go to those few practitioners left who still own their practices, and we’re cutting out some of the middleman every time we do something like that. There are other things you could do, too. Asking for a generic medicine actually cuts out the pharmaceutical company, right? Fighting a denial from an insurance company and appealing it, you’re fighting another third party, the insurance company. So there are little things we can do even if we don’t cause this big revolution, which I think we need. There are little things we can do to kind of push that revolution [00:21:00] forward. And some of that is demanding better, which is what you do when you go to a concierge or direct primary care doctor.
Jay Zigmont, CFP®: Yeah, and we’ll talk about both the macro and micro. You know, I think what I’ve been saying to my clients that are kind of in that retire world, they have a couple million dollars, is you get a bronze plan, which is the cheapest plan on the ACA, just to protect you ’cause shit happens. They used to call them catastrophic plans. They don’t call them that now. It’s just the system’s broken. But you don’t rely on using that. You use direct primary care or concierge, and then some folks are doing some great medical tourism, where you’re flying into fill in the blank, there’s a whole bunch of countries. You do the full day of testing, all that. It comes back, and it– People go, “Well, is that cheaper?” No. It’s probably not. Is it better care? In most cases, yes. And people go, “Well, but I’m not sure I want to pay that much for my healthcare.” I’m like, well, you kind of have to speak with your money. And I think that’s a challenge. People go, “Well, not everybody can afford that.” I agree completely. There’s a whole affordability crisis, and that’s the macro issue. But I think as [00:22:00] individuals, we can look at other options.
Jordan Grumet, MD: I wanna remind you how silly it is that in the United States, one of the wealthiest countries in the world, we still have to fly to a foreign land to get basic medical care. And that basic medical care, one of the reasons it’s so much cheaper, they just don’t have all the middlemans, right? You fly to, you know, Mexico, or you go to another country in Europe to get something done. There’s no insurance, no pharmaceutical company. You go get whatever procedure you need, you take out the cash and give it to them, and that’s it. It’s cheaper. It’s easier. Isn’t that really embarrassing? I mean, what does that say about our world? And one of the things I talk about in The Healthcare Heist, one of the first stories I tell is that of Mary Lou Retton, right? Famous gymnast on the Wheaties box, an American hero, gets pneumonia, gets critically ill, ends up in the hospital for months, has a hospital bill of, like, $500,000. And guess what? She doesn’t have insurance, even though she has a net worth of somewhere [00:23:00] around $2 million. Why didn’t she have insurance? Well, being a gymnast, she had, 20 or 30 surgeries, musculoskeletal. She had just gotten divorced, and she couldn’t afford it. How do our heroes not get the treatment they need? She had to crowdfund hundreds of thousands of, of dollars. She had to ask complete strangers to pay for her healthcare. What kind of world do we live in here in the US? It makes no sense.
Jay Zigmont, CFP®: And by the way, this whole crowdfunding for healthcare is a purely US thing. You, you don’t see this elsewhere.
Jordan Grumet, MD: And we’re seeing it with like stars too. There’s been a few cases of actors who’ve died recently whose families have had to crowdfund in order to pay their medical bills. It’s like, wow, these people are making lots of money. Why is it so difficult here?
Mid-Roll: Don’t let the conversation stop here. Get inspiration, quick tips, and behind-the-scenes content tailored for the Childfree life by following us on social media. We’re most active on Facebook and LinkedIn. Just search for Childfree [00:24:00] Insights. And for our deepest dives and event invites, make sure you join the inner circle by signing up for our weekly newsletter at childfreeinsights.com.
Jay Zigmont, CFP®: I wanna shift for a second. You know, we talk about kinda hospital, but I think a lot about this long-term care problem. You know, we got a huge aging population. Just in case you all don’t know, Medicare does not pay for long-term care. Medicaid only does when you’re broke, and Medicaid funds were just cut, I mean, almost in half. I was having a conversation with somebody, and they’re like, “Well, what are they gonna do, kick grandpa to the street?” I’m like, “Yes. These are commercial buildings. They will give him like one day’s notice and, like, roll him to the street and leave him on the street.” So what’s your answer? Do we, blow the whole thing up? Do we… I mean, do we go to Canada socialized medicine? I mean, which model do you like? I mean, to me, there is no answer right now, and there’s no appetite to actually fix this.
