25 January 2012

PSA

This is important. Please listen carefully: It is possible to give birth to a baby without health insurance coverage. Giving birth to a baby without coverage will not destroy you, your life, your financial future, or your credit rating.

It is even possible to give birth to a baby after having received a full schedule of prenatal care and in a hospital without being covered by health insurance. It is further possible to give birth to a baby after having received a full schedule of prenatal care and in a hospital without being covered by health insurance, but with the dubious aid of an obstetrician and several expensive nurses. It is EVEN FURTHER possible to give birth to a baby in a hospital without being covered by health insurance, but with the dubious aid of however many expensive people AND with the assistance of a well-paid anesthesiologist. 

I know this because I have personally myownself given birth to two babies--one living, one alive in Christ-- without the mantle of health insurance, in two different hospitals with two different sets of expensive staff-peoples. I am not impoverished or forced to wear a large "S" for stupid on my outer garments. We simply paid for the prenatal/birth-related services rendered over time, in increments we could afford. This paying was not embarrassing or shaming in any way. It's the way people have been paying for things for, like, ever. Health insurance is fine for what it is, but it is not Necessary. 

Behold a mystery: Birth cost us approximately the same out-of-pocket without health insurance coverage as it currently costs us with health insurance coverage. All in all, God provides. Be not afraid to carry out the fullness of your marital love. We brought nothing into the world; we can take nothing out of it; but we can bring forth children in the grace of our God without health insurance. Really.  

22 comments:

Rebekah said...

I have a friend who paid the final bill for the extensive prenatal care and surgical birth of her twins on their 16th birthday. She told me that some months she and her husband had as little as $5 to mail to the hospital, but as long as they kept sending the payments there was not and could not be any trouble.

Elizabeth said...

Ironically enough, one of the bills I received this time around (which was for a bilirubin check, I believe) cost us more with our health insurance pitching in than it would have if we had gotten the uninsured discount.

God does always provide, doesn't He? :)

Pr. H. R. said...

Indeed, if you tell them you are paying cash without health insurance and ask for a payment plan, they cut the price drastically. Welcome to the insanity caused (IMHO) by Medicaid, Medicare, all hospitals being forced by law to provide emergency services to folks they know will never pay, etc.

In addition, I have had more than one parishioner get gold medal care at one of the country's best hospitals without any insurance or means of support (one a heart/lung problem, the other a shattered arm). The hospitals have programs for such things.

We are very thankful to have insurance and an HSA plan now - but the tradeoffs are quite real between paying for premiums and just paying out of pocket.

+HRC

Untamed Shrew said...

We had no coverage for our first, but the OB was kind enough to type up a payment plan, which we signed and adhered to. At the end of my pregnancy, she gave us all our money back and said the state would not allow her to accept private payment. Still scratching my head over that one.

Katy said...

"All in all, God provides. Be not afraid to carry out the fullness of your marital love. We brought nothing into the world; we can take nothing out of it; but we can bring forth children in the grace of our God without health insurance. Really."

Beautiful.

And praise God for generous support from our natural and church families. Our second born was "paid for" in cash. (And cost about as much as our born-under-insurance first born.)

My father, an unexpected twin in an unexpected pregnancy (the other kids were 11, 13, and 15) was paid for by the family doctor. Now it's a favorite story that begins with "Dad was so cheap..." or "Donna (twin sister) was so big and Duke was so small, they didn't know he was there" or "Doc was a good man who helped our family in need."

Anonymous said...

. . . and in the days past, Pastors were also paid their salary with chickens or a side of beef . . . it's just rather hard to drag that side of beef to the Student Services Office at one of the Concordias to make a tuition payment. Although I must say I'd like to try.

