Updated on 08.02.10

Frugality and Fear of Health Care

Trent Hamm

Jennifer writes in:

My husband had been complaining about sharp pains in his side for several weeks. A few days ago I had to take him to the emergency room. He stayed overnight for observation and was released the next day with a ton of medications to take. It turns out he has a liver inflammation caused by a bacteria. He’s going to be fine.

Here’s the whole problem with this. We have health insurance with a $20 copay. My husband didn’t go to the doctor to avoid this copay because our budget is so tight. Now we’re stuck with a big pile of medical bills.

This is a problem that I often have as well. I’m a huge believer in self-care, which means that, for example, if my back hurts, I’ll just take it easy and do some careful stretches over the next few weeks instead of rushing to a doctor or a chiropractor. My instinct, in cases of minor pain, is to wait it out and see what develops.

I do that for several reasons. One, I’ve had bad experiences with prescription drugs and (especially) drug interactions in the past. An example: the last time I went to the doctor for a cold, I believed I was having allergies. The doctor diagnosed a sinus infection and prescribed Bactrim. I found out the hard way that I’m actually very allergic to Bactrim. Two, I usually feel better if I find non-pharmaceutical ways to treat a minor condition. And, yes, it’s less expensive, too.

This type of attitude – something that many frugal people follow – brings up a challenging point. When do we decide that it’s the appropriate time to go to the doctor? Ideally, there would be some magical indicator somewhere between “a few minor symptoms” and “emergency room situation” that tells us that it’s time to go to the doctor, but unfortunately, most of the time, there is no such indicator. When does an otherwise healthy person with good money sense visit the doctor?

Here’s what I’ve found.

First of all, my primary help in figuring out when to go is my wife – and I’m her guide as well. We’ve reached a balance in our relationship where we’re easily able to tell each other when there’s a problem. If I hurt my back, for example, I don’t try to use a stiff upper lip to hide it – I tell her what’s going on.

Second, I don’t use the internet to diagnose my medical problems. Almost every ache or pain a person has, when researched online, turns out to be cancer or ALS or multiple sclerosis or something else dreadful. Diagnosis should be left in the hands of a professional using professional tools, not someone reading a website, rubbing a bump, and guessing.

Third, I’m mostly concerned with chronic or worsening conditions. Over the short term, I don’t worry about most things unless they’re showing clear signs of getting worse. A cold is not a sign I should run to the doctor, but a cold that lasts for months is a sign that a repeat visit might be in order. An ache or a pain is just a sign that I’ve been overly active and I need to take it easy for a bit, but an ache or a pain that gets far worse over time or swells substantially means I might need to focus on it a bit.

Finally, I use free nursing services. Many communities offer a hotline where you can call medically trained professionals for quick advice and direction as to whether you should seek additional help or steps you can take to deal with a medical situation on your own. In my community, for example, First Nurse is available. Such services can go a long way towards helping you figure out whether a condition you have actually merits additional medical costs and efforts or whether it’s just a temporary thing that should just be monitored from home.

Your health isn’t something to mess around with. At the same time, being overcautious with your medical treatments can result in additional problems, from challenging costs to side effects of medications. If you’re struggling to find your own balance, I highly recommend seeking help from the people around you. Don’t ever be afraid to ask the people you care about most for their help and advice when you need it. It’s given with love and it’s given for free, whenever you need it. Never turn away from that resource.

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  1. Vicky says:

    What about health insurance?

    Right now where I work, I can get health care from my employer for $160 a month, with a $2000 deductible, and a $50 copay. However, if I add my husband, it shoots up to $480! (They pay half for me, and I’d have to pay all for my husband).

    We are almost NEVER ill, I use Planned Parenthood for all my reproductive health (including fixing me to not have kids), and outside of colds – neither of us has ever been sick and we’re 24 and 25.

    We can’t see a reason to pay almost a fifth of our income to health insurance.

  2. ABQBrent says:

    I’ve given this advice to many people. If you aren’t obviously seriously injured, leaking fluids out the wrong places, or having heart attack symptoms, call a nurses line and ask them. Odds are you won’t be seen for hours at the emergency room and a doctors appointment will fit your needs. Also, the emergency room is no substitute for a physical.

