The cost of raising a child in America has soared (2018)
marketwatch.com
marketwatch.com
We spent two months in the NICU (newborn intensive care unit). The nurses couldn't be more amazing. They took care of those babies like they were their own. And along the way, they took care of us. They made sure nothing was ever missing.
My sons got new pacifiers every time one got dirty. If their covers ever so slightly touch the floor it was thrown into the laundry basket. Their feeding tubes were constantly changed. I was grateful.
My sons were born barely weighing 2 pounds, but they came out of the hospital as plump babies. Then the bill came.
We have insurance. In fact, a very good insurance. The bill for the first born came a couple weeks later and it was in the amount of 1.25 million dollars. (I fainted) We called the insurance. They told us to wait, that the insurance will kick in.
It kicked in and the bill came back rectified with the amount of 250k. The adjusted bill for the second child came shortly after.
To give you an idea what is inside the bill, they moved the babies every couple days to a different section of the nicu. The bill showed that some section charged up to 20k a night. Those pacifiers that fell on the floor each cost 35 to 50 dollars. The formula they provided when we didn't bring breast milk cost hundreds of dollars.
I don't have any credit card debt, I'm frugal when it comes to trivial purchases, I pay for what I can afford. I even have insurance. But then, there is a bill to pay. To this day, we are trying to get the bill to be a reasonable price. And so far, it seems like it's going to happen. We are very hopeful.
Have you considered legal help to navigate this and have someone advocate for you?
I was advised that to get Medical which, I did right away, and it is supposed to be retroactive.
There's been some progress in states (including CA) to cut down on these sorts of billing practices, thankfully, but it's still a major issue elsewhere, even if you have an ostensibly gold-plated health plan. Many plans are starting to remove caps on out-of-network bills, too: https://khn.org/news/2016-ppo-plans-remove-out-of-network-co...
I assume something similar may have happened to OP, but there are a lot of other ways they can run up the bill. These kinds of billing practices are insane and need to stop.
How does the insurance bill end up being so high?
These costs were totally unreasonable, 35-50 dollars for a pacifier is just absurd and the fact that this price is hidden and reduced from most consumers means that it can continue being the sticker price.
America needs to seriously fix this BS.
State regulations matter a hell of a lot here. I'm seriously considering moving to Texas because of debtor laws - any health incident can cause one to accumulate a large amount of "debt" in a hurry, and being able to tell creditors to pound sand gives a hell of a lot of peace of mind.
Can you elaborate on this? What is so favorable about Texas law specifically as far as debtors are concerned?
Not to mention the way they over-serviced you sounds downright exploitative. I wonder if the staff had been covertly told to use as many consumables as possible?
total hospital bill: 0
What has gone so wrong?
My parents had no insurance and never paid the hospital anywhere close to the amount. But this was 1977 so cheaper than your bill.
Can HN help out? If you set up a GoFundMe account I will donate or I can send you a gift card to a grocery store of your choice.
Congratulations on your babies and time will fix the financial concerns. For now your babies are the most important thing.
After a few days it was clear there was no ongoing problem and absolutely no issues. He was not a preemie. At this point the bill would have been around $100,000.
But they insisted to keep him longer to be safe and we couldn't say no. Eventually he accumulated various hospital acquired infections and the stay had to be extended.
After six weeks he was released. The bill was $1.5 million.
Parents aren't allowed to say no. If they do it's evidence of neglect. And most parents wouldn't dare to and go with professional opinions.
Entering the NICU was a room where you had to clean your hands and arms thoroughly. This is good. Doctors and staff weren't required to use this room and never did. The argument is they could use the wash stations inside the unit instead.
So, what's the big deal? Well those doctors come in through the same door as visitors and they touch the door handle with their unsterile hands. Then the visitors/parents, having just sterilized, touch that door handle.
I brought this up and it was discarded as nonsense. After all I am not an expert and they are.
Yet still, subsequently, there was my kid, with an infection he got from the hospital. No problem man, only cost me a bit over a million. Not their issue.
Is strange to hear this histories. USA really feels archaic in this sense.
It is only recently that you can see how much was spent on your health care, and this requires an action from you (otherwise you would not know).
To my very limited understanding, we calculate inflation from some fixed [per comments below: not entirely fixed] index of consumer goods prices [per comments below: which include some notional aggregate of rent].
Is it possible that instead of saying "The cost of children, housing, healthcare, and education have risen sharply" we should instead be saying "Inflation has increased substantially more than previously calculated because the price of a loaf of bread has been fixed by subsidies"?
CPI includes housing, healthcare and tuition. The basket isn’t fixed, e.g. 1999 CPI didn’t include cell phone data costs.
Home prices work their way in through owner-imputed rent, i.e. the rent offset by owning the home. Home purchases include a utilitarian portion (the housing) and a speculative portion (the investment gains). We don’t include the stock market in inflation; we similarly don’t include housing prices beyond the housing utility. Nobody has to purchase a home; everyone needs a place to live.
