How do poor people in the states give birth without money?
I’m Canadian. And I’m already sorry for asking an ignorant question.
I know you have to pay for hospital visits in the states. I know lower economic status can come with lower access to birth control and sex education. But then, how do they afford to give birth? Do people ever avoid hospital visits because they don’t feel like they can’t afford it?
Do hospitals put people on a payment plan? Is it possible to give birth and not pay if you don’t have the means? How does it work in the states?
How does it all work?
Again. Canadian. And sorry.
My sister was on welfare and had a kid around the same time as me. Hers was covered completely by Medicaid.
Mine, because I had a job and health insurance, cost me $20,000. Didn’t finish paying for the kid until her 2nd birthday.
Oh my.
Medicaid is the correct answer. Surprised more people aren't mentioning it. It's specifically in place to cover people with low incomes who often don't have insurance through an employer.
Medicaid will often cover the cost of child birth for low-income people 100%.
That being said, if you have slightly higher income than allowed to enroll in Medicaid, your only option may be a long-term payment plan and lots of debt that you may carry for the rest of your life. It's an awful system that really only benefits the strong.
Canada, don't go down that road.
That's pretty much how it works. Newborns qualify for Medicaid, and low income pregnant women generally do too.
I always wonder what would of happened to my son if I wasn't Canadian. He was not growing properly in the womb which meant many doctors appointments and ultrasounds . And then he was born 3 months premature and spent 3 months in the NICU. I didn't have to pay a cent for any of it .
Natural selection would have taken place if you were American
Are you familiar enough with the details to share them? Because this sounds strange to me - every plan has an out of pocket maximum and the highest I've seen is $14k. Are you including premiums? Do the costs span multiple years?
This was pre-Obamacare, and the birth alone - with c section - was $20k.
I'm not American so maybe I'm getting something wrong... But aren't you making a faulty assumption about people having a plan at all? Isn't the amount of completely uninsured in the us in the double digits or something?
No.
Plus in the comment she said she had insurance.
The original commenter did mention they had health insurance
You're correct, my bad
Have I personally avoided going to the hospital? Absofuckinglutely. Unless I’m in immediate danger of dying I’ll figure it out myself. I’ve superglued more than one nasty cut that probably needed stitches, entirely possible I’ve ignored more than one concussion. Is it smart? Unequivocally and resoundingly not. Do I do it anyway so I can pay my rent? Yep.
I wonder about the effects of having a low grade constant stressor like that. Combine that with at-will employment and gum prevalence and it’s surprising anyone is able to feel secure and get healthy.
Purely anecdotal, since I can only draw from my own personal pool, but I don’t have a single friend or colleague who feels even remotely secure in their life. We’re all one emergency away from bankruptcy.
I’m so sorry. I want more for my neighbours.
Again just a personal opinion but I’m loving the change I’ve been seeing lately. More people seem to be standing up for their fellow man and calling for things like universal healthcare. I’ve never seen this much unionization and union positive thinking in my life. I have hope that this attitude of radical individualism is going away and that people are going to pull together for the benefit of all people, not some.
I really hope you're right. As a Dutch guy in the US it really baffled me how many Americans vote against their self interest only to then do a poor man's version of social healthcare via GoFundMe when their luck inevitably runs out
In the US it baffles us as well. Though most Americans do actually want universal healthcare, anytime it comes up as an issue in the national conversation there is such massive propaganda against it, articles talking about things like 'death panels', hypothetical committees under more socialized healthcare systems that will decide who lives and dies, or that you'd have to wait hours at the ER. Ridiculous things like that. It's seen as a 'left' issue, if you are on the right or conservative in the US you won't be as likely to support universal healthcare, which does align with one right-wing view of 'poor people should die more'.
The effects of having low grade stressor like that, combined with non-federal sick leave nor vacation and predatory corporate labor laws are what you witness in the US every day. Precipitously declining mental health for everyone, reduced social and coping skills. Commonplace violence and rage and incredible rates of anxiety and depression and resultant medication.
Heart disease like irregular heartbeat and stroke. Gastrointestinal problems such as ulcers and IBS. Increased susceptibility to illness. Ability to learn/memorize/perceive are reduced. Not to mention the effects of maladaptive coping mechanisms such as drinking, smoking, drugs etc.
Source.
I whole heartedly agree... We should ban all gum... Big chew included 😋/s
Lol I just noticed that. Imma leave it. It’s better this way.
I make good money and have reasonable health insurance. However, I grew up super poor. So I only use health insurance in life or death circumstances.
I don't want to be poor again.
Definitely same.
