EP 147: Retirement Planning with Aaron Fonseca

EP 147: Retirement Planning with Aaron Fonseca

Retirement Planning with Aaron Fonseca

As nurses, it is our job to take care of not only our patients but our finances as well.

How are you handling your money? Are you planning to invest in something fruitful in the future? Do you have any financial literacy?

In this episode, we would like to introduce our guest Aaron Fonseca. Aaron is a financial planner specializing in 401ks and retirement for traveling healthcare professionals. He initially went into this field because he enjoyed helping people in figuring out how they want to save, what they want to save for, and helping them understand that not all money has to be saved. 

Questions we asked Aaron Fonseca:

  • Tell us a little bit about yourself.
  • How did you end up in finance and specifically finance within the travel healthcare community?
  • What are some pitfalls to avoid right off the bat when entering a new higher-paying career?
  • What are some retirement options that travel healthcare professionals have? Can they do the standard 401k?
  • Besides a savings account, what are better options for storing, investing, or growing money?
  • Difference between a budget and financial planning?
  • What’s the best way to go about buying an expensive new car or a home?

Where can we find Aaron? Social links: http://aaronfonseca.nm.com/

 

SHOW NOTES:

0:00 Introduction
0:49 Cup of Nurses Introduction
1:58 Episode Introduction
2:14 Meet Our Guest – Aaron Fonseca
2:44 What made you pursue finance?
6:50 What are the basic ways to start Financial Planning?
10:18 What’s the difference between IRA and 401k?
19:38 What percentage of your paycheck should you start to invest/save?
22:17 Financial Advice for New Nurses
26:06 Aaron’s Journey to Financial Literacy
29:41 What’s the process of Investing?
32:37 The Power of Compound Interest
37:41 High-risk Investments
42:26 Do you recommend putting money in Savings Account?
44:34 Aaron’s Life Outside Finance
45:52 How Covid Impacts Saving Habits
47:18 Where can people find Aaron Fonseca?

Are Staffing Agencies Overcharging?

Are Staffing Agencies Overcharging?

Are Staffing Agencies Overcharging? 

Over the years, the issues among overcharging staffing agencies have become a problem. Many nurses have been asking for a better ratio and higher pay for their services, but it all seems to fall on deaf ears. Even before the pandemic, this has been an ongoing issue among the nursing community. Now that we are facing a pandemic, the same problem still exists. 

In this episode, we will talk about the overcharging staffing agencies for nurses, how the pandemic affected nurses’ jobs, and even share some of our experiences as travel nurses. 

In the letter, Senators Mark Kelly (D-Ariz.) and Bill Cassidy, MD (R-La.), and Representatives Doris Matsui (D-Calif.) and David B. McKinley (R-W.Va.) wrote:

“We have received anecdotal reports that the nurse staffing agencies are vastly inflating the price, by two, three or more times pre-pandemic rates, and then taking 40% or more of the amount being charged to the hospitals for themselves in profits.”

They asked for an investigation by “one or more of the federal agencies with competition and consumer protection authority” to find any evidence of anti-competitive price patterns, price collusion, and higher pay for nurses due to the rate increases.

 Our opinion is that they will find out the rates are driven by supply ad demand. There isn’t not necessarily pricing fixing or gouging going on, just a shortage of nurses. 

Insider info: This started with Aya, who, at the start of the pandemic, where in New York they were charging like $350/hr bill rates. The hospital fired them and filed a complaint [1]. 

We don’t think this will have any impact on nurses as they have been underpaid for years. The market dictates the rate, not the agencies. Don’t forget that the hospitals got $35,000 for every Covid patient. 

What does AMN Healthcare say about this? 

AMN Healthcare is the largest travel nursing company, with a 17% market share, and most significant in allied healthcare staffing, with a 12% market share [2].

Kelly Rakowski, chief operating officer for strategic talent solutions at AMN Healthcare, wrote in an email to MedPage in a general response that its “pricing is agreed upon directly with our healthcare organization clients. Inflationary pressures and demand drive up the wages needed to attract clinicians to open positions. Any price increases are driven primarily by the compensation directly to healthcare practitioners.”

Several things contributed to the healthcare shortage; it was not only a national pandemic. The pandemic did two things: Increasing the direct number of patients needing care and driving some nurses out of the healthcare system due to burnout. 

According to the Bureau of Labor Statistics, the seasonally adjusted number of nursing and residential care facility staff on payrolls nationwide dropped by 157,000 from October 2020 to October 2021, to just under 3 million.

