Oi Yanks!

"djmt1" (djmt1) 10/09/2016 at 11:41 • Filed to: None

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I don’t know what this is so feel free to chime in even if you know nothing about birthing costs

Your healthcare system is alien to me but I’m pretty sure I’m misunderstanding something here when this article says you guys pay on average $30,000 for a natural birth and close to $40,000 for a C-section. Also I’m sure insurance comes into play here but how much are your premiums?

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crowmolly > djmt1 10/09/2016 at 11:47

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Totally depends on your plan, to be honest. Same thing with the “average” cost.

TheHondaBro > djmt1 10/09/2016 at 11:48

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Depends on what insurance plan you got.

djmt1 > TheHondaBro 10/09/2016 at 11:50

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Care to elaborate?

Tristan > djmt1 10/09/2016 at 11:52

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I’m pretty new to it, since I spent most of my adult life in the military covered by sweet, sweet Tricare. Our premium is about $250/mo for 2 adults, however- employer pays a boatload of the premium so that $250 is just what’s left over. We are also having a baby this month and our out of pocket is somewhere around $3k. I’m pretty useless... still trying to wrap my head around how all of it works.

djmt1 > crowmolly 10/09/2016 at 11:54

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Could you elaborate on the average bit?

TheHondaBro > djmt1 10/09/2016 at 11:56

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You pay higher premiums for a plan that covers more of the bill.

Xyl0c41n3 > djmt1 10/09/2016 at 12:00

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I can’t comment on the hospital costs of having a baby, but the last time I went to the emergency room, it cost me $700 AFTER insurance to get three stitches in my finger. The total bill, including the portion paid by my insurance, was just over $2,000. I pulled the stitches out myself once my finger was healed, because fuck paying for that, too.

This was more than 10 years ago. Our healthcare situation is worse now.

DipodomysDeserti > djmt1 10/09/2016 at 12:07

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My wife had both our kids at home using a midwife. Cost us a few grand each. The problem with asking a question about average cost of US healthcare is there is no standard. There’s somebody limits now, but in the past hospitals could charge whatever they wanted. Also, there’s no standard for insurance coverage so deductibles am deathly premiums will vary widely.

Mercedes Streeter > Xyl0c41n3 10/09/2016 at 12:07

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Yep! Once I went to the ER a couple years ago because I had suddenly lost my voice and couldn’t talk at all. My co-pay was $999 (what a deal!) after my insurance fronted 80% of the cost...and all I got out of it were some stupid antibiotics.

Viggen > Tristan 10/09/2016 at 12:07

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So glad I’ve got Tricare right now. Can’t imagine how much the CT can, X-Rays, physical therapy, and chiropractor would have cost in the civilian side. Plus all the medication. 

RallyDarkstrike - Fan of 2-cyl FIATs, Eastern Bloc & Kei cars > Xyl0c41n3 10/09/2016 at 12:08

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Man...there are times I don’t understand how people aren’t All bankrupt with the costs you guys have for healthcare! 0_o $700 for three stitches is INSANE.

Phyrxes once again has a wagon! > djmt1 10/09/2016 at 12:09

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The style of private insurance varies greatly, I have a choice of three packages through my employer. My ppo premium for “family” is over 1000 a month. I work at small independent school so while they cover some of the cost most of it is on me.

area man > djmt1 10/09/2016 at 12:10

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Insurance covers a % range of the total cost (anywhere from 40-100%) of a procedure/hospital visit/etc depending on your plan, whether the healthcare provider is in your plan’s approved network, and the kind of services being provided. What no one tells you is that aside from basic stuff like a physical, you still have to pay a certain amount annually out of pocket before your plan kicks in. That amount varies as well but can be as high as several thousand dollars.

bhtooefr > RallyDarkstrike - Fan of 2-cyl FIATs, Eastern Bloc & Kei cars 10/09/2016 at 12:15

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Healthcare expenses are the leading cause of bankruptcy here, actually.

RallyDarkstrike - Fan of 2-cyl FIATs, Eastern Bloc & Kei cars > bhtooefr 10/09/2016 at 12:17

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And yet so many people seem to be against reform! :S

Xyl0c41n3 > RallyDarkstrike - Fan of 2-cyl FIATs, Eastern Bloc & Kei cars 10/09/2016 at 12:18

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That’s the thing: medical bills DO force people into bankruptcy in this country. All the time.

I know a man who filed for bankruptcy after having heart surgery.

I know another man who was in a motorcycle accident without a helmet. His brain was swelling so to relieve the pressure, they had to cut a piece of his skull off and implanted it in his abdomen so the bone tissue would stay alive in the days it took the brain swelling to go down. As soon as he was conscious again the hospital discharged him, even though he wasn’t fully lucid and in no condition to be home yet. Why? Because he didn’t have insurance, but his condition was no longer immediately life threatening.