Jordan Grumet, MD: So I, I think there are multiple answers. There’s, again, my statement that we shouldn’t have this problem, and we should really push for the revolutionary change that gets rid of it. But in the absence of [00:25:00] that, there are a number of answers, and I can run through them real quickly. But first and foremost, there’s exactly what you said. So the studies basically show that 86% of people will either need no long-term care or will need less than $100,000 of long-term care after everything’s been paid by insurance and et cetera, et cetera. So only about 14% of people are really gonna have a huge long-term care bill. So some people just wing it, and if you wing it and you are wrong, eventually you will spend down and you’ll get Medicaid. You’ll get rid of all your wealth, you might bankrupt your partner, but eventually you will get a Medicaid bed. And believe it or not, I took care of nursing home patients forever, and I would have a nursing home in which in one bed you’d have someone paying $15,000 a month, and in the next bed was a Medicaid bed, and you’d have someone who was paying nothing, and they were pretty much getting the same care. So a lot of good nursing facilities actually do have Medicaid beds. And it depends where you live. Where I was, they were actually [00:26:00] fairly plenty. So you can wing it, and if everything goes wrong, get Medicaid, and that is one answer. It’s not a perfect answer, but there is a safety net. That’s number one. Number two, you can try traditionally to buy long-term healthcare insurance. It is prohibitively expensive, but some people do that. Number three, you can do what I did, is, and this is probably a little bit better for the more wealthy people, is when I turned 40, I actually bought a whole life insurance policy with a long-term care rider. I hate whole life insurance. I had no interest in having whole life insurance, but I wanted that long-term care rider. And so for me, I plunked down one sum, it was a lot of money, but we paid it, it was $80,000. The age of 40, I paid $80,000 and got a long-term care insurance policy. Assuming the insurance company doesn’t go belly up, I’m covered, and then I did the same thing for my wife. If those things don’t work, there are, believe it or not, still some options. You talked about CCRCs. Most people don’t know what a CCRC is, but it’s a continuity of care continuum. What that [00:27:00] means is if you know that you are getting older, maybe you sell your house, you can either buy an apartment or condo or house in one of these communities. That’s kind of like the more wealthy side. If you’re on the less wealthy side, you can rent in an independent living. But they often have an assisted living, and some even have a skilled nursing portion connected. And once you’re in these communities in independent living, if you need an increase in your level of care, usually you can bump up to the next level, and it’s not cost-prohibitive. Yes, if you’re paying $5,000 of rent, you might have to pay $5,200 to be in the assisted living versus the regular. But the point being is it’s much more affordable. So if you have the forethought, these CCRC or continuity of care communities actually function for most people as long-term care. And that’s actually what my parents did. My parents are on the wealthy side. They bought into a really nice building that happens to have a fantastic assisted living, and they actually have a fantastic nursing home associated with it. And, you know, you’ll have people who [00:28:00] live in the independent, they’ll break their hip, they’ll go to the nursing home for a few months, maybe they’ll go to the assisted living for a while, and then they go back to independent and vice versa. If all that doesn’t work, poor man’s long-term care is you get yourself into some type of retirement community, or you build your own community of family or friends who support each other. And so I’ve heard Vicki Robin talk about this actually. Where she lives, she has a group of people that take care of each other. So when she needed a hip replacement, a neighbor came over and cooked for her, and someone else came over and helped her get around the house. And so if you live in these communities that are very, very close, or you have a family member and that’s what they do, is you’re like, “Okay, my son or daughter or someone’s gonna take care of me when I get sick,” that is another option. None of those options are perfect, and again, I wanna argue that we have a broken system, and the best way is to fix the system, but there are some options for those 14% of people who are gonna have to pay more than $100,000 of long-term care.
Jay Zigmont, CFP®: Yeah, and I’m gonna challenge [00:29:00] you. So the thing on that number is that assumes you have somebody to help you at home to do unpaid caregiving. Let’s be honest to that, that’s how that works. So for our audience that are Childfree, it’s a much harder road. That’s the hard part is as a Childfree person, you have to plan to build a network around you, and you’re probably gonna have to pay for that because the healthcare system is broken. That’s the problem. Like, there is essentially no social contract that says you’ve got a way to take care of your long-term care. You know? And, and I have a lot of clients that would love bodily autonomy that they could choose their time to go out too. Well, we can’t do that in our healthcare system either. This, this is the problem, is there’s so many of these barriers to actually, you know, getting the care you want in the way you want it, that I don’t know what to do.