  3. valleycat1 says:

    OK, this may be a double post, but my other comment just disappeared.

    One additional rule of thumb would be to at least call your doctor if you have severe pains for more than a couple of days – the office staff or nurse can usually give you an idea whether it’s something the doctor should check out.

    Jennifer can vouch for the fact that even an overnight hospital stay is formidably expensive – probably all bills total would be double what Vicky’s annual expense for insurance would be. Even 20 year olds get significantly ill or injured – I wouldn’t be too blase about not having coverage.

    I’m in my mid-50’s & have found that over the long run, premiums paid add up to a lot less than the medical services used, should you need the services. And that it’s well worth it to have routine checkups and an established relationship with a doctor. My current premium is $1200 a month for the family, and I’m still ahead of the game, even compared to the reduced payments the insurance company makes to the providers.

  4. Kathryn says:

    Because i’m disabled, i do have insurance, which i hardly ever use as they don’t cover alternative medicine.

    I’ve had Chronic Fatigue for many years, since i was a teen, although it was misdiagnosed as “depression” for many years. It became very, very bad 3 years ago when i was given Cipro for an infection. I’ve never really recovered, & my functioning has dropped from about 60% of normal to 20-40%. That said, i too have had multiple bad reactions to meds & essentially have chosen to eschew most conventional medicine. In my experience, very few doctors have good critical thinking skills to treat & cure an illness, they tend to go with diagnose & medicate (cover symptoms).

    One of my options is to have prescription coverage added to my insurance. It would cost me a monthly fee (say $30/month) plus a $310 deductible, & then i would pay 25% of the the cost of the med. I decided to forego this as i don’t use medication. I did require a medication (topical) last fall, the first in 27 months since the Cipro. The pharmacy clerk was very concerned that i didn’t have Rx coverage because she said the medicine was “expensive.” The brought hundreds of $$s to my mind. Turned out it was $89. So, for the past 27 months i could have been paying $30/month = $810. I’ll bypass the deductible issues altogether, but the 25% would have been $22.25. Because of the deductible issue, insurance probably would not have covered the cost of ANY of this, but even if it had, it would have cost me $810 over the course of more than 2 years so that i could get an $89 prescription for $22.25. No thank you.

    With that in mind, for me it works best to have the insurance as back up for something catastrophic like a car accident, & save the money i would put toward the Rx coverage in an emergency fund for health care. $810 goes a long way toward covering any needed prescriptions, especially as i need them so rarely. Most people don’t seem to think this way, however.

    While doctors, urgent care & emergency rooms still have their place, i disagree with Trent on the issue of utilizing the internet. If you choose to do alternative medicine, it is a wealth of info. I have 2 very trusted sites where i can access natural treatments, home care & specific info. In my experience, “Ask a Nurse” only tells you whether you should go to the ER or wait until you can see your own doctor. I just successfully treated a bad UTI with natural meds & herbs since i cannot safely use any antibiotic.

  5. Julia says:

    Being young is no reason to not have health care. I had cyst removed and it cost over 15K. There is no way I could have afforded this without my insurance through work. Now I go to my annual exams since the cyst could have been handled differently with normal visits. If a $20 copay was the issue, there are plenty of ways to find this in your budget. It may mean lower quality meals for a week or two or walking more, but $20 was cheaper than overnight in the hospital.

  6. Evangeline says:

    If you have insurance, use it. It is a cool miracle this man’s problem wasn’t so much worse. Yes, I know that’s difficult to come up with money. One year, even with insurance, we paid nearly 9,000 out of pocket on a less than huge income. Co-pays were 50 and 75 (for specialists).
    The ER had a 500 copay. Still, at least it was there in case something catastrophic happened. Perhaps $20 for preventive care would have been wiser and muchl less painful than this gentleman’s infection.

  7. ChrisD says:

    Hmm. I know somebody (in the US) who had heart problems, and delayed going to the doctor for ages. Turned out her heart was fine but she was VERY anaemic. A year later she had died of leukemia. Doctors LOVE telling you that you are healthy. Getting odd things checked out should not be a money issue. Vote for a national health service (where yes young people pay more than they use, but they are effectively paying for their old age). The UK spends as much per person as the US and we get a full health system for the whole country (the same NHS that Stephen Hawking owes his life to). In Europe people pay more (in Germany I paid ~12% of my income) and apparently 12-14 people in the UK die every day of cancers that would have been caught with European health care.

