As featured in The Wall Street Journal, Money Magazine, and more!

November 2009

Announcement: We have decided to extend the period for matching your charitable contributions through the end of this week. Contribute to your favorite charity this week and forward your contribution receipt to us. We will donate a matching amount to the World Food Programme. Here are the complete details.

Over the past few weeks, Consumerism Commentary has been auditioning six prospective staff writers. I am looking for an additional writer to add to the team in order to complement the articles I write and those written by Smithee. Although the intent of Consumerism Commentary has always been to share my thoughts about money and related topics in addition to keeping myself accountable for my own financial decisions, I think the website can benefit from occasional voices for others.

Although I will responsible for making the final decision, I would love to hear readers’ civil opinions about the twelve guest articles featured recently. When I originally indicated I was interested in adding a writer to the team, I received about thirty responses. I narrowed these down to the six summarized here:

V.C. McGuire is a regular contributor to the New York Times and other publications. Recently, she has written about real estate, insurance, home improvement, and personal finance. She lives in Philadelphia. V.C. offered these two articles to Consumerism Commentary in audition: How to Do Your Holiday Shopping Through Rebate Sites and Lifestyle Creep and the Self-Employed.

J.J. is a consultant for employer retirement plans and works with credit unions as a financial adviser. He works with individuals and businesses every day as they make important decisions about their money. J.J. offered these two articles to Consumerism Commentary in audition: 2010 Roth Conversion: Good Idea? and The Trouble With Target Date Funds.

Kelly Whalen is a mostly stay-at-home mom to four kids. She writes about personal finance at The Centsible Life. Kelly offered these two articles to Consumerism Commentary in audition: Triage Your Finances and How to Spend Smarter This Holiday Season.

FruGal currently serves as a Professional Development Consultant for a prominent online educational program and as a Social Media Specialist for a Luxury Real Estate company in Atlanta. FruGal offered these two articles to Consumerism Commentary in audition: Living It Up… At the Library? and Couponing Makes Cents.

Debbie Dragon is a full time freelance writer and co-owner of Debbie offered these two articles to Consumerism Commentary in audition: Is a College Degree Worth the Investment? and The Economy Triggers a Rebirth of the Entrepreneurial Spirit.

Ray is the owner and primary author of Financial Highway, where he discusses investing, saving and practical money management concepts. Ray offered these two articles to Consumerism Commentary in audition: Thanksgiving on a Budget and 4 Reasons Why You Should Read Your Bill Every Month.

I’m inviting readers to leave their thoughts on the above contributions. Again, the responsibility for the final decision rests with me, but I would like to receive feedback from those who read Consumerism Commentary every day or every week. Feel free to leave your comments here, contact me privately, or if you would rather be anonymous, you can use this form to contact me directly without leaving your name or email address.


Announcement: As I mentioned last week, Consumerism Commentary is matching your charitable contributions during the remainder of November. Please read this for more details.

A few years ago, we discussed medical tourism. Every visitor who expressed an opinion would visit or have visited a foreign country or territory to take advantage of reduced costs associated with procedures. In the past several years, medical tourism has been increasing.

I mentioned my health insurance expenses are increasing 10% in 2010, and the increase will be even greater for my employer’s portion of the expense.

If I were to face an expensive or complicated medical procedure, I would seriously consider options outside the United States. Thanks to the internet, due diligence is much easier and faster, regardless of where the doctors and hospitals are located. Employers and health insurers are starting to see the benefit of medical tourism, as well.

Medical care elsewhere is as capable

If I have the opportunity to prepare for a major medical procedure, as I would as long as I’m not dealing with an emergency situation, there is enough information available for me to feel confident about choosing a location. The process calls for working with a medical tourism facilitator. The Medical Tourism Association maintains a list of organizations they have certified although their certification process is still new and in development.

Medical care elsewhere costs less

If I can receive the same or better quality of care for less by traveling overseas, even when taking travel expenses into account, then the financially responsible decision is to consider medical tourism.

Here is a comparison of costs for surgery according to the Medical Tourism Association.

Medical Costs

Even if individuals are not yet on the medical tourism bandwagon, employers and health insurers are looking at the cost savings offered by having procedures done outside the United States according to a recent DailyFinance article.

With Americans able to save 50% to 90% by going to places like India, Thailand and Costa Rica, the uninsured aren’t the only ones considering the medical tourism option. Increasingly, U.S. employers, faced with soaring health care costs that are expected to rise another 9% in 2010, are sending their workers overseas for care…

Insurers like Blue Cross Blue Shield are getting into the act, too. For good reason: Even when employers or insurers waive co-pays and deductibles and throw in airfare and spending money for the patient and a companion — some of the typical incentives offered to employees who have medical procedures done abroad — they can still save $40,000, $50,000 or $60,000 per surgery, depending on the procedure.

Medical care elsewhere increases competition

Global competition may be the market-based way to drive the domestic health care industry to lower costs throughout the entire system. Lately, the United States government has been focused on health insurance reform through new laws designed to increase care for more Americans, offer new options, and reduce costs.