Jordan Grumet, MD: Yeah. Yeah, no, I, I agree with you 100%. And again, this is not an uncommon thing in the United States or throughout the world when you start seeing that [00:30:00] the government and the country just aren’t serving the people. So I talked about civil rights, a perfect example, but there are other examples. If you go back, I often tell the story about Upton Sinclair and his book The Jungle, right? So in the 1900s, Upton Sinclair, an avowed socialist, saw what was happening in the meatpacking industry and was worried about the workers who were being treated horribly, working crazy hours, unsanitary conditions. And so he wrote the book, The Jungle, to help the workers out. Well, it caused an outrage. It was a very well-read book, and actually it caused major change in the US, not originally how Upton Sinclair thought it would. So actually, people read about this, and the first thing is they were horrified how their food was being treated. So immediately, the president actually started legislation that cleaned up the meatpacking industry so the food was safer. But believe it or not, 20, 30 years after that, you had the first collective bargaining legislation and the building of the first unions. And so when [00:31:00] things get intolerable and people speak out and tell their stories, the more we talk about these things, the more likely the stakeholders, again, in this case, it’s the people receiving care and the people giving care, will come together and force change. And that does happen, but it takes a lot of work. Another example is the NHS, the UK’s healthcare system, their national healthcare system. They didn’t always have a national healthcare system. And in fact, in, I think around the same time, the early 1900s, you had a number of people trying to push the government to get better policy, and it stopped and started, stopped and started, and then there was this physician, believe it or not, a guy named A.J. Cronin, who wrote a book called The Citadel, and it was all about the atrocities of the healthcare system, how people were suffering, and also how the healthcare providers were suffering. And believe it or not, that has been noted as the impetus that actually got the legislation formed the [00:32:00] NHS, which was the first major universal healthcare system, the one the UK still has today, and everyone is covered. And so change does happen, and as bleak… When you and I talk about long-term care, when you and I talk about all these third parties who are robbing the system, it feels really bleak. But it’s out of that bleakness that we get these stories that bring the stakeholders together. So believe it or not, I think we’re not that far. I think Obamacare was a try. It didn’t really successfully make it. But if you look at this as the trajectory, it may be the beginning of the trajectory that eventually gets us a better healthcare system. I’m a lot more hopeful, I think, than a lot of people are.
Jay Zigmont, CFP®: Yeah, I’d like to be more hopeful. I’m, I’m just be honest, no, I, I—
Jordan Grumet, MD: Depressing.
Jay Zigmont, CFP®: I want to. I don’t see the will to do the wholesale change that needs to be done, a- and that’s the hard part. So let’s bring this all together and, you know, a couple kind of takeaways. One is the bottom line [00:33:00] is the healthcare system isn’t broken by accident. It’s engineered to extract wealth to corporate sh- shareholders. As Childfree people, we need to secure our own medical advocates and our own care team so that we can make sure we understand the business layer of the care. And frankly, doctors are often just as trapped as patients. Uniting with the doctors through open communication is probably our best line of defense. So we’ve reached our final segment of the Childfree Life by Design called the Deliberate Detail. It’s a segment where we ask you to share a small intentional thing you’re doing to design an amazing life. We share what it is, why it matters, and what it costs, if anything. So what is it for you?
Jordan Grumet, MD: So what I’ve done to design the life that fits me, the first thing I did is I got smart enough about my finances to figure out what I truly needed. And the reason why is that gave me the confidence and the courage to start then building the life I wanted to live. In that case, for me, it was stepping back from medicine that I had gotten so burned out from all of this struggle that we’ve just been [00:34:00] talking about, and investing my time in things that were deeply exciting and purposeful to me. And so, you know, the one thing I think I was lucky enough to do is realize that there were these things I loved and that I was building a financial framework not to get to some net worth number, not even to get to financial independence, but specifically I was building that financial framework to afford the life that I deeply wanted to live. And when we’re talking about all this, even our discussion today, we’re talking about healthcare and how to afford it and long-term care, what we’re really saying is, how do we have enough money and wherewithal to get the basics covered so we can start living our truest, most exciting, most purposeful life? And so that’s the idea is, like, how do we work… That’s why we have these podcasts, you and I, ’cause that’s why we spend all this time either talking about healthcare or finances or long-term care. Whatever it is, is we wanna help you get to this place where you feel free enough to invest your [00:35:00] time and energy in things that really excite you and light you up.
Jay Zigmont, CFP®: Yeah, that financial independence is financial freedom, bottom line.
Jordan Grumet, MD: Yeah. Yeah.
Jay Zigmont, CFP®: Thank you so much for sharing your insights today. Where can our listeners find you, your podcast, and grab a copy of “The Healthcare Heist”?
Jordan Grumet, MD: Easiest way is to go to jordangrumet.com. That’s J-O-R-D-A-N-G-R-U-M-E-T. There you can find all three of my books, Taking Stock, The Purpose Code, and the newest, The Healthcare Heist, as well as you can find all the places I create content like the Earn & Invest podcast and The Purpose Code Substack. Again, that is jordangrumet.com.
Jay Zigmont, CFP®: So that’s all for this episode of Childfree Life by Design. Remember, intentionally choosing to invest in moments of joy is just as important as investing in your future. Until next time, happy designing.
Outro: You’ve been listening to Childfree Life by Design. Make sure you follow the show, leave a rating or review, and connect with us on social @childfreeinsights. For more resources, guides, or upcoming events, visit [00:36:00] childfreeinsights.com.