Every study that tries to include housing prices finds an inflation figure lower than CPI [1].
[1] https://seekingalpha.com/article/4173463-cpi-housing-prices
You cannot include for sale housing in the index because the price paid is a speculation/estimate by the buyer (future looking)
Rent is a snapshot of today's price.
Though to be fair CPI is computed nationally and things like housing prices are so localized that it's impossible to come up with a number that makes sense across the whole country anyway.
There are CPIs calculated for each metropolitan area. When I'm considering my savings, for instance, I look at New York-Newark-Jersey City, NY-NJ-PA [1] and New York-Newark-Jersey City [2] statistics.
National CPI is useful if you're planning policy. Local CPI is better for individual planning.
[1] https://fred.stlouisfed.org/series/CUURA101SA0
[2] https://www.bls.gov/regions/new-york-new-jersey/news-release...
Interesting! I had never heard about this. Do you have a source for it?
Inflation statistics in the UK are almost entirely useless for the same reason.
You cannot use CPI to determine a "real rate of return" because anything you'd actually want to buy is not included.
The basket makes up something daft like 10-20% of my expenditure because, yeah, groceries and electronics and stuff are cheap.
It's a metric that only really has relevance to retirees with homes paid off on a fixed income. Everyone else spends ~40%+ on housing.
I have ongoing questions about how the weighting process works in general, I don't understand it; it is too complex for me. If they reweight the basket every couple of years to reflect purchases, can the index practically rise that much faster than wage growth? Goods for which there is real competition might disappear from the basket of goods. If they don't reweight, is the index relevant at all?
In terms of real returns, if I have to do something with my personal finances I adjust by the M3 monetary aggregate index (M2 for the Americans) or one of its siblings rather than published inflation numbers. Not only is it simpler it also seems like a more useful metric.
Births are usually cheap. You can go it alone for $0 or get a midwife for $2000 to $6000. Most of us have health insurance with an out-of-pocket maximum. For example, mine tops out around $11,000. Crazy bills can usually be negotiated, with the hospital very aware that you might just not pay at all.
Child care is sort of free (though an opportunity cost) when done by family. That choice also strengthens the family relationships. It scales well, with older kids assigned to help younger kids.
Housing isn't bad unless you insist on a bedroom for each kid. You need a house for yourself anyway, and most houses have 3 bedrooms. Homeschool to avoid the school district bidding wars.
Food... is a bit of an issue. I go through about $4000 per month, but I'm not living on beans and rice. Being more frugal, $100 per kid per month should be possible for a large family.
Transportation can be mostly avoided.
Clothes become cheap due to hand-me-down policy.
Sports can be cheap. You don't have to sign up for hockey. Play stick ball.
Dozen kids would cost about 1.6 million for 12 years of public education.
ETA: I just saw that you mentioned homeschooling.
If it’s ok to ask, how much are your expenses per month and do you own your home?
Expenses are primarily food, at about $4000 per month. The rest isn't usually notable unless something is broken, such as when our 4-ton air conditioner is low on coolant or gets the fan stuck. Normally somebody needs surgery (cracked skull, rib cage correction, etc.) so my medical bills hit the yearly out-of-pocket maximum at around $11,000. We probably do 100 to 200 miles per week, fuel being $2.25, so that is pretty much nothing.
I paid off my home in 8 years. It's 3500 square feet on 0.39 acre, about 0.9 mile from the beach. I got it for about $310,000 after the crash.
We cook. I look for sale prices. We eat a lot of chicken, but we also get fish.
I count just 3 of you. Scaling up for family size and ignoring the sizes of the people, your $1000 would be $4666 for me. I guess I'm doing well to spend only $4000. Scaling the other direction, you'd be on a similar per-person budget if you spent $857 per month.
I'm just enjoying your comments. Sounds like you're doing a lot of things right. Right on!
I buy normal packages from a normal supermarket. I try to buy a bit extra when there is a sale, but I only have two refrigerators and a chest freezer. What is "bulk" to most people can be eaten in a week. I might empty the supermarket's supply of sliced cheddar cheese when it goes on sale, grabbing 10 pounds of it, but we'll have that eaten within a week or two. Sometimes I'll grab all the extra-large packages of ground beef or an entire display box full of canned herring. We go through 2 gallons of milk per day. There just isn't any way to really stock up on things without more storage space, and I'd have to find a store that wouldn't run out of things when I go shopping.
Maybe I should see about having Sysco trucks deliver food. :-)
For us, it's always a struggle with waffles (And there's only 5 of us). If everyone eats two waffles in the morning (which happens 98% of the time) that's 10 waffles a day. Hardly anyone carries 48-counts so we end up grabbing as many 24-count boxes as we can and usually have to make another run by Sunday evening. Maybe when the kids get older we could switch to a waffle iron.
ps- if you think this is an endorsement of the situation, think again; simply a cold-blooded game theory thought on a most emotional topic
Agreed. Also, being born even on December 31 2019 qualifies you for having another dependent in your household for the entire 2019 taxes, so it's a double whammy.