For our northern cousins, an illustrative story. I was attacked by a dog and with my arm and leg bleeding everywhere my first call was to my wife to get her to come pick me up because I knew an ambulance would be insanely expensive, and my second call was to insurance to find out if I could go to the hospital instead of urgent care. They sent me to urgent care, where they told me it was the worst attack they'd ever seen that wasn't on the face.
The kicker is that I even have GOOD insurance, but that's the reality of not knowing if it's gonna bankrupt you or be covered or not: hesitation. That's the reality of having years of habit-forming second-guessing when you had bad insurance, or when with good insurance and a tight budget. Imagine what is like for people with bad or no insurance.
My housemate lost his awesome mom when he was like, 10, because of that. She refused to go to the hospital because she couldn't afford it, and it got infected. Fuck this country.
Are you sure you don’t qualify for Medicaid or other public assistance?
Yep. I make ok money and have insurance. Things being what they are, rent has skyrocketed over the past couple years. Food seems to be coming down in price but for a while there it was pretty alarming. I haven’t had a significant raise in about 3 years to keep up with cost of living increases. Choices must be made and if life and limb aren’t in immediate danger, I choose to not have a bill of several thousand dollars for something like a few stitches and/or fight with my insurance company over coverage.
This doesn't answer OPs questions at all. Medicaid is available for expecting families that covers the cost of prenatal, birthing, and postnatal services.
I can answer this: my son was born in 1990. We were extremely poor.
We had midwives help us out as best they could, to the tune of about $3200 at the time. The birth got complicated due to a variety of health factors, and both my son and wife almost died (not because of the midwives). Luckily the midwives had a direct line to Georgetown Hospital, and the cesarean was done there. The total hospital bill was $58,000, or $138k in today's money, although hospital costs have rose much higher vs inflation, so maybe it would be in the $200k range now. She was in the ICU for a week, hospital for another week, our son for about 3 weeks.
My wife job didn't have health insurance, because it wasn't required back then. Because she was gone a week, her job fired her for an unexcused absence. Oddly enough, this made her unemployed and Washington DC had some law (or rule or something) that immediately dropped the hospital bills because of her unemployment. In the end, we had to pay $15k to about two dozen practices who individually sued us, which took 7 years to pay off and a lot of court visits and wage garnishments. It financially ruined us, pretty much. Both suffered a lot afterwards because we just couldn't afford minimal care. It was hellish. I can't imagine how much worse it would be today. We got evicted from our apartment, and lived in government housing for six years.
So, yeah. Don't have a baby in America unless you can guarantee it will be healthy and you have a lot of money. Most of my friends don't have kids, they simply can't afford it and look at it like the previous generation looked at concepts like summer homes and yachts. Nice luxuries, but way out of affordabilty.
Wow. That's horrible. The US health system sounds like a dystopian nightmare.
And yet so many Canadians seem to want to dive head first in to a fully private healthcare system as if anyone could take that financial hit.
It doesn't help that many of the governing bodies are deliberately sabotaging it as much as possible in order to push voters into that direction. Doug Ford is one of the most notorious in this respect, but there are plenty of others too
meh Cannucks tend to adopt the worst of everything they see
You spelled Canucks wrong and your broad generalization is insulting to millions of people, especially since the majority of us are smarter than that.
Canned ducks?
Yes.
I'm sorry you and your family had to go through that.
I'm Canadian and I gladly pay more taxes than you so that I and my friends get free healthcare when we need it.
When we watched the fights over "Obamacare" we just shook our heads.
That's the ridiculous thing. Americans would rather pay a few dollars less in taxes than let people have free healthcare. And it ends up costing them far more than they would have paid in taxes.
Here's the thing. I worked in America for the better part of a decade and I had to submit two tax forms, one to each country. You end up paying the greater of the two and using it to offset the other.
What I know is this: every year, every year, I paid an extra 1% to America. No matter how my (binational) tax guys worked it, my obligation to America was always higher.
The year after I came home I still had to submit taxes (January layoff scares so I moved back) and it was still higher for America despite sitting in a different country (it's a factor) and using different services. It didn't matter.
In Canada I pay 1% lower income tax and enjoy healthcare access. While they've done away with the regional premiums, I was even okay paying that; as my yearly outlay, proudly at the top bracket, was still less than copays while in America. I would gladly pay the same premium to ensure equal access to dental and optical care for me and especially people who can't drop (now) c$1000 on some specs or way more on a dental crown.
It's not that I'm a good guy, but I pay taxes for schools because I don't want to live around dumb people. I do and will pay taxes so we can take people who aren't healthy and skilled and contributing income tax and make them so they are. Poverty should be no excuse for not being employable.
What the actual fuck, and this was in 1990
1990 was around the time of Hillary-care and Romney-care, so the politicians knew that they were going to have to fix it sooner or later by that point.
