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.
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.
Oh my.
Medicaid is the correct answer. Surprised more people aren’t mentioning it. It’s specifically in place to cover people with low incomes who often don’t have insurance through an employer.
Medicaid will often cover the cost of child birth for low-income people 100%.
That being said, if you have slightly higher income than allowed to enroll in Medicaid, your only option may be a long-term payment plan and lots of debt that you may carry for the rest of your life. It’s an awful system that really only benefits the strong.
Canada, don’t go down that road.
That’s pretty much how it works. Newborns qualify for Medicaid, and low income pregnant women generally do too.
I always wonder what would of happened to my son if I wasn’t Canadian. He was not growing properly in the womb which meant many doctors appointments and ultrasounds . And then he was born 3 months premature and spent 3 months in the NICU. I didn’t have to pay a cent for any of it .
Natural selection would have taken place if you were American
Are you familiar enough with the details to share them? Because this sounds strange to me - every plan has an out of pocket maximum and the highest I’ve seen is $14k. Are you including premiums? Do the costs span multiple years?
This was pre-Obamacare, and the birth alone - with c section - was $20k.
I’m not American so maybe I’m getting something wrong… But aren’t you making a faulty assumption about people having a plan at all? Isn’t the amount of completely uninsured in the us in the double digits or something?
The original commenter did mention they had health insurance
You’re correct, my bad
Isn’t the amount of completely uninsured in the us in the double digits or something?
No.
Plus in the comment she said she had insurance.
Have I personally avoided going to the hospital? Absofuckinglutely. Unless I’m in immediate danger of dying I’ll figure it out myself. I’ve superglued more than one nasty cut that probably needed stitches, entirely possible I’ve ignored more than one concussion. Is it smart? Unequivocally and resoundingly not. Do I do it anyway so I can pay my rent? Yep.
I wonder about the effects of having a low grade constant stressor like that. Combine that with at-will employment and gum prevalence and it’s surprising anyone is able to feel secure and get healthy.
Purely anecdotal, since I can only draw from my own personal pool, but I don’t have a single friend or colleague who feels even remotely secure in their life. We’re all one emergency away from bankruptcy.
I’m so sorry. I want more for my neighbours.
Again just a personal opinion but I’m loving the change I’ve been seeing lately. More people seem to be standing up for their fellow man and calling for things like universal healthcare. I’ve never seen this much unionization and union positive thinking in my life. I have hope that this attitude of radical individualism is going away and that people are going to pull together for the benefit of all people, not some.
I really hope you’re right. As a Dutch guy in the US it really baffled me how many Americans vote against their self interest only to then do a poor man’s version of social healthcare via GoFundMe when their luck inevitably runs out
In the US it baffles us as well. Though most Americans do actually want universal healthcare, anytime it comes up as an issue in the national conversation there is such massive propaganda against it, articles talking about things like ‘death panels’, hypothetical committees under more socialized healthcare systems that will decide who lives and dies, or that you’d have to wait hours at the ER. Ridiculous things like that. It’s seen as a ‘left’ issue, if you are on the right or conservative in the US you won’t be as likely to support universal healthcare, which does align with one right-wing view of ‘poor people should die more’.
The effects of having low grade stressor like that, combined with non-federal sick leave nor vacation and predatory corporate labor laws are what you witness in the US every day. Precipitously declining mental health for everyone, reduced social and coping skills. Commonplace violence and rage and incredible rates of anxiety and depression and resultant medication.
I whole heartedly agree… We should ban all gum… Big chew included 😋/s
Lol I just noticed that. Imma leave it. It’s better this way.
I wonder about the effects of having a low grade constant stressor like that.
Heart disease like irregular heartbeat and stroke. Gastrointestinal problems such as ulcers and IBS. Increased susceptibility to illness. Ability to learn/memorize/perceive are reduced. Not to mention the effects of maladaptive coping mechanisms such as drinking, smoking, drugs etc.
Many disorders originate from stress, especially if the stress is severe and prolonged. The medical community needs to have a greater appreciation for the significant role that stress may play in various diseases and then treat the patient accordingly using both pharmacological (medications and/or nutraceuticals) and non-pharmacological (change in lifestyle, daily exercise, healthy nutrition, and stress reduction programs) therapeutic interventions.
I make good money and have reasonable health insurance. However, I grew up super poor. So I only use health insurance in life or death circumstances.
I don’t want to be poor again.
Definitely same.
