11 ms·
> Google tells me that the most common reason for hospitalization in the US is childbirth. Thankfully, here in San Francisco, that would only set me back $15,00
by jstanley 8y ago
> Google tells me that the most common reason for hospitalization in the US is childbirth. Thankfully, here in San Francisco, that would only set me back $15,000
Surely this is not true?
Does having kids just bankrupt ordinary people in the US or what?
I'm not asking about exceptional cases, like what is the normal way of dealing with having to pay $15,000 just to have a baby climb out of your body, when I'm assuming most people don't have that much money?
- patrickg_zill 8y agoEven with a good health care package, a friend paid $10 thousand dollars (his maximum deductible) for the first year of one of his children, due to infant allergies.
- kasey_junk 8y agoThat is not what most people consider a 'good' health care package. That would be considered a 'high deductible' plan. When people talk about 'good' health care plans in the US they tend to think of traditional low deductible PPO. Those tend to have family deductibles in the $500-1k range. Though the employee premium differences might add up to more than 10K in the face of a 'good' health care plan so its largely not relevant to the argument about health care costs in a nation vs nation way (though you'd want to include tax burden for health insurance in that case).
- nradov 8y agoThere's no real correlation between the "goodness" of an insurance plan and its deductible. In the end all that really matters is the quality of care you receive and how much you have to pay for it. Many employers offer high deductible plans but also contribute into the employee's HSA which can be used to pay deductibles. In theory that incentivizes the employee to shop around and get the best possible deal on care.
- kasey_junk 8y agoAgreed but in this anecdote what do you think would happen in that case? I’d guess the person would complain about the deductible even though in real terms it might be cheaper than premiums on a low deductible plan.
- TomMarius 8y agoIt costs around the same in Europe if you don't have insurance. I'm pretty sure it's the same in the USA - this is the rate that would be charged to your insurance company. Rates are way lower for uninsured people if you ask them and tell them that you're not insured (I got a bill lowered 10 times when I broke my hand); and of course most people have some kind of insurance. To the people downvoting: please read properly. If you move your place of residence outside your country, you're no longer insured, and that's what I'm talking about - I specifically said "if you don't have insurance".
- ludoo 8y agoActually in Italy you don't pay a dime, unless you want to. The level of care you get varies by region, but is generally pretty good, especially for regular, mass events like birth.
- BeniBoy 8y agoSame in France. Standard care is free, extra can be taken care of by your private insurance.
- cronz 8y agoHaha, what? Childbirth costs 0 € in a public hospital
- feistypharit 8y agoIf it's not the birth itself, it doesn't stop there. No protected time off, expensive, subpar childcare options, long work hours if you want to advance your career. One way or another, you are punished for having kids. Unless you're really rich. It's now more of a status symbol amongst the rich. "Oh you have 5 kids? Two nannies, a cook too. That's the life!".
- chrisco255 8y agoAssuming you don't have healthcare insurance, which 90% of Americans do, it would set you back around $3000, according to: https://www.parents.com/pregnancy/considering-baby/financing-family/what-to-expect-hospital-birth-costs/ https://www.parents.com/pregnancy/considering-baby/financing...
- gambiting 8y agoBut if I understand it correctly, for some unfathomable reason American health insurance policies usually have a deductible on them - so even if you are insured, you could still be paying few thousand dollars out of your pocket, no? That's insane.
- vinay427 8y agoLots of insurance plans in other industries have deductibles in other countries, and the US certainly isn't unique in this respect. For example, deductibles are the norm in health insurance plans in Switzerland, which has a system not all that different from that in the US.
- snovv_crash 8y agoIn Switzerland the deductible is annual, not per visit. Once you hit that cap, everything is free (except voluntary cosmetic stuff). Thus, insurance actually acts like insurance, like car insurance or fire insurance, there to catch you in a bad situation, not to give you discounts on your day-to-day expenses.
- s3nnyy 8y agoIt's not like this in the US? In Switzerland there is a deductible for adults but everything connected to pregnancy and child-birth is deductible-free. Also, kids below 18 yrs old have mandatory insurance that is has no deductible, thus treatments for them are free.
