Medical Cost Sharing and Your Next Health Step

Show notes

One Next Step: Medical Cost Sharing, Price Transparency and Better Health

After their conversation with Dr. Tony Dale, Dr. John Oberg and Randy Lorensen get practical: medical cost sharing, shopping for care, and the one next step anyone can take for their health.

They start with coverage: who needs health insurance, why to shop for it, and how medical cost sharing works (John co-founded Sedera with Tony Dale). They also talk about finding an advocate, building a relationship with your provider, paying cash, and using price transparency, including a live look at the Surgery Center of Oklahoma's posted prices.

Then they move to health: lab panels and gut tests, how much science sits behind each, knowing your own body, Peter Attia's Outlive and health span, and why energy is part genetics, part skill and part exercise.

Their advice for listeners is to find what works for you and take one small step, whether that's a 10-minute walk or cutting out one food.

Direct Primary Care, Price Transparency and Health Span

What you'll discover:

How medical cost sharing works, and who it's for
Finding an advocate and building a relationship with your provider
Paying cash and using price transparency
Lab panels and gut tests: what the science supports
Outlive, health span and living long enough to benefit
Why one small step, like a 10-minute walk, matters

This episode is for educational purposes only and isn't medical advice.

Host Dr. John Oberg co-founded Sedera, which is discussed in this episode.

Timestamps

[00:00] Welcome: one next step after the Tony Dale conversation
[01:09] Good intentions across the industry
[02:13] Who needs health insurance?
[04:19] Shop for coverage
[05:22] Medical cost sharing and Sedera
[08:36] Member satisfaction
[09:38] Find an advocate
[10:40] Your relationship with your provider
[11:45] Fixing the patient experience
[14:55] Cash pay and price transparency
[18:05] Information asymmetry
[19:11] Looking up Surgery Center of Oklahoma prices
[21:20] Tests with and without strong science
[23:25] Lab panels
[24:28] Gut testing
[25:30] Move a little to the right
[27:40] Knowing your own body
[29:44] Outlive and health span
[31:53] Living long enough to benefit
[34:00] Dan Sullivan
[35:02] Energy: genetics, skill and exercise
[36:05] Scheduling workouts
[38:12] Standing desks and balance
[39:15] What works for one person may not work for another
[40:20] Where diets agree
[42:24] Is healthcare a right?
[43:29] Just move
[44:33] Longevity trends
[45:35] Next steps for listeners
[46:39] Find what works for you
[48:44] Cutting out junk food
[50:52] Make the picture smaller
[51:55] Wrap-up

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About the hosts

This is a hosts-only episode with Randy Lorensen and Dr. John Oberg (Anthony Marino isn't on this one). Host bios are on the host pages linked below.

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Related episodes

Meet the hosts: Randy Lorensen · Dr. John Oberg · Anthony Marino

Transcript

A full transcript is below. It was generated automatically from the episode audio, so expect some spelling errors in names and terms.

[00:06] Abundance. I am Dr. John Oberg. With me as always, Randy Lorensen, my co-host. Randy, here we are. We are ready ready to dig further into abundance as always. Yeah, abundance. And we're going to keep going with healthcare, I think. Yeah, this is We haven't really done this type of episode yet. I'm sure we'll do it a lot more often. I'm gonna shut that door. Yeah, shut this door behind us so we don't uh There we go. Click. And uh so maybe tell the listeners why we wanted to go a little deeper here and let's just we'll then we'll just dive right in like we usually do. Well, we we just this will be a follow-up episode to we just had a great episode with with Dr. Tony Dale Y and we are recording this immediately after. You may be listening to it later than that. But we want to give make sure people have steps that they can take and and be able to really explore how do they create abundance in their life and how do they apply this yeah to their day-to-day life to make their life better no matter what situation they happen to be in. Yep. And healthcare is a it's a it's a tangled ball of twine that everyone wants to make better. Lots of lots of great intentions throughout the entire industry and uh and things we can do.

[01:15] Yeah. Yeah. So, let's say somebody's listening, John, and let's hope someone's listening. Well, okay. Let's say the pe the the the billions of people that are listening. Uh, and we're I think we're talking mostly to an American audience. I apologize if you're out of the country now because the solutions we have are mostly, you know, I I don't I don't know that we're prepared to talk about this on other places. I think clinically the stuff we're going to talk about would work in most places throughout the world. I think economically it's a different So I think we acknowledged on the episode there's a lot of people that are frustrated with the system and I think we come to the place where regardless of where you sit fi philosophically we all agree the system is broken and we could go deep into the reasons um but where does somebody and I think I think we can start with a young person maybe somebody just starting out they're probably relatively healthy they maybe feel like they don't need health insurance But they, you know, I think it's a lot of the people that were uninsured previous to, you know, the Obamacare and all that. What do they do? What What would be the advice starting with somebody in their 20s or 30s that's just starting out? They probably don't make a ton of money yet. Yeah. And while they're in while their coverage and expense is going to be much lower than you or I and certainly somebody older. Yeah. It's still significant. maybe more significant to them and they feel cheated by the system, right? They like why again we we went into healthcare is a right. Yeah. Well, and in some companies you have, you know, health insurance available to you through the company. In some companies, you have medical cost sharing available to you through the company. Uh but there's also you can get individual plans whether it's through a state exchange or you can get, you know, medical cost sharing as an individual through a number of different companies.