  8. Gretchen says:

    A problem lasting “several weeks” is not what the emergency room is for.

  9. chacha1 says:

    And for those who have at least some insurance options through their employers (Vicky) please look into whether a high-deductible plan may be available. Mine costs half as much as my firm’s HMO coverage. Since neither I nor DH use much in the way of healthcare services (still, and we are 44 and 50) and take no prescriptions, the high-deductible plan is saving us over $3000/yr in premiums.

    In addition, if you have a high-deductible health insurance plan, you can open a Health Savings Account. It’s a tax-advantaged account that works like an IRA. You can use the funds in it for healthcare expenses up to retirement age, and after that for any purpose. So it works as retirement savings as well as enabling you to save specifically in advance for your copays or for unanticipated (i.e. emergency) health expenses.

  10. Gretchen says:

    Also, every time I’ve ever gone to the doctor, I’ve had to list my (long!) list of medications specifically to prevent drug interactions.

    Thought 3: What’s the difference between an internet diagnosis and the diagnosis of your spouse or best friend? Nothing.

  11. Steve R says:

    I tend to be on the other end of the spectrum – when in doubt, have it checked out. If you have health insurance, use it as prevention is definitely cheaper than the cure. Recently my son had headaches and blurry vision after re-injuring hishead. The doctor said it was a simple concussion, but my wife was still concerned. My brother in law is an ER doctor and recommended an MRI, which insurance would only cover a part of. The out of pocket was a few hundred to have the MRI done and the results came back that there wasn’t anything else wrong. The piece of mind this has given us was worth every cent of that money.

    If you’re employer offers a pre-tax medical reimbursement account, you should take advanatge of it. Every year we put enough to cover a typical year’sworth of doctor’s visits, presecriptions and vision expenses. We have yet to lose a single cent as you have 15 months to spend it. If we still have a few dollars left over, we buy some extra OTC medicines to use up the rest.

    I can’t stress enough not to skimp on health care as without our health, our ability to provide income suffers. Ironically I write this recovering from foot surgery two weeks ago which removed two growths from my foot. Fortunately they were not cancerous (which my family has a history of), just cysts.

    The one last thing I’ll say is that what you eat has a big effect on your health too. While it’s slightly more expensive, switching from a heavy diet of processed foods to one focusing on fresh, natural foods has made a big difference in my health. I’ve barely been sick, lost weight and have more energy than the last few years. If you won’t put crappy gas into your car, why would you do the equivalent to yourself just to save a few dollars?

  12. Kathy says:

    So, what are your thoughts about preventative health care? A check up w/ blood work once per year or more often if needed?

  13. Tammy says:

    When we were younger and didn’t have employer-assisted insurance available, our family went without insurance for about ten years. We saw it as gambling (paying privately for the premiums) that we’d get sick, so, instead, we gambled on staying well. It worked for us, and we have great insurance now, but if you’re young, and healthy, I think that for some people there are better things to do with your money than give them to an insurance company just in case something bad happens.

    We just paid cash for doctor visits when the occasional sinus infection or whatever popped up, and it saved us a LOT of money, a couple hundred a year versus about $5400 a year for insurance.

    We all have to make our own decisions, though. for us it was the right financial decision to make, but it’s not for everyone.

  14. Cheryl says:

    Our health insurance premium is $1350 per month, plus I sock away another $425 per month to cover our $5000 deductible. Our policy is individual as my husband is self-employed. We pay the first $5000 and then after that the insurance company pays 100%.

    This is our fourth year on this plan, and the first year was the most difficult because I had to change my way of thinking. When I set the funds aside to cover the deductible, I began to utilize our health insurance more fully. I think we will meet our deductible this year, which is a mixed blessing.