Hillary's plan was being developed and debated in '93-94, Romneycare in Massachusetts happened in 2006.
Man.... That is crazy. I'm so sorry for you guys.
Why didn't you have taxpayer paid (State) insurance if you were extremely poor and expecting? Is it because of the lost job and timing? If you are poor and have a family then you can spend a day at the welfare office and get public insurance.
Because we made too much (over minimum wage, dual income household). I was making $13k as a sales manager, my wife was making $8k as an assistant manager, and minimum wage was $3.35/hr or just under $7k/year back then. After taxes, we made about $1200/mo, and our rent was $650 for a single bedroom apartment. No car, we took the bus, barely had enough for food and utilities.
But we were considered way too over the "poverty line," which was I think less than $6k/year then. We had been using birth control but when they say some form of birth control is 99% effective, the DO mean 1% failed. I have no regrets our son was born, because it turned out we couldn't have kids later when we tried. And then later my wife died when he was 22, so if we had kids later, I would have been a widow with younger kids.
I feel awful he grew up poor with us until he was about 10, though.
Oof, yeah that's rough. The poverty line is really low. I can relate about wishing you weren't poor when your kid was a kid, we had the same experience. We would have been able to give him a lot more had he been born a decade later, but he still had a loving home, which is more than a lot of kids get.
I'm really sorry to hear about your wife. I can't even imagine.
for more on this subject, and in the spirit of looking on the bright side of s bad situation, see /c/childfree and childfree.cc. Includes talk, and memes, about some of the benefits, of not having children, including but not limited to finances. (also advice and directories about related options for medical things, where thise are wanted or needed).
Ah... In short.. Insurance covers a portion of it and whatever insurance doesn't pay, I just... Simply don't pay it. It goes to collections and they spam call me and I don't answer my phone. Suddenly they give up and after 7 years, it's gone. Is it right? I don't know. I definitely haven't devoted half of my paycheck to medical bills though.
Does that bork your credit?
Yes it does
That seems like an unfair and inescapable conundrum.
"Should've thought of that before you had kids while poor" -Republicans
"if you thought about it though and decided not to, too bad, we've decided for you that you must go through with it"
-Also Republicans
“And this is our plan to have a steady supply of impoverished, under educated people to make into wage slaves, military killbots, and to bolster the for-profit prison system!”
Once I got some physical therapy bills sent to collections. It wasn’t because I failed to pay. The practice was really shitty about billing and record keeping and never billed me for a bunch of visits. They went under and sent their records over to collections.
The collectors called me and pretty much opened with “this place went out of business. We would settle for pretty much anything. How about 10% of what you owe?”
They get a percentage of everything they collect so you might think they’d go for the full amount. But I think the game is sometimes just “what can we get easily and quickly.”
At least in my experience, we’ll generally be able to go to the hospital
Generally, I’ve just seen the debt transferred to a debt collection agency afterwards, since there’s no money for them to take. They’ll harass you, and it affects your credit score, but they can’t send you to jail
Credit score? Is it like the Chinese social credit system?
Yeah, just the American version
It affects where you can rent housing, what houses you can buy, whether you can get a car, etc
Love how everyone went insane with the social credit score while you got the same shit done to you and no one batted an eye
US credit score won't get you sent to jail or a re-education camp, at least. At least, not yet.
It will condem you to poverty tho, which may be even worse than jail
It can impact everything in your life, even jobs and housing now. It's practically the same thing except instead of being forced to live in a camp you're living on the street.
And if you dare get together with other people that are forced onto the street and make a camp together somewhere isolated, the government tears it down and evicts you and destroys your things. Thank god for our freedom.
My favorite part is when one of the three companies that does ours leaked all of our data with relatively no consequences.
https://www.ftc.gov/enforcement/refunds/equifax-data-breach-settlement
Well if it’s the free market abusing us it’s okay. That’s just freedom.
I mean it's not like your credit score immediately gets affected for something like jaywalking though.
I'm not sure that's entirely the bar we should be aiming for
It can even impact being hired for jobs. Low credit score? You might be untrustworthy or motivated to steal
It's not comparable at all. In the US your credit score only goes down if you borrow money and don't pay it back. If you get a loan and pay it back on time your credit score will be fine.
I'm not super familiar with the Chinese credit system, but I think it's effected by a lot more. What kind of products you buy, how much you work, posting certain content online, etc.
Yes these systems are not in any way whatsoever comparable to each other except in being reputation rating systems.
“What? A bank wants to know if you defaulted on the last loan you took? What is this?? Totalitarian China???”
