A Tale of 2 Births

A Tale of 2 Births

Let me tell you a tale of two births

Both beautiful and amazing.

One that took place in the US of A

One that took place in a nameless country, we’ll call it “Other Country”.

The difference you ask?

The Healthcare system!

I’m not interested in getting into politics, but I am going to share my own personal experiences: I have two children who were born in two different countries. My husband and I were U.S. Expats living in a country with Universal Healthcare while on a student visa for the second birth, while my first was born in the U.S.

birth

The First Birth

My first child was born in Florida. At the time, I was under 26 and therefore still under my parent’s healthcare place. They had what was considered to be very good insurance. Their insurance covered my pregnancy and childbirth, and part of my baby’s care. The rest was covered by Medicare (as I was ineligible for insurance through my work and we were low-income enough to qualify for it).

This was a few years ago and I was not the personal finance fiend that I am today so I don’t have exact numbers for what we actually paid for the birth. For the purpose of this post, I will use approximate numbers instead.

A few weeks before my due date, my doctor thought there was an issue with the baby. He advised us to go to the hospital, which we did. We went to the labor and delivery ward where we spent an hour (I may be exaggerating but I really don’t think I am) with a billing lady, giving our insurance information etc. We signed papers and “registered” for the birth. Please note, this is part of triage. Its possible that if I was in pain or it was an emergent case they would skipped this step. I don’t know. What I do know is that I was sent to the hospital and spent the first hour- before being checked, monitored etc. we dealt with billing issues. We did not have an unusual insurance situation and we were using an in-network hospital and doctor. This was just the routine.

I spent the day in the hospital and was sent home as all was fine.

Two weeks later my water broke and I went to the hospital again. Same thing. They did ask if I was in any pain and when I answered “no” we sat at that same desk with a billing agent and did the same thing again. Even though we had “pre-registered” (I don’t really know what that means) we still had at least a half-hour of paperwork and billing issues to go through, maybe more.

The hospital was really nice. At the birth, there was a doctor, 2 nurses, a pediatrician in the room. The birthing room had a shower, lights we could dim, an iPod dock for my labor playlist. I had a private room with a pull-out couch for my husband to sleep on. A TV, a fridge, 3 meals a day. The baby slept in my room with no nursery option but my husband was there the whole night to help. Water and juice was brought to me constantly. The nurses came when I had a question. A Lactation consultant came to help me (although she was shamefully ignorant about nursing). The pediatrician came on his rounds in the morning and checked the baby. All was well. I stayed the full 2 days. Discharge was another deluge of paperwork, signing papers etc.

After we got home is when the fun started. Bill after bill. From different places and different companies. We had no idea what they were for. Some we paid, some my parents paid. Some we disputed. A memorable one was for my child’s hearing test. As a newborn, babies are given a hearing test to make sure that they can hear. I vaguely remember signing a consent form soon after birth for this. It turns out that although the hospital was in-network, the nurses were in-network. The hearing test “lab?” was not and therefore not fully covered by insurance. Please remember that we had what was considered to be good insurance. The whole birth ended up costing us a few thousand dollars.

As an aside, we had some fun signing up my child for medicare. Before I had the baby, I had started the process of signing up. The advice was to sign up as a pregnant woman and then once you had the baby add them on as well. This led to a interesting phone conversation with a lady in the medicare office who could not understand basic biological function. This was our conversation:

Her: You had a baby?

Me: Yes

Her: But I have you listed here as a pregnant woman and you received prenatal care.

Me: Yes.

Her: So you mean to say that you were pregnant last week but now you’re telling me you had a baby?!? (the tone of incredulity in her voice made it hard for me to miss the insinuation that I was clearly attempting insurance fraud)

Me: Yes. This is how this works. I am not an unusual case.

For some reason, this was hard for her to comprehend.

Total Cost of Birth: $$$$

 

The Second Birth

Fast forward, we are living in a country with Universal Healthcare while under a student visa.

A month before we had the baby we had to register at a hospital. This involved filling out a piece of paper and dropping it off at the hospital, then taking it back to the Ministry of Health office where they process it. This was only because we were not citizens and there on a visa. If we had been citizens, this step would have been omitted.

