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

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?

Some Tips to Help with 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!

The Ultimate College Hacking Guide

The Problem of Student Loans

Basically people owe A LOT of money in student debt. This debt can cause extreme stress for its borrowers years down the line. Student loans keep people from getting married, buying houses, pursuing new opportunities and financial independence. Most would agree that having a huge amount of debt having over your head can really put a damper on your lifestyle.

  • Current U.S. Student Loan Debt = est. $1.53 Trillion
  • 1 in 4 Americans have student loan debt: An est. 44.7 Million people
  • Average student loan debt amount = $37,172
  • Average student loan payment = $393/month  (source)

In short, student loan debt is a huge problem that does not seem to be getting any smaller.

Student Loans

How I Hacked My Way Through College

I got my B.A and Masters without taking a drop of student loans, and no my parent’s did not pay for all of it either.

I also did not do the “traditional college experience” which many people would not be willing to forgo. Was it worth it? Maybe. It’s hard to say. But I wanted to share with you how I did it.

  1. HOPE scholarship/In-state school: I grew up and went to High School in Georgia which made me eligible for the HOPE scholarship. I had to attend an in-state college which limited the colleges I could even consider. However, the scholarship amount was too good to pass up. There are other states that offer similar programs as well: Florida, New Mexico, West Virginia and Tennessee all have similar scholarship programs. More states offer significant financial and student aid to those who meet their requirements and stay in-state for school. HOPE covered the bulk of my tuition and was the biggest contribution to my college expenses. A simple google search can help you find out if your state offers a similar program. 

  2. Living at home: Since I went to an in-state college I decided to live at home rent-free for most of my college career. My parents were kind enough to let me live rent-free at home which significantly reduced the amount I had to pay in housing, food and even entertainment costs. I did have to buy a car to do the commute. I found a $4,300 car (ten years old). It took a hefty amount of my savings at that point but was a great investment. It lasted me for 5 years.

  1. Work: I got a job before I even started college. It was not easy and quite stressful at times. I was lucky enough to be able to arrange my school schedule to accommodate work and vice versa but there were times where I was running back and forth:) I also took some online classes which allowed to have even more flexibility. I used the money from work to pay for whatever HOPE did not cover as well as my books and other fees. I was also able to put some money into a ROTH IRA and start saving up for graduate school. I completed my B.A not only with no debt but with money in the bank and a car.

  1. Summer and Mini-mesters: With my CLEP and AP credits I had quite a few of my non-major credits completed. The first summer I decided to knock more out. Since I worked in a school during the year I took advantage of the summer semester to double up on my classes. I took 24 credits. How? I took 4 courses (the limit I was allowed to enroll according to the University) and then took another 4 in community college. Then I transferred them over. It took some research to make sure that all the credits I took at CC would transfer properly. A few of those courses I took online as well to lessen the physical workload. Mini-mesters are a small semester tacked on during winter or spring break. They usually consist of enrolling in one class all day for one week. Its a great way to get a specific course or per-requisite in. What is the purpose of stuffing so many credits into a short period of time? While colleges charge per credit they also charge certain fees per semester. Every semester you spend in college will cost you more. By taking less semesters in school you will save yourself significant amount of money. In my University, mini-mesters did not have separate semester fees so you only paid for the actual credit.

  1. Used Books: Textbooks are expensive!! I used a variety of used book stores, rentals etc to buy whatever I could second hand. I looked at message boards from former students and emailed professors to see how important it was too have a newer edition of a textbook. In many cases, an older edition had no significant differences and was half the price. After the semester was over I tried to sell many of the textbooks again. Some I was able to, some I was not. I did not recoup the the price at all! But every little bit helps!

My college experience was not traditional at all. I am not sure if that made an impact on my life today. Maybe yes, maybe no. There is no way to know. I do know that no one has asked me in a job interview about the details of my college experience as it pertains to where I got my credits or where I lived during college. The intangibles of college are hard to quantify. Perhaps if I had lived on campus I would have made some connections that would have helped me later in life. Perhaps it would have just been a waste of money. Maybe if I hadn’t worked so hard to pay for school I would have had more experiences or more time to excel with my schoolwork. Perhaps the experience of working with teenagers in a school during those years was a better experience than any college experience. There is not way to know.

What I do know is that I have never had to deal with the stress of debt. When I was unemployed for a stretch I was able to focus on things that we NEEDED (shelter and food) without defaulting on debt that would have haunted me for years. I am extremely grateful o my former self for making those choices.

Hacking college is not for everyone, There are people who feel that the college experience was the greatest experience of their life. There are opportunities available in college that are not available anywhere else. I think that the college setting is the quickest and easiest way for someone to change their life than anywhere else. For many people, the opportunity is literally life-changing and worth any money and debt in the world. For a lot of people, not as much. It’s hard to quantify what going to college can do for you. However, spending and borrowing tons of money for something that may or may not pan out is not a great move. There are ways to cut down on the amount of student loans you have to borrow.

The Experts Weigh In

Student loan debt is widely discussed and analyzed in the personal finance twitter “world”.

I posted this comment on my timeline:

I read a lot of PF blogs and I want to say: IF YOU ARE GOING TO COLLEGE OR IN COLLEGE: DO WHATEVER YOU CAN TO REDUCE YOUR STUDENT LOANS. Take extra classes each semester, get a job, live on less, take out less. Starting adulthood with… Click To Tweet

I then asked:

A/o else have ideas?

And they did have ideas! Below are some of the responses I got from the great people of Twitter:

“Take dual enrollment & AP classes if you can. Do first couple of years at a community college. And make sure you live like a broke college student so you’re not a broke college grad.”

@SeptemberAcres  

CLEP tests. Saved me a few hundred $$$

@profitdare

Look at options to get college credit in high school. Dual credit courses, advanced placement, and international baccalaureate. They’re often cheap or free, and the more early credits you get, the fewer you pay (and borrow for) later. Just make sure they’re usable credits.

@FiPrincipal

I’m late to the party but SCHOLARSHIPS!!! So many scholarships actually have a small applicant pool because nobody takes the time to apply. Especially scholarships that have a brief written component; do a good job and your chances skyrocket!

@early20smoney

Take AP classes in High School. If you get a certain score, the credits will transfer over to college and you may be able to graduate a semester or even a year early. Apply for local scholarships, go to college locally so you can live at home.

@KUWTBulls

Apply for scholarships over and over again. Not just senior year of high school. And small ones!

@picksuppennies

I’d say college choice is a huge factor. If your family has an extra half million sitting around, a private college is a luxury you can afford. If not, unless you get a big scholarship, go instate. 99% of employers will take a state grad as fast as they’ll take an Ivy.

 @SmallIvy_SI

See if you can get class credits for an internship. Get ahead in the workforce before graduating. Perfect world, a paid internship to help keep costs down as well.

@dollarrev

While I don’t recommend enlisting in the Army National Guard SOLELY to get out of or avoid student loan debt, IF one is ALREADY so inclined, however: https://www.nationalguard.com/tools/student-loan-repayment-program … Some individual states also have even more generous programs. SPC Johns, #TXARNG ’89-95

@TimJohnsWA

If you are in a STEM degree, consider summer internships and CO-OPs. CO-OPs might go by a different name these days. They consist of taking a semester off to extend an internship. STEM interns can earn $12-$20 per hour. Use that money to avoid debt when you go back to class.

@BigH_29

My son watched us struggle under the weight of st. loans and was determined not to go that route. He chose an inexpensive but well respected program in his field and earned a pile of scholarship money in bowling tournaments of all things. He’s covered most of his tuition himself.

@MyWidowedLife