[03:11] So there's lots of ways to take care of that catastrophic risk, you know, and I I think about there's a young woman that I worked with who was, you know, very young, younger than 25 and was in an auto accident and ended up having an amputation, you know, and that's the type of thing you just don't you don't plan for, right? you know, and so, um, I think one of the important parts about the insurance aspect, the catastrophic, you know, risk mitigation is having something that if something really bad were to happen outside of your control, maybe that you doesn't economically impact you as negatively as it could, right? So, let's let's take an example. What would you what would you tell somebody they should consider doing if they're maybe they're an entrepreneur? Maybe they don't work for a company. If their company has insurance, they probably aren't worried about it, right? May maybe. I mean, sometimes sometimes that that company insurance may be more expensive than going out on someone's own and getting a plan through the exchange um that's subsidized in some cases or maybe getting um you know, like I said, a medical cost sharing. Um okay.

[04:19] you know, and I I think yeah, I think the important thing is to shop for it and and make sure that that the catastrophic issues are are actually taken care of and that risk is mitigated. But we have, you know, if somebody's listening, they're an entrepreneur, a business owner. Yeah. What should they do? I would say go find go find an insurance rep who specifically handles small businesses or individuals. Um, if you don't have the time to do all the homework yourself, if you have the time to do your homework yourself, go check out, you know, the different innovative solutions that are next to, you know, traditional health insurance through the company, you know, but and check out the exchange and see if you qualify for an exchange plan and I think, you know, that but I would look in I'd try to look at all the different things and and I put together like, you know, what is the is there a co-ay, is there an out-ofpocket expense, what's the total annual expense if things go poorly and then what things are excluded from the plan. Okay. So where would be a a good baseline for them to start like is there one company one place like let's talk about that I I am very fond of the healthcare sharing. Yeah medical cost sharing. Sedera is the company I think you're using right now the it's one of the company that I founded with Tony Dale. Look of course I'm partial to Sedera. I founded the company with Tony.

[05:35] Um but and we should probably I don't know if we need disclaimers here but to be safe on the safe side you are on the board still. I'm on the board of a Yeah. So so Sedara Sedera the for-profit was acquired by a company uh called Health Admins and I'm on the board of directors of Health Admins just to be totally trans. So you're on the board you're an investor. I'm also an investor in a much smaller level. Yeah. So we probably should Yeah. I don't know if it's necessary but okay lawyers box checked. Yeah. and it's amazing. Check it out. But there's other organizations that also have medical cost sharing and you can just search medical cost sharing. There's healthcare sharing ministries. If you're a person of faith, you could maybe join one of those. And then there are individual insurance plans as well. And so each state has a state exchange. And each of those state exchanges has likely some type of um subsidy if you're not making a lot of money that the cost comes down because the government subsidizes that through our taxes. And so I think that it's it's reasonable. Yeah, even even though I may not philosophically love the way that it's set up or the way the system's set up, I do think it's reasonable that if you're playing the game that you understand the rules of the game and you play by those rules. And so go look at all those different types of care. And there are also some other insurance companies you can look at um out there that uh that you may may have individual plans available and and you can get kind of um high deductible plans that are just for catastrophic care and then you can wrap other products around them which is where a broker who specializes in working with entrepreneurs can be really really helpful in terms of getting somebody the right kind of uh risk mitigation. Yeah. And I I will tell listeners as somebody that has used Sedera, my company uses it, it's there's a learning curve, right? Different. And even for me, I know the first time that, you know, we had to use it, I'd been trained, but I listened and then I didn't remember when it actually came time to use it a year later. And I just didn't remember to go in, tell them I was a cash pay, and I had to call the company. And they were great. they walked me through it. But just just know it's different, but I think the work and the effort of learning for what I I just think it's a much better system. It's certainly cheaper in my experience. I you know, and less expensive.

[08:04] Great. But it is it is a different process. I mean, you know, if we think back to the episode, I love the analogy Tony gave about, you know, having your oil changed and then and so just going in and saying, "I'm a cash customer and changing the whole thing." There's a little bit more work to do, right? It does take a little more work. Um it's a little less frustrating. Like if you look at the net promoter score of insurance um industry overall, I think the net promoter score has ranged between -4 and four on a negative 100 to 100 point scale. And um you know I don't remember the latest NPS scores for the Sedera uh members, but the last one I remember was like 67 or 70. So yeah, it's just a much much higher. It's a great experience. You just have to learn something new, which I know a lot of people don't like, but I would encourage people to just it's it's not that much effort. If you expect running and you get swimming, you're pretty disappointed, right? But you you do need to go in with the proper expectations. That's right. Yeah, that's right. Okay. All right. So, let's go to people that are probably more concerned about this. People now, they start having kids, they move into midlife, they're starting to make a little more money likely. What I mean, are there any steps that are different now? Is it the same steps? I I don't think it's that different. I think you you know, you want to find someone who's an advocate for you that can help you navigate the right package. And, you know, in many cases that'll come from a company if you're working for a larger company or a government. But if you're working for a smaller company and and your company doesn't offer those things, then I think it's about finding somebody who can be your advocate and help you kind of build the right package for you in terms of both the you know the risk mitigation but also the cost of that.

[09:45] Yeah. Okay. All right. And moving into later life again Tony talked about what he you know having a a what was it a a personal physician but there was another direct primary care direct primary care also sometimes called concierge medicine. Uh, and it's there's a pretty significant movement and and what it means is that you're paying someone monthly for their services whether you see the physician or not. And then, you know, I one of my sons got sick this week and um and had a same day appointment and and that appointment didn't cost any more. It was just a part of the monthly bill that we pay. And uh sometimes he'll see a physician twice in a month. It's pretty rare. um many months not see the physician at all, you know, but I can call when I have questions about wellness or working out or a medicine that I'm taking or recently a medicine that I wanted to come off of or, you know, and I I get a really quick call back and I have a really good relationship that's gone back years now. And when I talk to my provider, I I'm certainly know he looks at my chart. I watch him take notes, but I'm pretty sure he's like in touch with what's going on with me health-wise.

