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.
I always wonder what would of happened to my son if I wasn’t Canadian. He was not growing properly in the womb which meant many doctors appointments and ultrasounds . And then he was born 3 months premature and spent 3 months in the NICU. I didn’t have to pay a cent for any of it .
Natural selection would have taken place if you were American
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?
This was pre-Obamacare, and the birth alone - with c section - was $20k.
I’m not American so maybe I’m getting something wrong… But aren’t you making a faulty assumption about people having a plan at all? Isn’t the amount of completely uninsured in the us in the double digits or something?
The original commenter did mention they had health insurance
You’re correct, my bad
Isn’t the amount of completely uninsured in the us in the double digits or something?
No.
Plus in the comment she said she had insurance.
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.
I really hope you’re right. As a Dutch guy in the US it really baffled me how many Americans vote against their self interest only to then do a poor man’s version of social healthcare via GoFundMe when their luck inevitably runs out
In the US it baffles us as well. Though most Americans do actually want universal healthcare, anytime it comes up as an issue in the national conversation there is such massive propaganda against it, articles talking about things like ‘death panels’, hypothetical committees under more socialized healthcare systems that will decide who lives and dies, or that you’d have to wait hours at the ER. Ridiculous things like that. It’s seen as a ‘left’ issue, if you are on the right or conservative in the US you won’t be as likely to support universal healthcare, which does align with one right-wing view of ‘poor people should die more’.
The effects of having low grade stressor like that, combined with non-federal sick leave nor vacation and predatory corporate labor laws are what you witness in the US every day. Precipitously declining mental health for everyone, reduced social and coping skills. Commonplace violence and rage and incredible rates of anxiety and depression and resultant medication.
I wonder about the effects of having a low grade constant stressor like that.
Heart disease like irregular heartbeat and stroke. Gastrointestinal problems such as ulcers and IBS. Increased susceptibility to illness. Ability to learn/memorize/perceive are reduced. Not to mention the effects of maladaptive coping mechanisms such as drinking, smoking, drugs etc.
Many disorders originate from stress, especially if the stress is severe and prolonged. The medical community needs to have a greater appreciation for the significant role that stress may play in various diseases and then treat the patient accordingly using both pharmacological (medications and/or nutraceuticals) and non-pharmacological (change in lifestyle, daily exercise, healthy nutrition, and stress reduction programs) therapeutic interventions.
I whole heartedly agree… We should ban all gum… Big chew included 😋/s
Lol I just noticed that. Imma leave it. It’s better this way.
I make good money and have reasonable health insurance. However, I grew up super poor. So I only use health insurance in life or death circumstances.
I don’t want to be poor again.
Definitely same.
For our northern cousins, an illustrative story. I was attacked by a dog and with my arm and leg bleeding everywhere my first call was to my wife to get her to come pick me up because I knew an ambulance would be insanely expensive, and my second call was to insurance to find out if I could go to the hospital instead of urgent care. They sent me to urgent care, where they told me it was the worst attack they’d ever seen that wasn’t on the face.
The kicker is that I even have GOOD insurance, but that’s the reality of not knowing if it’s gonna bankrupt you or be covered or not: hesitation. That’s the reality of having years of habit-forming second-guessing when you had bad insurance, or when with good insurance and a tight budget. Imagine what is like for people with bad or no insurance.
Are you sure you don’t qualify for Medicaid or other public assistance?
My housemate lost his awesome mom when he was like, 10, because of that. She refused to go to the hospital because she couldn’t afford it, and it got infected. Fuck this country.
This doesn’t answer OPs questions at all. Medicaid is available for expecting families that covers the cost of prenatal, birthing, and postnatal services.
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.
Wow. That’s horrible. The US health system sounds like a dystopian nightmare.
And yet so many Canadians seem to want to dive head first in to a fully private healthcare system as if anyone could take that financial hit.
It doesn’t help that many of the governing bodies are deliberately sabotaging it as much as possible in order to push voters into that direction. Doug Ford is one of the most notorious in this respect, but there are plenty of others too
meh Cannucks tend to adopt the worst of everything they see
You spelled Canucks wrong and your broad generalization is insulting to millions of people, especially since the majority of us are smarter than that.
Canned ducks?
Yes.
I’m sorry you and your family had to go through that.
I’m Canadian and I gladly pay more taxes than you so that I and my friends get free healthcare when we need it.
When we watched the fights over “Obamacare” we just shook our heads.
That’s the ridiculous thing. Americans would rather pay a few dollars less in taxes than let people have free healthcare. And it ends up costing them far more than they would have paid in taxes.
I’m Canadian and I gladly pay more taxes than you so that I and my friends get free healthcare when we need it.
Here’s the thing. I worked in America for the better part of a decade and I had to submit two tax forms, one to each country. You end up paying the greater of the two and using it to offset the other.
What I know is this: every year, every year, I paid an extra 1% to America. No matter how my (binational) tax guys worked it, my obligation to America was always higher.
