How do poor people in the states give birth without money?
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.
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 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.
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.
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
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.
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.
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.
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
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 cliffs (the “cliff effect,a small increase in earnings.) you can get fucked lol. Murica
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.
Bankruptcy.
Debt. Massive amounts of debt.
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.
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).
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!
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.
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.
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.
The number one reason for bankruptcy in the USA is due to medical debt.
We just go into debt, is your answer.
Bathtub. Car. Alleyway. Crippling debt that, while shouldn't be impactful on credit score, will still follow you for your lifetime.
Here you go. This might answer some questions you have https://www.healthcare.gov/what-if-im-pregnant-or-plan-to-get-pregnant
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.)
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.
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.
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.
