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The High Cost of Health

Pediatricians take long weekends too. My husband and I were reminded of this on Memorial Day weekend when our 18-month-old daughter’s cough and fever just wouldn’t quit. While most of America barbequed away, we paid a visit to our local emergency room.

My husband’s question before the four-block walk: “What’s our emergency room co-pay?” No heartless Daddy he—our girl’s health knows no price—but a legitimate question since it could be $500 or more. Whew. No co-pay. But of course! She’s a child. With a huge co-pay the over 50% of Americans without health insurance would be discouraged from bringing their children in or would delay care until things got worse.

Emergency rooms have become doctor’s offices for so many without health insurance. Because my husband and I—before landing here—owned and ran our own business, we were covered under the Freelancers Union and our daughter was covered by New York State’s Child HealthCare Plus program, developed and modeled after Massachusetts’ drive to insure all their residents, especially children.

It’s a tremendous cost to go it alone—at one time it ate up 20% of our income a month—but the cost of not having insurance is even more costly. National and local group-discounted plans are thankfully cropping up more and more—are you a member of a union or organization that has ties to one? If not and you have to go through an insurance-shopping site like Esurance.com, make sure you look for high-deductible plans that will cost less monthly (and be more likely to fit into your budget) but will kick in coverage if there’s an emergency.

With some hospitals demanding payments—sometimes in the six figures—upfront, even when you have insurance, what’s a patient to do? Arm yourself with as much information as possible and know your rights (scour your medical bills!). With the amount of time we spend researching and shopping for a new car, shopping for and maintaining medical coverage should rank right up there in thoroughness and thoughtfulness.

By the way, our little B is much better – another couple days of rest and she was back to happily toddling. I wonder what happens when we get that bill?

To be continued…


Dear Carmen: I am glad to hear that your daughter is getting better and that it was nothing too serious. One thing that I would also like to mention is that it would be beneficial to advise your readers of a few alternative options other than going to the emergency room:

1. Call your primary care doctor, even if it is after hours. They often have doctors on call that can advise you of the best course of action. Perhaps it is to see a doctor that is available over the weekend. This is much less expensive than both the emergency room.

2. Take advantage of urgent care centers if your doctor or a doctor on call is not available. Often times these facilities are also open 24/7. These facilities are most likely more expensive than your doctors office, but are less expensive than the emergency room. In addition, you will often times be seen quicker for a cough at one of these facilities vs. the emergency room.

3. Call your insurance company. Often the insurance carriers have registered nurses available 24/7 to help families who are not sure where to go for services or what services they should seek. This is also something to keep in mind if you are traveling, and it is not an emergency, and you are not familiar with providers in the area. Often, you can call the insurance carrier and they can provide you with either doctors or other providers that you can see, and depending on your plan, potentially be covered on an in-network basis.

As you said, with all of the research we do regarding other things like shopping for cars or TVs, it is becoming very important for people to understand how their health plan works. --Larry Cass, CT

[Larry owns an insurance advisory and brokerage company that offers consulting services throughout the U.S. You can contact him at
lcass@alliancebenefitsolutions.com]


What is a very good health care supplement? I will be 65 later this year and would like your opinion. --James, AZ


Here in North Carolina, everyone seems to use Blue Cross Blue Shield. Is it that AETNA and UnitedHealth - who used to be the common insurers when I was in New York City - don't have a presence here? Which insurer would you recommend in North Carolina? --Ken, NC


I have a pre-existing condition (multiple sclerosis) and I cannot locate a health insurance provider that will cover me. I lost my job in Tampa and I'm currently on COBRA. Are there any health insurance companies that would consider me? --Cathy, FL

Getting private health insurance is a battle in and of itself, let alone with a pre-existing condition. Head to Healthinsuranceinfo.net, a non-profit site and organization that has more info on your options as well as a state-to-state guide on what’s available. --Carmen