Not only American. We in Germany have shit like that and most other European nations have it as well afaik
It exists in most places from what I can tell, but the specific implementation may differ
The technology of loan risk assessment? Yes, it exists worldwide, all banks are doing it. But there is a wide chasm between
"when I show up asking for a loan bank will xray all my previous financial history and craft its offer from that" in Europe (at least my country) and
"credit score is a houshold term, people employ lifehacks to improve it and you're screwed if it's bad because half of everything runs on credit".
There's also the fact that credit rating agencies in North America have hardly any supervision and are prone to make mistakes because they take correlated data by face value.
I think my credit report still says I work at "DOMINOES" after like 5 years of not being there. It doesn't effect anything, but I get mild amusement out of it being misspelled on top of that.
I don't have a credit score, and have never had a problem renting. It's getting a mortgage that I can't do without a partner who's been consistently paying off a credit card for decades.
My credit score wasn’t good enough, so I had to show the last place I rented 6 months of my employers payments to rent
I’ve never missed a payment, nor do I have any debt. I just don’t exist in the system enough to rent
The US version is a system that calculates the risk of loaning money vs being paid back. In order to be approved for a loan the credit score is used to evaluate whether or not it is likely to be paid back within the terms of the loan. As a result those with bad credit have trouble getting favorable terms for cars, housing and basically anything that can't be purchased outright. Does it negatively affect people for things outside of their control and perpetuate cycles of poverty? Absolutely, but it is based in actual fiscal risk to calculate sustainable loan practices.
China on the other hand took the US term of "credit" and abused the everloving shit out of it to punish people that the government dislikes. Did your cousin post a Xi Jinping Winnie the Pooh meme? Well too bad that you were shopping for a house, because your "credit" is no longer high enough to not be homeless. You should have thought of that before you were related to someone who disagreed with the government!
Not being able to demonstrate to a bank that you are financially reliable enough to pay back a loan is unfortunate, but a rational reason for an unfavorable interest rate or denial of a loan. Making people ineligible for even renting an apartment that is within their financial means because the dictator in charge dislikes you is a completely different thing altogether.
It’s similar but only take into account financial and professional information. As I understand it, the Chinese version also covers your daily activities.
At this point, pretty much
As the name hints, a credit score is used to rate the risk of making you a loan. It’s not some essential personal ID. It only comes into play if you are applying for credit and is a set of shared records that financial institutions and private companies use to decide if loaning you money is a good risk or not.
Someone else said it’s used to decide if you can get a car and that’s not accurate. If you need to borrow money to buy a car, your credit history will be checked. It’s the loan, not the car.
Is it crazy that lenders would want to know if you’ve walked away from your bills in the past? Making it sound like dystopian China is a gross exaggeration.
Landlords want to know if you will be able to pay rent and they may ask to know what you earn, what’s in your bank account, and if you have insane debt. It’s not credit per se but they are entering into a financial agreement with you which you could default on, so it’s got many of the same characteristics. Don’t want to give all this information? Don’t. It’s not required by law. Not everyone demands it. Some may choose not to rent to you without it.
Not really. It just keeps track of how often you miss your credit card payments so creditors will know how high of a risk you are to lend money to. If affects if you can get loans and what interest rates you can get on loans. But if you just pay your loans/credit card bills, you'll be fine.
yes, but in the classically American fashion we only care about money so much only the money stuff even goes into calculating it
Well yeah, because it's only used when talking about loaning money...
Would a hospital ever refuse you care if you have outstanding bills or hospital bills with collections?
It’s illegal in the Emergency Room. Anywhere else they can. Poor people end up relying on Emergency care, ignoring bills, and the hospitals write it off as “charity care,” which helps them justify their non-profit status, when they’re non-profits
Depends on the severity of the issue.
For a life threatening emergency, no
For like pain relief, yes
The hospital must stabilize you and save your life from immediate danger. They don't have to make you better or solve the problem.
Simply.
They don’t pay the hospital bills.
Wait for them to repo the baby...
"they don't pay"
Yikes, real "us vs them" without any experience understanding or compassion, eh?
I understand the point you are trying to make, but I'm not sure what you are reading into? The question was "how do poor people in the states..." I am a poor person in the states, if I was to answer I would probably say they, maybe 'we' if I was feeling like sharing. And it's true, many medical bills throughout my childhood that we couldn't afford just went unpaid, with debt on my parents credit.
Wow u just made up all that in ur head...just ...wow.
This is unfortunately true, though. A lot of people just don't pay them, especially homeless people. How are they gonna get billed? They have no address and many don't even have a phone. I'm not making a moral judgement, but it does happen very often.
Source: husband is an ER doc at a city hospital that serves most of the city's homeless and below-poverty-line population where we live.
Downvotes without any replies? Yeah, that checks out.
Hi, I down voted you.