Hospitals in states like Pennsylvania and Dewelare say the hospitals cannot compete with staffing agency pay rates, which makes them unable to retain local nursing staff. 

Travel Nursing Fun Facts

The most popular contract spots are Texas, California, and New York. 

The most popular cities for travel nurses are: 

  • Denver, Colorado
  • New York, New York
  • Austin, Texas
  • Tucson, Arizona
  • San Diego, California
  • Dallas, Texas.

Only about 20% of people that start traveling go back to a perm job for more than two years. The highest paying contract for 36hrs is $5,000-$6,000 per week, gross [3].

The lowest paying contract for 36hrs is $2,000 per week, gross. 

Nurses will not travel for less than $2,000 per week, gross.

To watch the full episode, click here for more 👇👇👇

SHOW NOTES:

0:00 Introduction
0:48 Cup of Nurses Introduction
2:33 Episode Introduction
3:00 Are Staffing Agencies Overcharging?
4:03 Letter about staffing agencies that are overcharging
10:48 How travel nursing agencies work
13:33 What AMN Healthcare say about this?
23:58 Who’s paying for FEMA nurses?
26:31 Travel Nursing fun facts

EP 118: Managing Your Finances as a Nurse

EP 118: Managing Your Finances as a Nurse

Managing Your Finances as a Nurse

Managing your finances is something schools and universities still neglect. Coming out of college some people don’t know how to open a bank account. A career in nursing can be lucrative when it is done right. The highest nursing salaries also allow you to pick and choose where you will work around the US.

We also did a great episode about how to pay off debt and save money with the DebtFreeNurse

Understand how much you get paid

The 2 biggest things in understanding your pay are; there is a difference in the amount you get paid by your employer and how much you take home. That is called net and gross income.

  • Gross income = Income before taxes
  • Net income = Income after tax (the amount you actually get)

It’s always good to know how much money you make on a yearly basis as well as know your average paycheck total. 

  • If you make $2,800 biweekly then your monthly income is double, $5,600/month
  • That’s $67,200 a year

Your income means that just by yourself you already make above the median household income of the US, according to the median income in 2019. Median household income was $68,703 in 2019, an increase of 6.8 percent from the 2018 median of $64,324.

It is also important to take into account how much you pay for insurance. Most people get health insurance, dental, and vision through their employer. It gets taken out directly from your paycheck. 

Understand your bills

We are entering a more and more subscription-based society. It is a lot harder to keep track of monthly occurring expenses vs a one-time payment basis. What makes it tricky is they offer something low cost with improved tiers which don’t seem like a lot at the time but multiply it for the year and it might add up to $1,000. 

Some staple bills to always keep in mind are; cell phone, internet, home bills (gas, electric, water, rent), Netflix, apple subscriptions, and car insurance. 

Take into consideration your costs of groceries.

Create a budget and stick to it

Knowing your income and expenses is the key to understanding your financial situation. Once you have those understood it is time to create a budget. When making a budget add up all the money you make from work and add up all your recurring monthly/weekly expenses.

This gives you an idea of how much you make and basic necessary spending. This also gives you an amount left over. You need to budget the money you have leftover when you subtract your expenses from your income. 

The money you have leftover is technical your “spending money”, but that also accounts for money you want to save. This is the money you have to do things outside of food, shelter, water, etc. Your budget should consist of 2 major things; money to save and money to spend.

It is important to realize what percentage of your money goes where. The best way to make a budget is to break it down into months. X% is devoted to categories like bills, food, restaurants, etc.. Let’s take $4,000/month of income for example

  • 40%: $1,600 in monthly bills (water, loans, mortgage, rent, comedy, internet, cellphone, etc..)
  • 15%: $600 on groceries
  • 25%: $1,000 saving
  • 10%: $400 extra
  • 10%: $400 eating out/leasure

Starting with just breaking down to the major categories gives you an idea of how much money it actually costs to live and how much you really make. Once you have the fundamentals of the budget you can then add other categories like goals, so managing your finances is easier. Once you have a budget you can safely save and spend. It’s about understanding your money not how much money, at least in the beginning. 

Saving and Paying off debt

The biggest and most inconvenient things about being an adult are saving for the now, saving for the future, and paying off debt. The best way to battle debt is to not get in it in the first place. 

The number one rule with paying off debt is to pay the high interest off the quickest because that’s the one that is charging you the most for borrowing. Another good step in managing your finances would be to pay your credit off in full if you have the chance to instead of just adhering to the monthly payments. It is also good to use your leftover income to get used on the loans, trying to make a higher than your regular/minimal monthly payments because you’ll pay it off quicker.  

