Friday, September 18, 2009

Health care costs for pregnant women and families

Sobering statistics about health insurance for women and families:

* The majority of individual health care plans (i.e. policies people without employer-based coverage buy on their own) do not cover maternity care. According to a study by the National Women's Law Center, only 12 percent out of more than 3,500 individual insurance market plans offered comprehensive maternity coverage. Unlike an employer-sponsored group plan, which can't discriminate based on gender or age (i.e. those policies have to cover everyone in the pool), plans sold on the private market can have a "female-only maternity exclusion." Only 14 states require that plans sold on the individual market include maternity care.

Women who want a plan with maternity coverage are charged astronomical premiums, often for policies that have major loopholes. As an example, read writer Sarah Wildman's article Health Insurance Woes: $22,000 Bill for Having a Baby—and I had coverage for maternity care! (published on's DoubleX blog). In the piece Wildman describes how her individual market CareFirst Blue Cross Blue Shield policy's maternity coverage did not cover her labor, delivery or hospital stay. To add insult to injury: The c-section she had can now be considered a risky pre-existing condition.

Imagine having to pay out-of-pocket for all of the medical care associated with a pregnancy—from prenatal care to delivery? Imagine if you also don't have maternity leave pay from your job, or if you're self-employed, or if you have to quit a job due to the challenges of a pregnancy. (That actually happened to me.) I wonder if these no-maternity policies cover Viagra? It's likely they do, and just as likely that they don't cover birth control.

And from the National Coalition on Health Care:

* The Henry J. Kaiser Family Foundation's Employee Health Benefits: 2008 Annual Survey reports that over the past decade, employer-sponsored health insurance premiums have increased 119 percent.

* The Congressional Budget Office estimates that without health care reform, employer-based family insurance for a family of four will cost nearly $25,000 per year by 2018. Many employer-based plans receive group discounts from insurance providers, so imagine what the costs will be for an individual trying to buy a personal or family plan on the open market! Imagine paying $25,000 a year or more just for health insurance premiums, and then adding the costs of co-pays, deductibles, out-of-network care or excluded fees and services.

Ugh, I feel sick.

Wednesday, September 16, 2009

Pay It Forward

I live near Annapolis, home of the U.S. Naval Academy. Because life for students at the Academy is intense, especially during the highly restrictive plebe (or freshman) year, area residents are invited to become “sponsor families,” essentially providing these often shell-shocked teens with a place they can go on their rare liberty days to relax, watch TV, veg out.

My husband and I volunteered for the Naval Academy’s sponsor program because, when we were new college grads, we traveled to Japan to study, teach English and experience living abroad. Our home in Tokyo was a rented room in a bare bones boarding house. Since we had no heat, hot water, kitchen or bath, we ate out for every meal and showered at a public bath house. We survived and thrived in Japan because we were befriended by our neighbors, the Kobayashis.

Mr. and Mrs. Kobayashi, and their college-age son and daughter, became our unofficial “sponsor family.” We spent countless hours at their elegant, modern home. When I had a terrible tooth ache, they took me to their dentist. When I had the flu, they took me to their doctor and moved me into their house while I convalesced. (Japan has national health care, and even though as a foreigner I wasn’t covered, the doctor and dentist charged me as if I had Japanese insurance. Hence I paid next to nothing, including for a root canal and fillings that dental specialists in the U.S. praised as being magnificently done.)

Two decades later, Brian and I are still in touch with the Kobayashis. Fearing that we were at our Manhattan jobs on September 11, 2001, they were among the first to call to ensure we were safe.

Having been the beneficiaries of such great kindness when we were far from home, Brian and I wanted to—and in many ways felt obligated to—provide the same kindness to others in need of a home away from home.

Our midshipmen, as Naval Academy students are called, are the older brothers our son doesn’t have. One accompanied our twins to their Girl Scout father-daughter dance when Brian was out of town. At commencement this past May, we were proud of our two graduates, both of whom lived with us for a time before heading to medical school and flight school.

The thank you note left by the grad who departed last week confirmed to me that a kindness shown one person does lead to kindness toward another. “Thank you for taking me in, and treating me like part of your family,” he wrote in his sign-off. “I hope I can repay your hospitality in kind to someone else down the road.”

Mr. and Mrs. Kobayashi's good deed lives on.

Pictured: Me and Mrs. Kobayashi, my Japanese mom, in her Tokyo living room in 19_ _. Well, the exact year doesn't matter. To reveal it would make me feel older than I already do.

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