A due date after September-ish ensures you're only paying the medical treatments/screens/hospitalization/etc for that year and that year only (vs, as you mention, a due date that happens potentially anytime between Jan-August).
It's tricky. Unfortunately.
Yes, folks outside the US, we here in America try to time pregnancies over bullshit details of how our insurance plans work. At least anyone who's thought about it does. Those who haven't get a nasty surprise, and pay (up to) double.
And almost everyone where some medical professional, somewhere in the chain of hospital visits, happened to be out of network - someone you had no idea would be involved. Examples would be where the doctor sent lab results to another doctor for analysis, etc.
Failing that, record yourself telling the hospital staff (or get it in writing) that any out of network charges will not be payed unless expressly signed for ahead of time.
The term commonly used here is “Balance Billing”, though that refers to a variety of “surprise” bills.
Very unfortunate. This makes the research into whether your preferred hospital/OB-associated-hospital is in- or out-of-network rather useless to some degree.
The insurance options (4 different providers over the years, 3 BIG players in the game, one self-funded) I've had so far in my fatherhood haven't offered a stepped plan, either (they were all or nothing).
See the Chinese ultrasound study. It's a study that is impossible to perform in the USA because it wouldn't pass ethical review. Ultrasounds were proven to cause structural changes in the brain. One can reasonably assume that structural changes are bad.
See: Geriatric Pregnancy/Advanced Maternal Age Pregnancy (Pregnancy after the age of 35).
I'm generally against anything but procedures that are absolutely necessary, and the ultrasounds and MRI certainly were not voluntary on our part. Personally, from all the research I have gathered it seems like ultrasounds are quite safe, although I am not an expert.
As for taking action, I had the same dilemma. Before we knew anything was wrong, one of the doctors ordered an MRI based on a hunch. I did not want to do the MRI unless it gave us some sort of information we could act on, and abortion was out of the question, legally and morally speaking under these circumstances. But we did it anyway, and at least the information has prepared us for what to expect.
They should be required to hang a sign outside L&D, "Half a womb still pays for the full room." just so you don't have a(nother) heart attack when the bill arrives in the mail.
I called my insurance to ask what I could expect to pay assuming a normal pregnancy after being amazed at the cost already billed. They suggested I a) call my doctor's office and get each billing code for each procedure expected b) call their billing office to get each cost for each c) call my insurance with these numbers and get out of pocket expected costs. I just can't imagine trying to compare costs between multiple hospitals or OBs.
I tracked medical costs fairly closely and noticed things like a quick procedure would get 2 separate coded procedures. Someone I know familiar with medical records said that kind of thing was commonplace. So for a laymen, it seems ridiculous to anticipate costs even for routine things.
In India, raising a child now is a very tough one. 1) Health Insurance - Not everyone has it and many who have turns out to be not sufficient. 2) Education - Schooling has become extremely expensive. There is not much regulation and schools apply a lot of tricks to get money from you, mainly under the guise of extra-curricular activities or development. They force the parents to pay, and legal recourse isn't available. 3) Health again - With the bad air, water and food that the children are getting these days, a lot of them get some or the other illness on a regular basis, which forces the kids to visit doctors frequently and take medicines. These all doctor visits don't get covered under insurance a lot of times. Kids of today are not developing a strong immune system. To top it all, many parents don't let their kids play outside. They give them a mobile and think they have done their duty.
I forsee a very bad/difficult future for a lot of children.
Edit: Why downvote this? It’s like talking about the cost of driving while ignoring all the costs being externalized and offloaded on everyone else.
Tragedy of the commons scenario.
Second, by the same logic, the best thing you could do for the environment is go on a murder spree and then commit suicide.
That should appall you. You should respond "No, because..." (If you don't, seriously, please get help rather than committing suicide.)
But what's the reason for your "no"? Because the murder spree is immoral? (It is.) Because suicide would hurt too many people around you? (It would.) Or is it because, despite the environmental cost of your continued existence, you feel that you could make a positive (net) difference with the rest of your life?
But if you can, so can your child.
> despite the environmental cost of your continued existence, you feel that you could make a positive (net) difference with the rest of your life?
I definitely do not feel that. I recognize that essentially every person is a net negative on the world (especially myself). But I have already been born and there's nothing I'm willing to do to change that at this time.
I mean I get that people like having kids, but at least acknowledge how stupid it is to have one and then recycle or whatever like it makes some difference.
This is not off topic at all by the way. The article is on the cost parents pay to give birth. But ignores the fact that parents are getting an unbelievable discount by offloading the environmental costs to the rest of the world. If we were serious about combatting climate change, having a child would be all but prohibitively expensive.
Now, you did kind of answer it in a way. The only way my murder point actually makes sense is if reducing the population (or the environment) is your only value. You obviously have other values as well (as you should). But just as those other values rule out murder and suicide (though that might benefit the environment), they could also allow a child.
Basically do whatever the fuck you want because your value system has allowed you to justify it to yourself.