E: Twice, actually
If you are poor enough you can qualify for Medicaid (MediCal in California) which is a sort of limited health insurance. This is life saving for poorer families and most of the time completely covers birth costs. After birth in some states they even offer follow up plans from nurses for assistance with food and meal plans for babies and toddlers.
Even if you don't qualify you can apply for financial aid which I believe is required to be offered in every public hospital even to people whether citizens or not. If not you can just take on the debt and not pay, which destroys your credit score but after long enough you might be offered a favorable financing or a discount... Only after being harassed by collections for months if not years.
Source: not American but I've worked with American healthcare workers interpreting for Spanish.
Also to clarify saying if you're poor enough makes it seem like it's a high bar, but iirc ~35% of people are on Medicare/Medicaid
Came here to explain this.
I just explained this before seeing your post. There's a lot of America bashing in this thread with completely inaccurate information. I was relatively poor when my son was born and we were on public insurance. Everything was paid for. It was actually a pretty good overall experience. Now that I'm making a lot more money I don't complain at all about taxes, since I know that at least some of it goes towards invaluable services like this.
American hospitals cannot legally refuse to treat you even if they know you can't pay/don't have insurance. So worst case scenario is you go and have whatever done and they bill you and you don't pay and it's a write off for the hospital.
Often times, if you can't pay they will offer a reduced amount to at least get something out of you if they know they won't get anything otherwise.
Fucking crooks
Edit: who the fuck is downvoting me? USA hosptials owners?
People are thinking you mean the poor people, not the hospitals.
I'm just laughing at the absurdity of someone calling poor people who can't afford their medical bills "fucking crooks" but that actually is a position I wouldn't surprised to see these days.
Not just these days. See Reagan and his lies about 'welfare queens' living on lobster and buying Cadillacs off of government money.
Unfortunately, yeah, it's very common in the south, so I'm used to seeing it :(
Even in the more 'blue' cities down here, it's usually safer to assume that whoever you're talking to is a republican piece of shit, or else has holdover ideas (like 'the poor don't deserve handouts') from being raised that way.
It's very expensive to be poor.
They send the infant to debtors prison to begin working off the $70,000 hospital bill. They don't have to pay the infant minimum wage though, and they charge them for room and board and meals, so by the time they're 18 they are actually indebted to the hospital an average of 1.4 million dollars, which they will then begin working off as adults earning minimum wage.
I man you joke, but don’t give them any ideas.
Arkansas has upvoted your comment and taken notes.
Ohio awaits program completion and results to “improve” on it.
I know you're joking, but Im pretty sure that there was a supreme court case that made debtors prison a thing of the past.
deleted by creator
Found it, it was 1983, much more recent than I remembered. https://www.justice.gov/usao-sdal/page/file/918356/download
The feds themselves call it a civil rights violation, they have a good chance at a lawsuit. IMO, the judges who sign the arrest warrants need to be debarred or taken out of office or whatever happens to judges.
Was poor, had a baby at 20. $6,000 hospital bill we paid in monthly installments of like $100
Paid off my kid being born when she was like 6 or 7 lol. Kind of like a car
Vaginally
Some people give birth in their own homes like in medival times. I know people who have done it. In my opinion people shouldn't be having kids if society is so broken you have to do stuff like this but to each their own.
There's nothing wrong with it. Thats what midwives are for.
Until it goes wrong.
We opted to have our second at home in a birthing pool, it was amazing! Mum and baby were monitored way more than when we were in the hospital with our first, and we could just recover and relax in our own home after. No stressing about having to get to the hospital etc.
As a poor Florida resident who grew up and has known several people giving birth in poverty; if you're lucky you qualify for WIC (women, infants, and children) which is essentially food stamps/ welfare for pregnant women and mothers. That covers food. If you qualify for WIC then you're also eligible for Medicaid which is the US' version of free* healthcare for people in poverty. That will cover pre and post natal care for the mother and baby. The baby is usually covered until they're ~6. Unless you're still poor by then, in which case it usually covers the child to adulthood or until their parents no longer qualify for Medicaid. Note that none of this covers diapers, clothes, or other necessities for the infant. Just food and drs visits. If you're poor, but on the [benefits cliff](https://www.ncsl.org/human-services/introduction-to-benefits-cliffs-and-public-assistance-programs#:~:text=Benefits%20cliffs%20(the%20%E2%80%9Ccliff%20effect,a%20small%20increase%20in%20earnings.) you can get fucked lol. Murica
To clarify, currently around ~40% of Americans have government funded insurance.
5% increase since your other comment?
My other comment was just Medicare/Medicaid. There's also VA, and insurance for federal employees.