[10:50] Wow, that's amazing. Yeah, because I know when I go to the doctor a lot of times, I've had other experiences, but the system it is, it's so broken and they're in such a hurry that I've tried to ask questions before and the doctor just walked out of the room because, and I don't think it's because they're a bad person. Yeah. I just think they got patients lined up. I sat in this room in that stupid gown waiting for 30 minutes or whatever for them to get to me. And I'm sure everybody else is waiting and they're they're pressured and they feel like they have to get to the next one and it is it's just kind of a shitty experience. Yeah. And you know the whole thing and every time going in and filling out 6,000 forms and filling the same thing out on five different forms. mean you know I mean look you're you're preaching to the choir like that's when when we when I went back to school to fix part of a part of the problem. We fixed the forms issue. We fixed the timing issue. A lot of those things from an experience perspective we fixed because we had to to get the clinical result we wanted and and fixing the economic part of that was hard but we did it. And so um it's not and that's one little tiny corner of the universe right and I mean tiny corner of the universe that we're working on. This is a rabbit trail but the forms if I fill out five different forms right? Yep. and they ask me the same exact questions. Is that because they're literally keeping them in paper or they're scanning them in? Are they not putting these in a computer where if you get the information once they don't have to get it four more times or is is it just outdated systems that or the they're not talking? I think there's a couple different problems. If you're asking about why one practice has you fill out the same form twice, that's a different question than why does every office ask me the same questions and nobody actually um understands it. And so like no like system to system. Yeah, I'm talking the same office. I'm talking they go in and they say fill out these five forms and there's just tons of duplicate information. Yeah. what what generally isn't happening and I'm being gen I'm generalizing here is that um there's unstructured data which is you know I scan a form and I put it into a digital format and there's structured data where there's like an optical character recognition that goes and grabs that information and then digitizes that information and puts it in letters and numbers into an electronic chart of some kind. Um a lot of times we don't have that that um structured data coming from unstructured data. Uh, so that's that's a part of the problem. And sometimes there's like, hey, we're missing this part of your chart or, hey, we want to get updated information so we can see the updated part of the information that we're looking for today. No, nobody has a desire to make it a crappy experience for the patient. But they're trying to run through a process that that has to comply with all the billing things that have to happen. And to be fair, the government's trying to fix some of that.

[13:41] Like they changed some of the rules for billing recently. And by recently, I mean the last few years that make for less kind of unnecessary charting for a physician. They didn't ring the entire problem out, but it did make it better. And so there there's a recognition of this. Yeah. I think we all need to have a little grace and realize that the the physicians, the hospitals, they're playing the the game by the rules that are written. But even the even the guys that write the rules for the game are trying to fix it. Like it's not like someone's nefariously thinking, "Haha, how do I screw everyone?" like there really are smart people who are trying to fix it. It's a it's a really complicated set of problems. we've talked about a company like Sedera or other healthc care sharing options and some of the Christian sharing that are out there. There's let's let's give them real solutions like you might want whether they choose these or this is the right answer. you're listening, some of these may or may not be the right answer for you, but at least things that they might want to research or look into.

[14:45] Where else would you say they should? Yeah, I think there's a really interesting model uh at the Surgery Center of Oklahoma or Texas Free Market Medical Association that tell people how to be cash payers um on their own. And so, and that works for an individual. It also works for sort of small companies who um who are interested. And then, you know, as you get into larger companies, you start talk about, you know, self-funded plans when you have the type of employment base that can afford a self-funded arrangement. And so, I think at every level and size of organization from individual into massive organization, there's some form of agency that you can grab back into your system and say, how do I help the community be healthier? And then the healthier that community is, generally, the lower the cost is. like these these groups, they measure utilization, right? And so if you take in $100 in premiums and you spend $105 in healthcare, then your premiums are going to go up. The one that you the surgery center of Oklahoma, is that what it's called?

[15:49] Yeah, this is a this is a a surgery center where when you go to have a surgery that they post their pricing online, right? you know, Texas Free Market Medical Association, great organization doing similar cash pay type of stuff. And so there's this desire to have transparency and you see it in, you know, I saw it this week. I was looking doing some market research and I saw it in a dental clinic where the dental clinic had like pricing online and I think that directionally is a good direction. It's tough because you know you see a price online and if you don't get what you need correct it can cause a lot of consternation and people being upset but so I think there are some downsides to that too that people are trying to mitigate. End of the day I think transparency is a good thing and getting people to consume health care similarly not exactly the same but similarly to how we consume other things is generally going to put the agency in the hand of a patient who can then make good decisions for themselves. Yeah. Yeah. Yeah. I mean, I just I it seems insane to an outsider that you would go buy anything and they don't have to tell you what it costs. Like, so, so the the Oklahoma Surgery Center has says, "You have a broken arm, here's what it costs." Yeah. I mean, one one of the things we saw with a group that I was consulting for was um someone broke their wrist on a Colorado ski mountain.

[17:11] And I can't remember the exact number, but it was on the orders of magnitude of like $80,000 for a broken wrist, which is just insanity. Like that that I mean almost to the point it made me so angry I was feeling like it should be criminal, which it shouldn't be criminal, but definitely should be, you know, talked about. Yeah. And so I think um Yeah. So end of the day, I think and I worry about this like with online platforms, not Amazon in particular, but I that's where I do a lot of shopping. Like I worry if Amazon sees where I'm price insensitive and they give me higher price, you know, options for some things than other things. And if that if that information is being used against me without my knowledge, I I philosophically have a problem with that. Yeah. you know, and and because if that if I'm I'm not saying that is happening, if it were to happen, I should have the option to plug in an engine that price shops for me, whether it's manually or, you know, in an automated way. But like um manipulation, the definition of manipulation is me having information you don't have and using against you in a conversation or in a transaction. Like that's the definition of manipulation and market manipulation. If that were to happen, like I think that the I think that the regulation should be severe and I mean, I know we're way off on a rather trail, but I'm just thinking at least they have a price. And also, yeah, right, at least they have a price. And because if you go to a hospital and they don't have a price, it's even worse. And the other thought I had is here's a business opportunity for somebody. If that's a problem, there's a big opportunity for somebody that could make a lot of money solving that problem.

