When I thought about what topic to write about for Blog Action Day, it was kind of a no-brainer for me. I have three NICU babies (well, they aren’t babies anymore). All told, their NICU (Neonatal Intensive Care Units) stays added up to a good $150,000-plus. That didn’t even include the delivery. I was extremely fortunate to have health insurance (although our co-pay for each birth was in the $2,000-plus realm, and two of them were born at the same time!).
I won’t even get on a rant about the price of health care, or the fact that so many American families don’t have any health insurance… although I probably should. I am trying to stay focused here.
Poor mothers get less prenatal care. They are more likely to have preterm babies who require a NICU stay. They must be horrified when they get hospital bills afterwards with tens of thousands of dollars on them, more money than they earn over several years.
Don’t tell me that hospitals work out payment plans, either. Hospitals also report these items on credit reports if unpaid right away, driving up the mother’s and family’s cost of doing everything from getting health insurance (oh, the irony) to buying a car or buying a house. They take these families to court to get their money.
They get harassed by both the hospitals and the myriad physicians who handle the cases. Even if they find someone friendly who works out a payment plan and even cuts the bill in half, they shouldn’t be paying the NICU bill off right before sending the kid to college.
They don’t make it easy to figure out if all those crazy charges are legitimate. I got double billed by two different entities charging for the same services. I repeatedly asked a hospital to itemize the thousands in charges, and they repeatedly ignored the requests. I’m a former consumer reporter who considers myself pretty savvy. How much are parents with little education and even fewer resources taken advantage of by these situations.
It’s time we make it so a mom with a 2-pound frail infant breathing through a tube and connected to any number of hoses and wires who isn’t even allowed to hold her own child has one less thing to worry about: money. I’m not sure what the answer is, but certainly writing letters to hospitals and government officials has to be a start. Also be sure to support agencies who support the cause of preventing preterm births like March of Dimes.
The law needs to make it possible for poor moms to go on bed rest without going bankrupt. Other countries have paid maternity leave. Also, moms who go on bed rest shouldn’t be forced, then, to have no maternity leave afterwards just because they’ve used up their Family Medical Leave Act time off. But even then, that doesn’t include pay.
Employers, do what you can to support expecting moms: reduce stress, allow them to have more flexible work schedules or work from home. Expecting moms: don’t let anything or anyone keep you from taking it easy. Educate yourself on ways to prevent preterm birth. If you don’t feel comfortable with what your OB/GYN is saying about your concerns, don’t be afraid to find a new one. Having regular contractions early in your pregnancy may very well mean bed rest is in order, as inconvenient as that may be.
Photo of NICU baby, © Benjamin Earwicker
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Excellent points Kelby. Medical bills can be impossible to decipher for a simple procedure, let alone an extended and complicated hospital stay. They never seem to be itemized, and you get bills from everywhere – the hospital, the neo, anesthesia, labs, etc. Fortunately, we made it out of the NICU ok as far as bills went, but my hospitalized bedrest and our child’s 46 day NICU stay has made it next to impossible to get and/or afford health insurance coverage for either of us.
It’s a very sad situation…
-Kristie
Kristie McNealys last blog post..Blog Action Day: When Illness Causes Financial Crisis
Awesome post Kelby! With America being such a power house, you would think that taking care of our citizens medical needs would be a number one priority. I think it’s wonderful that you’re shedding light on this situation.
Julie Ns last blog post..Blog Action Day 2008 – Let’s Fight Poverty Together!
I just had to comment on your post. First let me say glad your babies had such good care in NICU and grew up to be healthy children, and after all isn’t that what the very good care that they received in NICU gave them?
I am one of the “bad guys” who work for a Neonatalogist who is head of the NICU unit in a local hospital. I have been doing all his billing for over 10 years so I see it from a different prospective.
What I see is that this doctor saved thousands of infants lives over those 10 years and my first thought is that if I had been the parent of any one of those very precious newborns and the doctor saved that baby’s life I would be eternally grateful and money be damned, my child’s life was saved.
What price can you place on anyone’s life?
Obviously PRICELESS!!
Folks remember this we that file the claims are filing on YOUR behalf! It is your insurance so know what you are signing up for and what the policy will and won’t cover.
Yes I have to send statements for copays and deductibles and I get angry parents calling asking why they are being sent a statement, well the people to call is the insurance company not the doctor’s billing service they are simply doing what your insurance company has stated they MUST do, send you a bill.
Sorry I don’t mean to sound insensitive but I had to say what I see coming from a different point of view.
Terri healthymomss last blog post..Happy 2009 New Year savings tips
Hi Terri. I appreciate what you are saying, but I have a hard time feeling a lot of sympathy for wealthy doctors who are harassing impoverished parents for thousands of dollars just so their child can be alive. And in many countries, they wouldn’t have to worry about this at all. If saving a life is priceless, then there should be an awful lot more leeway for prents who can’t afford to pay. For pretty much anyone uninsured, the cost of even a short NICU stay will take them a lifetime to pay off. What do you propose they do?
And it doesn’t matter how grateful I am to a doctor who saved my child’s life. I shouldn’t have to have no money to raise that child because I am paying outrageous NICU bills.
Beyond all of that, the bills themselves are insanely high. Why does a doctor need to charge hundreds of dollars per day? I spent PLENTY of time in the NICU with my three children being there. The doctor did not spend all that much time with each child unless the child is having a crisis. Many days, in fact most days, it was simply checking in, looking over the chart, and chatting with us for maybe 5 minutes.
I’m not trying to dismiss what neonatologists do, but don’t tell me we should just pay up tens, even hundreds of thousands of dollars, and be thrilled they saved our children. Plenty of people save lives daily — police, firemen, EMTs — without demanding the life savings (or money not even earned yet) of the people whose lives they saved. No they don’t pay as much for their educations, but they don’t pay THAT much less.
