I’ve known Pamela Slim for years.  She’s the creator of Escape from Cubicle Nation.  Anything she does is awesome.

She’ll join Merideth Mehlberg tomorrow at 12:15 PACIFIC time to talk about starting a business.  The entire title is:

Test Often and Fail Fast: The Art of Rapid Deployment to Quickstart Your Business.

Here’s the link to join the webinar. Merideth has a really cool program called The Career Gold Club, which she has interviewed me for.  Definitely worth your time to check out.

A month ago, at this very minute (note: I started this post on Friday but took a very rare sick day during the post), I was laying in a hospital bed trying to “breathe through my nose.”   I never disliked breathing more than that day.

You can read the entire story here (I need to clean it up because I wrote it when I was on narcotics… it doesn’t read as well as it should).

The purpose of this post is to talk honestly about what you can expect to pay if you have an emergency that requires you to go to the E.R.

There were five or six vendors or service providers involved in this.  Below is what I was billed (approximations):

Hospital, including emergency room, operating room, recovery room: About $18,000

Operating surgeon: about $1,600

ER doctor: Bill amount: $888

Pathologist: To do what, I have no idea. Bill amount: $49

Anesthesiologist: Bill amount: $1,275.

Radiologist 1: Bill amount: $119.86.

Radiologist 2: Not sure if there was one, but was told there might be one.

Each of those are independent from one another, and no one would tell us what the bill might be, or even who to contact.  It was either make calls and figure it out or wait for the bill to come.

There is a reason to make the calls immediately.  Many medical vendors provide a discount for “self-pay,” which is the term you use if you don’t have insurance.

Why we don’t have insurance is for another post.  Trust me, we tried to get it (more than once), but the insurance industry is so corrupt it is disgusting.

Anyway, if you are self-pay there are two things that happen:

1. 1. You get offered a discount – up to 50% off.  You can see the discount amounts below.
2. 2. No one believes you will pay.  The government and media has done a masterful job creating an image of uninsured people (aka, self-pay) that if you are self-pay people think you are going to not pay.  Not true, but thanks to the gov’t and media, that’s a new stereotype to live under.

Here are the discounts we got:

Hospital, including emergency room, operating room, recovery room: About $18,000. They gave 50% off to self-pay if you pay within about 2 weeks.  That meant our bill would be about $9k.  We went in to talk about it, and when to pay, and the finance person lowered it another $1k (because much of the time billed was when I was in “recovery,” which didn’t really take the same resources as a bunch of people doding on me every minute.  Total bill: a little shy of $8k (for about 55% discount).

Operating surgeon: about $1,600. When I went in for the post-op checkup they said they would offer a 50% discount if paid THAT DAY or a 30% discount within (I don’t remember how many weeks).  We paid that day. I wish they could have given a little flexibility – perhaps 50% if paid in a week.  It wasn’t fun to pay that day, considering the payment to the hospital was made in the same week. Total bill: I think it was almost $800. Are you blown away that the person who controls the operation gets only $800 (less whatever his company takes in overhead)?  Crazy.

ER doctor: $888. I found their information and called them and learned they offer a 50% discount. I have to pay that by early March, which is about a 6 week timeframe.  Very thankful for this discount and the extra time. Total bill: $444. Nice savings

Pathologist: To do what, I have no idea. Bill amount: $49. They offered a 30% discount, which we were thankful for.  Ended up paying $34.

Anesthesiologist: Bill amount$1,275. I was highly disappointed in their discount, only 20%, to bring it down to about $1,000.

Radiologist 1: $119.86. 20% off put it down to (total bill) $95.89.  Not liking the small discount but the amount was so small that it was sixes.

Radiologist 2: Not sure if there was one, but was told there might be one.

The total out of pocket for this emergency surgery was about $10,375.

Are you ready for that capital outlay right now?

I wasn’t either.

Aside from being on insurance, what can you do to get ready?  I’m not talking about preventative because this could have been an ambulance ride from a car accident (and healthy eating usually doesn’t prevent that).

If you got a $10,000+ bill from the hospital, would you be in a world of (financial) pain?

You can prepare for medical emergencies.  I recommend:

1. Regular insurance

2. Accident insurance

3. Robust and growing savings

4. Knowing who you can tap into to get help from (family, etc.)

It’s a scary time without this $10k bill, but being able to do it can come from planning and preparation.  Start NOW!

I hate reports of the unemployment rate.  They are lies, usually.

Check out this post from Bill Humbert on RecruitingBlogs.com to understand the unemployment rate.

Check out my commentary on it at Career-Resumes.

Here’s a visual… Bill says the government reports an unemployment rate that is just part of the picture (U3).  The real unemployment rate, he says, is a few lines down (U6). (click image for original source)

Of course, the reality is if you are unemployed, your PERSONAL unemployment rate is 100%.