[18:44] Yeah. Yeah. Yeah. And I mean the problem in Marty McCary's book that we talked about very briefly in Tony's episode, uh there was a chapter on a um a place in New Mexico, there's a county where I can't remember the number, but something more than 90% of court cases were about hospital bills in that small county about the count the count the hospital going after patients. And I mean yikes. I mean that just yikes. Yeah. It's it it's interesting by the way. So, I just as we were talking, I pulled up the s Surgery Center of Oklahoma and I just I Googled surgery pricing. Yeah. And there was a a link. The very first thing on there is hits home with me. It's Achilles repair. $6,561. Yeah. Is what it costs. I don't know what. So, that one, the reason that hits home is I tore my Achilles 15 years ago or whatever it was 16, 17, 18 years ago now. And I don't remember what it cost back then, but I guarantee you it was a lot more than $6,561.

[19:51] price for every single thing. I mean, yeah. Arthroscopic elbow 44. I mean, knee boom boom boom. I mean, just the stuff. Yeah. I mean, some of the stuff I don't even know what it means, right? Lap band removal 66 6,800. I I think that and and really it's about again allowing us to be informed consumers of what's happening. Um yeah and and I I've got stories of patients I've talked to clinically where we just had to explain what was happening so that they could make a better informed decision. And it's not my choice as as someone in a clinic. It's not my choice to make a decision for them. That's not how I see it. my my job is to make sure that they are fully aware of what's happening to the best of my ability and then to um honor the choices they're making. Right. So, I I think I mentioned on the episode with Tony, I recently just signed up for a this full blood workup that's 100 150 60 markers and a whole bunch of different stuff versus a regular blood test. Yeah.

[21:01] In fairness listeners, I would have I didn't do the work to find that. My wonderful wife, she went deep and you know, she came across this and recommended it and I'm like, "Okay, great. Let's go." And do you do anything like that? Is there any Yeah, I mean, yeah, I've done a couple. So, uh, and some of them have a lot of scientific basis, and I've also been willing to do some that don't have the same scientific basis, and I go into that with eyes wide open, right? So I know like one of my personally held beliefs is like there are things that in western science we don't fully understand but in eastern medicine are very well accepted and have been practiced for 3,000 years and like I'm willing to accept that we don't understand everything scientifically and I just want to be educated about where the line is and what the science does or doesn't say and then I recognize that there are limit like we didn't understand kind of some of the wise behind gravity until pretty recently in history but when I was a kid I knew gravity gravity worked. I just, you know, open up my hand with a handful of jacks and they would all drop to the floor. And I accepted that gravity, even though I didn't know why, you know, it did like it was still a thing. And so I think there's a lot of things in like um Eastern versus Western medicine is kind of the easiest place to see that where I just don't understand all of it. Um acupuncture would be one of those things where I maybe there's great science behind it, maybe there's not. I've never studied it. I don't know.

[22:23] I think that there are some part people in western medicine that are a little leerary of or skeptical of acupuncture. My personal observations non-scientific just heristic are that I've seen people get amazing results and outcomes. Is it placebo? Is it not place? I don't know. Does that matter? I don't think so. Like so so I I I'm a I believe in science. I believe there's a limitation to what science knows. I know that science changes over time. like when I was taking biology or early in my life, I think there was like seven kingdoms. I think there's eight in biology now. So, I can't even help my kids with biology anymore. So, so I think I I just I I want to have strong convictions loosely held where in the face of new information, I'm willing to change my position. I think that's really important. And um I'm not sure we're still talking about healthcare and medicine, but I think it I think it's about curiosity and in information. And so to answer your question, I just bought one of these blood tests um and I went and did cursory research. My wife has done a bunch of the research on this company and I'll get a bunch of information that's kind of like what I would consider standard blood work. It does a bunch of work that I would consider atypical blood work, like things you normally wouldn't see and aren't like proven medicine, but they're interesting information for me to have.

[23:40] Right. Do do you want to share what company? Boy, I think I think the company's Viome. V I M E. Okay. same one. So mine is it's Dr. Mark Heyman's company. I think it's function health or function function health does one as well. I really like Mark Hyman's work. I really like Peter Aia's work that that's the one that Julie found that that I'm using. Yeah. Um Viome you mentioned years ago because of Peter Diamandis I did their food where you send in a stool sample and I got that one too. It told me what foods to eat. I found that very beneficial. I got that one too. Yeah. Um it's it by following their recommendations I had a bunch of gut problems that just completely went away like very quickly. Yeah. Look, and there are people that say you don't need supplements. Eat a well- balanced diet. All you're going to have is like um urine. Excuse me. And so I think um and then there are people like there's some new evidence that people are taking too many supplements and it's causing some liver damage. And I think that's real too. So I think you have to be prudent, right? I think you know more is not always better. We live in Texas, but taking more of everything is not always better. I was just reading about zinc. I was taking some zinc because um I thought it would help me feel better given a certain set of circumstances.

