Our Jacked Up Healthcare “Industry”

I have known for a long time that the medical industry in this country is just that: an industry. It’s about making money, not necessarily caring for people and making them better. I have heard stories about people who didn’t have insurance, or didn’t have good insurance, being denied for life saving medical procedures. I watched the movie “John Q” and cried, knowing that those kinds of stories really happened. Still, I never had any personal experience with the money-making side until recently.

When my husband got a new job a couple of months ago, he found out he wouldn’t have insurance through his company for the first six months. I was not thrilled about it, but I knew he had a better job and hoped that once he got benefits, that they would be good ones. I purchased a family policy from Blue Cross Blue Shield and thought I had a made a good decision for our family.

The plan I chose is known as a High Deductible Health Plan, or HDHP. This means that we have an insanely high deductible, $10,000 to be exact, and until we meet that, the only thing that is covered is preventive care. I can take the kids for well-child check-ups, they can get vaccines, my husband and I can get check-ups, but if any of us get sick, we have to pay for that. The benefit of a HDHP is that they are cheaper, and the federal government allows you to open a Health Savings Account, or HSA. A HSA is a special type of savings account that can be used for most medical, dental and vision expenses and the money is tax-deductible.

We have had the policy for one month now and I haven’t had the opportunity to open the HSA yet so we don’t have money sitting in a separate account to use for doctor’s visits. I’ve actually only used our insurance once in the past month when I had a suspicious problem in my breast checked by a specialist. I’m still waiting on the bill from that.

Today, I finally decided after six or seven weeks of my son coughing, that it was time for him to be seen. We tried treating it at home, natural and herbal remedies and even acupuncture. Nothing worked. He had the same problem last winter and the doctor told me then that we would just have to wait it out, that there was nothing to give him. That’s why I waited so long to take him in.

When we arrived at the doctor’s office, I presented my new insurance card, expecting them to send the claim to the insurance company and bill me for whatever was left over. The receptionist explained that their policy was that people had to pay up front, and then if the insurance said that the “allowable amount” was less than what I paid, I would get a credit on my account, not a refund. When you go to an “in-network” doctor, the insurance company tells them that they’ll pay a certain amount of each procedure or visit, and then whatever remains the doctor’s office has to write off. It’s called the contracted rate, or allowable amount. According to the receptionist, cash paying patients would have to pay $85 to see the doctor, but a BCBS patient only had to pay $60.

She refused to bill me. She said it wasn’t their policy to see what the insurance company deemed as “allowable”.

I asked if I could wait and pay until after I had seen the doctor. I really don’t like paying for services before I receive them. I told her that if the doctor listened to my son and said that he couldn’t do anything, only time would fix it, that maybe he wouldn’t charge me the office visit. I’ve had that happen on several occasions.

The receptionist laughed at me.

She said, “Of course he’ll charge you! You have to pay for his time!”

To that I replied, “Really? $60 for a 5 minute visit?”

She said, “Yes, it’s his time, you’re seeing him so you have to pay.”

You know what I should have asked her? I should have asked her if I had unknowingly scheduled an appointment with God Himself?!

I know doctor’s have to take time to chart and they don’t see one patient after another after another, and some visits are slightly longer than others. However, for the average 5 to 10 minute appointment, do you realize that it equates to $360 to $720 per hour?

Seriously.

I was in a real mood with this woman by this time. She was not budging with her policies and I couldn’t believe that the contracted rate for a 5 minute appointment was $60. Since I’d been through all this before, I knew that there was an excellent chance that the doctor would tell me to wait it out. I’d been told that before. Evan’s lungs were clear, he had no other symptoms and his cough was mostly at night and in the morning. He has post-nasal drip that I can’t figure out how to dry up.

By this point, tears welled up in my eyes because I was so angry. When I’m in public, if I get mad, I cry. I was so mad that this woman was treating me like this. She was speaking loudly to another family about how she had to wait on me to decide if I wanted to pay or not to be seen. She wouldn’t let anyone else check in while I tried to call my husband for him to (1) calm me down and (2) tell me what to do.