... which is not to say that it's free or even affordable (despite the name), or that residents in every state have equal access, or that the government is providing the plan. The ACA is a subsidy that slightly reduces the cost of private insurance, provided that you're poor enough to qualify and that your state chooses to accept the federal government's help beyond a certain threshold.
Mine were born at home with a midwife who did sliding scale pricing (charged based on your income). Only available to low risk women who lived close to the hospital though.
If you are quite poor, Medicaid will cover pregnancy and hospital birth expenses, even if you don't otherwise qualify. I know someone who did that and said the nurse yelled at her because she wasn't married.
Debt. Massive amounts of debt.
Bankruptcy.
My son was premature and racked up 14 days in the NICU. The hospital (which is 'legally a charity' billed $250,000.00. We were low-income with no employer-provided medical insurance, so the state Medicare provider got to pay a reduced rate of that.
You can tell what hospitals charge to out-of-pocket paying patients is predatory bullshit because the instant they receive a lower offer from insurance or state Medicare they take that lower figure. They just charge you, the private person, whatever the fuck they feel like in the hopes you'll just roll over and pay it unquestioningly.
A good first step into bullying medical providers into negotiating your bill is getting them to admit what insurance actually pays them.
Don't forget an itemized bill. They'll charge for shit they didn't do.
Once there's a kid in the equation then it's pretty easy to get on state paid insurance. It's even easier now with so called Obamacare in the equation (Affordable Care Act). If you qualify, then you'll have free neonatal care, free gyno visits, and free delivery and hospital services. It's not great insurance, like you'll be at the community hospital and not some swanky private birthing center, but it's not bad either. Medi-Cal, the California state insurance is actually pretty good for child care and birthing services. They pay for hearing aids too, which only 3% of private insurances pay for. So medical care when you're poor and have a kid is decent in the States. Now that there's Obamacare it's decent even without a kid. Where it falls short is if you're under-insured as a middle class citizen, and it's pretty easy to be uninsured, even with expensive plans.
My first kid was born at 27 weeks, and would have ended up costing us 3mill if they weren't on Medicaid due to being born so early. My second kid we were living in Canada (due to my job) and basically only cost us to park at the hospital.
Growing up in the US and living in Canada for a while, I genuinely don't understand why Universal Healthcare isn't fought for more. I know it's talked about but holy fuck, it's so much better in Canada.
To comment on OP's actual question, I have no idea how people do it.
And some fucks in Alberta want the US system because "I never get sick! My taxes are paying for someone else to be sick!"
As far as I know, Hospitals are not allowed to refuse you care; no matter what your finances are, they have to help you. Many people would go to ER for non-ER reasons because it was/is the only way for them to get treatment. (Because other medical centers can refuse you.)
The hospitals will try to get the money from you however they can and they do offer payment plans based on income. Ultimately, though, due many? The debt gets discharged to a debt collection agency that harasses you incessantly for 7 years until it gets discharged from your record.
It destroys your credit (an arbitrary number that every citizen has that supposedly shows how trustworthy they are and how much they are likely to pay you if you loan them money) until it drops off after the statute of limitations (7-10 years, depending on the state).
Unless you enter through the ER, a healthcare system can deny you.
Also, the ACA requires hospitals have a charity care program and notify people about it (often buried pages deep in your discharge papers). If you qualify, they’ll write off your debt and count it towards their “charity care,” which helps them justify their non-profit status, when applicable. The ACA has no rules about what charity care looks like and the hospital can set whatever criteria they want (some may have charity for those under 100% FPL, others higher).
Source: I’m in a masters program studying this
From my post: "Many people would go to the ER for non-ER reasons because it was the only way to get treatment when you didn't have the money to pay"
Seems pretty obvious that I meant the ER...
You distinguished between medical centers and hospitals, while most practices are hospital-owned now. It just sounded like you didn’t quite know that, sorry.
Perhaps I could have included a list of other places as an example that can refuse you for financial reasons. It would have helped for people not familiar with the system..
Question to Americans, is it a secret way to make poor people not have children?
No. The rich want poor people to crack out kids to fill up the military and create downward salary pressure on the working class.
Not to mention, being poor usually means poorly educated which means easily manipulated by the corporate media.
That's a steady supply of cannon fodder for a couple decades.
No I think it's the opposite. They expect people to get pregnant and have kids (though with abortion and birth control that is happening less- hence targeting those recently). This is designed to make sure they stay poor so that the wage slave class stays well populated.
If it is, it's a bad one lol. Poor people tend to have more kids, just in general, and that doesn't change in the states.