[24:53] And uh one of the things I read was that taking too much zinc can be bad for you, right? Especially if you have, you know, fat soluble supplements, those are generally where you generally where you see some more problems versus water soluble. And so, um I just like it's just good information to have, right? Just I want to be educated about the things I'm putting in my body. And um you know we talk about moving to the right. So of like packaged processed highly concentrated processing is on the left side of the spectrum arbitrarily. That's just what the way we talk about it in our medical practice. And then fully whole food is to the right. We talk to people about moving to the right. And wherever you are on the spectrum just move a little bit to the right and then move a little bit more. Like we don't start talking to someone who's eating Captain Crunch for breakfast, lunch, and dinner about kale and carrots, right? Because that jump isn't going to happen in my experience, generally speaking. Has it ever happened? Sure. Generally speaking, most people aren't going to move from Captain Crunch to kale. Just directionally better. Yeah. And so just one step better. Like how do you move one step better every, you know, every time period, day, week, month, year, whatever. And you and I have talked a little bit about, you know, everybody's different, right? That's that's one of the things I love about Viome is they actually take Yeah. your sample and they tell you these are the food. You get a list of here's and I'm talking about the the gut test now, not the blood, but here's here's your superfoods. Here's foods you should enjoy. Here's foods you should minimize. Here's foods you should never eat again. And for me, like I had already figured out cherries, for example. I'd figured out, oh, I like cherries and when I eat a lot of cherries, my stomach doesn't perform well. Yeah. Well, but then pistachios were on the list. And when I didn't eat pistachios for a couple years and then I took the test again, pistachios were removed and you know and so it ch it changes too. But I just think everybody's body is so different. I think those two things are key, Randy. I think the fact that everyone's body is different. We've got a different you know genetic makeup. We've got a different set of environmental history.

[26:51] And then you know there is some evidence. I don't know if I would call it science because I'm not again not my field. Maybe it is science, maybe it's not. But my understanding is that like over seasons that that's part of the way that a body regulates too. Like you know, and I think about bears hibernating for the winter and they eat all that salmon before they go in because they're building up all their fat stores and there's like a annual cycle for them like a rhythm, you know, and and so, you know, my understanding is that's probably true for some foods as well. And so, like, you know, we're coming into summertime as we record this particular episode and I'm starting to see strawberries, organic strawberries is something I'm I'm interested in eating this time of year, but like, you know, four months ago, I was able to get strawberries, but we didn't buy them in our house because they were out of season, too far to ship them, more expensive, whatever. And so, so I think I think um knowing yourself is really important. I've done this a couple times with my wife. we've gone through a whole 30 um cleanse where you have just this really really clean diet for a month and and and no cheat days. I mean zero because a cheat day will set you back two or three weeks. And then once you have that 30 days of kind of really really clean eating, you can take one thing at a time and only one and you do it for two or three days and you see how your body reacts. And if you're really paying attention, it's a great way to figure out without testing, without anything else like what your body is reacting to. And I know people are like, "Well, I added two things at a time."

[28:15] Well, then you can't tell which one is causing the reaction. I'm guilty of that a lot, right? I just I'm like, "Well, I'm going to try this and this and then I don't actually have any idea what worked or was it a combination or was it right? It's it's terrible science." Well, you've got to be and you've got to be like, you know, it's like if you're not taking your allergy medicine during allergy season, like you're not gonna do a great job of like, you know, so so I think I think you've got to be and again I'm not saying the whole 30 is for everyone, but I was really curious, you know, and so it really helped to you know um my body better and it's been really helpful for my wife, too. And so it's been, you know, um not saying we do it every year. I wish like every we don't do that but and by the way I think January is a tough month for us because you got the New Year's you've got you and we were married in January son's birthdays in January birthday cake I like to eat it so I'm thinking April's a better month for us when you're doing all this what what are your real goals your motivators like what are what are you trying to accomplish by whether it's eating healthy getting more tests done getting more information during the whole 30 or just in general just with your health in general, what are your what are your real goals? I mean, for me, I want to increase my my health span. I used to talk about living longer, but the truth is it's not that I want to live longer, like be alive. I want to live longer and like be alive. Like I want I want a health span. And I think the first time I really heard that, not that he was the first person that said it, but I was listening to Peter Aia's book, Outlive, and he talked about health span. And I know it's been talked about in lots of places, but the idea that you have quality of life for longer is really, really important. like you know that that's what I'm aimed at is I have I have some um aspirations about what I do in my life and that requires me to be alive a long time to experience lots of different things and so I want to be able to live healthy in those ways and I mean you saw me you saw me at my heaviest and and you've you know watched the whole journey and and what it's been like and it's um but it really is about like you know what I want to do with my time what the experiences are I have a really clear understanding of my why.

[30:24] And that helps me to, you know, and now that I understand what kind of health I have to have. And there's another book that I read recently called Die with Zero that talked a lot about like knowing when you're going to be able to have different experiences in your life. And so it's like, oh, I better travel on this trip while I'm at this age because when I'm older that I won't be able to do that, but I will be able to, you know, watch all the Jeopardy that I want to watch. Yeah. I for me I think a lot of it I I've I'm really convinced that people our age we have an opportunity to live long long lives. Sure. Now you know I don't know what the oldest person in the world is currently with 8 billion people but I'm going to guess it's 115 120 that there's you know 110. I think 114 was the the longest that I've heard of someone living. So, okay. In that range, right? Like I don't think anybody's ever lived. I thought somebody made it to 120 in Italy. Old lady, but I could be wrong. 122 in 164 days. Okay. Jean Clement, a French woman. Yep. Yep. All right. I gave I I thought she was Italian, but French. So, one person Yeah. out of billions has lived to be 122. Um, you know, 100 is for for most of our lifetimes, a hundred has been thought, wow, what a long long lifetime, right? Yeah. And I think we have a chance to change that with a lot of the stuff that's happening with technology.