For our northern cousins, an illustrative story. I was attacked by a dog and with my arm and leg bleeding everywhere my first call was to my wife to get her to come pick me up because I knew an ambulance would be insanely expensive, and my second call was to insurance to find out if I could go to the hospital instead of urgent care. They sent me to urgent care, where they told me it was the worst attack they’d ever seen that wasn’t on the face.
The kicker is that I even have GOOD insurance, but that’s the reality of not knowing if it’s gonna bankrupt you or be covered or not: hesitation. That’s the reality of having years of habit-forming second-guessing when you had bad insurance, or when with good insurance and a tight budget. Imagine what is like for people with bad or no insurance.
Are you sure you don’t qualify for Medicaid or other public assistance?
Yep. I make ok money and have insurance. Things being what they are, rent has skyrocketed over the past couple years. Food seems to be coming down in price but for a while there it was pretty alarming. I haven’t had a significant raise in about 3 years to keep up with cost of living increases. Choices must be made and if life and limb aren’t in immediate danger, I choose to not have a bill of several thousand dollars for something like a few stitches and/or fight with my insurance company over coverage.
My housemate lost his awesome mom when he was like, 10, because of that. She refused to go to the hospital because she couldn’t afford it, and it got infected. Fuck this country.
This doesn’t answer OPs questions at all. Medicaid is available for expecting families that covers the cost of prenatal, birthing, and postnatal services.
I can answer this: my son was born in 1990. We were extremely poor.
We had midwives help us out as best they could, to the tune of about $3200 at the time. The birth got complicated due to a variety of health factors, and both my son and wife almost died (not because of the midwives). Luckily the midwives had a direct line to Georgetown Hospital, and the cesarean was done there. The total hospital bill was $58,000, or $138k in today’s money, although hospital costs have rose much higher vs inflation, so maybe it would be in the $200k range now. She was in the ICU for a week, hospital for another week, our son for about 3 weeks.
My wife job didn’t have health insurance, because it wasn’t required back then. Because she was gone a week, her job fired her for an unexcused absence. Oddly enough, this made her unemployed and Washington DC had some law (or rule or something) that immediately dropped the hospital bills because of her unemployment. In the end, we had to pay $15k to about two dozen practices who individually sued us, which took 7 years to pay off and a lot of court visits and wage garnishments. It financially ruined us, pretty much. Both suffered a lot afterwards because we just couldn’t afford minimal care. It was hellish. I can’t imagine how much worse it would be today. We got evicted from our apartment, and lived in government housing for six years.
So, yeah. Don’t have a baby in America unless you can guarantee it will be healthy and you have a lot of money. Most of my friends don’t have kids, they simply can’t afford it and look at it like the previous generation looked at concepts like summer homes and yachts. Nice luxuries, but way out of affordabilty.
Wow. That’s horrible. The US health system sounds like a dystopian nightmare.
And yet so many Canadians seem to want to dive head first in to a fully private healthcare system as if anyone could take that financial hit.
It doesn’t help that many of the governing bodies are deliberately sabotaging it as much as possible in order to push voters into that direction. Doug Ford is one of the most notorious in this respect, but there are plenty of others too
meh Cannucks tend to adopt the worst of everything they see
You spelled Canucks wrong and your broad generalization is insulting to millions of people, especially since the majority of us are smarter than that.
Canned ducks?
Yes.
I’m sorry you and your family had to go through that.
I’m Canadian and I gladly pay more taxes than you so that I and my friends get free healthcare when we need it.
When we watched the fights over “Obamacare” we just shook our heads.
That’s the ridiculous thing. Americans would rather pay a few dollars less in taxes than let people have free healthcare. And it ends up costing them far more than they would have paid in taxes.
I’m Canadian and I gladly pay more taxes than you so that I and my friends get free healthcare when we need it.
Here’s the thing. I worked in America for the better part of a decade and I had to submit two tax forms, one to each country. You end up paying the greater of the two and using it to offset the other.
What I know is this: every year, every year, I paid an extra 1% to America. No matter how my (binational) tax guys worked it, my obligation to America was always higher.
The year after I came home I still had to submit taxes (January layoff scares so I moved back) and it was still higher for America despite sitting in a different country (it’s a factor) and using different services. It didn’t matter.
In Canada I pay 1% lower income tax and enjoy healthcare access. While they’ve done away with the regional premiums, I was even okay paying that; as my yearly outlay, proudly at the top bracket, was still less than copays while in America. I would gladly pay the same premium to ensure equal access to dental and optical care for me and especially people who can’t drop (now) c$1000 on some specs or way more on a dental crown.