The economy seems to be getting better… at least, when I speak, the job clubs say they are having people not come back because they land.  I’m hearing this a lot, lately.  That’s great, right?

In other news, layoffs are still abundant. Yahoo just dumped 2,000 engineers into the Silicon Valley area (again). Sony dumped 10,000 people (not sure where they are, I’m guessing many of them are outside of the U.S), and the Detroit Public School system pink-slipped “at least 4,100” teachers.

No one is safe from this.  Nowhere is safe.  No industry is safe.  What used to be safe (teacher, gov’t employee, etc.) is now fair game.

What does this mean for you?

Prepare on your own with the right skills and credentials.  In the olden days (a few years ago) that meant a good, solid education.

I think today it means something else (not necessarily replacing education).  Here are three things YOU can do to protect yourself, and try and get some sense of what we used to call “job security”:

• Sales ability. When I got laid off my younger brother said to get a sales job for one to three years, just to get sales training and experience. I think this is brilliant advice.  We sell all the time, but we aren’t trained, and we aren’t fearless, and many times we do a bad job.  Whether you think you are a “salesperson” or not, start learning sales techniques and strategies.
• Entrepreneurship. Decades ago you were a cog in a wheel.  You had a place, and depended on all the other cogs to do their job, and things would work.  You let higher-ups make the strategic decisions that would affect your livelihood and future spending capability.  TODAY it is different.  This year you might have multiple jobs, or multiple income streams.  That’s not bad. Personally, I think it’s empowering!  It’s awesome.  But we need to have that mindset change so we understand that we need to do our career more intentionally, rather than just “show up.”
• Career Management. For me this means cultivating and nurturing your network and your brand.  No one else is going to do this.  It’s up to you to finally get serious about your relationships, and how you manage them long-term, as well as how others perceive you (aka, your brand).  Keep neglecting this and your degrees and experience will sit on the shelf getting dusty while you have long, painful job searches.

What have I been up to?

I’m cranking through my book 101 Alternatives to a Real Job.  I hope to have it done and shipping by July, when I head to the D.C. area for some presentations.  If it’s out in July, it will only be 7 months behind schedule :p

What have YOU been up to?

On the user webinar this morning someone asked my thoughts about their situation: two advanced degrees, and not even able to get an entry level job.

I have a few thoughts on that:

The idea of a career and job has changed.

I’ve blogged about this quite a bit.  No longer are we shooting for a long-term career with retirement benefits.  We’re happy if we find a place where we might settle in for a few years.

My recruiter friend Robert Merrill told me a couple of years ago that he thinks we’re getting closer to becoming a world of 1099 workers.  What’s that?  1099 workers are contractors.   No more FTE (full time employees).

Have you seen a trend moving in that direction?

Even if you are hired as a FTE, the company treats you as a 1099, with frequent layoffs and rehiring.  Crazy stuff.

That’s one reason why I’m writing the book 101 Alternatives to a Real Job.

Whether we are out of the recession or not, employers are going to be cautious/skeptical.

Until they feel really good about their market and customers, they aren’t going to commit to the salary and overhead of a new employee, unless it’s critical. (So, how do you prove you are critical?)

The pending election will probably make employers wait on big (hiring, strategy, product line, etc.) decisions.

What impact would Romney or Gingrich have on our economy, trade, markets, taxes, etc.?

What impact would another Obama term have?

Whatever you think it will be, each employer has their own opinion, and they might be waiting on big decisions until… the end of the year :s

Trivia: One of the biggest spikes in JibberJobber signups was when Obama was elected President, through the inauguration.  I was amazed to see how many people started to seriously take career management into their own hands upon hearing that news.

If that’s the case, what does 2012 mean for job seekers?

A couple of years ago we had some expensive hospital work that we were trying to plan for.  For various reasons outside of our control, we didn’t have health insurance.  Today, with a different kind of health insurance we get from employers, and more people out of work, I thought it would be important to bring this up again.

Here’s a post that describes what happened.  It was scary, but such an amazingly positive experience (with regard to the finances). From an August 2009 post:

Three months ago we had a baby and paid for it without health insurance (even cheap health insurance) or government aid.

Last week my wife had a surgery and we’ll have it paid for as soon as we get the final invoice, again without any health insurance or government aid.

You should note that I have NOTHING against private health insurance (well, I think it’s grossly overpriced and doesn’t offer what it should) nor am I against getting government aid when appropriate (more on that tomorrow). This isn’t a political post, or a bashing post… I just wanted to share a couple of ideas that might help you save money (or, be able to afford the health care you need).

