Shocked about the cost of childbirth in the US!

(43 Posts)
somepeople2013 Mon 08-Jul-13 21:04:36
pointythings Mon 08-Jul-13 21:08:49

One word: Litigation.

somepeople2013 Mon 08-Jul-13 21:11:27

True. Am just utterly shocked....I just can't get my head round their health care system I guess!

DalekInAFestiveJumper Mon 08-Jul-13 21:35:37

The US health care system is bonkers. I can't blame you for not being able to understand it, somepeople. I've lived with it my whole life and I still struggle with the ins and outs of it every time I have to change insurance. One job my DH had renegotiated the insurance setup every single year, with a new set of rules and fees and having to change doctors and all.

We've moved to a new state recently, and I've the whole mess to sort through all over again. I'm paying through the nose for insurance that I can barely use because of the restrictions!

somepeople2013 Mon 08-Jul-13 21:50:03

It seems crazy....definitely makes me appreciate the nhs that's for sure.

Lighthousekeeping Mon 08-Jul-13 22:07:12

What happens if you have a premature baby?

pointythings Mon 08-Jul-13 22:13:29

Lighthouse let's just say that 25% of all bankruptcies in the US are related to medical bills. sad

DalekInAFestiveJumper Mon 08-Jul-13 22:23:48

Lighthouse, a co-worker of mine had a premature baby several years ago. She had insurance, but it was not very good. As a result of the bills, her family lost their home.

My friend's husband got cancer. Again, insured, but because of loopholes in the system, they are still paying a significant chunk of money every month towards the bills they incurred at the time. This was more than a decade ago!

Ponders Mon 08-Jul-13 22:26:27

I am shocked by that too. DD1 was born in NY 30 years ago, by CS - I believe the bill for surgery & staying in hospital for a week was c $2000, but anyway it was covered 100% by our insurance (which we'd had for 2 years. It was a HMI scheme though, which works kind of like the NHS, so more inclusive)

A friend of ours in his 60s had a severe stroke earlier this year & is currently in a rehab centre at a local hospital. The centre is a lovely place, quite new, lots of facilities, & all free of course.

DH recently wondered how a case like this would be managed in the US if you didn't have massive insurance; I mentioned this to DD1 & she told me about a friend of hers in NY whose father died when he was quite young, because he had cancer, & they couldn't afford the treatment, which is appalling in a supposedly civilised society sad angry

Our friend was resuscitated, repeatedly, by paramedics, then treated in hospital for weeks, then sent to one treatment centre for assessment, then on to the one where he is now. In the US, not being wealthy with massive insurance cover, he would probably just have died from the stroke.

I don't understand how the current Govt apparently can't see what a huge benefit to our society the NHS is confused

Ponders Mon 08-Jul-13 22:28:49

HMO, not HMI, sorry

FamiliesShareGerms Mon 08-Jul-13 22:34:10

This is exactly why, even though it's not perfect, the thought of losing the NHS and / or creeping privatisation scares and saddens me in equal measure

Beamur Mon 08-Jul-13 22:36:22

My Mum is about to undergo what could be an extremely expensive set of surgery/treatment and thanks to the NHS she won't have to sell her house in order to try and stay alive.
If you find yourself in need of the NHS is makes you bloody grateful for it!

DalekInAFestiveJumper Mon 08-Jul-13 22:37:32

Where I grew up, it was not uncommon for small children to rarely go to the doctor at all. We simply couldn't afford it. Short of breaking a bone, you just went with it and hoped for the best. My parents were both teachers, with fairly decent coverage for the area, and even I only went in case of dire emergency. Adults went to the doctor even less.

You can imagine the horror stories that result.

These days, I have good insurance, but even that requires me to spend hours on the phone jumping through hoops to convince the insurance company to actually pay for things. Doctors will often start out conversations about treatment by asking who your insurer is. It doesn't matter what the best option for treating a problem is, if insurance won't cover it. And there's a lot they won't cover!

