Granby
I should have called India.
I was searching for the lowest price on a nebulizer, recently prescribed to treat my 3-year-old son’s chest congestion. My husband is self-employed. I’m a stay-at-home mom. Our bare-bones insurance policy (the only type we can afford) doesn’t cover extravagances like doctors, unless you’re hospitalized. Medication and nebulizers have high deductibles.
Two phone calls and $75 later, I was the proud owner of a new nebulizer delivered to my door. I spent another $10 for medication and $130 on the office visit.
One chest cold … $215. Making your preschooler healthy again so he can go back to terrorizing his older sister … priceless.
Days later, I read how businesses that fund their own health insurance are sending workers to hospitals in India for cheaper surgeries. It costs much less to remove gallstones in New Delhi than in the United States. Americans already order lower-cost drugs from Canada. Hospitals outsource radiology analysis overseas. Had I shopped globally, imagine what I might have saved on a nebulizer.
My lesson in insurance and our health care system began three years ago. I was laid off, and lost health insurance coverage for my husband, daughter and me. Oh yeah, I was eight months pregnant at the time. With my benefits scheduled to end on the baby’s due date, the HR manager recommended taking long walks, so I would go into labor before my insurance ran out.
I left her office feeling sick. What if the baby was born with an expensive medical condition? Could we find affordable health insurance on our own? Since graduating from college, I made sure to take jobs with employer-sponsored health insurance. I firmly believed private plans were too expensive. Going without insurance guaranteed I would need multiple brain transplants. (My body would reject the first five.)
After the layoff, I learned no insurance company would cover us until a month after the baby was born. COBRA wasn’t a viable long-term option, and I didn’t quite trust it (despite its cuddly name). Thank goodness our son was born healthy, two or three days before my insurance ended.
Now, three years later, I’m reviewing our family policy to see if we can do better. Dozens of deductibles and loads of fine print make our coverage hard to understand. Through some loophole, state-mandated well-baby visits aren’t covered. If one of us got cancer, we could wind up paying over $10,000 in out-of-pocket expenses. And the monthly premiums keep going up.
President Bush recently said individuals need to take more responsibility for their medical spending. It’s true. Forced to pay more ourselves, I think twice before we go to the clinic. I question the need for every X-ray and prescription. Doctors are in the business of healing people, not managing the bottom line. And rightfully so. Ask how much a procedure costs, and the reply you’ll likely get is: “Insurance will cover it.” Explain to medical staff that you don’t have insurance, and you get a glassy-eyed stare that says, “Then what are you doing here? Go to India where you can get cheap surgeries!”
After we no longer had coverage for office visits, I noticed my bills were 20 to 30 percent higher than what my insurance company used to pay. I learned that insurance companies negotiate a lower price. But on our own, we were stuck paying the highest amount. I’ve learned to ask clinics and doctors for a “self-pay” discount, but that doesn’t always work. Administrative costs for filing insurance account for 30 percent of all medical expenses. Why should I subsidize processing I don’t use?
An insurance broker recently warned, no matter what policy we chose, expect the premiums to increase 12 percent every year. Our current policy certainly has. It doesn’t take a genius to realize these annual increases aren’t sustainable. With rising premiums, a growing number of Medicare recipients, skyrocketing prices (and more well-insured Americans seeking surgeries overseas), it’s easy to see we are headed for disaster.
The number of kids in Colorado covered by private insurance has dropped 11 percent since 1997. And the number of Colorado kids enrolled in public health insurance, funded by taxpayers, has increased 69 percent in the past decade.
On the bright side, we are healthy. My husband is his own boss. For now, I have the luxury of staying home with our children.
Plus, we live in a country with the best medical care in the world.
If only we could afford it.
Gretchen Bergen (gretchenbergen@yahoo.com) is a freelance writer.
