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Comment by semi-extrinsic | Hacker News Reader

> potentially-giant bill for the birth

It boggles my mind that we consider the US a first-world country when I read things like this.

Also not sure I agree about the breastfeeding being so bad. Sure, it's a bit of a chore, but most mothers I know (including my wife) found it to be a positive experience that increases attachment.

And the leaving the house/car part I also don't follow. You have one more person to dress and one more item of luggage to carry; it's hardly an exponential increase.

Otherwise I agree, esp. about stress if kid has serious health issues. (We have two kids, aged 1.5 and 4).

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> It boggles my mind that we consider the US a first-world country when I read things like this.

We had a hospital stay before the birth, emergency c-section (the cord was around my son's neck), hospital stay after the birth, and about 2 weeks of him staying in the neonatal ICU. I think the bill came to around $30,000 (covered by insurance), and I think we paid a couple of $20 copays.

> And the leaving the house/car part I also don't follow.

Exponential? No, but I don't think anyone claimed that. But compared to a couple going out, a couple and a child takes several times more time to do each step. Everything takes more planning, and nothing is completely spontaneous.

> We had a hospital stay before the birth, emergency c-section (the cord was around my son's neck), hospital stay after the birth, and about 2 weeks of him staying in the neonatal ICU. I think the bill came to around $30,000 (covered by insurance), and I think we paid a couple of $20 copays.

If you that's the case and you hadn't already hit a larger yearly out-of-pocket-max through other bills, then your insurance is uncommonly good to put it mildly. If you additionally didn't have to fight with insurance to get that stuff covered so completely then you have ZOMGWTF good insurance.

I don't think everyone realizes just how much worse health insurance has gotten in the past couple years for many of us. When my kids were born (10+ years ago), I'm sure the whole pregnancy and birth was covered by just one co-pay. Now, with a $5k deductible on the best plan we can afford, it would be a different story.

My wife actually handled the bills and tends to have a better memory for this stuff than I do.

There was a stress-related stay in the hospital for her for several days with a $250 copay, around late January. Then the whole birth+surgery+NICU+breast pump rental was judged as one incident, with a $250 copay.

Individual doctor visits are $20. Hospital stays are $250. Medication is heavily subsidized, and most of it that we've ever gotten had a copay under $10.

There was an with a demand for payment for the entire bill+interest. A series of calls to their billing department led to them finding the mistake in their system and sending us the bill for just the copay.

I'm positive that we fall under the "uncommonly good" category.

> I'm positive that we fall under the "uncommonly good" category.

For comparison, my wife and I are on a marketplace plan, and out of a total of $60k in expenses for our newborn daughter, we were responsible for ~$12k.

We want to have more children, but I would move from the US to a first world country to do so.

I know you're making a joke, but first/second/third refers to political affiliation in the cold war and is not to do with economic prowess.

First = US/W.Europe + Allies

Second = Soviet Union/China + Allies

Third = Non-aligned

I find your comment an important reminder of the original sense of the phrase, but I disagree that third world has nothing to do with economic prowess. You are referring to both the etymology and formal definition of the phrase "third world" country. Political journals will generally use third world in this restricted sense, and dictionaries may even list the original definition first. Nonetheless, in modern parlance it has everything to do with economic prowess. It is used--in developed countries at the very least--as the pejorative analog to "developing country".

As a first world resident I am not sure about the prevalence of this usage in developing countries. I know I would not be thrilled to have my country--and, by extension, culture--referred to as "third world". I wouldn't be surprised if it is common in developing countries to note this original sense to both blunt the pain of being dissed by denizens of rich countries and to establish a sort of reverse superiority by insisting on and noting the original sense of the word.

Medical billing in the US is a nightmare. Even if an insurance looks very good on paper, the entire health industry finds ways to screw the patients. Claims are rejected that should've been covered and it requires endless forms and phone calls (and the phone calls always have long wait times) to correct the issue. It's all a big mess.

My wife and I have had 3 kids (now 8,6 and 1), all 3 were C-sections with extended hospital stays and all 3 births were covered, in their entirety, including pre-birth obstetrician visits, my wife's follow-up visits and initial pediatric appointments for the kids with zero co-pays. Literally we paid nothing to the doctors or hospitals for the entire year. We've had various flavors of Blue Cross/Blue Shield "HMO Blue" Massachusetts. This is not even the top tier plan Blue Cross offers from my employer - that's the "PPO" plan which has significantly better out of network coverage.

> And the leaving the house/car part I also don't follow. You have one more person to dress and one more item of luggage to carry; it's hardly an exponential increase.

It's mainly that something so easy you barely think about it becomes something you do have to think about. It's a vanishingly tiny value being acted upon such that it is many times larger than it was, though still not huge. It does get worse with older kids—newborns are in many ways very easy, sleep and constant feedings aside—and I understand that some people have lots and lots of trouble with the process, though for us it's not that bad, just a non-issue that is now a once-or-more-a-day minor issue.

Yes, getting an older child out of the house can be like a hostage negotiation.

Michael McIntyre explains the leaving the house/car part perfectly: https://www.youtube.com/watch?v=4GO2xz0L9gQ

(Edit: The full presentation is pretty relevant to the topic too if you are interested: https://www.youtube.com/watch?v=j1cFt2tWsI4)

Well, you might have one more person to dress but it might be a person screaming and crying and not wanting to be dressed.

And when you're all finished and ready to get into the car, the person has a full diaper that needs to be taken care of, so when you've done that you're back to square one.

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