Cultural Connection

Healthcare has been at the forefront of the news lately.  Health insurance was never even something I thought much about, until recently.  We had it.  The coverage was decent.  It paid for stuff.  Yet now it is something I am constantly concerned about.

For a long time, we have had a healthy savings account.  We bought out house, continued to save for whatever next big project we decided.  Then I had two pregnancy losses, both of which required hospital stays, and occurred in two different plan years.  Each visit cost us thousands out of pocket, between first hitting the deductible, and then the out-of-pocket maximum for me.  We have had various testing done, genetic and otherwise, as we try to uncover answers.  Always expensive and not always covered by insurance, but we felt like it was something we had to do.

Then last year, Ger changed jobs and left a multi-national corporations to join me at my employer.  The health insurance premiums were a bit higher per month, but otherwise pretty comparable coverage.

Later in the year, we got a blow: upon renewal, our choices were either that premiums would go up by about $200/month, or we could keep a similar premium and have the deductible go from $1,500 to $3,500.  Ouch.  I was not pregnant yet, but knowing that was the direction that we wanted to go, it was a great unknown.  We chose the higher deductible, which would make more sense if I were not to get pregnant, and squirreled the extra $200/month that would have gone toward a higher premium into a Flex Savings Account to offset medical costs.  I was pregnant the month after the plan went into place.

Then we were hit with a second blow.  Maternity care is supposed to be 100% covered under the Affordable Care Act, even high-risk care.  However, some plans were grandfathered in and had until December 31, 2017 to include this coverage.  We had one of those plans.  Maternity care under our plan was subject to the deductible, so we have been shelling out exorbitant sums for each visit.  At this point, I have hit the deductible, and know that a delivery – at any point – will cause me to hit the max-out-of-pocket.  In total, it will cost me $6,850 for this pregnancy, out of pocket.  That does not include all other medical expenses we have had to pay for everyone else in this family, like doctor’s visits and such.  That also does not include some expenses that were not covered at all.

Our Flex Spending Account money is gone.  I have watched our savings dwindle.  I know that we have enough to pay the anticipated remaining expenses, but what if something else happens?  What if someone else in this family has a major medical issue in that timeframe?  I rearranged our budget and started putting more into savings, to have more of a safety net.  But it is hard to comprehend that all of that saving that we had done has vanished over the past 18 months due to medical costs.

And what if we had not been saving?  We were planning to use that money for other things, and lucky we had it.  It is appalling to me that having a baby should cost $6,850 out of pocket.  I know for certain that many people could not afford that.  When I had Theo, I paid $0 out of pocket – everything was covered.  For Quentin, the health insurance plan we had covered all office visits 100% and we only paid co-insurance for delivery, which was still a lot.

I have to do a follow-up visit with my primary care provider, and with medical bills coming in constantly, Ger asked me “How much is that going to cost?”  Should be just an office visit co-pay.  But those expenses are constantly on our minds now, knowing that each expense will further come out of our savings.  And we are not complaining.  We know that for us, making the decision to pay for an office visit means “not going to a movie with the kids” versus “not having food.”  We still have plenty of room to get the medical care needed.

But it emphasizes so many failing aspects of healthcare.  That a small employer cannot leverage the way that a large employer can.  That essential benefits – like maternity care – are at risk depending on what changes are made to the affordable care act.  I absolutely know that our situation is not dire.  And if the costs are constantly on our minds, I cannot even begin to fathom what other people are going through.  I wish that health care were something that no one ever had to worry about – that everyone had health insurance – regardless of income or employment.  “Access” is a misnomer, because arguably health insurance that is not affordable is inaccessible.  It should be among the most basic of our rights.  We all have a right to be healthy.