When asked what our insurance is we simply respond that we are “self-pay.”  This means it doesn’t go through insurance, rather that we pay for it ourselves.  As self-pay you can finance the service(s) through the service provider (hospital, doctor., etc.).  Or you can pay in full.  Why would you pay in full? Read on.

When we had our baby we told them we were self-pay and asked them if they offered a discount.  Guess what the discount was?

OVER 50%!  Instead of paying more than $8,000, our total hospital bill was around $3,400.  That is a huge, significant savings.  I like getting things on sale, and I like saving almost $4,000.

Note: We had to pay this in full before my wife got out of the hospital.

Fast forward three month (yeah, surgery three months later sucks).  My wife goes in for a surgery, fairly standard, and the doctor said he would do surgery wherever we wanted, so we could shop around.  We didn’t know you could or should shop around, asking hospitals what the cost would be.  We found there were pretty significant differences and chose to stay with this same hospital, which offered 50% off of this procedure. (we also learned that if you are insured and pay the copay up front you save 25%)

The doctor also offered 50% off – we took advantage of this for both the birth and the surgery.

Did you know you could save so much?  We had no idea.  But for us it’s a necessity.

We also learned we could get a prescription for any oral medicine the doctor would prescribe that was to be administered in the hospital and get that filled at our local pharmacy and then just bring that in for another significant savings.  I have no idea how much we saved but it was cool to know we could do that.

My point with this post is that health insurance isn’t the only way to get stuff paid for… if you don’t have it simply ask your doctor or the staff (the medicine thing was a suggestion from his front desk staff), and the hospital finance people… there are plenty of people who are self-pay and it isn’t as bad, scary or undoable as we thought it would be.

The scary part of this is that it exposes how expensive health insurance is.  If a doctor and a hospital are willing to discount 50% of their invoice just to (a) get paid in full upfront, and (b) not go through the insurance system, can you imagine what healthcare would be without health insurance in our system?

Do you have any other suggestions on finding affordable healthcare.

Two years later the question is still highly relevant – what suggestions do you have?

Read this post form Seth Godin: The forever recession (and the coming revolution)

In a nutshell, Seth describes a new recession that is here to stay, brought on by how the internet has changed business.

This recession is a problem.

From problems come opportunities.

The opportunities might be yours.

Here’s how he ends his post (read the whole thing):

This revolution is at least as big as the last one, and the last one changed everything.

The last one changed everything, created new businesses, created new wealth, and created new millionaires.

This one will do the same thing.

Maybe… just maybe, you should think about how you can get a piece of the pie.

Or, I guess you can continue to look for that old, traditional job with benefits that you used to have, at a company that was loyal to employees, and valued your long-term loyalty.

The choice is yours.

I’ve had some money thoughts on my mind over the last few months and had to get them out.

I remember a few years ago, when I was deep in my job search and starting to working on JibberJobber, but without any financial success and deep in worry about how/when the money would be enough to sustain my personal expenses, I had an experience.

I was at my parents house, visiting for Christmas.  Right before our trip, our microwave had blown out.

My good wife said it was no big deal, we could simply do without a microwave.

I didn’t think we could, and was on the lookout for a way to get a microwave.

Understand, a replacement microwave was anywhere from a hundred bucks to a few hundred bucks.

This amount of money doesn’t seem like a big deal right now, especially for something as important as a microwave, but at the time, this was an insurmountable challenge.

It was immensely stressful.

My parents had an extra microwave, brand new, in their attic, and offered it to us. I remember the stress of trying to figure out how to get a box so we could get it on the plane… I’m embarrassed at how stressed I was when we were trying to find a good box (and get our kids and other luggage ready for a flight)… but again, that microwave, with a value of probably $150 bucks, represented something much more than $150 bucks!

Right now I’m in a position where a $150 replacement is not a big deal.  (my fridge, on the other hand, which seems to be dying a slow death, is another story, as it will be about a $1,000 replacement).

But then, $150 seemed to be more than I could emotionally/mentally handle.

What is $150?

Not much, now.

But 5 years ago, it might have been $150,000 to me!

Think about your financial problems today, right now.

Are they insurmountable?

For me, my perspective changed when I realized (later) that there was money out there that could be made… it was just a matter of me finding out how to do it, and doing it. In a traditional job, I would have to budget based on my salary (we had been living paycheck to paycheck for too long), and plan accordingly. As someone empowered to make money on my own, I am not limited to the calendar.

Another perspective-changing event happened when I read Atlas Shrugged. This is a a super-huge book that helped me rethink money, who can have it, why and how you can get it, and how to think about it.