It’s not that I’m a good guy, but I pay taxes for schools because I don’t want to live around dumb people. I do and will pay taxes so we can take people who aren’t healthy and skilled and contributing income tax and make them so they are. Poverty should be no excuse for not being employable.
Man… That is crazy. I’m so sorry for you guys.
What the actual fuck, and this was in 1990
1990 was around the time of Hillary-care and Romney-care, so the politicians knew that they were going to have to fix it sooner or later by that point.
Hillary’s plan was being developed and debated in '93-94, Romneycare in Massachusetts happened in 2006.
… “So, yeah. Don’t have a baby in America…”
for more on this subject, and in the spirit of looking on the bright side of s bad situation, see /c/childfree and childfree.cc. Includes talk, and memes, about some of the benefits, of not having children, including but not limited to finances. (also advice and directories about related options for medical things, where thise are wanted or needed).
Why didn’t you have taxpayer paid (State) insurance if you were extremely poor and expecting? Is it because of the lost job and timing? If you are poor and have a family then you can spend a day at the welfare office and get public insurance.
Because we made too much (over minimum wage, dual income household). I was making $13k as a sales manager, my wife was making $8k as an assistant manager, and minimum wage was $3.35/hr or just under $7k/year back then. After taxes, we made about $1200/mo, and our rent was $650 for a single bedroom apartment. No car, we took the bus, barely had enough for food and utilities.
But we were considered way too over the “poverty line,” which was I think less than $6k/year then. We had been using birth control but when they say some form of birth control is 99% effective, the DO mean 1% failed. I have no regrets our son was born, because it turned out we couldn’t have kids later when we tried. And then later my wife died when he was 22, so if we had kids later, I would have been a widow with younger kids.
I feel awful he grew up poor with us until he was about 10, though.
Oof, yeah that’s rough. The poverty line is really low. I can relate about wishing you weren’t poor when your kid was a kid, we had the same experience. We would have been able to give him a lot more had he been born a decade later, but he still had a loving home, which is more than a lot of kids get.
I’m really sorry to hear about your wife. I can’t even imagine.
Ah… In short… Insurance covers a portion of it and whatever insurance doesn’t pay, I just… Simply don’t pay it. It goes to collections and they spam call me and I don’t answer my phone. Suddenly they give up and after 7 years, it’s gone. Is it right? I don’t know. I definitely haven’t devoted half of my paycheck to medical bills though.
Does that bork your credit?
Yes it does
That seems like an unfair and inescapable conundrum.
“Should’ve thought of that before you had kids while poor” -Republicans
“if you thought about it though and decided not to, too bad, we’ve decided for you that you must go through with it”
-Also Republicans
“And this is our plan to have a steady supply of impoverished, under educated people to make into wage slaves, military killbots, and to bolster the for-profit prison system!”
Once I got some physical therapy bills sent to collections. It wasn’t because I failed to pay. The practice was really shitty about billing and record keeping and never billed me for a bunch of visits. They went under and sent their records over to collections.
The collectors called me and pretty much opened with “this place went out of business. We would settle for pretty much anything. How about 10% of what you owe?”
They get a percentage of everything they collect so you might think they’d go for the full amount. But I think the game is sometimes just “what can we get easily and quickly.”
Simply.
They don’t pay the hospital bills.
Wait for them to repo the baby…
Do people ever avoid hospital visits
At least in my experience, we’ll generally be able to go to the hospital
Do hospitals put people on a payment plan
Generally, I’ve just seen the debt transferred to a debt collection agency afterwards, since there’s no money for them to take. They’ll harass you, and it affects your credit score, but they can’t send you to jail
Would a hospital ever refuse you care if you have outstanding bills or hospital bills with collections?
It’s illegal in the Emergency Room. Anywhere else they can. Poor people end up relying on Emergency care, ignoring bills, and the hospitals write it off as “charity care,” which helps them justify their non-profit status, when they’re non-profits
Depends on the severity of the issue.
For a life threatening emergency, no
For like pain relief, yes
The hospital must stabilize you and save your life from immediate danger. They don’t have to make you better or solve the problem.
If you are poor enough you can qualify for Medicaid (MediCal in California) which is a sort of limited health insurance. This is life saving for poorer families and most of the time completely covers birth costs. After birth in some states they even offer follow up plans from nurses for assistance with food and meal plans for babies and toddlers.