In the end, I trusted my gut instinct and I took Evan by the hand and told the lady that I wasn’t going to pay their outrageous charges when she couldn’t even guarantee that we would even receive any treatment. We walked out of that office with tears streaming down my face. That receptionist completely humiliated me, but at least I stood up for myself and my child and followed what my heart was telling me to do.

This just further solidifies my point that I hate the medical establishment. Yes, they have their place and I know there are good doctors out there, but they are rare. Everyone else cares about how much money they can bring in, telling patients to be on time while they make them wait for an hour for a five-minute appointment before they are shuttled out the door so the next patient can come into the room. Why else make patient’s pay up front?

We all know that something is clearly wrong with the medical system in this country. I don’t think Obama’s health care reform bill was or is helpful, but something has to change. The focus needs to shift away from money and back to the patient and overall health and well-being. Until then, we’re in a big pot of hot water.


Postpartum Depression: Part 1

I want to make the point here and now that every woman is different and just because I experienced postpartum depression one way, doesn’t mean the next person will. This is my story and my experience. If you feel like you might be experiencing postpartum depression, or depression in any form, talk to someone!

My pregnancy with Lindy wasn’t the happy and joyful time I wished for. Before the pregnancy even began, my husband and I had tried for 14 months to get pregnant. Wewent through infertility testing and it began to seem like we weren’t going to have a second child. Doctors tell young, healthy couples to give it a year, but they’re assuming that most people don’t understand how their bodies work, when their fertile time is, and how exactly to time things to conceive a baby.

They underestimated me.

As a nurse, and someone who likes to know as much as she can on just about everything, I knew all about my menstrual cycle. I learned to chart my basal body temperatures, indicating that my body ovulated (released the egg) on day 15 to 17 of my cycle. I knew that I didn’t have a 28 day cycle like they teach you in health class. My cycles were normally 30 to 32 days long. I also knew that sperm can live three to five days in the right conditions, meaning that the cervical mucus, or discharge that women have each month, has to look like egg-whites, or pretty darn close.

With all of this knowledge and knowing how to time things, one would think we should have conceived right away.

We didn’t.

Month after month after month passed and no matter how much we vowed that we wouldn’t stress, we would relax and enjoy our little family for three, there was always disappointment each time my period came. It got to a point where we really began to question our faith and our ability to have any more children.

Fertility testing was a mess. Even though the doctor we saw at UNC was one of the best, she seriously lacked in personality and understanding. Initially she told us that our test results were normal, but two weeks later she called me and told me that Mike had deficiencies and that she recommended a $400 per month procedure if we wanted to have another baby. I told her that we were a one income family and asked if there were any other options. Were there any natural options to increase our chances and correct the deficiencies? She said no.

I hung up the phone and cried. I called a dear friend of mine and expressed my concerns to her. She agreed to pray for us and gave me some recommendations on natural supplements that might help. I began to do research as well and found a variety of supplements that could help boost male fertility, and I ordered some that very day.

So beautiful!

One month later, I got a positive pregnancy test.

I go a little overboard with pregnancy tests!

And then of course

there is prayer! Never underestimate the power of prayer! I believe that God guided me in seeking out natural remedies, providing us with the tools we needed to restore the health to our bodies.The doctor said it wasn’t possible for supplements to help either of us, but I don’t believe her. I believe that nutritional deficiencies wreak a lot of havoc on a couple’s fertility and correcting these imbalances can go a long way to improving the odds of natural conception. I know that sperm take a couple of months to develop and mature, so the supplements probably didn’t have time to affect them in that way. After 14 months though, I don’t think it was just coincidence. Whatever the deficiency was, the supplements helped.

If you’d like to learn more about the supplement we used, check out Coast Science. The supplement was pricey, but worth it!

The day that I found out I was pregnant, I had a migraine and took a test to see if it was safe to take medicine. I took a digital test, not even knowing what day of the cycle I was on or if I should even be testing at all. I cannot begin to describe my shock or surprise when I saw the word “Pregnant” displayed. I jumped for joy, and called Mike immediately, who was on the way to pick up my medicine. He couldn’t believe what I was telling him. It was an answered prayer, and a total miracle!

Postpartum Depression: Preface

Do you ever think that sometimes you are your own worst enemy?

