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Yeah this is 95% of what my fiance and I talked about when deciding whether we wanted to have a baby. It wasn't about paying for the kid's schooling or where we

Yeah this is 95% of what my fiance and I talked about when deciding whether we wanted to have a baby. It wasn't about paying for the kid's schooling or where we were going to live. It literally boiled down to whether we were willing to potentially wipe out our entire savings and go into debt to have a child. And when she quit her job earlier this year it was mainly because we didn't want her to get sick and hospitalized because then I would get sick and hospitalized, and that would completely erase our savings. Thank god her previous employer had good medical insurance so we could do COBRA. Now we just have to have a kid within 18 months of her separation date. The insurance system in the US is completely broken because it doesn't actually insure you against catestrophic costs.

aidenn0 6y ago
Yeah, health insurance in the US is kind of the opposite of insurance. It covers every-day expenses more-or-less but effectively will not cover unexpected large expenses (because the insurance companies will put the full force of their legal resources into not paying large claims).
- duxup 6y ago
  That greatly depends on the type of insurance / plan (or at least it did...). Cheaper plans absolutely apply to what you describe, or at least did a while ago, other plans do not. Even knowing can be hard. But your description is way too general.
  - aidenn0 6y ago
    All 4 employer provided health insurance programs I've used worked that way, though only the last two were post ACA.
- lotsofpulp 6y ago
  That’s not true at all. Other than ACA mandated well visits and vaccines, insurance forces you to pay for everyday expenses via deductibles and copays until you reach your out of pocket maximum. And then insurance will take over for large expenses. And by and large, they do pay for the largest expenses, such as medications for anemia and cancer treatment and NICU situation.
- learc83 6y ago
  That isn’t true at all. It used to be true because health care plans had lifetime limits to coverage, but the ACA removed those limits. The ACA also ads out of pocket maximums. They might still be high enough to cause problems for some people, but it’s a lot better than it used to be. As far as not paying, your chances of them just deciding not to pay are low. It’s definitely not high enough to support your claim that they effectively don’t cover large expenses. Here the ACA also helps because insurers are forced to spend at least 80% of premiums on healthcare costs and quality improvements for customers.
  - jeffbee 6y ago
    > your chances of them just deciding not to pay are low What's your data on that? The US government says that private insurers deny 20% of claims. Last year my insurer tried to say that it was medically unnecessary to get an MRI after I'd had a tumor removed from my brain. You see, I'd also had an MRI before the surgery and according to the quack on the insurance company payroll who "reviewed my case" more than 1 MRI in a year just can't be justified. Your chances that an American health insurance firm will deny your claim, or at least attempt to, are very high. Virtually all of the staff at these firms are dedicated to not paying claims.
    - mywittyname 6y ago
      > The US government says that private insurers deny 20% of claims. Most insurers deny every claim. Hospitals employ pretty large teams (of nurses, mostly) whose job it is to go through these denials and justify the medical care a patient received while in the hospital. If the insurance company doesn't think the treatment was necessary, they won't pay. If they can find a technicality, such as, a patient came in for a belly ache, but had a heart attack, they won't pay. I'm willing to bet this 20% figure only represent denied claims not absorbed mostly, or entirely by the hospital. I've been pushing the person whom I get this information from to write a book, because most Americans are completely ignorant about how fucked the health insurance scheme is in the US. That $6,000 asprin on your hospital bill is there to cover all the aspects of your treatment that the insurance company will successfully deny.
    - 6y ago
- poulsbohemian 6y ago
  Except that it doesn't even really cover every-day expenses... Yes, if you have a catastrophic event it will kick in, but realistically if you are a healthy person, you are paying hundreds per person per month for coverage, plus will pay out of pocket for most of your care in a year before hitting that $5K+ deductible. It's simultaneously too expensive to not have insurance AND too expensive to go to the doctor. I'll never quite understand why I have to pay out $XXX for a blood test that might give me preventative feedback about my health, yet once I finally get heart disease, cancer, diabetes, etc, magically the health system and health insurance system kick in. The whole system is perverse.
