I’m Canadian. And I’m already sorry for asking an ignorant question.
I know you have to pay for hospital visits in the states. I know lower economic status can come with lower access to birth control and sex education. But then, how do they afford to give birth? Do people ever avoid hospital visits because they don’t feel like they can’t afford it?
Do hospitals put people on a payment plan? Is it possible to give birth and not pay if you don’t have the means? How does it work in the states?
How does it all work?
Again. Canadian. And sorry.
The number one reason for bankruptcy in the USA is due to medical debt.
We just go into debt, is your answer.
As far as I know, Hospitals are not allowed to refuse you care; no matter what your finances are, they have to help you. Many people would go to ER for non-ER reasons because it was/is the only way for them to get treatment. (Because other medical centers can refuse you.)
The hospitals will try to get the money from you however they can and they do offer payment plans based on income. Ultimately, though, due many? The debt gets discharged to a debt collection agency that harasses you incessantly for 7 years until it gets discharged from your record.
It destroys your credit (an arbitrary number that every citizen has that supposedly shows how trustworthy they are and how much they are likely to pay you if you loan them money) until it drops off after the statute of limitations (7-10 years, depending on the state).
My sister was on welfare and had a kid around the same time as me. Hers was covered completely by Medicaid.
Mine, because I had a job and health insurance, cost me $20,000. Didn’t finish paying for the kid until her 2nd birthday.
That’s pretty much how it works. Newborns qualify for Medicaid, and low income pregnant women generally do too.
My son was premature and racked up 14 days in the NICU. The hospital (which is ‘legally a charity’ billed $250,000.00. We were low-income with no employer-provided medical insurance, so the state Medicare provider got to pay a reduced rate of that.
Healthcare in the US generally screws the middle, not the poor, even then it’s the lower middle. The poor qualify for Medicaid which generally pays for anything major and basic healthcare, though options may be limited. The old get Medicare which covers pretty much everything outside a nursing home for fairly little out of pocket. The middle and upper class generally has decent insurance that isn’t crazy expensive to have and doesn’t have a ton of out of pocket costs provided by an employer.
It’s the people with high deductible plans that can’t or won’t contribute to an hsa, and those that don’t have employer provided healthcare that really get screwed.
Idk where your coming from but as someone who had $12k in an HSA and employer medical that’s bs.
I went to the eye doctor and needed glasses. Tried using my HSA. Nope. Not an approved medical expense. Tried paying a copay at the er. Nope not an approved medical expense. Wife got a kidney stone removed via surgery. Wanted to pay coinsurance. Nope not an approved medical expense. I needed a cpap for my sleep apnea. Nope not an approved medical expense. Year rolled over and all that money disappeared. I asked where it went and was told I either used it or lost it. So I got rid of it. Fucking garbage.
As for the employer coverage, we had a zero dollar deductible plan. My wife gave birth last year. Ambulance ride from her work? Nope, not necessary. All the gyno visits? Nope, not necessary. The ER visit when she slipped and fell at 6 months? Nope, not necessary. The 2 week hospital stay when she went preeclamptic? Nope, not necessary. The delivery? Nope, not necessary. The NICU stay for our premature daughter? Nope, not necessary.
I payed $1700 per PAY for my health insurance and they didn’t cover a cent from our entire family last year. We racked up over $70k in medical debt. Our MOOP was $5k/$10k and they said none of it applied.
Hospital sent it to collections because we couldn’t fit their minimum payment of $9k/mth (fuck duke lifepoint but this is an insurance rant). We complained to the pa board of health insurance and were advised to get a lawyer but no lawyer would take it. They said it would be years to get anything back, let alone the full amount.
We ended up proving that my employer doesn’t offer comprehensive insurance. The main component is covering pre and post natal care which they claim to, but they deny every time. So now we have insurance through penni for $60/mth with government help. Oh and we went through bankruptcy to get rid of the collections debt.
Fuck Cigna, fuck duke lifepoint, fuck insurance, fuck for profit healthcare, fuck the American healthcare system.
Those are definitely all HSA things, and something I use mine for all the time. Dunno how it worked for you but I basically just have a debit card I can use that has my HSA balance on it. Functions like any other card.
I mean yeah fuck insurance but everyone of those things you listed is definitely covered by HSA. I use my HSA every year for glasses, hospital bills and doctors appointments. also it sounds like you had an FSA since you lost what you didn’t spend. HSA has rollover. But all those expenses you listed are also eligible for FSA.