Our system is fucked. Not gonna lie, the exorbitant cost of healthcare is one of the reasons I don’t have kids right now. I simply can’t afford it.

fintail > djmt1 10/09/2016 at 12:19

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Bedford CA van. Prolific in the Matchbox range back in the day:

In a Mini; let them mock me as My Mini Countryman is higher than you > Xyl0c41n3 10/09/2016 at 12:21

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That surgery actually sound really innovative. I’ve never heard of that.

In a Mini; let them mock me as My Mini Countryman is higher than you > Viggen 10/09/2016 at 12:21

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Explain?

Viggen > In a Mini; let them mock me as My Mini Countryman is higher than you 10/09/2016 at 12:28

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Tricare is the health insurance provided to all service members on active duty in the US and their immediate family and dependants. It’s funded by the tax payer. Apart from a montly fee, I’m pretty sure I haven’t payed shit for medical stuff in the past four years.

Steve is equipped with Electronic Fool Injection > djmt1 10/09/2016 at 12:32

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Here’s our situation. My wife and I pay ~$500/month for an employer-sponsored health plan. All in all it’s a good plan -better than most actually. But we still pay a ton out of pocket.

Our plan is a $500 deductible PPO (preferred provider organization) that pays 80/20 and 70/30 with zero counsurance or deductible on annual visits with in-network doctors. $1000 deductible paying 70/30 and 60/40 for out of network. We have a $10,000 out of pocket max in network and 15,000 out.

Our prescription plan is so convoluted that you kind of need an accounting degree to understand it. Drugs are categorized into four tiers based on cost and efficacy and the higher the tier, the less the company pays.

What this means is that the first $500 in medical expenses comes out of pocket unless it’s an annual physical. If we go to a primary care doctor they pay 80%. If we go to a specialist they pay 70%. After our out of pocket expenses total $10,000 per year, the plan pays 100%

These rates only apply to care facilities that are contracted with our insurance company. If we go to a doctor or hospital that isn’t, the higher out of pocket expenses apply.

Still following?

Now, my wife has monthly appointments with a specialist because she has type 2 diabetes. It developed as a side effect of a drug that caused her to gain 120 lbs in a year. She’s lost about half of that, but the rest doesn’t want to come off. These appointments come to around $60/month. I have appointments every two weeks with a therapist and the plan pays all but $25/appt. Her insulin and other diabetes medication is over $250/month after insurance.

Recently she had some serious arthritis pain in one of her knees and had to go get a brace, x-rays, and an exam by a specialist. The bill for two visits was around $600 after insurance. (Our deductible was gone by January.)

After insurance premiums, coinsurance, and prescriptions, we pay about $1000/month for healthcare. If we dropped down to the $400/mo plan we would be at nearly double that. If you add in lost wages (because our jobs require paid time off to be scheduled) then you have another $4-600 a month depending on how many hours we miss.

The issue also tends to be that doctors and hospitals often overbill for services to make up for the fact that insurance companies will do all they can to negotiate down to pay the least possible at the latest possible time. Seriously - I worked in insurance for a while and the things I saw on claims side were crazy. Insurance companies use a fee schedule and billing system based on codes. Each code has a “reasonable and customary” fee associated with it. Then they try to pay about half that. So the lost revenue has to be made up elsewhere, like on the “ancillary fees” that show up, or on bills to uninsured people, et cetera.

So literally every developed country has a better plan for taking care of the health of their citizens than we do.

Spaceball-Two > djmt1 10/09/2016 at 12:33

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When my so was born a little over a year ago it cost about 23k, that’s all natural with no drugs and an 18 your stay at the hospital. After insurance kicked in we owed about 3k.

wiffleballtony > djmt1 10/09/2016 at 12:34

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What the hospital charges and what it actually costs you aren’t related. The hospital may charge 30k, insurance covers a certain percentage. And then you have maximums you can be charged.

djmt1 > Steve is equipped with Electronic Fool Injection 10/09/2016 at 12:39

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Full Disclosure: I do indeed have an accounting degree.

LongbowMkII > djmt1 10/09/2016 at 12:47

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Much of the price is inflated to allow for insurance ‘negotiation’ and tax write-offs. The hospital gets to ‘donate’ a 30k service instead of a 17k service. With all the accounting fungibility that allows.

There are no poor hospital administrators.

TheRealBicycleBuck > djmt1 10/09/2016 at 12:50

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The cost of the premiums depends on your plan selection, your deductible, and how much your employer covers. How much we pay to see a doctor depends on your plan and the rates the insurance company negotiated with the provider. When our kids were born, we had double coverage. The rates were cheap enough through our respective employers to make it reasonable to get coverage for both. So when my daughter was born, the hospital was paid through my wife’s insurance. The hospital tried to bill the remainder to us, but we sent the bill to our secondary coverage. Our secondary coverage was through one of the biggest insurance companies here and they refused to pay. The argument was that the primary coverage had already paid more than the negotiated rate for the secondary. Being a big company, they told the hospital to back off since they were in violation of their contract.

Some of the insurance programs have little or no out of pocket cost for a doctor visit. It’s the complicated procedures that get you. A CAT scan cost me over $500. If we still had double coverage, the cost would have been zero. A hospital stay a couple of years ago maxed out our deductibles.