I live in Canada…and in my province we pay monthly for our health care but that covers mostly any hospital visits (with limits), xrays and things like that (and pay extra for prescriptions and ambulance things like that). (Most provinces it’s free.) I know my baby was in the NICU….even though it was only a couple of hours I could be rest assured that I wouldn’t have to pay for the care that he got. It would be amazing if parents wouldn’t have to worry about such a thing like that and focus on getting their NICU baby home where it should be.
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I totally agree with this post. Before I read Taylor’s comment, I was just going to mention that when I was pregnant I used to joke frequently that I wanted to move to Canada because they have such a great maternity program there.
I personally feel many points in your post. For example, when I was pregnant with my girls (first set of twins), there were major changes at my job in the form of a new boss that came in and turned our department upside down. I was 24-25 weeks pregnant and suddenly my job because very demanding. And I ended up in the hospital at 26 weeks for preterm labor. The new boss KNEW that it was her fault too. She even called me in the hospital to apologize. Now, my *usual* boss was very understanding and took it easy on me, but some bosses don’t care and some workers are not lucky enough to have good relationships with their bosses to even ask about working from home, etc.
I was lucky enough to have awesome insurance threw my job, so i did not have to pay a penny for anything. But, those bills sure did arrive in the mail as soon as we got home! And it was not pretty. I cannot imagine having to worry about paying that on top of all the other bills and responsibilities that I already had.
With my 2nd set of twins, one of them ended up in the NICU for 11 days. Luckily it was a short stay. But again, when that bill hit the house when he was barely home, I would have worried like crazy about having the $$ to pay.
In closing, I completely agree that the US needs to prioritize how important they thing reproduction is. I know in one sense it’s a “problem” here. But there are also plenty of people who want nothing more but to have healthy children. The costs associated with that often leads to a lot more stress than it should.
Kris Cains last blog post..Yes I know, they are 2 years old…
Terri-
First off, let me say that I don’t see you as a “bad guy” at all. I see a broken system. As a self employed parent who’s child spent 46 days in the NICU, I am horrified by how much it cost. The neo’s visit was several hundred dollars per day, and I rarely even spoke to them. A bed was well over $1,000 per day.
I know everyone in the NICU does very important work, and any amount of money is worth my child’s life. The problem comes when families are completely ruined by trying to pay back this money they have little or no control over owing. This is not a giant elective procedure – it is an unexpected life and death issue – an unforeseen tragedy. On top of bills, you are also faced with problems getting future insurance coverage, and often, lifelong health concerns that require care.
As for the fact that we chose our own insurance and know what it covers – in part true – but seriously, most people in the US take what they can get when it comes to insurance. They take what ever their job offers (if it does) because it is fine 98% of the time. Problems don’t arise until you have a preemie, or a kid with cancer. Then you are basically screwed for life. As a person dependent on individual insurance coverage, I can tell you it is nearly impossible to afford coverage that wouldn’t leave you bankrupt if you had a prolonged critical illness. Even very good coverage has lifetime caps that often become an issue in the case of extreme prematurity.
On the medical provider side of the coin, I understand that Medicaid and Medicare reimbursements are often very poor, and malpractice insurance can be very expensive. I know providers are struggling in many areas to keep their doors open, and they work very long hours, have loans to pay back, etc. There needs to be a balance.
I have ABSOLUTELY no idea how to fix the system, but perhaps a bailout is in order…
-Kristie
Kristie McNealys last blog post..$10 Kids Tix to Denver High School Musical: The Ice Tour
I agree there must be a balance. My daughter’s bills were a quarter of a million dollars. We didn’t plan on the bedrest or me having to be off work so long from an emergency c-section. Of course, her life is precious. Of course I will be eternally grateful. I wouldn’t trade her for the world. But even after she was home we had to go bankrupt to make her continued expenses. We brought her home to a 30 foot travel trailer. It was three years before we got our feet back on the ground and back into a home.
I think the answer is a combination of the above. If doctors could reduce what they take in (or perhaps a scale based on income), it would help. And then perhaps non-profits could build funds/grants for families with neonatal families to help them pay for care and expenses. There is nothing like having to worry about not only your little one in the NICU but also how you will afford their needs after they are home.
Yes, doctors need paid for their expertise. With that expertise, they save lives. Yes, they must pay for insurance and school loans and their own families.
But our system is broken-and when it is broken, we all suffer. It affects even the doctors when the parents cannot pay the bills (eventually).
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I hope one day we can move to universal health care like so many other countries have already done. No mother or baby should ever be refused of health care because of finances.
If you don’t pay people for going to undergraduate (for four years), medical school (four years), pediatric residency (three years), and neonatology fellowship (even more!), the best and the brightest will not be willing to give up their own family-time and livelihood to do it. You can neglect the loans, the years of lost income during school and training, the challenging years of residency and the fact that 25-weekers commonly survive well (versus 30-weekers struggling years ago)! It costs money for advanced equipment and advanced nursing and advanced facilities…have insurance (or Medicaid) pay for it or the government can tax you mercilessly (Oh, Canada!) to pay for it. Take your pick…but don’t complain when no one wants to train to be a neonatologist and save your premies.
I disagree to a point with your post. If a woman is so impoverished and can’t afford thing, well then, she shouldn’t be getting pregnant. Going to medical school and learning the craft of medicine is very expensive. A doctor then has to pay high malpractice insurance, pay his office and billing staff, etc. This costs hundreds of thousands of dollars. I personally know a physician who pays close to $35,000 a year in malpractice insurance and it’s required by law that he does so.