I am definitely my own worst enemy! My brain gets all wrapped up in the negative and the what-if’s, leaving me in a whirlwind of worry, doubt and anxiety that is so powerful I get knots in my stomach and have a hard time breathing. While I’ve never actually had a panic attack, sometimes I’ve been close.

You see, I come from a family of worry-worts. My dad does not fall into this category, but my mother, grandmother, great-grandmother and great-aunt worry (or worried) a lot. I remember my Great Aunt Elsie fussing at us for climbing on things because she was afraid we would fall and break our necks. I loved my Aunt Elsie dearly, but she didn’t really know about the power of the tongue.

I really began to notice anxiety creeping into my life when I became a mother. I would wake up a million times a night to make sure Evan was breathing. Even after his second and third birthdays, I remember occasionally wondering the same thing, especially if he slept late in the morning. Sometimes I would open his door quietly just to check. I knew it was ridiculous. We prayed over Evan right after we found out I was pregnant. We prayed for his safety and that God would always take care of him.

It’s difficult for mothers to put a pin in the anxiety that creeps in so easily. From the moment we see those two pink lines, the maternal instinct slams into overdrive with an intense desire to protect the growing life within us. Throughout the entire pregnancy, we watch what we eat and monitor every movement for signs of abnormality. After the birth, with the baby in our arms, we silently dare anything to bother our little sweetness, or else a ferocious mother-bear will spring to attack. Simultaneously, we pray constantly for protection, peace and health.

In our weakest moments, especially when we’ve had little sleep and the crying seems like it will never end, the doubt and anxiety begins to weave it’s lies and deceptive thoughts into our minds. If we don’t recognize what is going on, these thoughts can take over and if you’re like me, depression may set in. Even if you do recognize what’s going on, depression may still take root.

Defending the Choice to Stay Home

For the past four years, I’ve spent quite a lot of time feeling lonely, confused and exhausted from constantly defending myself and my choices to people I barely know.

When a woman decides to quit her job and stay at home with her children, assumptions are often made about the kind of person she is, her character and her work ethic. When she is around mothers who work outside the home, she is made to feel silly for giving up her paycheck. If money is tight, others question her for giving up the comforts of her job and salary for a life of budgets and coupons.

(Few people seem to understand the cost of daycare and how little most women would actually bring home if a daycare bill was deducted from their paychecks.)

What it really boils down to is this: you shouldn’t have to defend your choices to anyone because no one should be sticking their noses into your family and finances in the first place. The choice to stay at home is never one that anyone makes at the drop of a dime. It’s always well thought out, planned for and executed with as much care as humanly possible. No one wakes up one morning and decides to quit their job without first figuring out how the bills are going to get paid. It doesn’t work that way.

Here’s what people need to understand: If a stay-at-home mother voices any of her struggles to you, it’s not for your pity or your understanding (unless you’re a fellow SAHM). She’s talking to you because she trusts you and she simply needs someone to LISTEN to her. While being a SAHM does have its advantages, it can get lonely and monotonous if you don’t make an effort to connect with other people and groups during the day. For me personally, staying home all day with two kids under the age of five leaves me craving adult interaction and the ability to discuss things other than cartoons and action figures.

The decision to quit a job, reduce the family to 50 percent of its previous income and stay home with the kids can be a difficult decision to make. All parents make sacrifices for the good of their families, whether they work outside the home or not. Mother’s who decide to stay home with their kids should be praised, not questioned, mocked or ridiculed. Deciding to stay at home doesn’t mean we give up on our dreams or become empty shells of the women we once were. Women who decide to stay at home do so because they feel it’s the best thing for their family. It is for the same reason that some women choose to go back to work.

We can only do what we feel is best for our individual families, and what is right for mine, may not be right for yours. My choices were well thought out and although money can be tight, scary tight sometimes, it’s a choice I would make again and again and again.

My pride and joy and the reason why I'm ok not getting a paycheck.

Instead of questioning our fellow mothers about the rightness of our choices, why can’t we be supportive of each other? I might not be able to buy my kids everything they want, or have the nicest clothes, make-up and jewelry for myself, but that’s ok with me. In the end these things are only material possessions, but knowing that I did what was best for me and my kids is a lesson that will stay with me long after toys and clothes are gone.