  - lotsofpulp 6y ago
    > It's simultaneously too expensive to not have insurance AND too expensive to go to the doctor. Because healthcare is too expensive for Americans. Adding insurance doesn’t make the healthcare stop being expensive, it just helps distribute the costs more evenly across the population. Like universal taxpayer funded healthcare would. In order to bring healthcare costs down, the supply of healthcare and number of sellers of healthcare in the market would need to increase.
lotsofpulp 6y ago
If anything, it does insure you against catastrophic loss. ACA took away maximum benefit amounts. The problem is most people don’t have enough cash to even pay for out of pocket maximums, which is around $25k to $30k for a family ($12k to $15k per year, but you need to have two year’s worth in case something happens to you at the end of the year and costs continue into the next year).
- mattacular 6y ago
  On paper it may seem to insure you against catastrophic loss, that is, if the insurance company can't find a way to deny your claim for one reason or another. You can surely bet they will be trying.
  - Someone1234 6y ago
    "You didn't check that the second doctor in your surgery, who came in while you were unconscious was in-networking? Well, too bad, you should have done your due diligence more carefully!" When we had a kid, it was $10K out-of-pocket, and we had a bunch of "out-of-networking" bingo due to mostly lab tests or a doctor out of network at an in-network ER. Since then kid themselves also had an ambulance ride (seizure), and that too was "out of networking" in spite of being the only ambulance provider available within 15+ minutes.
    - lotsofpulp 6y ago
      The involuntary treatment by out of network providers and them being able to charge you whatever they feel like definitely needs to be outlawed.
      - deleted 6y ago
        [deleted]
    - learc83 6y ago
      What you're describing is completely illegal now. Under the Affordable Care Act, which applies nationwide, insurers are required to cover out-of-network emergency care as if it was in-network care, which means your deductible and coinsurance can't be higher than the regular in-network amounts.
dimitrios1 6y ago
The insurance system is completely broken, but the bankruptcy protection system isn't!
scottlocklin 6y ago
I used to vaguely know this illegal alien sushi chef who had two kids. Nice enough guy, made good sushi, liked life in California; probably still works in the same place in Mountain View. I was always confused as to how he afforded two kids living in Mountain View. Well, it turns out, in California, the state apparently pays for it. I mean, he was a nice guy, and family formation should be a priority for any sane government, but the idea that you get subsidized if you break the rules and penalized if you don't kind of rankles.
- triceratops 6y ago
  > Well, it turns out, in California, the state apparently pays for it. Pays for what? His sushi chef salary? His kids' medical bills? Housing?
  - scottlocklin 6y ago
    California paid for all the hospital bills for childbirth, all the subsequent doctors bills for the kids. I have no idea how he paid his rent; probably by making sushi. Only reason I knew about the kids thing was by asking. He was kind of surprised that wasn't available for everyone, like, you know, citizens and people like above who was worried making a baby would bankrupt him and his fiancee. I assume it was ordinary Calmed and his job was off the books; didn't pry into details.
    - learc83 6y ago
      >you know, citizens It has nothing to do with immigration status. Medicaid is available in California for people making below a certain income.
      - scottlocklin 6y ago
        I kind of said that. Meanwhile, legally employed OP above fears bankruptcy for putting a baby in his fiancee. Good job America.
heavyset_go 6y ago
> Thank god her previous employer had good medical insurance so we could do COBRA. Now we just have to have a kid within 18 months of her separation date. We're lucky to be in positions to be able to afford COBRA. I used it about a decade ago, and the premiums were over $2k a month. I don't think that most people can afford anything like that while they aren't working.
- deleted 6y ago
  [deleted]
stickyricky 6y ago
How much were you expecting it to be?
- Balgair 6y ago
  I don't know about OP, but where I am the cost of the average vaginal delivery is ~$8k and the average c-section is ~$12k on top of that, so ~$20k. C-sections account for ~30% of the births where I am. Complications with the birth will add to the cost. The devil is in the details though. I don't know if Medicaid is factored into these averages and I don't know what the median cost is. Individual insurance will vary wildly, and the specifics of every delivery also vary wildly. You could be paying $0 or $100,000, it's a total crap-shoot.
  - stickyricky 6y ago