Actually it's easier to pay hospital bills when you're poor. You either go to a non-profit hospital and ask for charity, where they'll wipe your bill clean if you make too little, or you just don't pay the bill. What's bankruptcy if you're too poor to have credit anyways?
what about a midde class person? someone that makes enough to be able to pay 20k, but meaning that would be their savings
The actual middle class generally has a job that gives health insurance which will pay for it almost entirely. If you don't, you're probably not middle class unfortunately
While it's a fact that the middle class is shrinking, I think you're miscalibrated.
https://www.npr.org/templates/story/story.php?storyId=4631736
https://abcnews.go.com/Health/middle-class-americans-crushed-rising-health-insurance-costs/story?id=67131097
https://www.forbes.com/sites/debgordon/2022/03/30/with-inflation-rising-medical-costs-hurt-the-middle-class-most-new-report-shows/
You're describing what people used to think "middle class" meant. These days, we all know that health insurance doesn't cover nearly as much as you want it to. Costs have skyrocketed in the last few years, let alone decades.
Giving birth is an inexorable* consequence of being pregnant.
... Which itself is an inexorable* consequence of living in a state that decries and represses reproductive freedom.
Which is what the rest of (in the US) will all have to face down in the next 10 years.
Fun, right?
*s inexorable, as in what the GOP demands any more go forth and multiply, OR ELSE!
Ours was completely covered by state provided health insurance.
Healthcare in the US generally screws the middle, not the poor, even then it's the lower middle. The poor qualify for Medicaid which generally pays for anything major and basic healthcare, though options may be limited. The old get Medicare which covers pretty much everything outside a nursing home for fairly little out of pocket. The middle and upper class generally has decent insurance that isn't crazy expensive to have and doesn't have a ton of out of pocket costs provided by an employer.
It's the people with high deductible plans that can't or won't contribute to an hsa, and those that don't have employer provided healthcare that really get screwed.
Idk where your coming from but as someone who had $12k in an HSA and employer medical that’s bs.
I went to the eye doctor and needed glasses. Tried using my HSA. Nope. Not an approved medical expense. Tried paying a copay at the er. Nope not an approved medical expense. Wife got a kidney stone removed via surgery. Wanted to pay coinsurance. Nope not an approved medical expense. I needed a cpap for my sleep apnea. Nope not an approved medical expense. Year rolled over and all that money disappeared. I asked where it went and was told I either used it or lost it. So I got rid of it. Fucking garbage.
As for the employer coverage, we had a zero dollar deductible plan. My wife gave birth last year. Ambulance ride from her work? Nope, not necessary. All the gyno visits? Nope, not necessary. The ER visit when she slipped and fell at 6 months? Nope, not necessary. The 2 week hospital stay when she went preeclamptic? Nope, not necessary. The delivery? Nope, not necessary. The NICU stay for our premature daughter? Nope, not necessary.
I payed $1700 per PAY for my health insurance and they didn’t cover a cent from our entire family last year. We racked up over $70k in medical debt. Our MOOP was $5k/$10k and they said none of it applied.
Hospital sent it to collections because we couldn’t fit their minimum payment of $9k/mth (fuck duke lifepoint but this is an insurance rant). We complained to the pa board of health insurance and were advised to get a lawyer but no lawyer would take it. They said it would be years to get anything back, let alone the full amount.
We ended up proving that my employer doesn’t offer comprehensive insurance. The main component is covering pre and post natal care which they claim to, but they deny every time. So now we have insurance through penni for $60/mth with government help. Oh and we went through bankruptcy to get rid of the collections debt.
Fuck Cigna, fuck duke lifepoint, fuck insurance, fuck for profit healthcare, fuck the American healthcare system.
I mean yeah fuck insurance but everyone of those things you listed is definitely covered by HSA. I use my HSA every year for glasses, hospital bills and doctors appointments. also it sounds like you had an FSA since you lost what you didn't spend. HSA has rollover. But all those expenses you listed are also eligible for FSA.
Sorry for the late reply, I typically browse on Artemis and notifications are broke.
But ya, that was my point. You can have “good” insurance but whats covered is still up to them. They can deny whatever they want and get away with it because no one wants to fight back. Every one of those things are legitimate medical purchases but they don’t care because there is nothing to enforce payment. So they deny everything to keep your money and give you nothing in return.
Those are definitely all HSA things, and something I use mine for all the time. Dunno how it worked for you but I basically just have a debit card I can use that has my HSA balance on it. Functions like any other card.
I had to give an account number for my purchases and they billed it like insurance. Then they would call me and harass me for miss using the card and demand a ton of business information that they could just ask the business for. I would need to get EIN numbers from my eye doctors and stuff to get them to believe it was a business. Then they would tell me they can’t authorize it and garnish my wages as “repayment”
Part of the issue with healthcare costs in the US is that many people never pay. That means those with insurance have to cover them via higher prices.