Ponders Mon 08-Jul-13 22:40:10

from that piece linked in the OP

$20 or so for the splash of gentian violet used as a disinfectant on the umbilical cord (Walgreens’ price per bottle: $2.59)

it's not just down to litigation - this is pure profiteering hmm

PoppyWearer Mon 08-Jul-13 22:50:02

Even with good insurance, friends of ours paid $1000 for a trip to the emergency room for their DC after a head bump. shock

I've never heard of a child in the UK being given a CAT or MRI scan for a run-of-the-mill bumped head, but that is what happened over there. At great cost to them and their insurance company.

Blatant profiteering on a parent's concern, surely? And wouldn't you think twice about taking your child if it was going to cost that?

Of course all children bump their heads, and I took my own DCs into the GP/A&E after some nasty ones in the UK, but at that cost I may well not have done. $1000 shockshock

bico Mon 08-Jul-13 22:51:43

Not surprised in the slightest.

Many many years ago I spent time working as a lawyer in the US. I had one case where I was local counsel on a products liability case (my job was to assist the out of state counsel of a drug company). The drug company was one of over a dozen defendants being sued because a child had been given too much of a particular drug that caused brain damage. There was absolutely no evidence to support the our client drug company's medicine had been used. There were other drug companies supplying the same drug to the hospital. It was a pretty clear medical malpractice case and nothing to do with our client's drug other than a drug of the same type had been administered incorrectly to this poor child.

The case against our client was thrown out after a year of depositions, endless case conferences etc. The litigation cost to our client was over US$1m.

This was one of the reasons why I moved back to the UK.

Lighthousekeeping Mon 08-Jul-13 22:54:54

I was watching Modern Family this week and the granny was in a nursing home with lakes and white picket fences. Does insurance pay for that kind of care? I know it's a tv show

My friends granny had cancer in New York and she had to pay four different specialities for her care when in this country she would have just been on a palliative pathway but they squeezed every drop out of the family. It's disgusting. And the care is no better than here. God, we are so bloody lucky.

WouldBeHarrietVane Mon 08-Jul-13 22:59:15

I think in the us if you have great insurance or are well off the care can be much better than here tbh. There is a lot of hidden rationing in the uk system, where drs prescribe cheaper less good drugs and gps also sometimes refuse access to specialists inappropriately IME.

DalekInAFestiveJumper Mon 08-Jul-13 23:02:24

It depends on the insurance. But generally, if someone is in a nice-ish nursing home, odds are they either had money saved up or (more usually in my experience) their kids are paying a substantial sum.

One of the theatre groups I teach regularly performs at the lower cost sort of nursing facilities. They are grim. We can't take the youngest groups of performers anymore, because these places are so dire that it gives the kids nightmares. Hell, they give me nightmares.

Lighthousekeeping Mon 08-Jul-13 23:04:13

Abit like here thensad

I always think of American ones to be like the Notebook!

bico Mon 08-Jul-13 23:06:48

The thing you find in the US which we don't seem to have hear thank heavens is consultants having a share of an associated business. For example it is common practice to go to the GP and he'll suggest that you have a blood test. He has shares in the lab that does the blood test. They are mostly not needed but it is an income generator for the GP. Same for having shares in MRI machines etc.

DalekInAFestiveJumper Mon 08-Jul-13 23:16:31

The US insurance system is heavily tied to employers as well. So whatever insurance scheme your employer has is (as a general rule) what you're stuck with. If it doesn't meet your needs, more often than not, you have to find a new job. There are ways to get add on insurance, but it costs the moon.

And if you lose your job, you lose your insurance. People sometimes have to put up with horrifying treatment from bosses, because they can't afford to lose their insurance.

Lighthousekeeping Mon 08-Jul-13 23:32:07

If you worked for the government like nursing or policing would you get good insurance?

DalekInAFestiveJumper Mon 08-Jul-13 23:43:53

It depends on which government. City/State/Federal varies a good bit, and then benefits vary within each. My parents worked for the state government as high school teachers, and we had awful insurance. When I first got married, I worked for the same state, but for a University. My insurance was not good, but it was better than my parents.

I have taught secondary school myself, for a different state, and that was some of the best insurance I've ever had. Much better than the stuff I've got now, even though I am currently far wealthier than I was back then!

Nursing is not generally a government job. Police tend to have good insurance, because they have unions.

lalalonglegs Tue 09-Jul-13 19:20:27

It's bloody awful. It's one of the reasons that US pregnancy- and birth-related deaths are relatively high compared to most other developed countries.