    Brutal. I've seen a lot of people advertise giving birth in bathtubs (or small pools) with just a midwife. Now I'm starting to wonder if that's a response to the high costs of hospital delivery.
    - jschwartzi 6y ago
      That's exactly what it is. We did a lot of research on this to try to keep the costs low, but the risk of complications with delivery requiring us to then go to the hospital is high enough that this doesn't save us any money. It just makes it more likely she or the baby will die from complications before they get to the hospital.
    - WarOnPrivacy 6y ago
      We birthed at home (& later at birthing centers) so my wife could be appropriately in control. She's a chemical sensitive. Staying out of a hospital was the only way to keep some rando hospital staffer caked in perfume (or Tide) from walking in & triggering an 8 hour migraine.
    - RhysU 6y ago
      We used a birthing center, twice. In conjunction with medical insurance from a large local employer, the births and associated pre/post-natal visits each cost us $500 out-of-pocket roughly a decade ago. The insurer, not surprisingly, was happy to have us pursue that route. Hence including pre/post-natal care in the bundle. Now, the birthing center screened for low-risk mothers and we were indeed lucky. Still, a considerable fraction of the population should be able to to access, at low cost, "technology" that we have exercised as a species since time immemorial.
deleted 6y ago
[deleted]
warent 6y ago
Adding to this, another reason I hate private insurance is the concept of networks and claims. It doesn't really matter what insurance you have. I have an upper-middle tier PPO, and still two doctors offices have turned me away because they don't accept it... completely boggling. Not to mention the herculean efforts you have to put forth to synchronize your personal health records / documents between offices and systems because everyone is using different nightmarishly siloed systems (although in theory will start improving eventually thanks to the FHIR standard, but still change in healthcare is SLOW). If it was like that between US states, I would understand. But between offices up the road from each other? Give me a break. In my opinion, the only thing we have that works well is Planned Parenthood, which I've used a couple of times and attest that they are just phenomenal. Unsurprisingly they also happen to be a non-profit. For-profit does not work for everything, and thinking it does (or should be a requirement of capitalism) is completely lacking in imagination and empathy.
- Jommi 6y ago
  Why not just use on HMO?
  - 1auralynn 6y ago
    HMOs are poorer quality insurance. PPOs you don't need referrals - you don't have to make two appointments if you need to see a specialist or convince your primary care doctor it's necessary.
    - Jommi 6y ago
      Why wouldnt you get an opinon from your doc first before getting a specialist you might not even need?
vmchale 6y ago
> it doesn't actually insure you against catestrophic costs. Unless you're old enough to get medicare. Works for the people who vote :\
CalRobert 6y ago
It's drastic, but are you in a position to emigrate? Canada still has Jus soli citizenship and if you can pull it off you might be doing your child a big favour for just the reasons you state.
- deleted 6y ago
  [deleted]
ozmbie 6y ago
I’m so sorry you have to live with that system. I’m in Australia and had my first child not that long ago. After multiple hospital visits due to ongoing complications during pregnancy, an induced labour and an emergency c-section followed by a week in hospital for my wife to recover...the only thing we had to pay for was parking at the hospital and a few meals for myself at the cafeteria. The whole ordeal was stressful enough but the financial aspect was never in our minds. I can’t even imagine having to add financial stress on top of that.
heresie-dabord 6y ago
What is community for? What is society for? Community is for mutual care, support, and education. A society of communities is for betterment and civilisation. These are not hard things to do but they require ethics and sharing and must be protected. They are vulnerable to barbarians. It is barbaric to create a predatory environment where the powerful manipulate the poor for profit and then cast the poor away when they are sick.
Konohamaru 6y ago
How do people on the Maury Povich show manage to have five children? Or what about other Darwinian success stories such as this gentleman? <https://www.google.com/amp/s/www.dailymail.co.uk/news/article-2146545/amp/Man-fathered-30-kids-11-different-women-says-needs-break--child-support.html> https://www.google.com/amp/s/www.dailymail.co.uk/news/articl... I think the problem is that you want both children and an upper middle class (read: upper class) lifestyle. But that's not how this works. You are going to consume a lot of your resources in creating and raising children, but you will gain the wisdom to rebuild those same resources and in the end finish with more than you started (timescale: 20-40 years) EDIT: Povitch -> Povich