One of my favorite quotes on money was from Harrison Ford, in a magazine I can’t remember, about his personal life.  When asked about money, or spending money, he said something like “I don’t think about money anymore. I haven’t thought about money for a long time.” (sorry if misquoted)

I read this quote when I was thinking about money 25 hours a day!  I couldn’t stop thinking about money!  I wasn’t thinking about boats and mansions and riches, I was thinking about paying this month’s bills!

Thoughts of money had consumed me, because I didn’t have any, and I was worried and scared.

Life has changed, and in the last five years I’ve changed the way I think about money.

I remember my wife saying a few times that money is like oxygen… if you don’t have it, you suddenly are consumed with thoughts about it!  If you have it, you usually don’t think about it.

How do you think about money?  Do you have an abundance mentality? Do you have a scarcity mentality? Do you believe you deserve to have at least the basic comforts (have bills get paid, etc.), and maybe even some of the finer things in life (like a vacation)?

What does money mean to you?

Lately I’ve run into a number of singer/songwriters who are interested in moving forward in their careers.

I’ve randomly seen a number of songwriters sign up for JibberJobber (not because of my wife’s songwriting journey).

Why are these people getting on JibberJobber?  Or, why shouldn’t they get on JibberJobber?

JibberJobber is a personal relationship management tool.  It is a database that helps you keep track of your relationships.

Originally designed for job seekers, JibberJobber helps you keep track or your target companies and your professional contacts (as well as your personal contacts).

Does this sound like something a songwriter would need?

ABSOLUTELY.

In some of the workshops my wife has been to they stress the importance of networking and branding.

Songwriters are doing the same things that job seekers need to do.

• They need to keep track of who they meet.
• They need to keep track of what they talked about.
• They need to set up reminders to follow-up with people.
• They should have a place to store the contact info and relevant links to contacts.
• They should wordsmith their own 30 second elevator pitch.
• They should network into companies.

All of these are things that JibberJobber offers, and perhaps that’s why songwriters are heading over to JibberJobber.

It’s simply a relationship manager.

A few weeks ago I was in Charlotte, NC. It is a beautiful town with very cool people, and I had a great experience there.

One evening, at dinner, we were talking about the projects we were working on.

I was talking about stuff I am currently working on.  My thoughts wandered to my old employer from almost 6 years ago. If I would have proposed to do any of these projects six years ago they would not have been approved, for sure.

The management wouldn’t have seen how they would bring value to the organization, or the bottom line.

But I see how they bring value.

And so I’ve written a book.  It wasn’t supposed to make me any money, but I can easily attribute at least $100,000 of income to writing that book.

And I wrote another book.  Even though it took a lot of time, I did it.  And more money followed.

I decided to write a children’s book.  I did that on personal time, but by this time I realized I could do what I wanted.

And when doubt moved in, I asked “WHY NOT?”

Why not write a children’s book?  I’m one line away from having that masterpiece done, but I did it.

Why not?

It has helped my refine writing skills, since it was a completely different style than I was accustomed to.

One night I thought of an awesome idea for a movie manuscript.

WHY NOT?

I started a couple of years ago, and recently made some excellent progress.

WHY NOT? Because there are thousands of movies.  Because I’m not a movie writer.  Because I don’t know what I’m doing, or what I’ll do when I have the first draft done.

But seriously, WHY NOT? Those are things that keep me from doing what I want to do.

I don’t have someone keeping me from doing it.

So I do it. I think about it. And sometimes I make progress on it.

After watching my oldest daughter excel at the piano for about 11 years I finally decided to take the plunge, sit down, and start learning the piano.

WHY NOT?

I’m too old, perhaps.  I don’t have enough time.  But I’ve always wanted to learn to play the piano.  I’d love to sit down and plunk out a tune, whether I’m alone and it’s to relax me, or because I’m somewhere and want to show my mad piano playing skillz.

Right now I can play a few tunes with my right hand.  I’m a beginner.  But I’m only a few months into it.  Wait for 11 years, like my daughter got, and I’ll be doing some pretty cool things on the keys.

My wife declared, one day, that she is a songwriter.

WHY NOT?

She didn’t make the best grades in school… so she really isn’t qualified to write for the arts, right?

But she’s been a student of lyrics for many, many years, and even wrote her first lyrics when she was around eleven.  Now her goal is to get her first 100 songs written, and go from there.

WHY NOT?

Why not do what you’ve always wanted to do?

You don’t have enough money?  Not good enough.

You don’t have enough time?  Not good enough.

You are too old (or too young)?  Not good enough.

Go for it.

At least try.

I’ve wanted to play the piano for decades.  It is too late for me, really.  But I don’t care.  Maybe I’ll be good at it when I’m 70.  And I’ll enjoy it!

Do it.  Try it.  Make progress.

There is NO reason to not move forward.