I am interested to see how the industry reacts as more employers and insurance companies turn to medical tourism facilitators. I expect organizations representing medical professionals in the United States would try to limit medical tourism. The American Medical Association offers nine guidelines on medical tourism for employers and insurers, not quite discrediting the practice but helping to ensure patients remain educated.

The AMA advocates that employers, insurance companies, and other entities that facilitate or incentivize medical care outside the U.S. adhere to the following principles:

  1. Medical care outside of the U.S. must be voluntary.
  2. Financial incentives to travel outside the U.S. for medical care should not inappropriately limit the diagnostic and therapeutic alternatives that are offered to patients, or restrict treatment or referral options.
  3. Patients should only be referred for medical care to institutions that have been accredited by recognized international accrediting bodies (e.g., the Joint Commission International or the International Society for Quality in Health Care).
  4. Prior to travel, local follow-up care should be coordinated and financing should be arranged to ensure continuity of care when patients return from medical care outside the US.
  5. Coverage for travel outside the U.S. for medical care must include the costs of necessary follow-up care upon return to the U.S.
  6. Patients should be informed of their rights and legal recourse prior to agreeing to travel outside the U.S. for medical care.
  7. Access to physician licensing and outcome data, as well as facility accreditation and outcomes data, should be arranged for patients seeking medical care outside the U.S.
  8. The transfer of patient medical records to and from facilities outside the U.S. should be consistent with HIPAA guidelines.
  9. Patients choosing to travel outside the U.S. for medical care should be provided with information about the potential risks of combining surgical procedures with long flights and vacation activities.

Like the international outsourcing that has changed the shape of a number of industries, medical tourism lowers the costs for businesses that can then pass those savings onto the consumer. With outsourcing, whether good or bad, Americans benefit by the lower standards of living across in countries across the globe. A surgeon can earn hundreds of thousands of dollars each year in the United States; the salary is high to offset the risk of malpractice suits. Surgeons in other countries may not have the same high risk, and with a lower standard of living, they can afford to be paid much less.

Would you consider traveling overseas for a medical procedure?


The first guest on today’s Consumerism Commentary Podcast is Jim Sharvin, a Certified Public Accountant affiliated with the California Society of CPAs. Tom Dziubek and Jim discuss how consumers can protect themselves when buying and using one of the most popular holiday gifts, gift cards.

After the break Tom speaks with Heather Booth, Executive Director of Americans for Financial Reform. Americans for Financial Reform is a coalition of over two hundred national, state and local consumer, labor, retiree, investor, community and civil rights organizations. Tom and Heather discuss current and future regulation of the financial industry.

Production Number: S02E06
Segment Numbers: 47, 46

To listen, use the player above (Adobe Flash required), download the podcast here, subscribe to the podcast RSS feed, or use the iTunes link. Note: open links in a new window (Ctrl-click or Command-click) to avoid interrupting the podcast.

[00:00] Introduction from Tom Dziubek
[00:40] Interview with Jim Sharvin, California Society of CPAs on gift card purchases
[01:20] Why CPAs are concerned about gift card usage
[01:42] Tip #1: Buy gift cards from the store the recipient frequents
[02:16] Tip #2: Use gift card within the first year
[02:50] Tip #3: Understand card fees and procedures before purchasing
[04:11] Tip #4: Check expiration date before purchasing
[05:50] Tip #5: Verify card value after purchase
[06:40] Tip #6: Keep receipt
[07:13] Tip #7: Make sure card isn’t damaged or tampered with before purchasing
[08:15] Tip #8: Don’t provide personal information to clerk
[08:40] Tip #9: Understand limitations of cards, especially the stores in which it’s valid
[09:30] Tip #10: Use your card wisely
[10:46] Tip #11: The possibilities of bankruptcy
[12:57] Tip #12: Additional research websites
[14:03] Fee regulations under the 2009 Credit Card Act
[15:26] Interview with Heather Booth, Americans for Financial Reform
[15:39] Goal of the Americans for Financial Reform coalition
[16:47] Is regulation of the credit card industry backfiring?
[17:50] Organizing regulation and consumer protection responsibilities
[18:58] Additional regulation concepts
[21:10] Is “too big to fail” a reason for government intervention?
[22:18] Executive compensation reform
[25:33] End

We always welcome feedback from listeners. If you have any comments for this episode or for any other, or if you have suggestions for future episodes, please leave us comments here or email us at podcast at this domain name.


I’ve been thinking a lot since the last time we talked about my ongoing internal troubles with stealing entertainment. In general, my habits are tending more toward avoiding theft, even accidentally. I want to make sure that the creators know that the thing they made was good, and I want to help them make more.

The no brainer: “new media” creators

I’m proudly displaying DVDs for Homestar Runner (we also bought some figurines and a car window cling of The Cheat), Tiki Bar TV and Dr. Horrible’s Sing-Along Blog on my shelf. Those are great shows that would never have found a home on traditional television, so it’s up to people like me to reward them and help them make more.