My American SIL's mother worked (in a hospital but not as medical staff) well into her 70s to pay for the insurance that covered the care of her disabled daughter. It is scandalous.

itsatiggerday Tue 09-Jul-13 19:56:03

It's interesting too from a medic's perspective.

DH had a run in over the phone when he worked in A&E with a parent of a student who fell off his bike and bumped his head.

Guy came in, was reviewed as per normal procedure, kept in for a while to see (can you tell I'm not a medic and know no specifics!) and after a few hours they were happy to discharge him. Cue call from his Dad in the middle of the night US time (was by now early am in UK) to rant about how his son had a head trauma and needed a CAT, MRI, full bloods and possibly ultrasounds. He could not see his son but had spoken to him (conscious, fully functioning) had no actual symptoms that hadn't been dealt with but thought that was simply required for any kind of bump to the head. DH could not get rid of him, just kept phoning back and ranting. Eventually the consultant got fed up because he would not listen and said that he was satisfied son was fine and if there was a complaint here were the PAL details.

DH actually said he'd hate to practise in the US as it would massively reduce the value of being the dr other than to have learnt how to read a load of test results. No diagnostic capability at all. He said it wasn't even a close call, the guy just didn't need all the tests and given that there are side effects and potential implications of many of them, it's not just financially that you wouldn't want to make them routine.

Patchouli Tue 09-Jul-13 20:01:15

That Lionel Shriver book (I can't think of the title now) was interesting: the husband's employers had him on a rubbish insurance to save money and his wife got cancer, he ended up spending hundreds of thousands of dollars on treatment for her (which extended her life a few months) because you can't not, can you?

timidviper Tue 09-Jul-13 20:09:44

I agree that the US system is expensive and profit oriented but we are very sheltered from the true costs of healthcare in this country. We tend to assume costs are not high because we never encounter them as the NHS is free at the point of delivery. Most people would view healthcare very differently if they knew the costs

didireallysaythat Tue 09-Jul-13 20:28:23

When I worked at a university in the US in the late 1990s a colleague was billed $800 for an epidural. Students got married and had kids because while they were students they had 0% co-pay (is 100% cover). Having a baby when 22 and doing a PhD because it's the only time you will be able to afford to deliver a baby seems crazy to me. The NHS isn't perfect but I'd rather pay taxes towards it than not.

expatinscotland Tue 09-Jul-13 20:35:39

I had a bankruptcy in the US due to medical debt.

I was made redundant, and so temping as a secretary and no insurance.

One morning, on my way to work at 7.30, a drunk driver ran a red light and t-boned the car I was driving (my boyfriend's but I was insured on it) on the passenger side.

I spent a couple of weeks in the hospital and needed loads of physio and treatment.

Needless to say, the drunk guy was driving a 'friend's' car, no insurance and was a repeat offender from another state.

There's no way I'd ever live there again and a BIG part of it is the healthcare 'system'.

My daughter died of complications from cancer treatment last year. If we were in the US, her treatment would have run into the millions.

expatinscotland Tue 09-Jul-13 20:36:39

Meaning, we had liability insurance for me to drive the car, but that doesn't cover healthcare, and the driver well, he was no insured at all, so I was stuck with the entire bill for his fuck up.

Lighthousekeeping Tue 09-Jul-13 20:52:05

What happens if your child is born with CP or something that requires lifelong input?

expatinscotland Tue 09-Jul-13 21:01:07

Depends, Lighthouse, but it is far rarer there to hear people say they cannot work at all as they are carers. A person has be very disabled to not work at all, or old.

Lighthousekeeping Tue 09-Jul-13 21:06:11

I know a couple over here who are both wheelchair dependant and go to the States for their holidays because the facilities are so much more geared up to their needs and they say people treat them much better and "normal" over there. Over here they have carers and a fully adapted flat so, what would happen if they actually lived there?

DalekInAFestiveJumper Tue 09-Jul-13 21:39:41

The ADA is brilliant, and is one reason facilities in the states are better for wheelchair users. The law is very harsh for people not providing equal access. It also helps that most buildings are newer, and therefore built to be wheelchair friendly. Well, and due to the sheer volume of space, buildings are bigger and easier to negotiate with a wheelchair.

