Thursday, July 15

for what?

I am pretty upset right now. Some might say I have good reason to be, but I am slowly calming down.

Health insurance. I hate it, and I love it. Generally speaking, we are pretty healthy, but who wants to be surprised with an illness or injury that takes us out financially for years to come? Not me. So we had a generic plan, with dental coverage as well for my genetically horrid teeth. The rates kept rising, so we decided to make a switch. Eventually we are hoping to switch to an HSA policy, but until we can get our savings built up, we found a traditional coverage plan that will do.

Today I got a letter explaining to me that my rate was going to be 30% higher than quoted. I called. Reason? C-section.

Why am I upset?
1. the policy doesn't cover maternity care.
2. the c-section was unnecessary, definitely, without a doubt, unnecessary.
3. there are no means to appeal except to find medical documentation that it didn't happen.
4. there are no breaks for my VBAC status.
5. THE POLICY DOESN'T COVER MATERNITY CARE!
6. I feel like the c-section keeps costing me. It cost me initially in ways financial and other, but here we are 4 years later and it is STILL costing.

Now, before you express concern over my current state of frustration, I DO know that God is sovereign and He knows about this. He will provide (and has!) for all our needs. He keeps His promises, all the time. I'm disappointed that the money we thought we'd be saving by switching policies just went away because of a doctor's decision based on who knows what. So all the hassle ended up being for nothing.

I do feel that there is injustice here. I think that is why I'm upset. I can see why people sue doctors - not that I am going to, I can just see why. Poor decisions by doctors end up costing in so many unexpected ways.

So here's another reason to avoid a c-section if it is at ALL possible, especially if you will ever have to pay your own health insurance. It will cost more every month.

Incidentally, about the lawsuits. Does anyone else think the reason health care costs are through the roof ridiculous is due in part to those lawyers whose commercials urge you to sue for health care mistakes? And then the insurance required to keep doctors "covered" if a lawsuit is ever filed against them? Oh, for simpler days...no really, more like - oh, for heaven and home!

8 comments:

Alex F. said...

I hear you! Thank you for having the courage to say the cesarean was unnecessary. Anger is a valid emotion too, especially when we are angry about all the frustrating complications of living in a broken world.

Tina said...

I'm so sorry this has happened to you. Fortunately our insurance hasn't done the same thing. But, I feel as you do that I continue to suffer repercussions from the (completely unnecessary) c-section - 7 years later. It's always amazing to me that such precautions are taken to inform women about the dangers of other procedures (especially VBACs), but they never tell you all the dangers of a c-section. And they certainly don't talk about the affect it's going to have on your future, both physically and in instances like insurance.

Carrie said...

Wow, that is crazy. I would be upset too!! We don't have health insurance (well, we have Medicaid for the kids); we just haven't been able to afford it up to this point. Jim has had barely any work all summer and so he is looking into regular jobs. He just applied for one which would provide some benefits (not sure how much), which is something I would LOVE about it. I really hope he gets the job . . . but we're resting in God's will.

Have you ever checked into a need-sharing program such as Samaritan Ministries? I know several people who have had good experiences with them. We've looked into it, but even that has not been affordable for us, up to this point.

Shelley said...

Eric and I didn't have insurance when I had Carmen we made payments and we were low income.
Then with Lissa we had insurance but they didn't cover us because I got pregnant before the waiting period. So we made payments till our children started school.
Because we are self employed we don't get group rates. We pay a lot of money for insurance. We only go to the dr. for a physical and I for a mammogram each year. We pay for all medications, our deductible is almost 10,000 dollars a year per person. So we pay for everything. No dental insurance we just save up and go. We have insurance for incase something major happens. We save each month for any medical needs that may come up.
We found it's not worth getting dental insurance. Just save up for it and tell your dentist your paying cash.
What is it going to cost me, sometimes you can negotiate on the fee.
We paid for my colonoscopy, asking for a better deal.

Mary Ann said...

What a stinky pickle! Insurance is a definitely a hate it/love it thing. I think everyone has had their go-arounds with it.
I agree with your theory that a major reason health care has become so expensive is the cost of malpractice insurance & cases. I read an article a while ago about a volunteer clinic where the doctors said they would be happy to volunteer their time (up to 15 hours a week or something like that) if the government would pay for or eliminate the need for malpractice insurance. Can you imagine the benefit of so much volunteer doctor time?
Like Alex F. said above, the complications of living in a broken world...& yes, heaven & home will be so much better!

Kelly Glupker said...

How frustrating! I'm so sorry! Why did you have a c-section if it was unnecessary? Just curious.

TwoMuths said...

Kelly, sorry it has taken so long to get back to you on this - with Aaron, I consented to an induction and it ended in c-section - they told me Aaron's heart rate was plummeting.

When I was pregnant with Evan, the new OB wanted to see my records - I looked over them and realized that the doctors at the hospital had told me Aaron's heart rate was "dangerously low" but according to the medical records it had been in the acceptable range. So that is why I say it was unnecessary - for me. I take dual responsibility, as I should have asked more questions ahead of time and required more medical indications that an induction was necessary.

C-sections are a great lifesaving surgery for those who need it. I feel that I should have taken more time to ask questions and that I never should have agreed to an induction at that point. I was only 1 day past my due date and should have insisted on waiting longer, asked for more testing, etc.

I also should have known the hospital's c-section rate. It's right around 50%, which is much higher than the national average.

Hope that answers your question!

Kelly Glupker said...

I'm so sorry to hear that Jenny! Before having Owen I read the Bradley book and in it I read that most (not all) c-sections are unnecessary. I am with you . . . I like to do things all natural. I had to have an induction with Owen. I had talked to my doctor before I got preeclampsia and he was willing to let me go two weeks overdue. Thank the Lord Aubrey came sooner than that! :) It's so important for us to do our homework and not just trust everything we're told. I'm glad you were able to have a VBAC!!!