[31:46] I mean, talking about abundance, right? There's there's really I think some really exciting things coming down the pipeline. So, partially I just want to live long enough to be able to benefit from all that, whether Yeah. it's stem cells or some new whatever it is. Right. Think about what she saw. She she was born in 1875. Wow. She was 25 years old 1900, right? So she saw all the things happening in kind of like I think like the late part of the gold rush if she was watching what was happening in the US, right? I don't know what's happening in Europe at that time. Well, the late 1800s was an industrial revolution that I mean yeah, the whole industrial revolution. Then you have World War I, the Great War, then then the war to end all wars and World War II. And then you had like, you know, airplane flight for the first time ever that she saw. And then she saw a man on the moon. So she saw from like never flying ever industrial revolution not not only never flying no cars no I mean they would have had trains but no car I don't know that in France I don't know how I'm assum yeah yeah I'm assuming I'm guessing they had trains yeah but I mean just from from like from like the industrial revolution to man on the moon and then she had 22 years of life after that.

[33:02] Yeah. I mean that's and I I I think we have a chance to live much longer. I think it's a real thing and you know I know you and I have talked about this. I don't know how much we've talked about on the podcast but you know I I'm scared when I hear people they're going to retire. I'm I'm scared for them because so many people retire and when they stop having that purpose they stop living and they die shortly after. Right. So yeah, five years is typically the number I hear thrown around. And but then I look at somebody, you know, Dan Sullivan who, you know, I don't know what he's in his 80s. He's still running his company, Strategic Coach. He I believe I forget his number. He talks, he's lived for talked for a long time for like his numbers 156 he wants to live to. But the saying he says is your future has to be brighter than your past. Yeah. And I think that's amazing. amazing guidance or insight, wisdom, whatever you want to call it. I've never met Dan Sullivan, but I've read his stuff and I've seen his work and I'll tell you if he lives to 156, it makes the world a better place. Yeah. Yeah. Yeah. And so I just think that's a real opportunity with everything that's coming down the pipeline and Yeah. You know, and but I think we have to think in terms of health span, Randy. And I think it's, you know, the thing that I have come to after really diving deep into this personally and professionally is it's it's lots of little choices and and h and the importance of habits and the importance of community and um and then the importance of, you know, being willing to figure out your why. It doesn't need to be some deep philosophical I mean I you and I talk about these things pretty deeply and that's fine. Doesn't have to be that.

[34:42] There there's a lots of things that are worth living for and and you know you just got to find yours. Yeah. And I think energy level for a lot of people there's a lot of people their energy level sucks. Mhm. Right. All ages. Yeah. You know and you know I would encourage people if your energy level isn't where you want it figure out why. I mean an energy level is part genetic. It's part skill set and it's part exercise. And so the two parts you can control are your skills around that like learning the skill set of energy management and energy growth. And then the let's let's give people specifics. What do what do you mean by that? Well, I think you know um manage what do you do? Yeah. I so one of the things I do for energy management is I make sure that different during time during different times of the day when I'm better at certain things I do those things. like my energy dips around 3 or 4:00. I'm naturally very comfortable engaging with people um during those hours. And so like I do my really highly cognitive difficult work to do when my energy levels are the highest which you know early morning might be one of those times. And then I do the the work that I find easier to do in those times where I'm going to dip a little bit in my kind of circadian rhythms or whatever. And that works for me. I don't encourage the same thing for everybody else. You got to find kind of what works for you, but that works for me. And so that's been a skill of scheduling appropriately. Right. Right.

[36:12] And then I also exercise that by pushing myself when I have low energy to to do things, you know, whether it's working out or reading or, you know, so I try to I try to expand my pool of energy by also exercising in the same way I would exercise in the gym. Yeah. And so there's a skill set and there's also a a a discipline or an exercise to it. Do you use um calisthenics or movement? How often do you use movement to get the energy level up? So in the morning for me there's some things that I like I you know early morning it's working out or showering or like like when I get out of bed it's not reading and journaling for me personally. I know a lot of people who got up in the morning and that's their deep thought, thinking, reading, you writing, but that's not wrong. It's just wrong for me. Right? So for me, it's like I either if I'm going to be getting up thinking and doing all those things, I have to get up, shower, and then do that or get up and go work out and move or right. So for me, I like working out in the afternoon when So I similar to you hit that energy dip sometimes in the afternoon. And by the way, taking a nap, even a 10-minute nap recharges me in an amazing way. Um, but equally effective is I go to the gym. Yeah. And I I go to I go work out and that gets I whatever scientific endorphins. Yeah. But sometimes it's as simple as between calls I walk outside and I walk around my yard for five minutes. I've got a little mini You've seen me on calls. You've been like Randy, it's a trampoline listeners. Yeah. Can you quit? So I have a standing desk and I will if I start getting tired or just to get exercise cuz you know that what's the saying? Sitting is the new smoking.

[37:59] And I don't know if it's that but it's not great for sitting all day. If you ever on a call with Randy, by the way, and he's on his mini trampoline, just for me, Dramamine helps. Yes, I have. I try I try to not jump. I just But even just standing on it, moving around, you know, I've got a balance. I don't know what you call them, those little half balance things and just anything to get a little blood moving. That's great. Stretching, whatever is very effective for me. So I to me the fat almost I don't know if it's a hack a cheat code but getting blood moving and doing something physical can snap can change that state very very quickly. Yeah that's right. I think there's a, you know, there's tons of author's books, uh, you know, people can read and the the the danger I would say is that when people have the answer, I would just encourage people that's an answer like and so and it's an answer for some people. I'll give you a great example in my household um 168 fasting where I don't eat for 16 hours, eat for eight hours. Um, that's a tool that I employ some parts of the year. I don't employ it all the time. Sometimes I'll employ it when I'm stuck, want to make a change, like like there's times I'll I'll use that tool and it works really really well for my body. Like it's a it's a great tool for my body. Uh does not work well at all for my wife. It just does not work for her, you know?

