After President Obama came into office, there has been a lot of attention on Health Care Reform. I think medical care costs vary so much between individuals and areas of the country that it’s hard to even know if you are getting ripped off one place or another, or if your insurance is fairly priced. This is a peek at the biggest medical costs in my life; childbirth.
My wife and I have three kids. Our first child was born completely on Medicaid. At the time, I was self-employed and not making enough money to pay for any insurance through a private insurer so we got to take full advantage of this Government provided insurance coverage for low income families. My wife ended up having a C-section due to complications but we never saw a bill.
C-sections cost between $3,000 on the very low end all the way up to $15,000 on the high, all without complications. Any complications added into the mix can really bump the cost up but for this comparison and argument, I will use an average figure of $10,000 for a C-section + prenatal medical visits.
Total Approximate Cost: $10,000
Our second child was born during a time that I was still self-employed but I was making more money and we didn’t qualify for any insurance or assistance. We started saving for the birth as soon as we found out we were pregnant and knew we would be paying out of pocket for the entire delivery. Luckily, we had a great doctor that was experienced with VBAC deliveries (Vaginal Birth After Cesarean) so my wife was able to deliver vaginally without complications. Our overall cost came out to about $6 including OB visits, epidural and hospital stay.
Total Approximate Cost: $6,000
My wife is pregnant now and due in February. This go-around I have a more traditional job with insurance coverage. Our insurance premiums are around $300 a month and we have a deductible of $2000 this year with an 80/20 payment plan after the deductible is met. This year we met the deductible but seeing as the baby will be born next year, our deductible will need to be met again. Next year, due to health care costs on the rise, our deductible is being raised to $3000. My company does offer an HRA or Healthcare Reimburement Account to help pay the deductible which will reimburse $1,000 of our health care costs. Adding premiums (9 months worth, just to get the cost of pregnancy), and our deductible, we are already in about $4,700. Then if we take the cost of our previous birth, $6,000, and add the 20% we are responsible for after insurance pays 80% of qualifying costs, our total comes to $5,900.
Total Approximate Cost: $5,900
If you look at these numbers, the cost of birth without insurance, and the cost with insurance is almost the same, if insurance considers every bit of the $6,000 as qualifying which isn’t usually the case.
On top of that, when we were negotiating with the hospital concerning the out of pocket delivery of our second child, they told me that the $6,000 was the cost for birth without insurance but if we had insurance, the total billable cost would be $18,000 and that is just for the delivery and hospital stay and didn’t take OB visits into account which made up about $2,500 of the $6,000 total cost.
20% of $18,000 is much different than 20% of $6,000 and that would bump our cost with insurance up to almost $9,000 which brings me to the conclusion that having insurance is more expensive than not having it in the pregnancy scenario and the only reason we have insurance is for catastrophic events.
There is something wrong here and while I don’t believe that insurance should be completely run by a government body, I do think that the medical field needs more stringent regulations on what they can charge. If they are reaming the insurance at every chance they get, just because they can, that cost comes back to us. That causes premiums to rise, insurance companies to be more strict on what qualifies for coverage and in the end completely defeats the purpose of having insurance.
Have you experienced life without insurance? Please share your own experiences in the comments.
Image by jen_maiser br>
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Tags: bill c, c section, c sections, change health care, deliveries, enough money, epidural, health care costs, health care reform, healthcare costs, hra, insurance, insurance coverage, insurance premiums, low income families, medicaid, medical visits, plea, private insurer, three kids, traditional job, vaginal birth after cesarean