Insurance in America and the family

iVillage Member
Registered: 03-26-2003
Insurance in America and the family
55
Mon, 08-04-2003 - 11:19am
We took Alex, our toddler, to the emergency room for stitches. We could not go to the ped because it was after hours. The doctor decided to sedate him since the cut was on his face. The nurse did the sedation and he was kept maybe 30 minutes for observation. There were three stitches. The bill was $2,300. They discounted it because my insurance paid $1,041. My cost is $25.00-our emergency room co-pay. Thank goodness for good insurance.

Here are my questions about health insurance:

1. Do you think it is a neccisity? In these days of lay-offs and unemployment, alot of families go without health insurance. Newsweek had an article about "going bare" last week. We have friends that have done without insurance and they have 3 children.

2. What do you think the answer is to the working uninsured? My mother was one of these for a year. She is a dental hygienist. Her employer did not offer insurance. She bought a caustrophic insurance policy but it did not cover regular doctor visits or procedures. Some of the working uninsured are minimum wage employees that can not afford even those insurance policies.

3. Is there any solution to the raising cost of health care? I am just floored that stitches could cost so much. I know that I am helping pay for the people that come to the emergency room without insurance. It just seems ridiculous that 3 stitches and sedation could cost thousands of dollars.

We consider health insurance very important due to DH's brain cancer. I work for insurance in case DH passes away. He is getting ready to get laid-off and the prospect of him finding a job with good benefits scares the poop out of me.

KG

"I do not want to be a princess! I want to be myself"

Mallory (age 3)

      &nbs

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Avatar for biancamami
iVillage Member
Registered: 03-25-2003
Mon, 08-04-2003 - 12:06pm
I work in healthcare and I see every day examples of people who thought 'it could never happen to them'....I also see the choices that parents have to make when their insurance is mediocre (not being able to get certain tests or not going to the best specialists because they are 'out of network')

Frankly, I would NEVER have my DD or anyone in my family go unisured. I have a friend who got pregnant without inurance...what a nightmare it has turned out to be for them! Because I work for a large medical center, my family has the BEST medical insurance. That alone is worth it to me to work out of the home.

Ana
iVillage Member
Registered: 03-27-2003
Mon, 08-04-2003 - 12:37pm
In response to your questions, rather than cut and paste I will just number them.

#1 Yes, health insurance is a necessity. I think it is horribly irresonsible of parents not to have health insurance. We have NEVER had our family uninsured. I want the best for my family. If something ever happens to any of us, I want to have the resources for the best care.

#2 I am not sure what the answer is for this, but I know that even McDonalds has health insurance benefits.

#3 Yes, there is a solution to rising health care costs. It is called Tort Reform. We need to put limits on lawsuits against Dr's. The reason why your hospital bill was so high is because the amount of money Dr's/hospitals must pay for liability insurance. These rates are making many dr's quit practicing. Until we put caps on settlements we will never see health care costs go down. Dr's do not make much money these days, I do loans for plenty of them and I am amazed at how little they make. I wouldn't want the liability or time put in to becoming a Dr for what they really make.

iVillage Member
Registered: 03-27-2003
Mon, 08-04-2003 - 12:51pm
1)insurance is a necessity for all

2)catastrophic insurance is a must for a person who can't afford more comprehensive insurance. Maybe the government could work something out with small employers so that even those with one or two employees can offer insurance. I know large companies get a bulk discount, but if you own a small dental practise (guessing at your example) you may employ only one or two people and be ineligable for the insurance companies group rates and so can't afford to both 1)pay salary and 2) offer insurance.

3)tort reform! malpractise insurance is sooooooo expensive because malpractise lawsuits with no cap are so common. And the expenses are passed on to you. For every person who thinks the doctors/hospital should be punished by being forced to pay out millions, there is somebody else paying a couple thousand dollars for stitches.