aidenn0 6y ago

Yeah, health insurance in the US is kind of the opposite of insurance. It covers every-day expenses more-or-less but effectively will not cover unexpected large expenses (because the insurance companies will put the full force of their legal resources into not paying large claims).

duxup 6y ago
That greatly depends on the type of insurance / plan (or at least it did...). Cheaper plans absolutely apply to what you describe, or at least did a while ago, other plans do not. Even knowing can be hard. But your description is way too general.
- aidenn0 6y ago
  All 4 employer provided health insurance programs I've used worked that way, though only the last two were post ACA.
lotsofpulp 6y ago
That’s not true at all. Other than ACA mandated well visits and vaccines, insurance forces you to pay for everyday expenses via deductibles and copays until you reach your out of pocket maximum. And then insurance will take over for large expenses. And by and large, they do pay for the largest expenses, such as medications for anemia and cancer treatment and NICU situation.
learc83 6y ago
That isn’t true at all. It used to be true because health care plans had lifetime limits to coverage, but the ACA removed those limits. The ACA also ads out of pocket maximums. They might still be high enough to cause problems for some people, but it’s a lot better than it used to be. As far as not paying, your chances of them just deciding not to pay are low. It’s definitely not high enough to support your claim that they effectively don’t cover large expenses. Here the ACA also helps because insurers are forced to spend at least 80% of premiums on healthcare costs and quality improvements for customers.
- jeffbee 6y ago
  > your chances of them just deciding not to pay are low What's your data on that? The US government says that private insurers deny 20% of claims. Last year my insurer tried to say that it was medically unnecessary to get an MRI after I'd had a tumor removed from my brain. You see, I'd also had an MRI before the surgery and according to the quack on the insurance company payroll who "reviewed my case" more than 1 MRI in a year just can't be justified. Your chances that an American health insurance firm will deny your claim, or at least attempt to, are very high. Virtually all of the staff at these firms are dedicated to not paying claims.
  - mywittyname 6y ago
    > The US government says that private insurers deny 20% of claims. Most insurers deny every claim. Hospitals employ pretty large teams (of nurses, mostly) whose job it is to go through these denials and justify the medical care a patient received while in the hospital. If the insurance company doesn't think the treatment was necessary, they won't pay. If they can find a technicality, such as, a patient came in for a belly ache, but had a heart attack, they won't pay. I'm willing to bet this 20% figure only represent denied claims not absorbed mostly, or entirely by the hospital. I've been pushing the person whom I get this information from to write a book, because most Americans are completely ignorant about how fucked the health insurance scheme is in the US. That $6,000 asprin on your hospital bill is there to cover all the aspects of your treatment that the insurance company will successfully deny.
  - 6y ago
poulsbohemian 6y ago
Except that it doesn't even really cover every-day expenses... Yes, if you have a catastrophic event it will kick in, but realistically if you are a healthy person, you are paying hundreds per person per month for coverage, plus will pay out of pocket for most of your care in a year before hitting that $5K+ deductible. It's simultaneously too expensive to not have insurance AND too expensive to go to the doctor. I'll never quite understand why I have to pay out $XXX for a blood test that might give me preventative feedback about my health, yet once I finally get heart disease, cancer, diabetes, etc, magically the health system and health insurance system kick in. The whole system is perverse.
- lotsofpulp 6y ago
  > It's simultaneously too expensive to not have insurance AND too expensive to go to the doctor. Because healthcare is too expensive for Americans. Adding insurance doesn’t make the healthcare stop being expensive, it just helps distribute the costs more evenly across the population. Like universal taxpayer funded healthcare would. In order to bring healthcare costs down, the supply of healthcare and number of sellers of healthcare in the market would need to increase.

