Paying Cash for Kids
"Hi, my name is Kelsey Timmerman. How much does it cost to have a kid at your hospital? I'll pay cash. "
This is the state of the American medical system today. Patients are forced to approach the birth of a child like they would shopping for a used car. That's exactly how it felt, and that's exactly how an expecting mother described her similar experience shopping for hospitals recently to the New York Times:
"I feel like I'm in a used-car lot."
Like the woman featured in the story, we had insurance, just not insurance that covered maternity expenses. Of course, we didn't realize that we didn't have maternity coverage until after my wife Annie was pregnant with our second child.
We had different insurance for the birth of our first child, but then the doctor that Annie worked for decided to not offer his employees health insurance and not a single penny at all toward any healthcare costs of any kind.
Yes, you read that right. She worked for a doctor who didn't offer his employees health insurance. (If that hasn't convinced you how mucked up the American medical system is, keep reading.)
My job as a writer comes with the benefit of being able to wear pajamas at 3 p.m., but no medical or dental plans. So we have the pleasure of buying private health insurance.
To get prices from the first hospital we called was more painful than a minor surgery without anesthesia. Finally we learned that they don't give any discounts for paying cash, and make no adjustments at all for individuals without maternity coverage. This meant that the hospital charges individuals more than they charge insurance companies because insurance companies negotiate adjustments on most of the expenses. To have baby #2 at this hospital was going to cost us at least $15,000.
The next hospital told us about a discount for paying in cash and a program that they had in place for those without maternity insurance. They gave us estimated expenses after the discounts, which were way cheaper than hospital #1. However, if Annie needed a C-section, things would still get pretty expensive. And, of course, Annie wanted to have an epidural and we learned that was going to run another $1,500 or so.
I imagined the conversations.
Annie in labor, me taking a break from live tweeting the events:
"Annie, are you REALLY sure that you need an epidural? Can't you just push through the pain? For $1,500 we could get that new kitchen table you've been wanting."
"Come on, Annie! Push! You don't need a C-section more than you need that new car!"
Thankfully, we were able to save for the birth and the epidural for the delivery, she didn't need a C-section, and Annie didn't have to strangle me to death with an IV tube.
Our beautiful boy Griffin was born and he only cost us about $5,000. What a bargain!
Paying Cash for Cancer
Today, I found myself in a similar position: calling dermatologists trying to get good deals. I have a recurrence of a basal cell carcinoma -- the best type of skin cancer to have, if there is such a thing.
I'll be having a Mohs surgery on Friday, which entails a surgeon cutting on my head, that's where my cancer is (on my right temple), and then the surgeon will examine the tissue under a microscope while I wait, bleeding out the hole in my head. If the surgeon doesn't get it all, they'll cut again. The more stages they do, the more the price goes up.
I shopped for prices, and it seems the place I'm scheduled to have the procedure done is competitive. The first stage costs about $1,000, every stage after that about $550, and then depending on how big the hole in my head is, patching me up could run anywhere between $1,500 and $2,500.
This means my surgery could cost between $2,500 to more than $5,000.
However, I do have insurance. Just insurance with a very high deductible, which means I'm pretty much on the hook for all the costs. Unless they do, like, 25 stages, removing my entire head, and thus we'd meet our very high deductible, and Annie would cash in on some life insurance.
Insurance will make adjustments, which I'm thankful that paying a $400 a month premium buys us something. I called the insurance company to ask what kind of adjustment to expect. They informed me they needed the tax ID number of the dermatologist and the medical codes for the procedure. I told them that I had an address and the actual name and cost of the procedure from the dermatologist. They told me that wasn't enough. To which I said, "Thank you," but wanted to say so much more.
Friday I'll go under the knife to have an outpatient surgery to remove my skin cancer and have no idea how much the whole thing will cost me until a month or so later.
It's possible that to have a nickel-sized spot of cancer cut from my head will cost us more than the birth of our second child. And I think that's pretty screwed up.
I doubt I've got it in me to ask the surgeon to go without a local anesthetic, but maybe I will bring my own bandages and painkiller to cut down on costs.
For more by Kelsey Timmerman, click here.
For more on personal health, click here.