- 8y ago
- cowsandmilk 8y agoHealth insurance will cover much of it, but more importantly Northern California is overpriced for medical procedures. Boston is $5,000 less and has equally good hospitals. And St. Louis is down at $6,000 and has really good hospitals as well. I had a friend who got an appendectomy at Stanford that was paid for by Google (she was on business travel, works in the London office) and the price was obscene, far above what should ever be charged, literally 10x what other hospitals charge. That place is crazy.
- lotsofpulp 8y agoIt’s not overpriced if there is no monopoly. No one is stopping other providers from moving to Northern California and stealing business by offering lower prices. If people want to live in a place with great weather, outdoors, food, and career opportunities, then they have to compete for it because lots of other people do too, and hence they have to compete to purchase things like homes and service from healthcare providers.
- mikeash 8y agoNothing is stopping them, other than people not shopping medical procedures based on price, partly due to a complete lack of price transparency. Maybe you could move in and set up a maternity ward and advertise it as “only $10,000!” And then people will ask what the competition charges and you won’t be able to answer. They won’t be able to answer.
- lotsofpulp 8y agoI would hope it’s common knowledge nowadays, at least amongst the educated, that you should call your insurance or check their website for in network providers. I can call mine and find out how much certain procedures or codes cost, and if it’s not an exact amount, they can usually give a pretty good estimate. Also, I would expect any service to cost 50% more in the Bay Area.
- mikeash 8y ago
- nelsonic 8y agoThere's a reason for the saying: "The Rich get Richer and the Poor get Children". Perversely having children is a "luxury" many people simply cannot afford. The happiness a "bundle of joy" should bring to the family is often replaced by additional stress of having to work a "better paying" (but often soul-destroying) job to be able to afford the bigger house, school/education, extra curricular activities like sports/music/ballet and eventually college tuition. Conrad Bastable's well-researched post could easily have concluded that having kids "too early" will bankrupt a family. The solution/answer is affordable housing. Housing is the single biggest "expense" for all people/families. Which is why it's the problem I want to tackle personally: https://github.com/dwyl/home https://github.com/dwyl/home The fact that merely giving birth to a child in SF is $15k is mind-boggling. The "Government" needs to fix that or risk population decline catastrophe which will have many knock-on effects! SF should follow the model from Finland where young parents/mothers are given cash incentives and all FREE healthcare: https://www.kela.fi/web/en/families https://www.kela.fi/web/en/families
- expertentipp 8y ago> The fact that merely giving birth to a child in SF is $15k is mind-boggling. The "Government" needs to fix that or risk population decline catastrophe which will have many knock-on effects! The fertility and associated problems of local population can be completely ignored by the government of country like US - country with low population density, predictable steady population growth, and always a large group of people around the world willing to immigrate into the country. If not you, it's going to be someone else.
- berberous 8y agoApologies if this unsolicited advice comes off as rude, but consider easing up on the italicizing and "quoting" of random words. It makes your writing style hard to read and waters down the effect when you do each once per paragraph.
- SmallDeadGuy 8y agoI completely agree. To me, 9 formatting changes in a single sentence, e.g. in the second sentence of that GitHub repo readme, is incredibly excessive. While the comment you replied to isn't nearly as extreme, it still has a similar issue of too many formatting changes per paragraph.
- blihp 8y agoOur medical costs are so out of control it's not funny. Many years ago (i.e. last century) you'd go to the doctor and either they'd treat you on the spot or possibly prescribe something for most common ailments. And if that didn't work, you'd go back and then they'd run some tests and/or send you to a specialist. Today you go to your doctor, who most likely refers you to a specialist, who orders tests from a lab (of course each step racks up costs)... then maybe you get your prescription. Didn't work? Rinse and repeat with a more specialized specialist. Part of it is CYA to protect from liability, part of it is just the health care industry growing out of control.
- Joeri 8y agoMaybe the problem is insurance networks. This incentivizes doctors and hospitals to play by the rules of high-revenue / high-payout insurance providers, whose revenues are high because of those rules.