  15. Leah says:

    Vickey, I pay $140 a month for my health care. I’ve got a $5k deductible but do get $1k worth of free office visits a year. I rarely go to the doctor — in a typical year I might go once for my annual and once for a sinus infection or something. But I keep my health insurance for two reasons:

    1) I get free generic prescriptions. My one allergy med I take on occasion and my regular birth control are totally covered

    2) When there is a problem, it is totally worth it. I went to the ER last year with horrible abdominal pains. It turned out to be nothing (literally — no diagnosis or anything) . . . but I did run up a $5k bill making sure I didn’t have appendicitis. I was so worried because of my $5k deductible, but it turned out that I only owed $850. How? Well, my insurance company negotiated the bill for me, a bit was covered in the $1k worth of visits, etc. Even though I had a high deductible, it definitely paid to have insurance negotiating for me in a worst case scenario.

    At a minimum, I’d look into getting “catastrophic” insurance for worst case scenarios. It doesn’t cover a lot, but it will cover ER visits and cancer and stuff like that. It’s much cheaper than standard insurance and would give you some peace of mind.

  16. K.sol says:

    Would you gamble that your house won’t burn down? That you won’t be at fault in an auto accident where someone gets hurt? The problem with “gambling” that you’ll stay well is that you are not gambling with your own money — you’re gambling with the money of all those who are responsible enough to obtain insurance. Sorry to sound heartless, but no one wants to pay for their own health care but everyone expects to be taken care of when they’re really sick. And at some point, for most of us, you WILL get sick. Health care should be like housing & food — it should be assumed, barring extraordinary circumstances, that you will put adequate resources toward taking care of yourself. It should be an expected expense. Don’t assume, either, that because you exercise, are vegetarian, whatever, you are immune. I know more than one health-conscious person with a devastating illness.

  17. Elizabeth says:

    This year, my medical expenses have been much higher then usual due to an ER visit and preparing for a trip to Kenya, which required a number of immunizations and anti-malarial pills. Insurance has helped keep my costs down. The other thing that saved me this year is my emergency fund.

    My health plan deductible is $1,200/year. So I make sure that my emergency fund can cover that. When I ended up in the ER earlier this year, I didn’t have to worry about the cost- I could just focus on recovering as quickly as possible. It was a bummer later to pay out that deductible, but that’s what an emergency fund is for. I’m now working to replenish that fund, but I’m happy to be healthy and not stressing about debt.

    I keep my health costs down in two ways. One way is exercising and eating healthy. The other is through annual check-ups. Yes, both cost money, but it’s cheaper then dealing with an emergency later.

  18. Barb says:

    Without having read ahead I think it needs to be made much clearer that acting in the way the OP did probably resulted in additional medical bills. Going to the emergency roomof course always costs more. In other words, people with high deductibles need to find a happy medium between the er and not going to the doctor. I imagine that had this couple bitten the bullet and seen even an urgent care center, their bills would be at least halved. Its what in the olden days we called pound foolish.

  19. Meredith says:

    I am an emergency room RN and I also want to stress that many people come to the ER with urgent problems – meaning they do need help today – but that could be handled in an urgent care facility and not the ER. Of course if you have chest pain you want to go to the ER because they have the capabilities to handle that sort of complaint but it is helpful to learn when you can go elsewhere. Urgent care facilities cost way less…in most emergency rooms it will cost you at least five hundred dollars just to see the doctor. And that’s before you have any labs, xrays, etc. So go if you need to (because your health is worth it) but if it is less serious, find out the other alternatives!

  20. Sam says:

    I can recommend a great book: “Your Body’s Red Light Warning Signals” by 3 ER Doctors- Shulman, Birge and Ahn. Cover price: 7.99 Its sorted by body area and symptom, so you can look up whether that pain in your side requires emergency care or a referral to a regular doctor. I’ve bought copies for both my elderly parents as well as myself.

  21. jay says:

