Yesterday I was home with the kids (and dogs), and it went like this:
8:00 am: take kid #1’s car to drop kid #2 off at her summer arts program (cost, $200+/week for 4 weeks, for $800+);
8:30 am: drop kid #1’s car off at the Ford dealership for badly-overdue tune up/maintenance (initial quote, about $1500; later find out the alternator’s bad, so $2000 (but refuse to raise that to $3500 to get the AC fixed));
10:00 am: bring kid #3 to her ballet camp (cost, $250+/week for 4 weeks, for $1000+);
10:30 am: bring kid #1 to the oral surgeon to get 4 impacted wisdom teeth removed per our regular dentist’s orders (cost, $2745 out of pocket before our insurance, which the dentist does not participate in);
1:00 pm: bring groggy kid #1 home to pick up kid #4 (who’s been home alone for awhile because I couldn’t get him to come with me for kid #1’s appointment), and bring kid #4 to the (same) oral surgeon to get 2 baby molars extracted per our orthodontist’s orders (cost, a mere $490, also out of pocket before insurance);
3:00 pm: go out to fill prescriptions for kids #1 and #4 (out-of-pocket cost for the generic antibiotics, pain killers, and anti-nausea medicine, a shockingly low $4-$5 TOTAL);
3:10 pm: while prescriptions are being filled, go to grocery store to buy lots of liquid and otherwise soft foods and somehow end up spending $150+ on juices, yogurt, applesauce, canned soup, and ice cream.
Let’s see, that’s about $7200 worth of family infrastructure spending! Not exactly a “typical day” for our family, but it’s proof that one really has to be rich these days in order to have kids (especially that many kids). (At least I didn’t really spend anything on the dogs yesterday, although my old beagle made sure that I spent time cleaning up his evening “accident”–to make it a pretty typical day in that regard…)
Fortunately, it turns out our very generous dental insurance (courtesy of the Federal Reserve) will reimburse us for 90% of those dental expenses I paid up front, even though the oral surgeon “does not participate” with any insurance plans. I didn’t find out the high reimbursement rate until this morning when I called our insurance company. Yep, I had made and gone through with the appointments knowing in advance that the surgeon did not accept insurance, knowing the cost was estimated at $3000-$3500 for the two kids, and yet not knowing how much our insurance would cover for us. Why? Well, the “mom” in me was obviously more in charge than the “economist” in me, going through that simple, irrational, two-question test: (i) is there any possible benefit associated with the expenditure (is marginal benefit positive)?, and (ii) do I have the money to pay for it?
A week ago I was at my regular dentist for a checkup and mentioned that our favorite oral surgeon (and the one our dentist had referred us to) was no longer participating in any insurance and how much we had to come up with in advance to pay for the treatments. My regular dentist said she knew of other oral surgeons that she thought did still participate in insurance that she could refer us to instead. But then when I mentioned that we already had appointments (with nonparticipating oral surgeon) for the following week (and which I had easily scheduled just the week before) and how both kids were already overdue and could not afford to wait until August when cheerleading and fall baseball started (so it seemed they had to have it done ”now or never”), my dentist said “oh, well, you’ll never get an appointment with that little notice with [that oral surgeon who takes insurance].”
Plus, we already knew and liked this (nonparticipating) oral surgeon–we’ve been his patients for many years. He’s got such a pleasant chairside manner for someone who’s putting you through torture…
And there you have it–back to my earlier point about why health care will always be unreasonably expensive. I can’t shop for my family’s health care the way I love to comparison shop for other things. There will always be people like me who are willing to pay unreasonably high prices for high quality (good and fast, and familiar) health care, even without the reality or awareness of third-party payments to hide the true prices. And for the others who will not, or cannot, pay those unreasonably high prices– well, they just have to wait an unreasonable amount of time for an appointment.