When we arrived at the hospital, they asked us our name and for my prenatal paperwork (you are supposed to bring documents from the doctor giving you prenatal care). We had it and the process took about 30 seconds. I was in a delivery room within seconds. This apparently is unusual as there is usually a waiting period before being given a room. This is not due to paperwork or billing but rather due to overcrowding. I have heard stories of women giving birth in hallways and waiting rooms and triage areas, not because they came too late but because there were not enough beds. I did not have that though, it was the middle of the night and the hospital was empty. I was sent straight to the delivery room.

The delivery room was ugly. One tiny chair for my husband to sit on. No TV. I could not touch the lights, let alone dim them. No speakers. The delivery was attended by a midwife and a nurse. There was a doctor on call but I did not see them at any point. It was a smooth delivery and the care was excellent.

Soon after I delivered they took the baby to the nursery to be washed and given tests. The pediatrician does not come to the room. My husband was told to get the baby himself afterwards from the nursery. The room where I stayed had 3 beds in it divided by curtains. By some stroke of luck I was by myself and had no roommates. This is unusual. There was one bathroom for us to share. No couches. No TV. No fridge. No diapers for the baby. There were a few personal care items for me. I had to request more which they gave me grudgingly. Visiting hours were strictly enforced and I basically spent the day by myself. There were so many “rules”. A nurse snapped at me, “This is a hospital, not a hotel!”. The nurses were busy nursing and this does NOT include bringing the patient things that they want and need. They gave medication and took fever and blood pressure. Anything else is not their problem. At a specific time I walked my baby to the nursery where they checked him and then I had to go back and get him myself. This was a lot of walking for someone so soon after childbirth! But there are studies that show that ambulation so soon after birth can actually promote healing so perhaps it wasn’t that bad?

The night was long and difficult. There was no one to help me. I had to get water by myself. The air-conditioning was off and it was so hot! I had no way to change it myself and the nurses were less than helpful. Nurses came to check on me but not to bring me anything. If I wanted anything or needed help I needed to get up and get it myself. Pediatrician rounds were at 6 am in the nursery. I dragged myself out of bed and brought my baby to the nursery to be checked. Walked back to bed, where a doctor came to check me and then went back to the nursery and picked up my baby. As soon as visitors were allowed, my husband came and I checked myself out AMA (against medical advice). I figured I would be more comfortable and have more help at home.

Before I left, they brought me a birth certificate to sign. That was the only piece of paper I signed the entire time I was there besides for the AMA form.

The next day, my husband brought the baby to the government run baby clinic for his heel prick test and to weigh him.

Total Cost of birth and baby care: $0

The main difference in the care received at the two hospitals is the attitude to the patients. In American, the patient comfort was extremely important to them. There were no “rules”. It was beautiful. We got free things. The doctors and nurses came to me (although I still had to beg for pain mess and the advice they gave me was suspect). Food was brought to me. They encourage relaxing, watching TV and doing nothing.

In “Other Country”- The hospital was a place to give birth and be monitored. I wasn’t “taken care of”. Nothing was given to me. I had to schlep to the nursery, to the cafeteria and ask the nurses for more pads. I brought my own diapers and water bottle. But the medical care was excellent.

Comparing the “experience” American was a million times nicer. In the “Other Country” no one gave a darn about the “experience” they cared about the medical process and that’s it.

Is paying a lot of money (and I am talking about thousands!!!!) worth it for a better experience?

In my experience the medical care in both places were good. Studies have shown that “Other Country” has much better maternal and baby outcomes. Significantly less C-sections, episiotomies and complications. Maybe because the doctors don’t attend the births? Maybe- I am not an expert and this is not what this post is about.

2 Births. 2 Experiences. Only 1 charged me.

Passover Without Debt

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Passover on a Dime

Passover is behind us, and with it all the myriads of expenses associated with celebrating this, and any, holiday. Passover may be one of the most expensive Jewish Holidays and therefore probably causes the most stress! Passover is also a time of freedom. A time to celebrate like royalty. What better way to celebrate freedom than by being free from debt?