The year after I came home I still had to submit taxes (January layoff scares so I moved back) and it was still higher for America despite sitting in a different country (it’s a factor) and using different services. It didn’t matter.
In Canada I pay 1% lower income tax and enjoy healthcare access. While they’ve done away with the regional premiums, I was even okay paying that; as my yearly outlay, proudly at the top bracket, was still less than copays while in America. I would gladly pay the same premium to ensure equal access to dental and optical care for me and especially people who can’t drop (now) c$1000 on some specs or way more on a dental crown.
It’s not that I’m a good guy, but I pay taxes for schools because I don’t want to live around dumb people. I do and will pay taxes so we can take people who aren’t healthy and skilled and contributing income tax and make them so they are. Poverty should be no excuse for not being employable.
What the actual fuck, and this was in 1990
1990 was around the time of Hillary-care and Romney-care, so the politicians knew that they were going to have to fix it sooner or later by that point.
Hillary’s plan was being developed and debated in '93-94, Romneycare in Massachusetts happened in 2006.
Man… That is crazy. I’m so sorry for you guys.
Why didn’t you have taxpayer paid (State) insurance if you were extremely poor and expecting? Is it because of the lost job and timing? If you are poor and have a family then you can spend a day at the welfare office and get public insurance.
Because we made too much (over minimum wage, dual income household). I was making $13k as a sales manager, my wife was making $8k as an assistant manager, and minimum wage was $3.35/hr or just under $7k/year back then. After taxes, we made about $1200/mo, and our rent was $650 for a single bedroom apartment. No car, we took the bus, barely had enough for food and utilities.
But we were considered way too over the “poverty line,” which was I think less than $6k/year then. We had been using birth control but when they say some form of birth control is 99% effective, the DO mean 1% failed. I have no regrets our son was born, because it turned out we couldn’t have kids later when we tried. And then later my wife died when he was 22, so if we had kids later, I would have been a widow with younger kids.
I feel awful he grew up poor with us until he was about 10, though.
Oof, yeah that’s rough. The poverty line is really low. I can relate about wishing you weren’t poor when your kid was a kid, we had the same experience. We would have been able to give him a lot more had he been born a decade later, but he still had a loving home, which is more than a lot of kids get.
I’m really sorry to hear about your wife. I can’t even imagine.
… “So, yeah. Don’t have a baby in America…”
for more on this subject, and in the spirit of looking on the bright side of s bad situation, see /c/childfree and childfree.cc. Includes talk, and memes, about some of the benefits, of not having children, including but not limited to finances. (also advice and directories about related options for medical things, where thise are wanted or needed).
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.
Does that bork your credit?
Yes it does
That seems like an unfair and inescapable conundrum.
Once I got some physical therapy bills sent to collections. It wasn’t because I failed to pay. The practice was really shitty about billing and record keeping and never billed me for a bunch of visits. They went under and sent their records over to collections.
The collectors called me and pretty much opened with “this place went out of business. We would settle for pretty much anything. How about 10% of what you owe?”
They get a percentage of everything they collect so you might think they’d go for the full amount. But I think the game is sometimes just “what can we get easily and quickly.”
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.
It will condem you to poverty tho, which may be even worse than jail
It can impact everything in your life, even jobs and housing now. It’s practically the same thing except instead of being forced to live in a camp you’re living on the street.
And if you dare get together with other people that are forced onto the street and make a camp together somewhere isolated, the government tears it down and evicts you and destroys your things. Thank god for our freedom.
My favorite part is when one of the three companies that does ours leaked all of our data with relatively no consequences.
https://www.ftc.gov/enforcement/refunds/equifax-data-breach-settlement
Well if it’s the free market abusing us it’s okay. That’s just freedom.
I mean it’s not like your credit score immediately gets affected for something like jaywalking though.
I’m not sure that’s entirely the bar we should be aiming for
It can even impact being hired for jobs. Low credit score? You might be untrustworthy or motivated to steal
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 think my credit report still says I work at “DOMINOES” after like 5 years of not being there. It doesn’t effect anything, but I get mild amusement out of it being misspelled on top of that.
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
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.
It’s similar but only take into account financial and professional information. As I understand it, the Chinese version also covers your daily activities.
As the name hints, a credit score is used to rate the risk of making you a loan. It’s not some essential personal ID. It only comes into play if you are applying for credit and is a set of shared records that financial institutions and private companies use to decide if loaning you money is a good risk or not.
Someone else said it’s used to decide if you can get a car and that’s not accurate. If you need to borrow money to buy a car, your credit history will be checked. It’s the loan, not the car.
Is it crazy that lenders would want to know if you’ve walked away from your bills in the past? Making it sound like dystopian China is a gross exaggeration.
At this point, pretty much
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?
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
Depends on the severity of the issue.
For a life threatening emergency, no
For like pain relief, yes
The hospital must stabilize you and save your life from immediate danger. They don’t have to make you better or solve the problem.
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.