The Cast of the GuildI’ve also been meaning to pick up The Guild on DVD. Wait a sec.

*click* There. Done.

My wife and I are also both subscribing for $5 a month to The Sound of Young America, and I’ve recently started buying some iRiffs here and there (these are like the fan-made commentaries we talked about earlier, but usually by people you’ve never heard of).

All of these shows have different business models, because “new media” (the linguist in me really hates that term) is still figuring itself out. The important thing is that they make it convenient to enjoy the things they make, and that they make it easy to reward them.

Where are you, high-def movie downloads?

We have the technology in place right now to make blu-ray obsolete. I’ve streamed high-def movies through my TV provider’s DVR, and through Netflix on the XBox, and I bought “Terminator 2” in HD through iTunes (which I have connected to our TV). That last one even came with “extras” like a blu-ray disc would. So it seems absurd to me that “the market” still wants me to get a blu-ray player. I don’t need a separate device to play HD movies. I can already play them.

Besides, a blu-ray disc usually also costs more than its DVD equivalent, which makes no sense to me, because they both contain the same thing: one movie.

The sad truth is that it is easier for me to download the blu-ray high-def version of a movie for free, illegally, and store it on my home network than it is for me to stomach the idea of buying a blu-ray player (not least of which because I was rooting for HD-DVD, since that format was region-free). But I don’t want to be a thief. So, lately I also started buying the blu-ray versions of movies that I already downloaded, and which I know we’ll watch again and again. “Galaxy Quest” for example, and the new “Star Trek” movie. In fact I just ordered “Star Trek” at the same time I bought “The Guild” a few paragraphs ago.

But this isn’t what I want to do. I want to pay directly for a digital—software—version of the movie. I don’t want “the market” to think that actual blu-ray discs are more popular than they are. The only place I know I can do this is inside of iTunes, and as of this article there are only 286 HD movies available to buy. And for the life of me, I can’t see any rhyme or reason to which movies are there on the store. It seems totally random; not the kind of movies I want to enjoy many times over.

The downside: not rewarding bad content

All that being said – and I hope you agree I’ve made some improvements – I still don’t feel right paying for something that I didn’t enjoy. Earlier this summer we managed to go out to three movies in a row that weren’t any good. After that, I decided to be a lot more strict about getting reviews from places like Metacritic and Rotten Tomatoes before heading to the theater.

And I’m trying to be more patient when things seem iffy. I was excited to see “Drag Me to Hell”, because I’ve always liked Sam Raimi’s work (yes, up to and including “Xena: Warrior Princess”), but I waited for it to be available to download (on Netflix or otherwise), and I’m very glad I did, because wow, did I not enjoy that movie. In fact I only saw about 60% of it before I thought of something better to do.

Thankfully, the guys at Rifftrax are making an alternate commentary, which should help erase the memory of watching it raw the first time.

Photo credit: Lan Bui


Consumerism Commentary Matching Charitable Donations for Thanksgiving

by Luke Landes

On behalf of myself, Smithee, and Tom Dziubek, to all those who celebrate today, have a happy Thanksgiving. I will be spending the day with my girlfriend’s family in New York. Although there’s nothing that makes one day of the calendar inherently more special than any other day, Thanksgiving is a good opportunity to think […]

29 comments Read the full article →

Triage Your Finances

by Kelly Whalen

Over the past couple of weeks, six finalists have been auditioning for the opening of “staff writer” at Consumerism Commentary. Each is providing two guest articles to share with readers. After the six writers have shared their guest articles, readers will have an opportunity to provide feedback before we select the staff writer. This article […]

11 comments Read the full article →

Annual Benefits Enrollment: My Cost Increasing 10%

by Luke Landes

The open enrollment period for my company’s 2010 benefits came to a close yesterday. My procrastination came to an end when I logged into our benefits management website, reviewed the options one last time, and decided to stick with the same plan I’ve had since I joined the company, an HMO plan offered by Aetna […]

19 comments Read the full article →

Thanksgiving on a Budget

by Ray

Over the past couple of weeks, six finalists have been auditioning for the opening of “staff writer” at Consumerism Commentary. Each is providing two guest articles to share with readers. After the six writers have shared their guest articles, readers will have an opportunity to provide feedback before we select the staff writer. This article […]

17 comments Read the full article →

6 Items That Exemplify Conspicuous Spending

by Luke Landes

This post is part of the one day blog event “The Spectrum of Personal Finance.” In this event, comic book nerd Brian of My Next Buck, will discuss 8 different emotions (taken from the Green Lantern comic series) and relate them to personal finance. Here at Consumerism Commentary we will be looking at Avarice. To […]

9 comments Read the full article →

Is a College Degree Worth the Investment?

by Debbie

Over the next couple of weeks, six finalists will be auditioning for the opening of “staff writer” at Consumerism Commentary. Each will be providing two guest articles to share with readers. After the six writers have shared their guest articles, readers will have an opportunity to provide feedback before we select the staff writer. This […]

15 comments Read the full article →
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