I left one job and went to another. There was a 3 month gap where I had no health insurance, didn’t qualify right away at the new job. Got an infection that required a two week round of antibiotics.
The cost without insurance was a little over $2000. My COBRA coverage was $600+ and a couple dollars with insurance for the anti biotics. I felt lucky to only have to spend the $600+ to enact COBRA coverage and that it happened in the first month so I could only pay once and drop it.
I haven’t looked too deep into it because I don’t plan on having children, but it’s probably cheaper to have the kid at home. I’ve met a couple people who opted for the home birth and they were glad they did.
(I’ve also just personally always thought giving birth in the bath with water would be the way to go if I ever did it. Feelings that it might be easier for baby to be born into water and not directly into cold air after being in the warm amniotic fluid so long.)
The average out-of-pocket payment is under 3k.
As a poor Florida resident who grew up and has known several people giving birth in poverty; if you’re lucky you qualify for WIC (women, infants, and children) which is essentially food stamps/ welfare for pregnant women and mothers. That covers food. If you qualify for WIC then you’re also eligible for Medicaid which is the US’ version of free* healthcare for people in poverty. That will cover pre and post natal care for the mother and baby. The baby is usually covered until they’re ~6. Unless you’re still poor by then, in which case it usually covers the child to adulthood or until their parents no longer qualify for Medicaid. Note that none of this covers diapers, clothes, or other necessities for the infant. Just food and drs visits. If you’re poor, but on the [benefits cliff](https://www.ncsl.org/human-services/introduction-to-benefits-cliffs-and-public-assistance-programs#:~:text=Benefits cliffs (the “cliff effect,a small increase in earnings.) you can get fucked lol. Murica
American hospitals cannot legally refuse to treat you even if they know you can’t pay/don’t have insurance. So worst case scenario is you go and have whatever done and they bill you and you don’t pay and it’s a write off for the hospital.
Often times, if you can’t pay they will offer a reduced amount to at least get something out of you if they know they won’t get anything otherwise.
Fucking crooks
People are thinking you mean the poor people, not the hospitals.
I’m just laughing at the absurdity of someone calling poor people who can’t afford their medical bills “fucking crooks” but that actually is a position I wouldn’t surprised to see these days.
Unfortunately, yeah, it’s very common in the south, so I’m used to seeing it :(
Even in the more ‘blue’ cities down here, it’s usually safer to assume that whoever you’re talking to is a republican piece of shit, or else has holdover ideas (like ‘the poor don’t deserve handouts’) from being raised that way.
It’s very expensive to be poor.
Bathtub. Car. Alleyway. Crippling debt that, while shouldn’t be impactful on credit score, will still follow you for your lifetime.
Vaginally
Exactly, the little bastard is going to claw their way out one way or another. Usually.
Once there’s a kid in the equation then it’s pretty easy to get on state paid insurance. It’s even easier now with so called Obamacare in the equation (Affordable Care Act). If you qualify, then you’ll have free neonatal care, free gyno visits, and free delivery and hospital services. It’s not great insurance, like you’ll be at the community hospital and not some swanky private birthing center, but it’s not bad either. Medi-Cal, the California state insurance is actually pretty good for child care and birthing services. They pay for hearing aids too, which only 3% of private insurances pay for. So medical care when you’re poor and have a kid is decent in the States. Now that there’s Obamacare it’s decent even without a kid. Where it falls short is if you’re under-insured as a middle class citizen, and it’s pretty easy to be uninsured, even with expensive plans.
They send the infant to debtors prison to begin working off the $70,000 hospital bill. They don’t have to pay the infant minimum wage though, and they charge them for room and board and meals, so by the time they’re 18 they are actually indebted to the hospital an average of 1.4 million dollars, which they will then begin working off as adults earning minimum wage.
I know you’re joking, but Im pretty sure that there was a supreme court case that made debtors prison a thing of the past.
Might want to take a look at this then.
EDITED TO ADD: While court cases involving “debtors prison” exist, NONE of them have “made debtors prison a thing of the past” in the US because imprisonment for private debt is very much alive and well today in 2023. Given that a person imprisoned over debt is unlikely to sue unless an organization such as ACLU takes on the case, and even more unlikely to win in courts that are dominated by commercial interests and partisan judges, it’s only going to get worse, not better. Going by the above linked articles that is exactly how it’s working out right now. Trying to prove that this horrific problem of criminalizing poverty does not exist today by pointing to a single 1983 lawsuit and going, “See! I told you!” is just completely privileged assholery.
me and my two brothers were at home births
why is no one else mentioning home birth??