Other than finding a benevolent sponsor it still seems like questionable stewardship to approach the birth of a baby without adequate insurance. Yes, your hospital might discount your fee because you have no insurance - but that discount simply causes your brother or sister to pay higher fees to cover the uninsured.
A non-exceptional delivery might be had for a song, but a complicated delivery and neonatal care for baby (or possibly ICU for mommy) could bankrupt your family for years. As much as we'd like to think it's so, the hospital accounting department is not your friend - their concern is their bottom line and those of us in the working class who do not qualify for state or federal help have much to lose without adequate insurance. We don't go to the grocery and "hope" they might not make us pay for our groceries - it seems risky to hope that a hospital will be benevolent if charges outweigh our ability to pay.

Gauntlets said...

Anon: Neither I nor anyone is advocating we all fling off the yoke of health insurance while pretending that money doesn't exist. Furthermore, neither I nor anyone is insinuating that "uninsured" means "have a baby for free." C'mon, for reals? A non-exceptional delivery can NOT be had for a song. It can, however, be paid for using government-approved currency outside of the bounds of a health insurance contract, without bankrupting anyone. As can a very expensive exceptional delivery, as my dear friend pointed out in the first comment following this post.

Though many would have you believe that hospitals are evil, sinister institutions that lust obsessively for the government's dull fiat paper, the truth plays out quite differently. Of course the people (THE PEOPLE! HUMAN PEOPLE!) who run the places want to be paid. Of course we absolutely MUST PAY THEM. And yes, insurance has changed the game drastically. But that does not mean that everyone has to play the game according to Medicaid's rules. Especially given that, as I and others here have pointed out, the out-of-pocket cost is ALMOST EXACTLY THE SAME whether you're insured or not.

Jesus is coming back. He provides. You don't HAVE to have insurance to have bring a child into the world. It is not irresponsible to fling from yourself the garrote of contraception in the midst of being uninsured. Doing so is an act of faith, yes; but it is not irresponsible.

Anonymous said...

Okay . . . I didn't mention or insinuate "free = uninsured" anywhere. I'd be interested in seeing any hard data, rather than antecdotal summaries, that demonstrates that out of pocket costs are "almost exactly the same" whether you're insured or not.

Of course you don't have to have insurance to have a baby - but to act responsibly as Christian stewards one MUST contemplate how they would cover the costs of a hospital bill that is tens or thousands of times higher than an uncomplicated delivery.

One can also drive a car without auto insurance - however at the risk of losing my home I choose to plan ahead and pay my premium. And no . . . I'm not equating a baby with my junker car. This is an interesting topic given the historic LCMS take on insurance. I wonder if there's anyone hanging around here who lived in the day when insurance was taboo.

Rebekah said...

Fact: hospitals bill at different rates for each of the following groups: the insured, the uninsured, those on Medicare/Medicaid.

The ethical high ground could just as easily be to refuse insurance so as not to be complicit in forcing unjustly superinflated charges upon insurance companies, which happens every time a claim is filed thanks to insolvent government programs which "allow" payments incommensurate with actual costs. But then we'd be bad stewardishly uninsured.

Gauntlets said...

I will not be researching the hard facts for you today. I invite you to call your favorite hospital’s accounting department during non-peak hours to ask for a breakdown of costs for different insurance brackets. But I’m quite confident my claim and those of my sisters here are not growing from piles of bunk. :D Take them or leave them.

That said, it is true, sometimes painfully true, that having a baby while uninsured entails a great deal of sacrifice. But as we’ve mentioned on this site more than once, sacrifice is good. We Christians are called to it. We pick up our crosses, die to ourselves, and do what we’ve been given to do. Modern ideas of Christian monetary stewardship, while very popular and comfortable-sounding, are not easily swapped out for the Church’s historic position on the creation of human life within the Body of Christ. The Church has not historically concerned herself with budget forecasts when it comes to the creation of her children. I daresay she still does not. And to say, “I am not immediately certain of the location of every cent needed to cover a very unlikely tragedy, and I thus must prevent my own wife from conceiving my own child at all costs” is not even finding its fuel in modern ideas of Christian monetary stewardship.