When it comes to credit cards you should use them like a debit card. Only spend money you have, not money you will have. The majority of the time it is more beneficial to use your credit card so you can earn points and build your credit. Most debit cards don/t offer any perks. 

It is good to save outside of your 401k, most employers over a 401k plan which makes it very simple. You should still have a savings account as your savings for the short term. In your savings, you should also have an emergency fund with at least 3 months worth of living expenses.

Understand your credit score

Your credit score is a three-digit number that can have a big impact on your finances. Lenders are willing to offer borrowers with high credit scores better loan terms and lower interest rates.

As you apply for large loans such as a mortgage, a small interest rate reduction can save you thousands of dollars. Credit scores generally range from 300 to 850

What Factors Impact Your Credit Score?

  • Pay your bills on time, every time.
  • Pay off your debts as quickly as you can.
  • Keep your credit card balance well below the limit.
  • Applying for multiple credit cards
What Is the Future of Medicine & Health Technologies in 25 Years?

What Is the Future of Medicine & Health Technologies in 25 Years?

What Is the Future of Medicine & Health Technologies in 25 Years?

What is the future of medicine in our country? For many years, science and technology have evolved almost hand in hand. So what should we expect in the next 25 years?

Universal Health Coverage in the U.S.

  • Nearly 92 percent of the population was estimated to have coverage in 2018, leaving 27.5 million people, or 8.5 percent of the population, uninsured. Medicare ensures a universal right to health care for persons age 65 and older.
  • Ensuring that all people in the United States have affordable health care coverage that provides a defined set of essential health benefits (EHB) is necessary in order to move toward a healthier and more productive society.

Patient Empowerment Due to the Tech Revolution

  • From the patients’ side, the advancement of technology is the result of the ‘e-patient’ – where the ‘e’ stands for ‘electronic, empowered, or engaged. 
  • A patient who takes responsibility for their health, and actively engages in shaping their future. This can possibly lead to an equal level partnership between physicians and patients with shared decision-making and the democratization of care.

Brain-computer Interfaces Bring Hope for the Paralyzed

The modernization of healthcare is coming to a whole lot of progress. Brain implants can now be used to help treat conditions like depression and many others.

  • Imagine creating a Brain-computer interface (BCI) like a retinal chip giving you perfect eyesight or the ability to see in the dark, a cochlear implant granting you perfect hearing, or a memory chip bestowing you with almost limitless memory. What if you could type into a computer with only your thoughts or control your entire smart house by sending out the necessary brainwaves? 
  • The first neuroprosthetics is already on the market: you can purchase cochlear implants, and retinal implants – the latter was approved by the FDA in 2013. Moreover, implants for people with Parkinson’s disease send electrical pulses deep into the brain, activating some of the pathways involved in motor control. 

3D Printing Drugs

  • If the entire house can be 3D printed, why wouldn’t 3D printed drugs be a surprise? In 2015 University of College of London experimented with 3D printing drugs in odd shapes; such as dinosaurs or octopuses, in order to make it easier for kids to take pills. 
  • In August 2015, the FDA approved an epilepsy drug called Spritam which is made by 3D printers. It prints out the powdered drug layer by layer to make it dissolve faster than average pills. 

Do new technologies potentially bring new diseases?

  • New types of diseases might appear due to the excessive use of virtual reality solutions, video consoles or smartphones. Examples include virtual post-traumatic stress disorder (v-PTSD), which might be the diagnosis for gamers who participate in large virtual battles wearing VR masks (such as Call of Duty) and experience similar symptoms as those soldiers who fought in real wars.
  • Video-game epilepsy has been well documented, where games provoke a higher likelihood of seizures than standard television programs.

Artificial food will bring hope against food shortages?

  • Researchers of the Cultured Beef Project remove muscle cells from the shoulder of a cow and feed the cells with a nutrient mix in a Petri dish, and then they grow into muscle tissue. From a few starter cells, one can derive tons of meat. 
  • Bill Gates advocated for citizens of the richest countries in the world to switch to diets consisting entirely of what he called synthetic meat in an effort to curb greenhouse gas emissions.
  • Total U.S Greenhouse Gas Emissions by economic sector in 2019
    • Transportation (29%) – Greenhouse gas emissions from transportation primarily come from burning fossil fuels for our cars, trucks, ships, trains, and planes. Over 90 percent of the fuel used for transportation is petroleum-based, which includes primarily gasoline and diesel.
    • Electricity production (25%) – Approximately 62 percent of our electricity comes from burning fossil fuels, mostly coal and natural gas.
    • Industry (23%) – Greenhouse gas emissions from industry primarily come from burning fossil fuels for energy, as well as greenhouse gas emissions from certain chemical reactions necessary to produce goods from raw materials.
    • Commercial and residential (13%) – Greenhouse gas emissions from businesses and homes arise primarily from fossil fuels burned for heat, the use of certain products that contain greenhouse gases, and the handling of waste.
    • Agriculture (10%) – Greenhouse gas emissions from agriculture come from livestock such as cows, agricultural soils, and rice production [1].
  • Emission trend – In 2019, U.S. greenhouse gas emissions decreased compared to 2018 levels.