You can take this post and substitute any holiday instead of Passover and the principals remain the same. As with all things related to Personal Finance there are basic tenants that apply to all situations.

Passover on a Budget

You can skimp and scrape to make the holiday more affordable. Shop sales, shop in advance, make do with less- these are all great ways to make the cost burden less. You can purposely choose to make food that is cheap and filling. You can cut down the expensive desserts, side dishes and snacks. But the fact remains that Passover is EXPENSIVE.

Add to the fact that Passover is in many places the beginning of spring and winter clothes need to be put away and summer clothes taken out. We had this exact situation this year when the first days of Passover were COLD and my kids wore all their winter clothes but second days were HOT and it was time to switch to short sleeves and shorts. Again, all the same frugality rules apply. Shop sales, use hand-me-downs, do with less, push it off as much as you can. But if you have children who grow, new clothes are a necessity. And even if you are as cheap as can be (I shop Walmart and Children’s Place- even for formal wear, try never to pay full price, and didn’t buy myself anything) it is still a large expense.

How do you do it?

How do you finish Passover with no debt?

The only way I know how is to use all the frugal tips and hacks to stay within my Holiday Budget. Frugality and hacks help you stay within a predetermined budget, the tips and tricks don’t make you money or make the holiday more affordable on their own. Meaningful actions can help you stay within your budget.

How do I determine my Holiday Budget?

Very simply. It is the amount of money I have in my Holiday account. There is no math involved. No calculations. The money in that account is the money I have to spend. Click To Tweet

All year, I put 5% of my paycheck into my Holiday account and 5% into my clothing account. This is automatic. As soon as my paycheck hits my bank account- I transfer the money into my separate Capital One 360 savings accounts. (That is an affiliate link. If you sign up for an account using that link, then we BOTH get a bonus!) If I get any “extra money” like a bonus, I might dump that in there too. This year I took some of my tax refund and used it to bulk that account up.

Celebrating Holidays are extremely important to me. It is not something that I will be flexible about. There are certain expenses that will have to be paid no matter what. I am not doing without Matzoh and wine. Its not happening. By saving money ALL YEAR for holiday expenses I am able to do that. This year we were lucky enough to have enough money to splurge a bit on things that are not strictly “necessities”. We were able to celebrate with expansiveness, without feeling TOO pinched. (Don’t worry! I still shopped sales and was careful with what I made, bought etc! I’m not rich enough to go ALL out!).

Now I have to work on rebuilding that account to start saving for summer vacation and the next holiday! It never ends!

How Do you Do it?

This is the question that comes up in all conversation leading up to Passover (possibly more than the 4 questions are asked!) How do I do it? How do you handle all the expenses? There is no magic secret. There is only planning ahead and being strict with your budget. It means sacrificing a little each month so you can be able to celebrate without going into debt. The best way to do this is to have a separate account where you put these savings. If you leave it in your checking account- YOU WILL SPEND IT. Unless you are a mythical creature with amazing self-control and in that case, why are you even reading this?

5 Tips to Save a Dime on Holiday Expenses:

  1. Take out a credit card with a good sign-up bonus. Many credit cards offer a bonus for spending a certain amount of money within a certain amount of time. Usually, you spend enough money before Passover to qualify for the bonus which can put money back in your pocket. As always with credit cards: Don’t spend more money than you would have just to meet the bonus. Don’t spend a dollar just to save a dime! I do not recommend getting a credit card unless you can pay if off in full!
  1. If you cannot pay all your bills and you will be going into debt, stay away from reward cards. You can look around for a no-interest card that offers no bonuses but will give you more grace time in paying your balance. If you don’t qualify for a no-interest card, try to get a card that has the lowest possible interest rate. This will help save you tons of money on your debt.
  2. Shop Sales- Look around. Shop around. Calculate how much you can save by shopping online, different stores etc.
  3. Plan you Menu Accordingly- Make a menu that is centered around what is cheap and easily available.
  4. Do without- If you can’t afford it, think about whether you really NEED it or you just really WANT it. Then put it back.

Happy Holidays!