While there are some instances in this great America where a family truly cannot afford to conceive children, those instances are rare. More often than not, those who feel they cannot afford another child really can. It is necessary to prioritize children born and potential, over being comfortable and feeling prepared. Having lived through the difficulty of paying for medical care sans insurance for several years (and not only the birth of children), I can attest that it is absolutely necessary to commit to doing without. We didn't carry cell phones in those days. We didn't have Internet service or cable TV (still don't). We didn't rent movies or go out to eat or buy new clothes or take vacations to interesting places (neither these). We didn't rack up huge debts on credit cards or borrow money to acquire things, and we didn't even have a savings account. And while we were boring and shoddy looking (still are), we didn't go bankrupt, either. We simply paid our bills and moved ahead.

Again, it would be difficult for the terminally uninsured (and again, by this I do not mean completely bereft and impoverished) family to adopt a perpetually parturitional life, perhaps, but I will not say that doing so would be irresponsible or foolish or bad stewardship by Christian standards. By the world's maybe, but what do we care what they think? Again, having children is a matter of faith. And, if you please, not in the sense of This Is What Saves You faith (so let's not get into that debate; no you are not saved by childbirth in that sense; Jesus blood is all that is necessary; you are Baptized; Thanks be to God). The answer to the question, “Should we be fruitful and multiply?” should not be another question, like “Will my budget allow it?” The answer is: Christ is coming back. He is coming back! Faith can afford everything under the sun and more. Eternity can afford more precious human souls. You can afford to have more children. God will provide.

Jody S. said...

With regard to a non-exceptional delivery being had for a song. . . less than two months ago I had a non-exceptional delivery(really? is there such a thing as non-exceptional delivery?) which was not had for a song. Among the various charges from the hospital (that does not include any labs, ob/gyn, or pediatric charges), was one for "Diagnostic Services" for $250. Can anybody tell me what they had to diagnose?!? I was in labor! I also was amazed to note that my 4 doses of ibuprofen and one stool softener cost $150 (for prescription medications).

I am friends with somebody in charge of accounting for a hospital, and the charges are very complicated. Prices fluctuate for them depending on how many beds are occupied. For example, nurses still must be paid to be on hand whether there are 2 women delivering or 12. Frustrating for us, but necessary for them.

Sarah Osbun said...

We contemplated going without insurance for our second child, but as the cost was approximately the same we kept the insurance "just in case" something drastic happened.

However, I'm still irritated that my insurance won't cover a home birth, but will cover the birthing center 30 minutes away. Really? I live less than five minutes from the local hospital, a transfer from home would be way easier than driving half an hour and then transferring to a hospital if needed. And you'd think the insurance company would want to go with the less expensive option.

Katy said...

Next baby will probably be born under CareNet, not because we're morally against traditional insurance, but because 1) of our young age 2) self-employment 3) having a whole passel of kids

lisa said...

Katy, what is CareNet?

I have only heard that name in regard to crisis pregnancy.

Katy said...

Oops, I meant Samaritan Ministries (and I think I was confusing it with MediShare, which we won't be using). We have several self-employed friends with many children who use it (+ a traditional, very high deductible insurance plan). Recently our American Family insurance agent, a family friend, suggested it, and said personally he would use it for his family if his wife didn't have some health problems.

MooreMama said...

As a working lay woman, married to a working lay man, I am doubly insured. (I have "free" insurance offered as a benefit through my employer and my husband's employer offers a "better" policy, which covers our whole family.)

My BFF and I had children about 6 weeks apart the last go round. She is self employed as a realtor and has no maternity coverage. She negotiated "private pay" rates for the OB (we used the same doctor), anesthesia, and hospital (again, same anesthesiologist, same hospital, similar pregnancies and deliveries, she and her daughter actually stayed one additional night).
Her out of pocket medical expenses for the whole shebang (from her first positive HPT to discharge with baby) were about $200 LESS than mine.

