After years of failed self-improvement in a number of aspects of life that most people tend to consider important, like organization, time management, and self-motivation, I’ve come to accept some of my flaws while taking advantage of my strengths. I haven’t completely given up on the strive to improve facets about myself that could lead to being a better all-around person, whatever that happens to mean at the time. I just realize that it isn’t in my nature to excel at certain things.

I’ve been trying to motivate myself to get in shape for several years. After college, my stomach assumed a rounder form, and I’ve never found the right combination of motivation and activities to fix this. Over the years, I’ve resigned myself to the idea that I would succeed much better if I had a partner interested in the same goal, sharing the journey towards a healthier lifestyle. But then again, perhaps that’s just an excuse.

At the beginning of the year, I got in the habit of using RunKeeper on my phone to track my outdoor runs, but several weeks of snowstorms prevented this three-times-weekly activity from becoming a long-term habit. When the weather improved, I considered myself too busy with business to take the time to get back outside for a workout.

And then I saw photographs of myself at the Financial Blogger Conference. I decided — again — I needed to do something about my waistline, and this time I was determined to find help. Although it’s not cheap, I decided to join the gym nearest to me. Before doing so, I took a tour. It’s exceptionally clean, and it doesn’t seem to ever be too busy. The equipment is nice; it’s nicer than the equipment I would have purchased for myself was I was considering taking up space in my apartment for an exercise area.

Check out these fees, though.

• Enrollment fee: $69 (but they gave me a “discount” at $49)
• Monthly fee: $19 (first and last months’ payments due immediately)
• Processing fee: $25
• Club enhancement fee: $29 (paid once a year)
• Early cancellation fee: $150 (or balance of the year’s monthly fees, whichever is less)

Although there is an early cancellation fee, it sounded like this fee could easily be waived at the manager’s discretion, particularly if the cancellation is due to moving away from the area.

The typical rationalization for moving forward with the membership despite these fees is that the knowledge of the monthly charges to my credit card account would motivate me for using the service I’m paying for. It’s the same rationalization that parents use for not paying for their kids’ education — the children will be more responsible if they have “ownership” of their education by working to pay for it without assistance.

I also signed up for a free session with a personal trainer. I’ll use the free session to determine if there’s something I can learn from someone else leading me through a plan that would help me reach my goals.

For the most part, gym memberships are traps. People spend a lot of money to join and maintain a membership but often don’t take advantage of the benefits. Did I make a mistake by joining a gym? If you’re a member of a gym, how do you make the expense worthwhile?

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My dentist’s office is changing billing procedure. I should note that my dentist is not part of an insurance network. It may be a cliché, but I have heard people who say that any dentist who aligns his office with insurance carriers is one you want to avoid. That doesn’t mean that I have to pay the full cost of my visits; my insurance (currently Aetna with COBRA through my former employer) still covers almost all of what my dentist charges for semi-annual maintenance. I haven’t had any problems come up, but the insurance company would cover most of that cost, as well.

As long as I have been a patient of my current dentist, the office calculates what it expects my insurance to cover before I leave the office. They submit the bill to my insurance company, and I pay the estimated remainder. It’s often not much. Occasionally, the estimate is off, and the dentist credits my account or bills me for their underestimation of the insurance company’s reimbursement. This system has worked well, at least for me. It’s less money out of my pocket than if I had to pay the full bill myself and submit the claim to my insurance company after the fact.

Starting with my next visit, approaching within the next few months, this will be the new procedure. The office has decided that rather dealing with the insurance companies directly for payment, this will be the patients’ responsibility. Before leaving the office, I will need to pay the full amount on the bill, and when I get home, I’ll need to submit a claim to my insurance company. I’m not particularly happy about the change.

I’ll need to pay more out of pocket. While the dentist office has claimed that insurance payments come within just a couple weeks, now that payments are going to a patient rather than the dentist, the claims could take longer to process. If there are any disputes, I may have less leverage than a dentist, though I have more motivation to pursue the case. I don’t like the idea that more paperwork will be my responsibility, but it’s always my responsibility to ensure I’m paying no more than I need to.

I was reminded of my dentist’s procedural change by Cameron Huddleston’s article in Kipligner. She received a bill from her doctor that was higher than she expected. She called the office to confirm that the doctor did not submit a claim to her insurance. I would imagine that some patients blindly pay any bill they receive from their doctor’s office, assuming the amount listed is what they owe after the insurance company has already covered part of the bill. It’s good to be aware of the costs of services and to review the bills.

Kiplinger

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Earning or having more money might not universally increase happiness or health. Wealthy people can be sad or sick just like those who are less financially fortunate. More money does provide more access to “stuff,” though, and people often like that “stuff.” Businesses that cater to the rich with services for which they might be willing to pay extra often thrive. In economic downturns, rich consumers often stay rich and save more of their money, but they’ll likely return to their luxury items.

One of these services is medicine. Concierge doctors, doctor to whom you can pay a retainer to ensure personal attention at any time, have increased in number over the past few years. Not all of the popularity increase can be attributed to the entertaining television program Royal Pains, in which a doctor whose career abruptly ends due to his positive ethics that conflicted with the medical establishment moves to the Hamptons to seek out a wealthy clientele while also treating the residential underclass for free. More doctors are turning to this style of business because medical school was expensive, they have bills to pay, general practice doesn’t provide great salaries, and the thought of higher income beckons.

This doesn’t necessarily mean that the wealthier one is, the greater the quality of medical care one might receive. Doctors are ethically bound to treat everyone to the best of their ability, regardless of financial situation. Paying for membership to a private doctor might increase availability for appointments but won’t increase the quality of your medicine or advice. It can, however, provide the feeling that one is well cared for and reduce the anticipation of stress during a hypothetical emergency. If one has little faith in the healthcare system — a system that works well for the most part — concierge medicine provides an alternative option if you have $1,500 to $25,000 to spend per month (according to the New York Times).

Even if the only benefits were easier access and less stress, is it fair that only those who can afford sizable monthly fees can take advantage of these services? The medical industry will continue to mutate as market forces pull it one way or another. The concept of the health maintenance organization (HMO) began around one hundred years ago when society faced the same question: how to bring quality medical care to more people. While the HMO may now be a symbol for bureaucracy and inefficiency, the system has helped keep society healthier. If traditional medicine eventually falls by the wayside in favor of more lucrative business plans, the system will continue to change to accommodate the needs of the many.

Do you think concierge medicine will help or hurt the medical industry? Is it a problem that a certain selection of medical professionals want to cater only to the rich?

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