Most of those higher prices come from insurance companies only paying a percentage of what they are billed, and the cost of the staff involved with dealing with those companies.
I wonder how much impact the cost of nonpayment has on the end user vs the cost of the middle men and insurance administration itself.
Honestly, in Arizona surprisingly, the state paid for it because we were poor and eligible for their healthcare programs. I know its bad everywhere here, but we got lucky.
One thing others haven’t mentioned: most states accepted the ACA Medicaid expansion, which means most poor people qualify for Medicaid (at least in 80%ish of states). Medicaid is pretty cheap out of pocket. It can get complicated around who accepts the insurance, but almost any hospital where you go to give birth will.
I left one job and went to another. There was a 3 month gap where I had no health insurance, didn’t qualify right away at the new job. Got an infection that required a two week round of antibiotics.
The cost without insurance was a little over $2000. My COBRA coverage was $600+ and a couple dollars with insurance for the anti biotics. I felt lucky to only have to spend the $600+ to enact COBRA coverage and that it happened in the first month so I could only pay once and drop it.
Is that where you send a big snake into the medical billing goons' office to distract and/or eat them?
Here you go. This might answer some questions you have https://www.healthcare.gov/what-if-im-pregnant-or-plan-to-get-pregnant
The number one reason for bankruptcy in the USA is due to medical debt.
We just go into debt, is your answer.
Same with any hospital visit here afaik. Most hospitals have a loophole if you can't pay, you can dispute the fees, they check your income, etc.. like others have said I think it affects your credit score either way. But it's all part of the privatized healthcare grift.
The average out-of-pocket payment is under 3k.
You say that like it's not supposed to say over 2.5k. Making any price under something makes it seem cheap. And let's not forget that the majority in the US don't have 1k in their bank at the end of the month.
I say that because the average was some number that hadn't reached 3k.
dunno, my sister hired a midwife to handle the birth. i heard it was cheaper than a hospital visit but I have no idea of the actual cost.
I haven't looked too deep into it because I don't plan on having children, but it's probably cheaper to have the kid at home. I've met a couple people who opted for the home birth and they were glad they did.
(I've also just personally always thought giving birth in the bath with water would be the way to go if I ever did it. Feelings that it might be easier for baby to be born into water and not directly into cold air after being in the warm amniotic fluid so long.)
Bathtub. Car. Alleyway. Crippling debt that, while shouldn't be impactful on credit score, will still follow you for your lifetime.
You generally don't pay for hospital visits 95+% of people have some form of insurance that would cover the vast majority of the cost for going to hospitals for giving birth.
95% of people have insurance? Does not caring about medical debt you'll never pay count as insurance now, because thats the only way that number makes sense. Unless i missed your point, which im known to do.
Sorry it was 91.4%
The question asked was what the other 8.6% do. That's a big number btw. You talk like it's not a significant number but it absolutely is.
I don't think that was the question. I interpreted it as them saying they thought it was higher than that.
Go back and read the original post. Not the discussion in this comment thread, but the question you answered originally. OP asked what do poor people that can't afford healthcare do. You answered that most people can afford it which is a mobster way of answering the question.
No the question was about poor people without money, not people without insurance.
Babies and births were things before money was a thing.
The same way anyone else does you go to the hospital. They are required to provide anyone with medical care especially in emergency situations.
Many hospitals in the us simply offer these kinds of medical things for free, if one qualifies.
The difference is at the end of the medical procedures one could get slapped with a medical bill... That one can discard outright. Medical dept is more often than not forgiven or forgotten by the hospital. It could be reported on your credit history but that is also often times overlooked or not calculated by the credit reporting agency.
America basically has universal healthcare. Of course there are very serious situations concerning long term care and unorthodox or experimental procedures that can be denied if they aren't paid for.
And don't get me wrong the health care system in America is a travesty and a human and civil rights issue that needs to be resolved!
I'm just saying you're not gonna die if they can help it.
Stupid question: can you just not tell them who you are?
Nope. You will have to fill out paperwork after triage and before being put in a bed.
You can be prosecuted for fraud for providing false info.
If you want to give birth in the hospital they're going to need to create a birth certificate. That probably requires ID.
Otherwise if you just get dropped off at the front door of the emergency room with no ID on you, you'll get treated as a John Doe. Basically, unidentified person needs assistance. I don't know how exactly that situation works its way through the billing department.
For stuff like in and out treatment you can but if you need ongoing care or prescriptions it would be difficult and either way if you get caught you are gonna get in trouble, fines, possible jail time so it's best to just give your real info and just not pay or plead your case with the indigent fund hospitals usually have. All that said I've known plenty of people who have given fake info and have had no repercussions
Dead people can't pay, so it's in their interests to keep you alive.