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.

Equal Access to Financial Independence

#InternationalWomensDay2019

March 8th is International Women’s Day. To celebrate, Brynne from Femme Frugality got together with some fab personal finance bloggers to arrange a blog tour. Each one of us answered the question, “Why is financial independence important to you as a woman?”

To read more amazing blog posts answering this question click here. 

By: Brynne from Femme Frugality

International Womens Day

Before I was exposed to world of FIRE and 4% withdrawal rules, financial independence had a significant and different meaning for me. It wasn’t a label just for the independently wealthy. It was a label for anyone who could function financially without assistance.

 

Functioning on my own financially is important to me not just because of pride, but also because it means that no matter what happens, I can take care of myself.

 

This sounds basic. Like a given.

 

But it’s not.

 

Up until very recent history, as a woman I would not have been able to hold a job, or if I did, it would be one in my father’s or husband’s business. If I ventured out to start a business on my own, I may be labelled a witch.

 

Even if I did start my own business, there’s a strong probability that I would have been required to hand it over to my father or husband to manage. Today, we’d call that financial abuse. But not so long ago, it was just what you did.

 

Financial independence means that I can make my own decisions about my work, my own property, my family and my relationships. Without the ability to achieve economic autonomy, none of these things would be possible.

 

There will be times in all of our lives where we’re not financially independent. Where we need help from others. That’s nothing to be ashamed of. In these moments of need, we should reach out and get help so that we can recover and become independent again as quickly as possible. If we don’t get the help we need today, we won’t be able to extend help to others tomorrow.

 

When we’re back on the track to economic independence, we’re able to not only manage our lives as they currently are, but we’re also capable of building big, beautiful dreams. Want to own a beach house someday? If it’s a priority,  you can totally start saving for that. Wanted to go to the Outback since you were a kid? Save up some cash and make it happen.

 

You can do all that because you’re allowed to bring in and manage those dollars independently.

 

As I mused on my great luck of being born into such a time when all this was possible, I couldn’t help but think of those for whom it is not. I have friends, acquaintances and family members in various disability communities. Contrary to common perception, having a disability does not always mean that you can’t work; it just means you can’t work in a traditional manner without accommodations. You can make valid and important contributions to this world. In fact, sometimes you wouldn’t be able to make those contributions without your disability.

 

When you’re collecting government benefits–sometimes even something as direly important as your state’s Medicaid plan–you’re not allowed to work past a certain amount. At one point in the past few years, the most you were allowed to bring in monthly was somewhere between $700 and $800. Again, in some states, if you earn more than that, you’ll lose the health insurance that in some cases is literally keeping you alive.

 

So you’re forced into poverty. You learn to get by on what little you have–a few hundred in income, Social Security benefits, maybe insurance payouts depending on if you had a disability policy or not.

 

There is no pathway to financial independence.

 

And that’s not okay.

 

As a woman, there are still hurdles in my pathway. But there is a road to pursue. As we work to take down the barriers we face as female residents of this country, like the wage gap, investment gap, and the unfair distribution of both domestic and financial responsibilities based on gender, let us also remember to make sure everyone has access to the road.

What does Financial Independence mean to me? #InternationalWomen'sDay2019 Click To Tweet

 

Living With A Broken Dustpan: Lessons Learned from the Frugal-Not-By-Choice trenches

Living With A Broken Dustpan

Lessons Learned from the Frugal-Not-By-Choice trenches

dustpan

There was a time in my life when I was unemployed and we (my husband and I) had very, very little money. It was a dark, depressing time. I was extremely hesitant to use credit cards or dip into savings because I had no idea if I would ever get another job or be able to pay it back. I had watched too many people sink deep into credit card debt and I really didn’t want that happening to me.

I was on a tiny, strict budget and I really stuck to it. I sometimes look back and wonder how we managed to make it work and I honestly don’t know. We had so little. (One day I’ll write a blog post about that!)

One day my dustpan broke. Cracked. I didn’t know what to do. I really needed a new dustpan but I didn’t have the money to buy one. My husband and I discussed putting it on the credit card- it was a real need after all! But we decided to wait until we actually had cash to do it. This meant waiting until my husband could make it with his “side-hustle” which was very sporadic and not at all consistent or I could make the money with online tasks and surveys. So we waited. In the meantime, I was still using the broken dustpan. And I really made it work. I would get on the floor and push all the dirt to one corner of the pan and then hold it tilted so the dirt wouldn’t fall through the crack while I carried to the garbage can. It took longer but I soon got the hang of it.

We finally had the money to buy a new dustpan (online surveys WILL NOT make you rich-even if you read that it will but it did get me some money when I really needed it) but it seemed silly to buy a new dustpan (remember, we had VERY little money) when we were making do with the old one. Our old, cracked dustpan continued to serve us faithfully until I finally got a new job and we were able to easily afford a new dustpan.

But the experience taught me some important lessons:

  1. Even when you think you can’t use it anymore- it still may surprise you and give you more use!
  2. You may think something is broken but there is more there.
  1. If you really need an item but you can’t afford it, push off the decision one more day. And one more. And then see if you really still can’t live without it.
  2. When life pushes you to the point where you think you can do it anymore, when it seems that a broken dustpan is the only tool you have at your disposal- you have it in you to make it work. You are stronger than you give yourself credit for. You may think you can’t live with a broken dustpan, that you need something better than you have- but you may surprise yourself! You can make it work! You can do it!
  3. When you are struggling with money, it may seem like another blow to have to clean your house with a broken dustpan. It can depress you every time you have to sweep. It is another indignity that must be suffered. Things will get better. Things will change. When the sun does come out, you will have an experience that will have made you a stronger, tougher person. Click To Tweet

If you have ever been at a point where you feel so low and are cleaning your house with a broken dustpan, remember: there are other people out there who are struggling as well (in many ways). You are not alone. You are a hero.

 

How much do I put into my retirement fund? Not a lot, unfortunately. But I put what I can. Why? to create good financial habits. Read: Why I put $5 a month into a Retirement account.