[39:18] And I think that's a great example of just some really clear differences where we've tested things out and we want to be supportive of each other, but we learn like I need to support her with what works for her. She's amazing at supporting me and what works for me and and not being um not feeding off the wrong things, but feeding off the support and the positivity and and recognizing like just, you know, another one, peppers don't make me feel great and she loves peppers. That doesn't mean no peppers in the house. It means she eats peppers and I don't like we had we had a a Greek salad just this week and like I left all the peppers. She doesn't love cherry tomatoes and it was like a marriage made in heaven, right? Yeah. It's great. Um, you know, and the other thing we mentioned Dr. Mark Heyman, and I saw him give a little message not that long ago, and one of the things I appreciated is he talked about both. All right, if you want to be a vegan, great. If you want to be on a carnivore, great. He's like, but you know what? Like these two groups are more similar than different. They both both of these groups are stay away from processed foods, stay away from sugars. Yeah. Stay away from seed oils.

[40:25] and all they really disagree on is where you get your protein from if you and I and I thought, "Wow, that's, you know, I've I've kind of thought that for a long time, but he summed it up better than I could." And and I think that's really true. I just I don't think I would do well on a vegan diet. Like I I need meat and when I have meat, I am less hungry. Sure. But I know people that are vegans and they do very well. And yeah, I think again it's about finding the thing that works for you, right? And you know, Oscar, I have this little quote on my desk. It's from Oscar Wild that says, "Modderation in all things, especially moderation." And so, like, you know, I I I think I'm pretty moderate in my eating, but there are times, you know, I was on vacation recently and someone had Jenny's birthday cake ice cream and it's packaged and it is amazing, right? Like I I I'm not a guy who does drugs. Uh but if if crack was that good, I get it. It's so good. Have you ever had Jenny's birthday cake ice cream? Oh, I thought you were going to ask me if I ever had crack. The answer to both is is no. Okay, we'll skip the crack. Go straight to Jenny's. Jenny's birthday cake ice cream. It's gluten-free, which means my wife can have it. Okay. And um we made the mistake of introducing our friends.

[41:36] We went to visit some friends on vacation and we and they got Jenny's ice cream for us and something else for them. And then she had them taste the Jenny's ice cream and I had to split it more than two ways. I was like, "What the hell are you doing?" All right. So, we should definitely get a sponsorship from Jenny's. There we go. AB: Absolutely. Come on, Jenny. Give us a call. Uh, so let's let's go back a little bit to because I'm sure there's people listening or maybe they've turned off by now that they feel left behind by the health care system, right? because they're going, "Well, you got you said you got health insurance and then you pay for this other $500 test and this other test and and that's great and you're talking about living to be 200 and you have all this abundance." But not the vast majority of patients that I deal with though, but we feel you know we feel left out. Healthc care is a right. Why should you know what do we let's let's give a final message to that person or kind of have I guess a little empathy a little grace for for people that are in that situation. Yeah. Look, I mean I went in the problem that I wanted to solve in healthcare dealt with people that had low access to care were not, you know, middle income. There was less than middle income. They were kind of being left behind by the system. And so for those people, I think it's um it's it's again it's that next one step. So, wherever somebody is on the spectrum for medicines, wherever they are on the spectrum for food, exercise, um, labs, any of those things, like just take the next one step to move in that direction and get the inertia going in the right direction. And like I didn't start my healthcare journey with Viome and, you know, fecal testing and all those things like I start I started with like I just need to get moving, right? Um, I was talking to a patient recently and they were like, "Gym, exercise, work." I was like, "I don't need you to work out. I just need you to move for 10 minutes."

[43:34] And I don't mean get sweaty. I literally just mean move for 10 minutes. Like, oh, I could do that. Like, yeah, that's great. And let's check in in a couple days and see how it feels. And you might be tired and we just got to keep you moving, right? Start with 10 minutes a day and let's get you to 30 minutes a day and three 10-minute spurts. And like that means like walk to the mailbox. Yeah. And back for 10 minutes. Yeah. So, so I I think there's, you know, wherever you are, be there and then take the the next one step in your journey. And look, as frustrating as the health care system is and can be, we everyone can take the next one step. And and that's a little less frustrating because it gives you some um some semblance of control about what you can do. And so I think you get what you focus on. And if you're frustrated and you want to talk about that frustration, all you talk, then you get more frustration. But if you're grateful for the fact that we live in the greatest medical time in the history of mankind, we're living a long time right now. Although we're seeing, you know, um longevity decrease in some first world countries including the US in some segments. I think I think I my I would say start with gratitude.

[44:44] Start with gratitude and take that one next step. And it's really easy to get sucked into all the brokenness. It's true that it's broken. I accept all of that. And I'm also grateful for the opportunity I have to take the next one step. And even people who are in like really serious poverty in in our country are still living better than than some parts of, you know, emperors and kings of history. And so in no way am I de minimizing the difficulties they have. They're real. And there's still a one next step. Yeah, I agree. I I I think a lot of it comes down to just deciding to take control of your journey, right? And controlling what you can and whether that's going and getting exercise, being, you know, being grateful, stop eating, you know, eating better, whatever it is, just yeah, do something to take control. So, just thinking through like if I'm if I'm a listener I'm like okay I want more abundance. I think the last thing I'd talk a lot about the mental health component of all this um but we do a lot of that work you know our clinics and so I I think um without getting into like clinical mental health Stephen CVY did a nice job of talking about circles of influence versus circles of concern. And so one of the things that I try to talk to people about is what do you have control over?