iVillage Member
Registered: 03-27-2003
Mon, 08-04-2003 - 12:57pm
I can't imagine not being insured either. I had a friend who didn't put her child and husband on her policy because it cost too much (even though her employer paid half). They didn't put the baby on because they couldn't "afford" it. Although they could afford Bucs season tickets, vacations and a new SUV. It is all about priorities.
iVillage Member
Registered: 03-27-2003
Mon, 08-04-2003 - 1:02pm
Man, that is just dumb. People who had any idea what illness or even minor injury costs would put insurance on the list right after food, shelter and clothes. And by "right after" I mean after the MINIMUM of those needs have been met. Better to be insured and live in a small apartment than be uninsured and own a home. Because illness or injury could steal that home away from you if you aren't insured.
iVillage Member
Registered: 03-26-2003
Mon, 08-04-2003 - 1:06pm
My friends that went without insurance are two college graduates. She stays at home with their 3 children and he was fired from his job. They decided not to COBRA or to get caustrophic insurance because it was too expensive. At the time, she was thinking about having another child and their middle child needed tubes in his ears. They could not afford for him to have the surgery. She would call me in a panic because they needed to go to the doctor and they did not have money. He finally got a part-time temporary position that offered insurance. She got pregnant immediately. They are surviving on his part-time job and looking for money every month to pay for their house and their car. She refuses to get a job (even though she has a CPA) because God meant for her to stay home. That is a whole other debate, though.

K

"I do not want to be a princess! I want to be myself"

Mallory (age 3)

      &nbs

iVillage Member
Registered: 03-26-2003
Mon, 08-04-2003 - 1:12pm
I have another friend whose DH is self-employed. They are always a little short of money each month. They have caustrophic insurance but not good health insurance. She was a special-ed teacher before she decided to stay home with their two children. She found out she had breast cancer last year. They owe thousands of dollars for her treatment since she had surgery, radiation and three different types of chemotherapy. She is now preparing for her surgery to reconstruct the breast they removed. The church has had several benefits to raise money for her but they still owe a considerable amount of money. I don't know what they are going to do. They just thought it would never happen to them and they still do not have good health insurance.

K

"I do not want to be a princess! I want to be myself"

Mallory (age 3)

      &nbs

iVillage Member
Registered: 03-28-2003
Mon, 08-04-2003 - 1:33pm
I don't have any answers. Insurance is a tricky subject, period. Some people think it is criminal to not purchase life insurance in an amount that would set a family up (comfortably) forever should the wage-earner die. Others don't see that as a necessity at all. People have different ideas on what kinds of risks are acceptable in life.

I do believe that one thing wrong with our current medical insurance/health care system is that we are no longer consumers of services. If it only costs $10 to see the pediatrician, how many people think long and hard about utilizing that service? Do they realize that the insurance company may incur costs up to say, $300 on a doctor visit? I think there needs to be a closer link between the medical choices a person makes and how those services get paid. When you have to pay full price for an antibiotic, you are much more likely to use it properly and make sure it is truely needed in the first place. I know of people who have a prescription filled (only a $15 co-pay) for a $175 drug that they end up not using because they just wanted a "back-up." There is some mis-use going on.

iVillage Member
Registered: 05-28-2003
Mon, 08-04-2003 - 1:46pm
In the same line of thought....

Medication costs, I think, are a *hugh* part of what's driving health care costs.

I've seen doctors who will prescribe expensive medications just because the patient's insurance will cover it (even though a less expensive substitute will do the exactly the same job) and I've seen people who will demand the expensive "latest" brand-name medication even if the less expensive generic will do the same job.

Sometimes, I think "universal health care" similar to Canada or many countries in Europe is the answer, but then.... what if my family member, say an 85 year old otherwise healthy and functional person, needs heart surgery but is denied because he is "too old." I don't know. No easy answers, I guess.
iVillage Member
Registered: 03-26-2003
Mon, 08-04-2003 - 1:57pm
My DH is on experimental chemo right now. He takes high dosages of Celebrex because some studies have showed it retards tumor cell growth. Without insurance, the cost per month would be $300.00. With insurance, the cost is $20.00. Medication is so expensive and, with DH, there is no choice. He is not taking medication for colds-he is taking medication to hopefully prolong his life.

You are right in that there are no easy answers. It just makes me sick to my stomach that health care is such a mess. Here in Tennessee, we have state medicaid called TNcare. I was on it with my first pregnancy (working but no insurance) and DH was on it with his first brain surgery (same situation). Thank God, we had the option. Otherwise, we would not have been able to afford our house or our life. We would still be paying the bills. The problem is that now health insurance companies have been marking all sorts of people uninsurable because they know TNcare will pick it up. Also, people have taken advantage of it. The state is pratically going bankrupt over it. Of course, most states are in financial crisis these days.

"I do not want to be a princess! I want to be myself"

Mallory (age 3)

      &nbs

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