lotsofpulp 6y ago

If anything, it does insure you against catastrophic loss. ACA took away maximum benefit amounts. The problem is most people don’t have enough cash to even pay for out of pocket maximums, which is around $25k to $30k for a family ($12k to $15k per year, but you need to have two year’s worth in case something happens to you at the end of the year and costs continue into the next year).

mattacular 6y ago
On paper it may seem to insure you against catastrophic loss, that is, if the insurance company can't find a way to deny your claim for one reason or another. You can surely bet they will be trying.
- Someone1234 6y ago
  "You didn't check that the second doctor in your surgery, who came in while you were unconscious was in-networking? Well, too bad, you should have done your due diligence more carefully!" When we had a kid, it was $10K out-of-pocket, and we had a bunch of "out-of-networking" bingo due to mostly lab tests or a doctor out of network at an in-network ER. Since then kid themselves also had an ambulance ride (seizure), and that too was "out of networking" in spite of being the only ambulance provider available within 15+ minutes.
  - lotsofpulp 6y ago
    The involuntary treatment by out of network providers and them being able to charge you whatever they feel like definitely needs to be outlawed.
    - deleted 6y ago
      [deleted]
  - learc83 6y ago
    What you're describing is completely illegal now. Under the Affordable Care Act, which applies nationwide, insurers are required to cover out-of-network emergency care as if it was in-network care, which means your deductible and coinsurance can't be higher than the regular in-network amounts.

dimitrios1 6y ago

The insurance system is completely broken, but the bankruptcy protection system isn't!

scottlocklin 6y ago

I used to vaguely know this illegal alien sushi chef who had two kids. Nice enough guy, made good sushi, liked life in California; probably still works in the same place in Mountain View. I was always confused as to how he afforded two kids living in Mountain View. Well, it turns out, in California, the state apparently pays for it. I mean, he was a nice guy, and family formation should be a priority for any sane government, but the idea that you get subsidized if you break the rules and penalized if you don't kind of rankles.

triceratops 6y ago
> Well, it turns out, in California, the state apparently pays for it. Pays for what? His sushi chef salary? His kids' medical bills? Housing?
- scottlocklin 6y ago
  California paid for all the hospital bills for childbirth, all the subsequent doctors bills for the kids. I have no idea how he paid his rent; probably by making sushi. Only reason I knew about the kids thing was by asking. He was kind of surprised that wasn't available for everyone, like, you know, citizens and people like above who was worried making a baby would bankrupt him and his fiancee. I assume it was ordinary Calmed and his job was off the books; didn't pry into details.
  - learc83 6y ago
    >you know, citizens It has nothing to do with immigration status. Medicaid is available in California for people making below a certain income.
    - scottlocklin 6y ago
      I kind of said that. Meanwhile, legally employed OP above fears bankruptcy for putting a baby in his fiancee. Good job America.

heavyset_go 6y ago

> Thank god her previous employer had good medical insurance so we could do COBRA. Now we just have to have a kid within 18 months of her separation date. We're lucky to be in positions to be able to afford COBRA. I used it about a decade ago, and the premiums were over $2k a month. I don't think that most people can afford anything like that while they aren't working.

deleted 6y ago
[deleted]

stickyricky 6y ago

How much were you expecting it to be?