[46:09] what are the things you can do and try to kind of exercise control over those first. Yeah. I I don't maybe you have data on this thoughts, beliefs. I mean the the the psychological the mental part I think that is really really everybody talks about eating the right foods and exercise and care. Yeah. But if you have a shitty attitude and it it's hard to be healthy when you Yeah. And you got to find a you got to find what's working for you. Like again, if you hate kale and carrots, your goal should never be kale and carrots, right? You got to find some other way to so it's not doesn't feel like a temporary diet. It feels like a lifestyle change you're making. And so that's been really important for us and our family. And so like there's little things I do to game the system for myself. Like we choose not to keep sugar in the house like in a really highly processed form for the most part so that we're not tempted by ice cream every night. By the way, I eat ice cream. Like I like like I I do. And so but I don't eat dessert twice a day. I was on a vacation once where I did and man that was rough. I mean it was just it I didn't feel good, you know? And so um it it to me I'm starting to view sugar more like I view alcohol which is like there's a consequence for me drinking too much alcohol. You know, I learned that in my 20s and I don't drink a whole lot of alcohol now, but I I drink alcohol. Like, you know, someone I was joking with uh you know, Dr. Dustin Williams, who's the chief medical officer for our medical practice, and someone asked about wine. He's like, I drink alcohol. Like, so so I don't think being a tea totler or being a like, is that right for some people? Sure. High five. That's awesome if that's if that's the thing you want to do. It's not what's required to be healthy is the next one step for most people. Well, I think it's like anything else. One of the one of probably the things that almost guarantees you're not going to succeed is if your only standard is perfection and if you're miserable, like if you're just if you're just miserable in that perfection, it's even worse, right? And so, yeah, like I love high standards, right? But perfection and never eating whatever delicious food. See, for me, some stuff's easy. Like I stopped drinking soda or pop as I grew up calling it in the Midwest.

[48:27] even know where it came from. I just thought why do I drink this? I used to drink Mountain Dew like crazy. I was literally at a Arby's drive-thru. I had ordered a large Mountain Dew and I just thought to myself, why do I drink that? Why don't I just drink water? And there was, you know, it wasn't demonized back then like it is now, right? And I just stopped and I've never never drank it since. and junk food, fast food. For whatever reason, that stuff has been unbelievably easy to cut out of my diet, right? Yeah. I drink soda water a lot now. And then I have, if I'm at a bar, I haven't put lime juice and olive juice, and then two olives in it. And it looks it's a little mocktail with no sugar at all. A lot a lot of mocktails have a lot of sugar in them. And so I just do soda water, a shot of lime juice, or a squeeze of lime juice, a shot of olive juice, so an ounce. So So I've got eight ounces of soda. I've got salt in there because I I love salty things. It kind of that way I don't need to eat like chips or whatever on there because I still love chips even though I don't want to eat a whole lot of them. And then I put olives in there so I can have something to snack on, you know. And I I love that drink. And you know, my friends kind of they chuckle. They know it's coming, but it's like squeeze a lime, ounce of olive juice. I actually should try that. See how I like it. I'd probably like that. Well, what I was going to say though is while that stuff was easy for me, last night Julie and I went to a Mexican restaurant and they have a chip and salsa bar that's amazing. Oh, yeah. And I had a bunch of chips. Well, there aren't very many. I mean, you want to talk about all the carbs, processed foods, seed oils.

[49:55] It had it all. Very few things could be worse, right? Yeah. But great. And I thought about it. I thought, "Oh, I should skip the chips." But I didn't. It's just I for whatever reason that's the like it's easy for me not to go McDonald's. It's easy for me not to have a Mountain Dew or a Snickers. But by the way, there goes a whole bunch of sponsors. Yeah. The uh but the chips the chips and salsa is really really hard for me to say no. Almost impossible. Yeah. Look, like I said, all things in moderation, including moderation, right? And so I think, you know, a life well-lived has to actually be lived. Yeah. So I think that's important. So, well, you know, coming out of this today, I'd say, you know, the things I hope a listener gets to is agency in healthcare matters a lot. It's around your providers, your lifestyle, and it's just and do the little things, right? And and uh you know, we we do have control of a lot and and it's easy to be frustrated about the bigger picture, and I think it's really understandable, but if if that draws you into a funk, like just, you know, tighten tighten the aperture on the picture. or make it a smaller picture so you're frustrated about less because if you can't do anything about it, it's more frustrating. And then talk about and spend energy on the things you can do something about. Yeah, I ask you that question all the time, right? Like we're talking about philosophical things like Randy, what can we do about it? No, it's By the way, with the chips, I'm just thinking at some point I stopped. A few years ago, I would have eaten double or triple the amount of chips that I did.

[51:18] Sure. So, I guess I've made prog when I say I can't drinking a lot of water so you're less hungry. um eating slower so you're less hungry. That's what these GLP1 drugs do is they make you think you're not as hungry. And so there's there's a lot of things that can be done to kind of, you know, smaller portion control for sure. Um but yeah, focus on what you can control. Yeah. And just small improvements. It doesn't have you don't have to shoot for perfection. If you're 1% better today and 1% better, whether it's tomorrow or next week, you're you're moving in the right direction. And if you're 1% worse the next day, then just go back the other direction the next. Like it's okay. Yeah. Good. You know, Jenny's ice cream is all right. All right. Once in a while. I Come on, Jenny. Give us a call. Salted caramel. There you go. Birthday cake. All right. Well, let's wrap this thing up. And uh I think this has been a good episode and hopefully listeners got some some tips and some takeaways and things they can do uh to live a more abundant life. And uh again, subscribe, listen, tell your friends, download, give us comment, feedback, whatever.

[52:20] Yeah. Um, you know, all of that is a blessing. Thank Thank you listeners. Uh, oh, check out the website talesofabundance.com for other tools, etc. And we're gonna get some lunch. There you go. All right. All right. Thanks, Randy. Bye.

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