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.
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?
Do people ever avoid hospital visits
At least in my experience, we’ll generally be able to go to the hospital
Do hospitals put people on a payment plan
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.
I mean it’s not like your credit score immediately gets affected for something like jaywalking though.
Well if it’s the free market abusing us it’s okay. That’s just freedom.
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 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
It’s similar but only take into account financial and professional information. As I understand it, the Chinese version also covers your daily activities.
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.
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?
Depends on the severity of the issue.
For a life threatening emergency, no
For like pain relief, yes
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
The hospital must stabilize you and save your life from immediate danger. They don’t have to make you better or solve the problem.
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.
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.
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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.
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.
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.
Here you go. This might answer some questions you have https://www.healthcare.gov/what-if-im-pregnant-or-plan-to-get-pregnant
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”
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.
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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.
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?
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.
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.
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.
