Wednesday, July 07, 2021

Some Thoughts on Managing Family Health


This was one of the toughest weeks of my life. 

Let me start with a legendary tale of our Unions. 

There was an urban rumour that once upon a time, a union leader with NTUC had health problems and went for a heart scan. He discovered blockages in his veins and promptly resolved them with an angiogram followed by an angioplasty where a stent was installed to resolve the blockage. After the operation was over, the union leader hectored all his union drinking buddies to take the scan. After all, they had the same unhealthy habits. The other leaders went, albeit reluctantly as the scan was expensive. But quite a few union leaders also discovered they had blockages and promptly had operations to save their lives. Many lives were saved by this union leader, I did not share his name as the person who related the story to me was also not clear who he was.

When my mum had high blood pressure for an umpteenth time, I also decided to take her medical matters into my own hands. The sad truth is that I don't really trust GPs because they often had 5 minutes to determine what was your problem. So I switched over to a cardiologist in the private sector to take control of managing my mum's hypertension. The cardiologist improved her average BP reading from 200 to <120 with the new drug. Not satisfied, I wanted to break the family curse so I insisted my mum take the Heart CT Scan as well and blew thousands of dollars of family funds on it.  Unfortunately or fortunately for us, the scan detected a major blockage so my mum had to complete an angiogram and angioplasty yesterday. 

Today she is resting at home after a successful operation.

On hindsight, I really have no idea what her GP was doing. She always had BP medicine but she had a special drug to eat when her BP spikes. The GP's approach was a quick fix without delving into the root cause of the issue. It was only pulling strings and asking one of my students for help (he works in healthcare) was I able to be introduced to a good cardiologist who could make the problem disappear.

Anyway, this is just one data point but I'd like to raise two lessons I learnt for readers.   

The first lesson was that "advisor equity" matters. 

I can walk into the sunset and FIRE, but teaching my program allows me to network with my students, many with useful information and contacts that can enhance other areas in my life. On top of my work as a trainer, I have doctor friends who regularly ask me for stock information over Whatsapp who can easily spare a second or two with medical opinions on pricing information I share with them. Even though I do not practice law, I do act as the first point of contact for friends in trouble and can introduce someone currently in practice. In fact, I play rainmaker to my lawyer buddies. 

If you think you can "Tang Ping" or lie down after you FIRE, then you are losing a major resource. Most successful FIRErs know a bit about markets that can make them very useful to others. 

The second lesson was that a sufficiently large investment hoard can function as a health and surgical plan.

I could not get H&S insurance for my mum even if I wanted to because she had hypertension her whole life. Going through an angioplasty in a private hospital is going to be extremely pricey even if you took the cheapest suite like us at Gleneagles. Predictably, my mum had a rude shock when she heard about the price. 

When I heard the price tag, I calmly told my mum about the lifetime of savings she and my late dad made when they DID NOT PAY H&S insurance. This was a proactive surgery made while my mum was healthy, we can reduce the risk of complications. More importantly, the savings over my father's lifetime allowed the full sum to be replenished with only 3 months of dividend payouts! 

So we are trading three months of dividends for an unknown but significant extension of my mother's life. My mum's blockage was actually 90%, all this while she was living on borrowed time. 

In the end, even Medisave came to my rescue when my mum went private, it was not much but it was better than nothing.  

Anyway, the money spent on health will recover in time, my family will obviously be very careful when we re-accumulate our lost income over the next three months. Just like Singapore reserves, we will never know when we will need it again in the future so best be prudent. 

( Readers who need an introduction to a cardiologist can email me in private. I did not share details on costs and billings, but I guarantee smart readers can figure it out with the info I shared )


1 comment:

  1. Luckily you intervened when you did & successfully managed it, even if it took a good 5-figure sum.

    Just to add that for someone who is being managed on a longer term in a polyclinic, chances are that they'll be sent for a heart scan if BP is persistently high (200 is considered emergency liao) & followup with cardio specialist.

    If you've gone into A&E with BP at 200 (hypertensive crisis), they'll probably do a heart scan on you.

    But for poly to be good, you need to be on a longterm chronic disease mgmt with them.

    If you go to poly once in a blue moon, then they are no better than typical GPs.