I’m a lurker in this list. However, your post compels me to say something. It seems to me that someone who is employed, as your husband is, should have access to medical insurance, which covers basic medical needs such as yearly checkups and dental cleanings. Dental hypogene is important for heart health. I would opt for taking him and yourself to counseling. At least that is seeing one medical practitioner, who may influence him when you can’t.
Someone who pays no attention to basic medical needs such as dental and yearly checkups at age 46 has, in the words of Ann Landers, “a geranium in his cranium”, and may end up in an early grave.
And since I’m going back to lurker status, I do want to say before returning to it that the recommendations of this list of Dave Ramsey’s books is a great one. If you haven’t already started reading his books, I would suggest you do and start applying his methods for controlling debt. I’m on baby step one.