Even if you don’t qualify you can apply for financial aid which I believe is required to be offered in every public hospital even to people whether citizens or not. If not you can just take on the debt and not pay, which destroys your credit score but after long enough you might be offered a favorable financing or a discount… Only after being harassed by collections for months if not years.
Source: not American but I’ve worked with American healthcare workers interpreting for Spanish.
Also to clarify saying if you’re poor enough makes it seem like it’s a high bar, but iirc ~35% of people are on Medicare/Medicaid
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I just explained this before seeing your post. There’s a lot of America bashing in this thread with completely inaccurate information. I was relatively poor when my son was born and we were on public insurance. Everything was paid for. It was actually a pretty good overall experience. Now that I’m making a lot more money I don’t complain at all about taxes, since I know that at least some of it goes towards invaluable services like this.
Came here to explain this.
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 man you joke, but don’t give them any ideas.
Arkansas has upvoted your comment and taken notes.
Ohio awaits program completion and results to “improve” on it.
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.
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If you have a masters and 20 years of experience, you’re pretty much guaranteed to have a job that has the health insurance to pay for all of that. If you don’t, then you need a new job
If they’ve got a masters and 20 years of experience they’re either a genius or almost 50 years old. Children are already a huge commitment, being older makes it that much harder
I have 15 years of experience in software engineering, but that’s only because I started when I was 12. Experience is experience. Now, if they meant professional experience that’s a bit different
Generally it’d be professional experience.
Health insurance still leaves you with a large bill. Expect like $10k for the hospital part for a lot of insurances. Don’t forget the obgyn visits throughout the pregnancy (probably only $25-$75 per visit, depending on if you need a specialist). Labs are extra. In fact, the one that really tells a lot of info (lots of recessive gene issues can be found with it) is like a $750 lab that insurance doesn’t usually pay for (“it’s too new, and not required”).
I have 2 children. Insurance covered almost everything. The out of pocket expenses for the hospital were something like $700, not thousands. For doctor’s visits it was just the $20 co-pay for each visit, and all the labs were fully covered.
Good insurance! Our child born this year the hospital bill looks like around $8k after insurance, but we keep getting other bills from the provider’s offices so it’s hard to say exactly. Fortunately my wife has a secondary insurance of some sort we can submit the $8k to get that knocked down to hopefully $4k. If it works. It’s been months trying to get it sorted.
This year? Check out the no surprise bill (federal). Those extra bills might not be legal
I had an 8k bill for a TIA I had last year. It’s a lot of money, but if you have a job that will cover most of your hospital bills, you can probably pay for it without drowning
To be clear, I’m not saying it’s a good system
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Sure, maybe the hospital bills but raising 3 kids and going on vacations every year? You’re talking multi million dollar salary to be able to afford all of that on one income in SoCal of all places
Then… Don’t live in SoCal?
Leave California and this all becomes possible with your salary.
I live in SoCal and love it, and do not intend to have kids, but it really seems like you’d be struggling to raise 3 kids around here on less than $150k (2 cars, rent/mortgage, etc).
Obviously many people manage it somehow, but it must be incredibly stressful. I have no idea how most of them do it.
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Was poor, had a baby at 20. $6,000 hospital bill we paid in monthly installments of like $100
Paid off my kid being born when she was like 6 or 7 lol. Kind of like a car
Some people give birth in their own homes like in medival times. I know people who have done it. In my opinion people shouldn’t be having kids if society is so broken you have to do stuff like this but to each their own.
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There’s nothing wrong with it. Thats what midwives are for.
Until it goes wrong.
We opted to have our second at home in a birthing pool, it was amazing! Mum and baby were monitored way more than when we were in the hospital with our first, and we could just recover and relax in our own home after. No stressing about having to get to the hospital etc.
Vaginally
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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
To clarify, currently around ~40% of Americans have government funded insurance.
5% increase since your other comment?
My other comment was just Medicare/Medicaid. There’s also VA, and insurance for federal employees.
… which is not to say that it’s free or even affordable (despite the name), or that residents in every state have equal access, or that the government is providing the plan. The ACA is a subsidy that slightly reduces the cost of private insurance, provided that you’re poor enough to qualify and that your state chooses to accept the federal government’s help beyond a certain threshold.
Mine were born at home with a midwife who did sliding scale pricing (charged based on your income). Only available to low risk women who lived close to the hospital though.
If you are quite poor, Medicaid will cover pregnancy and hospital birth expenses, even if you don’t otherwise qualify. I know someone who did that and said the nurse yelled at her because she wasn’t married.