*Disclaimer for Whomever: I'm sure that this still qualifies as anecdotal and I'm not interested in scanning and emailing the bills for comparison/proof, but for a few minutes when we found out that we were pregnant with DD#2, we considered dropping the insurance, banking the premiums, and going the private pay route. We didn't, because we had no way of knowing if anything catestrophic would happen, but we thought about it.

We've lived uninsured and we've lived with major medical insurance before we were fortunate enough to have access to actual health insurance that pays anything on routine health care. I've never run across a health care provider that was unwilling to take payments for as long as necessary to pay off a bill.

Pam said...

Katy, I've been checking into these Christian medical sharing groups, too, and I wonder if you would explain why you are going with Samaritan over Medishare. I've been going between the two, and I don't personally know anyone who has them. Is Samaritan better for maternity coverage?

We are not self-employed, and my husband is actually a called Lutheran teacher, but the school offers no insurance for the family. I agree that it is possible to have a baby without insurance, but it also makes me angry that a Lutheran employer is making us go that route.

Maybe this is an isolated case, but this particular school has no other families in which the mother stays home, and most of the teachers are young and single. I hope that other schools are more pro-family and less focused on the bottom line.

I do appreciate this post, however. It's such a backwards way of thinking in this society. I don't know how many people have told me they'd like another baby, but they can't afford it. I fall into the same trap, but I appreciate the reminder that "all in all, God provides."

Gauntlets said...

Pam: My husband was a Lutheran h.s. teacher for the first few years of our marriage. Like you, I was not insured by the school. We were ineligible for Medicaid and our case was rejected by Unicare.

The school was just as yours is: focused on the bottom line. And just like you, we were the only young, traditional family of the bunch. It is hard. Schools have their good reasons, but it makes it no less hard for us. I'm so sorry.

Gauntlets said...

In the interest of disclosure, I'll add that when I became pregnant with our oldest child, I took on work with that Lutheran h.s. for the sole purpose of gaining health insurance to cover the birth. It ended up being a moderately complicated delivery, and my little daughter spent several days in the NICU. We payed out the nose for our care, in spite of the health insurance. And in addition to having the stress of medical bills, I had the stress of leaving our beloved child at daycare coupled with the stress of working outside of the home in a very demanding job that was supposed to eliminate the stress of medical bills. It was so stupid. In retrospect . . . but of course, I am much smarter in retrospect. :P

Purple Koolaid said...

Anon et al,
It is illegal for a hospital/doctor to charge a lower fee than they charge the govt, ie medicaid or medicare. SO, chances are the rate the uninsured were allowed to pay was the same as a medicaid person.
And as for Lutheran schools focusing on "bottom line" rather than providing insurance, my guess is that the insurance is far too expensive for the school to provide. I'm sure you've noticed that most Lutheran schools are not relaxing in wads of cash...many are closing or barely making it. The bottom line is it's called a wages and benefits package. Whatever an employer gives you in benefits, that means less take-home pay. Many people think their benefits are free, but they're not. I highly recommend samaritans or medishare.

Katy said...

Our insurance agent recommended Samaritan, and our friends who own a business and have 8 kids go through them, without any problems at all. I'm sure Medishare is dependable, so nothing against them generally. The philosophies of Samaritan seem more in line with our beliefs. Here are the pages with what they require participants to confess

http://mychristiancare.org/guidelines.aspx#IIB

http://www.samaritanministries.org/guidelines/#I

At one time I thought Medishare required all abstinence from alcohol, but it looks like I was mistaken or they revised it. Both require all abstinence from tobacco. (Our clove-smoking days are over anyway, since those cigs were outlawed. JUST KIDDING. I mean, kidding that we had clove-smoking days.) My husband is ornery about these sorts of pieties, but of course such abstinences will keep costs down.

If we drop Medicaid for one of these alternatives, I'll report back. Anyone out there using either one and have good or bad stories to tell?

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