Also to clarify saying if you’re poor enough makes it seem like it’s a high bar, but iirc ~35% of people are on Medicare/Medicaid
Everyone over 65 is eligible for Medicare, regardless of income, but others can qualify under some circumstances.
In 2022, according to the 2023 Medicare Trustees Report, Medicare provided health insurance for 65.0 million individuals—more than 57 million people aged 65 and older and about 8 million younger people.
You have to qualify for Medicaid, and I think different states have different requirments.
Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 85 million low-income and disabled people as of 2022; in 2019, the program paid for half of all U.S. births.
There is also CHIP, and I think that is part of Medicaid.
I just explained this before seeing your post. There’s a lot of America bashing in this thread with completely inaccurate information. I was relatively poor when my son was born and we were on public insurance. Everything was paid for. It was actually a pretty good overall experience. Now that I’m making a lot more money I don’t complain at all about taxes, since I know that at least some of it goes towards invaluable services like this.
Came here to explain this.
Simply.
They don’t pay the hospital bills.
Wait for them to repo the baby…
“they don’t pay”
Yikes, real “us vs them” without any experience understanding or compassion, eh?
I understand the point you are trying to make, but I’m not sure what you are reading into? The question was “how do poor people in the states…” I am a poor person in the states, if I was to answer I would probably say they, maybe ‘we’ if I was feeling like sharing. And it’s true, many medical bills throughout my childhood that we couldn’t afford just went unpaid, with debt on my parents credit.
Wow u just made up all that in ur head…just …wow.
This is unfortunately true, though. A lot of people just don’t pay them, especially homeless people. How are they gonna get billed? They have no address and many don’t even have a phone. I’m not making a moral judgement, but it does happen very often.
Source: husband is an ER doc at a city hospital that serves most of the city’s homeless and below-poverty-line population where we live.
Downvotes without any replies? Yeah, that checks out.
Hi, I down voted you.
E: Twice, actually
deleted by creator
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.
Might want to take a look at this then.
EDITED TO ADD: While court cases involving “debtors prison” exist, NONE of them have “made debtors prison a thing of the past” in the US because imprisonment for private debt is very much alive and well today in 2023. Given that a person imprisoned over debt is unlikely to sue unless an organization such as ACLU takes on the case, and even more unlikely to win in courts that are dominated by commercial interests and partisan judges, it’s only going to get worse, not better. Going by the above linked articles that is exactly how it’s working out right now. Trying to prove that this horrific problem of criminalizing poverty does not exist today by pointing to a single 1983 lawsuit and going, “See! I told you!” is just completely privileged assholery.
Found it, it was 1983, much more recent than I remembered. https://www.justice.gov/usao-sdal/page/file/918356/download
The feds themselves call it a civil rights violation, they have a good chance at a lawsuit. IMO, the judges who sign the arrest warrants need to be debarred or taken out of office or whatever happens to judges.
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.
Fucking crooks
Edit: who the fuck is downvoting me? USA hosptials owners?
People are thinking you mean the poor people, not the hospitals.
I’m just laughing at the absurdity of someone calling poor people who can’t afford their medical bills “fucking crooks” but that actually is a position I wouldn’t surprised to see these days.
Not just these days. See Reagan and his lies about ‘welfare queens’ living on lobster and buying Cadillacs off of government money.
Unfortunately, yeah, it’s very common in the south, so I’m used to seeing it :(
Even in the more ‘blue’ cities down here, it’s usually safer to assume that whoever you’re talking to is a republican piece of shit, or else has holdover ideas (like ‘the poor don’t deserve handouts’) from being raised that way.
It’s very expensive to be poor.
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
Removed by mod
If you have a masters and 20 years of experience, you’re pretty much guaranteed to have a job that has the health insurance to pay for all of that. If you don’t, then you need a new job
Removed by mod
Sure, maybe the hospital bills but raising 3 kids and going on vacations every year? You’re talking multi million dollar salary to be able to afford all of that on one income in SoCal of all places
Then… Don’t live in SoCal?
I live in SoCal and love it, and do not intend to have kids, but it really seems like you’d be struggling to raise 3 kids around here on less than $150k (2 cars, rent/mortgage, etc).
Obviously many people manage it somehow, but it must be incredibly stressful. I have no idea how most of them do it.
Removed by mod
Leave California and this all becomes possible with your salary.
When he leaves California, he will leave his salary too (and possibly his industry too)
It will still be more affordable. We couldn’t afford to live in SoCal after my daughter was born. We moved back to Indiana where we grew up and, as awful as Indiana is in many ways, at least we could afford to buy a house.
not if its a remote job…
Remote doesn’t pay the same if you’re not in a HCOL area. Most jobs scale based on location
Yea well where I live out of staters have been scamming their states and companies for years. I know a guy who works for the California educational system but lives here.
Vaginally
Exactly, the little bastard is going to claw their way out one way or another. Usually.
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.
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.
And some fucks in Alberta want the US system because “I never get sick! My taxes are paying for someone else to be sick!”
Bankruptcy.