The Merger of Wearable Manufacturers and Health Insurance Companies

  • In November 2017, Qualcomm and United Healthcare announced that they have integrated Samsung and Garmin wearables into their national wellness program. It enables eligible plan participants to earn more than $1,000 per year by meeting daily walking goals. 
  • Could this motivate people into desired behavior such as a healthy way of life? Could this increase premiums for high-risk patients or reduce their business risks by alerting patients about bad lifestyle choices? What will happen to the patients’ private data? Should we prepare for Dr. Big Brother? How will the relationship between employers, employees, and health insurance companies change in the light of easily obtainable personal fitness and health data? 

John Nkengasong

Director, Africa Centres for Disease Control and Prevention

  • Population-wise, Africa is the continent of the future. By 2050, it is estimated that its population will be 2.5 billion people. This means that one in every four persons in the world might be an African, with rapidly growing economies and a rising middle class.
  • Precision medicine will need to take center stage in a new public health order—whereby a more precise and targeted approach to screening, diagnosis, treatment, and, potentially, the cure is based on each patient’s unique genetic and biological make-up.
  • Based on the Africans Union’s Agenda 2063, goals include national strategies to improve healthcare. This includes genomic data policy and increase diagnostic capacity, and the creation of biobanks, such as H3Africa, that encompass both physical and bioinformatics facilities.

Is it possible for Amazon to run the world’s largest HMO?

HMO stands for health maintenance organization. HMOs have their own network of doctors, hospitals, and other healthcare providers who have agreed to accept payment at a certain level for any services they provide. This allows the HMO to keep costs in check for its members.

  • Amazon has confirmed that the services will be available nationwide starting the summer of 2021. An Amazon spokesperson confirmed that the service would be delivered through Care Medical, an independent private medical practice consisting of licensed clinicians with whom Amazon has contracted as Amazon Care’s clinical team.
  • This is the first time a big tech firm will be directly in the healthcare services business. Will it be another failed experiment or the breakthrough we’ve been waiting for?
  • Amazon care addresses two major emerging trends in healthcare delivery: telehealth and home-based care.
  • The future of healthcare in-home care and mobile care nurse
  • They can offer in-person treatments, exams, and medicine 
  • Delivering prescriptions 

Here’s our prediction for the next 25 years. Check out the full video here 👇

TIME STAMPS:

0:00 – Intro
0:35 – RV Trip Plans
1:20 – The Future of Medicine and Health Technologies in 25 Years
2:38 – More people will get health insurance
5:55 – Your health, your responsibility
9:10 – Brain computing interfaces
11:30 – 3D Printing Drugs
13:30 – Virtual Reality
15:50 – Artificial Food
18:35 – Merger of Wearable Manufacturers and Health Insurance Companies
23:23 – Amazon wants to develop their own HMO
26:00 – The future of treatments and exams
26:26 – It’s a wrap!

EP 105: How to Manage Your Finances with Allie Grotteland

When it comes to money, it can be hard to manage it sometimes, especially when you think that you will get paid any time soon. But as a nurse, how can you manage your finances like a pro?

In this episode, we would like to introduce you to our guest Allie Grotteland, who shares her expertise on how to manage your finances well. Allie is also a PICU nurse and owner and founder of the debt-free nurse LLC. She helps nurses pay off debt, and save money without sacrificing things they love. 

IG page: @the_debtfreenurse

The questions below are some we tackled on the show

  • How did you first become self-aware of investing?
  • How do you first start teaching people about money?
  • What is the mindset you should have about saving and investing? 
  • Is there any advice that you can share to start paying off debt? 
  • What is your best advice to start saving your life? 
  • How do you create financial goals?
  • How do you stop impulse spending? 
  • One of your goals is to retire a millionaire; what systems do you have in place to bring that to reality? 
  • Difference between Roth IRA vs. 401K? 
  • Tell us your experience with nurse bullying?