But actual care? Not so great. I know a number of wheelchair bound people, none of them have a carer, unless you count uncompensated family members.

Weegiemum Tue 09-Jul-13 22:19:19

I get a treatment every 6 weeks for a form of peripheral neuropathy (numbness in my hands and feet, dizziness, fatigue, loss of balance etc). It's a lifelong condition. I will continue on the treatment indefinitely.

Through the Internet I'm in touch with people globally with this disease (it's very rare). In the USA, you can usually get the treatment for a year on insurance. After that it easily costs $15000 a month. Without it I can't walk, write, feed or dress myself, eat safely etc etc ...

God bless the nhs!

amandine07 Sat 13-Jul-13 09:34:04

Indeed God bless the NHS!
This thread has been an interesting read as I know virtually nothing of the US healthcare system.

A friend has just moved over to New York.
I don't think I could ever contemplate a move over to the States, and healthcare would be the main reason why.

Is it really that bad with insurance costs & hospital bills?
That is a rhetorical question- I am so glad we have the NHS here in the UK, despite its faults & frustrations!

purplewithred Sat 13-Jul-13 09:43:04

My great niece was born in the USA at 24 weeks while her parents were on holiday. Fabulous treatment and very good insurance, which was lucky as the total cost seems to have amounted to about $1,000,000.

purplewithred Sat 13-Jul-13 09:48:38

I was also surprised when on a trip to the US to discover how much monthly insurance costs are: 3-4 years ago a 55 year old was paying about $700 a month for medical cover. He was astonished to discover a) that our 'state' healthcare was really rather good and not at all like they imagined b) that we had private healthcare over here in the UK too if we wanted and c) that I was paying only £65/month for mine but getting the expensive long term stuff covered for that.

I think US spends 3x the proportion of GDP than we do on healthcare, but that only covers 75% of the population to our 100% and their life expectancy is 1 year less. Go Figure, as I believe they say.

nicecupofteaandbiscuit Sat 13-Jul-13 09:53:01

My sister-in-law had a baby in the US last year and the total costs (including all visits to the midwife, tests, through to delivery) was $70,000 (all covered by insurance). She was an older mum, so she did have extra tests, but still...There weren't any complications with the birth other than requiring forceps.

meddie Tue 16-Jul-13 13:40:00

A lot of people dont realise what good value the NHS is.
In the uk if i had a sore knee
my gp would more than likely suggest anti inflammatories and rest and review in a few weeks to see if it settles. Most times it would. So job done.

In the USA due to threat of litigation i would be more likely to be sent for bloods. Cat/mri scan possibly even scope. In the vast majority of cases totally unecessary and expensive.

CrackersandCheese Tue 16-Jul-13 13:54:54

I remember being in the US when they were discussing the healthcare reforms a few years ago. I was watching the news and they were interviewing people back in the UK who were slagging off the NHS. It made me so madconfused

edam Tue 16-Jul-13 18:33:58

Ponders, I think the government doesn't value the NHS for several political reasons. One, it is always a positive for Labour. The Tories know they will never score highly on 'which party would protect the NHS' (or not as highly as Labour).

Two, it was a Labour invention - the post-war Atlee government. The Tories have long memories and still resent the fact that a socialist idea is popular and embedded in our national consciousness. Three, Tories are (since Thatcher) in favour of privatisation and the 'free' market (usually rigged, but whatever) and the NHS directly contradicts that. They would rather have private companies competing to commission and provide healthcare - and indeed their Health Act enables that to happen.

America has the most expensive healthcare in the world yet some of the poorest health outcomes. Their system is mad. There are all sorts of ways different players can manipulate the system to generate profits - doctors ordering unnecessary (and sometimes dangerous/painful) tests, drug companies ramping up prices, the endless bureaucracy caused by having to work out who pays who for what, insurance companies gaming the system by excluding stuff that should be covered, or dropping people once they develop something expensive.

Expat is right about bankruptcy - medical bills are the biggest cause of bankruptcy in the US. European brain surgeons tell me if you develop a glioblastoma tumour in the US, you will go bankrupt. And that's just the financial cost, God knows what the human cost is - but avoidable mortality is significant.

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