- lotsofpulp 8y agoNot really, since people would switch to other health insurance providers who have lower premiums. The problem was not forcing everyone into the same insurance market. Letting all the healthy white collar office people stick with their employer chosen health insurance means the leftovers are the poor and unhealthy which many insurance companies can’t handle the losses from since there is no health population to balance it out, so you have places that have no health insurance competition. Even then, the people that make the most money in healthcare are the providers (doctors) and by a significant multiple, so increasing their supply would be necessary to bringing costs down.
- deleted 8y ago[deleted]
- vechagup 8y agoMost insurance plans that allow access to providers in a broad network without a referral (these are often dubbed "PPO" or "high deductible" plans) have an annual out of pocket maximum that the insured will be required to pay before the insurance covers all remaining expenses. E.g., the maximum for "family" coverage on my plan is $5400. It's commonly said that having a baby will result in costs that exceed your out of pocket max, so you can think of the out of pocket max as the real cost to a family on one of these for the medical services from prenatal care through the birth. Caveat: Your accumulation towards this maximum will typically reset to 0 at the beginning of the calendar year, so try to finish your pregnancy before 12/31.
- codingdave 8y agoIt doesn't bankrupt us, but it does cost money. Not really the childbirth itself... that is a one time cost, and it varies greatly with 15K being the high end. But food, housing, education, clothing, and everything else you provide kids, not the least of which is health care.... it all adds up. To about a quarter of a million over time, if you believe the analysts. So with 3 kids, I'm likely $750K down on my wealth. As a tech worker, that is not bankrupt. But if I were living closer to poverty? Then the problem is less about my personal wealth and more about where I choose to cut corners when raising the kids.
- vishnugupta 8y agoContinuing that sentence... > ...unless of course we needed a C-section, in which case it’ll be a casual $30,000. In India, we got c-section done in a luxurious hospital in a suite ward for slightly over $1K. About 80% of that was covered by insurance. Even if it wasn't that kind of money is a typical middle class family in India can easily afford. Note that I'm talking about top of the line hospital so the median cost for a c-section is somewhere around $500. I guess what I'm trying to say is that I'm really blown away by that kind of cost difference. In a developed country shouldn't health be more affordable? No wonder medical tourism is on the rise in India.
- JetSetWilly 8y agoIn the UK a C-section costs an average of 2219USD to the NHS, This cost disparity is not one of developed world vs undeveloped, it is one of an insane health care system vs a rational one.
- elhudy 8y agoIn the UK, nurses are also hardly paid living wages [1]. Particularly in high cost of living areas like London. About USD15/HR for an experienced band 5 nurse. [1]https://www.rcn.org.uk/employment-and-pay/nhs-pay-scales-2017-18 https://www.rcn.org.uk/employment-and-pay/nhs-pay-scales-201...
- verisimilitude 8y agoThat is correct. To corroborate: my health insurance contract states I must pay $13,600 towards my medical expenses (this is AFTER premiums) per year, before they will begin paying on my behalf.
- maxxxxx 8y agoThat's an extreme deductible. How much are your premiums?
- verisimilitude 8y agoI just got next year's fees: premiums are $911.86 per month for family of three. More than the principal and interest on my house...
- Digory 8y agoIt's patchwork. They can't turn you away in an emergency, and Medicaid covers expenses for the poor. An uninsured family member recently had their unexpectedly complicated delivery written off entirely under the hospital's charity guidelines. But I recall reading a vivid passage about ten years ago, talking about the difference between rich and poor maternity wards: the wailing. Anesthesia is an elective expense in childbirth, not always covered by Medicaid.
- sbinthree 8y agoMy wife and I had a child in Canada with about as extreme a complication as you can get (transferred to Level 3 ICU for the sake of mother and baby). We calculated that it would have cost at least $200k in the US in direct costs, let alone things we couldn't quite get a price for (medication, the hourly rate of the over 20 medical professionals in the room during delivery, etc.). Would have ruined us for sure if out of pocket.
- georgeecollins 8y agoHaving a child is really expensive if you don't have health insurance. You can negotiate that cost in advance, but I don't know if people really do that very often.
- megaman8 8y agoIt's worth noting, the birth rate here in CA has been reducing for the last 30 years and recently has reached a 100 year low. It's currently lower than it was during the great depression.
- InclinedPlane 8y agoAbsolutely true, having kids bankrupts plenty of people in the US, especially if there is a medical issue with the child.