Balgair 6y ago
I don't know about OP, but where I am the cost of the average vaginal delivery is ~$8k and the average c-section is ~$12k on top of that, so ~$20k. C-sections account for ~30% of the births where I am. Complications with the birth will add to the cost. The devil is in the details though. I don't know if Medicaid is factored into these averages and I don't know what the median cost is. Individual insurance will vary wildly, and the specifics of every delivery also vary wildly. You could be paying $0 or $100,000, it's a total crap-shoot.
- stickyricky 6y ago
  Brutal. I've seen a lot of people advertise giving birth in bathtubs (or small pools) with just a midwife. Now I'm starting to wonder if that's a response to the high costs of hospital delivery.
  - jschwartzi 6y ago
    That's exactly what it is. We did a lot of research on this to try to keep the costs low, but the risk of complications with delivery requiring us to then go to the hospital is high enough that this doesn't save us any money. It just makes it more likely she or the baby will die from complications before they get to the hospital.
  - WarOnPrivacy 6y ago
    We birthed at home (& later at birthing centers) so my wife could be appropriately in control. She's a chemical sensitive. Staying out of a hospital was the only way to keep some rando hospital staffer caked in perfume (or Tide) from walking in & triggering an 8 hour migraine.
  - RhysU 6y ago
    We used a birthing center, twice. In conjunction with medical insurance from a large local employer, the births and associated pre/post-natal visits each cost us $500 out-of-pocket roughly a decade ago. The insurer, not surprisingly, was happy to have us pursue that route. Hence including pre/post-natal care in the bundle. Now, the birthing center screened for low-risk mothers and we were indeed lucky. Still, a considerable fraction of the population should be able to to access, at low cost, "technology" that we have exercised as a species since time immemorial.

deleted 6y ago

[deleted]

warent 6y ago

Adding to this, another reason I hate private insurance is the concept of networks and claims. It doesn't really matter what insurance you have. I have an upper-middle tier PPO, and still two doctors offices have turned me away because they don't accept it... completely boggling. Not to mention the herculean efforts you have to put forth to synchronize your personal health records / documents between offices and systems because everyone is using different nightmarishly siloed systems (although in theory will start improving eventually thanks to the FHIR standard, but still change in healthcare is SLOW). If it was like that between US states, I would understand. But between offices up the road from each other? Give me a break. In my opinion, the only thing we have that works well is Planned Parenthood, which I've used a couple of times and attest that they are just phenomenal. Unsurprisingly they also happen to be a non-profit. For-profit does not work for everything, and thinking it does (or should be a requirement of capitalism) is completely lacking in imagination and empathy.

Jommi 6y ago
Why not just use on HMO?
- 1auralynn 6y ago
  HMOs are poorer quality insurance. PPOs you don't need referrals - you don't have to make two appointments if you need to see a specialist or convince your primary care doctor it's necessary.
  - Jommi 6y ago
    Why wouldnt you get an opinon from your doc first before getting a specialist you might not even need?

vmchale 6y ago

> it doesn't actually insure you against catestrophic costs. Unless you're old enough to get medicare. Works for the people who vote :\

CalRobert 6y ago

It's drastic, but are you in a position to emigrate? Canada still has Jus soli citizenship and if you can pull it off you might be doing your child a big favour for just the reasons you state.

deleted 6y ago
[deleted]

ozmbie 6y ago

I’m so sorry you have to live with that system. I’m in Australia and had my first child not that long ago. After multiple hospital visits due to ongoing complications during pregnancy, an induced labour and an emergency c-section followed by a week in hospital for my wife to recover...the only thing we had to pay for was parking at the hospital and a few meals for myself at the cafeteria. The whole ordeal was stressful enough but the financial aspect was never in our minds. I can’t even imagine having to add financial stress on top of that.

heresie-dabord 6y ago

What is community for? What is society for? Community is for mutual care, support, and education. A society of communities is for betterment and civilisation. These are not hard things to do but they require ethics and sharing and must be protected. They are vulnerable to barbarians. It is barbaric to create a predatory environment where the powerful manipulate the poor for profit and then cast the poor away when they are sick.

Konohamaru 6y ago

How do people on the Maury Povich show manage to have five children? Or what about other Darwinian success stories such as this gentleman? <https://www.google.com/amp/s/www.dailymail.co.uk/news/article-2146545/amp/Man-fathered-30-kids-11-different-women-says-needs-break--child-support.html> https://www.google.com/amp/s/www.dailymail.co.uk/news/articl... I think the problem is that you want both children and an upper middle class (read: upper class) lifestyle. But that's not how this works. You are going to consume a lot of your resources in creating and raising children, but you will gain the wisdom to rebuild those same resources and in the end finish with more than you started (timescale: 20-40 years) EDIT: Povitch -> Povich