As long as you can afford the premiums and can cover the deductibles, it works out ok. If you can’t, you end up negotiating with the providers to get the after-insurance remainder reduced to something affordable.

shop-teacher > djmt1 10/09/2016 at 13:08

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I have an HMO insurance plan. They tend to be cheaper and cover more, but there’s a lot more paper work. Everything done by a specialist has to be referred to by my primary care physician. I pay a couple thousand a year for my share of the coverage, and my employer pays something like $8k, but other than that I don’t pay for very much. I got a vecectomy recently, the bill from the hospital (I had to be put under to do it) came to nearly $17k, but my share of it, called a co-pay, was only $100.

If I had a PPO, my insurance would have cost me closer to $3k a year, plus I would have to pay everything up to a deductible (I can’t remember what the deductible would have been, it varies from plan to plan), plus I would have to pay for 20% of everything beyond the deductible. That vesectomy would’ve cost me thousands. The only “advantage” to PPOs, and this is why people still choose them, is you can go to any specialist instead of the one your doctor refers you to. Not worth it IMO.

Jordan and the Slowrunner, Boomer Intensifies > Xyl0c41n3 10/09/2016 at 13:14

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It cost me $1200 for an X-ray and breathing treatment, all of which took place in 45 minutes.

TheHondaBro > Xyl0c41n3 10/09/2016 at 13:28

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It’s worse because Congress keeps whining about the ACA and stopping it from reaching its full potential.

Xyl0c41n3 > TheHondaBro 10/09/2016 at 13:35

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Yup, exactly. I live in Texas, where former Governor Perry and current Governor Abbot have routinely denied Medicaid expansions and refused to allow an ACA marketplace. As a result, tens of thousands of Texans are struggling under the weight of the costs of healthcare, even for small issues. But so many Texans I know gripe about the Dems and how ACA is bullshit because their premiums are skyrocketing. No, dipshit, that’s not on the Dems, that’s on the Republicans for effectively castrating ACA.

One of the most heartbreaking examples I know is a friend who’s raising his kids alone. One of them is severely autistic and depends very much on therapy to learn basic things like communicating with people and learning how to deal with breaks in routine. My friend’s Medicaid assistance, which was paying for that therapy, was cut this year thanks to Gov. Abbott. Kids shouldn’t have to suffer because of the hubris of the adults around them.

Santiago of Escuderia Boricua > djmt1 10/09/2016 at 13:39

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I just avoid going to the doctor

Mercedes Streeter > In a Mini; let them mock me as My Mini Countryman is higher than you 10/09/2016 at 13:39

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Oh yeah, the American Healthcare system is often amazing in what it could achieve, but it’s so expensive could actually afford it.

crowmolly > djmt1 10/09/2016 at 13:49

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What you are responsible for and what your plan pays vary depending on what plan you have.

Example, Person A has plan A, they pay $50 for a prescription. Person B has plan B, they pay $5 for the exact same drug.

It’s the same way with some procedures.

Nothing > djmt1 10/09/2016 at 14:14

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All depends on your insurance plan. My current plan is really good, so our out of pocket costs are quite low. Our out of pocket C section birth for twins with a 2 night stay was $50. Our neighbor was out of pocket $20k for a “regular” delivery. We pay roughly $390/month, pretax.

In a Mini; let them mock me as My Mini Countryman is higher than you > Viggen 10/09/2016 at 14:23

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So, it’s NOT the VA shit

Viggen > In a Mini; let them mock me as My Mini Countryman is higher than you 10/09/2016 at 14:25

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Nope. I don’t have to deal with that...yet. Should be interesting to see what they say about my back and hip though.

FTTOHG Has Moved to https://opposite-lock.com > djmt1 10/09/2016 at 14:39

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2 kids, both C-sections. Total cost out of my pocket: less than $1000. I have pretty good insurance. The only time I’ve paid more than $300 for any single procedure, ER, hospital stay or office visit was one time my son was sick his doctor was outside of my insurance company’s contacted “network”. My premiums are something like $2400/month. I pay around $550/month pre-tax, and my employer pays the rest as a benefit. It’s one way that large companies can compete for the best workers besides just salary. An observation: my health insurance premiums are basically 2x what somebody working full time and making the federal minimum wage makes in a year.

FTTOHG Has Moved to https://opposite-lock.com > Viggen 10/09/2016 at 14:42

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Chiropractors can be pretty reasonable. I have a long-term issue with my back. My insurance decided to stop covering it after 3 months saying it had been fixed, but realistically I need to be stretched and adjusted every other week to keep it from getting worse again. I negotiated with the doctor and pay $130/month to come in every other week.

KnowsAboutCars > fintail 10/09/2016 at 17:11

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CA Dormobile to be exact.

Dusty Ventures > Santiago of Escuderia Boricua 10/09/2016 at 18:56

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Sadly this is the only viable option for many people

Santiago of Escuderia Boricua > Dusty Ventures 10/09/2016 at 23:49

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More race car money!

*cough dies*