    re: the original post, sometimes you can get away with it, sometimes you can’t…
    re:Vicky: Shesh! Makes me crazy to read of someone who is “hardly ever sick” so why pay for health insurance! My thought is, so your plan of action is….? Should you get sick, go to the ER and have someone else pay your bills? Great plan, really selfish.
    On the other hand our health care system has -until now- been ridiculous from all three fronts: the patient, the health care providers, AND the insurance company. Ridiculous not to insure yourself, absolutely ridiculous; however, insurance companies have traditionally made it [ridiculously] expensive as individuals to purchase, and health care providers have created the tradition of having the insured, by charging a [ridiculously] huge amount, pay for the uninsured. Great system.
    Personally we’ve had two diametrically opposed experiences at the same local ER. Brought Hubby in late at night because of dizziness. Of course there was the requisite wait, but he was seen, treatment suggested, and given. Overall a good experience. The second, our regular Doc suggested our daughter go directly to the ER for abdominal pain as she would be seen more quickly. Ha. 9 hours and a $16,0000 bill later, she was told she had a virus. Won’t go into the wasteful practices (I’m a nurse) during those 9 hours, but I was furious when we received the bill. Wrote a nasty email to the hospital. Even more ridiculous is that our obligation for that bill was reduced to $1700 by our insurance company. Still too much, and am in discussion with the hospital. As it is, the two ER bills will be a huge burden, but I cannot imagine seeing a $16K bill for the level of care she got had we not had insurance.
    We have a broken system, and I don’t know that it will be fixed by the new laws, but one can only hope.
    To those grousing about now having to buy insurance, DON’T be so selfish. It will catch up with you.

  22. D.Socal says:

    I don’t see how being frugal should physically hurt you. At some point paying the 100$ for the visit seems nominal to the eventual cost, not to mention the pain and frustration for those several weeks.

  23. Bren says:

    It pains me to hear that you would even consider seeing a chiropractor. There is no scientific basis whatsoever to the concept of chiropractic subluxations. Chiropractic is based on unsubstantiated claims and while it has been shown to help with some minor lower back pain you’ll always be far far better off seeing a qualified physical therapist. Undercover investigations have again and again shown incorrect and inconsistent diagnoses and failure to refer serious conditions to a qualified medical professional. Chiropractors are quacks and do not deserve you throwing your money at them. Please do take out your own research – the Wikipedia page on chiropractic is a good starting point.

  24. To those who think “Oh, I’m healthy, always have been”: You ARE gambling and you might lose.
    My 19-year-old daughter was *very* healthy — until she wasn’t. Right before she got sick, she and her boyfriend walked eight miles on a whim. When she caught a stomach bug going around campus, she couldn’t shake it off the way everyone else had. One morning she was literally crawling to the bathroom because her legs would not support her.
    About eight hours later she was on life support in the ICU. She had Guillain-Barre syndrome and within a couple of days was paralyzed right up to her eyeballs. The docs were amazed, because GBS tends to be an older person’s disease. They’d never seen anyone that young get it that badly that quickly.
    No, you can’t predict something that catastrophic. But it doesn’t take a true catastrophe to land you in a world of hurt, so to speak. My best friend tripped on the stairs leading from her garage to her house. She sustained a very bad radial fracture that went right up into the rotator cuff, and needed major surgery. It was 14 months before she was completely healed. A simple slip and fall was all it took.
    I’m a divorced freelance writer and I pay my own insurance. Does the $338 monthly premium hurt? You bet it does. I didn’t like paying car insurance, either. But I do these things because — not to sound like an old poop, or an insurance agent — you just never know. Ask me how I know.

  25. MLJ says:

    Vicky – wake up! If you or your husband develop cancer or some other dread disease that happens to otherwise perfectly healthy people, what are you going to do? Put a jar out at the local fast food joint for people to drop quarters into?

    I agree with Jay, “great plan”! And he’s right, it is stupidly selfish.

  26. Sue F says:

    Do not balance your budget by avoiding a $20 copay. Sharp pains in the side for several weeks is nothing to mess with. See a doc after one day. Also, people need a well check every year and a blood test. My husband was able to avoid the bad results of prostate cancer by having it caught at an early state through blood work.
    I hate to sound sexist, but many men do not want to go for a checkup. Ladies, help your men survive.
    And for you immortal types avoiding health insurance, the question is not IF you get sick, but WHEN you get sick. Get coverage before you become uninsurable.

  27. Alex says:

    My Fiancee is studying to be a medical doctor and we find ourselves having the same issue. I think in many cases we both are better at saying when to go to the doctor, but when a doctor is unsure tells you that the human condition is complex. You can see many doctors that have varying opinions when to go and what to do. I agree you need not to self diagnose as my home doctor tells me. You will either over or under diagnose the issue. You need to figure if your body is getting worse do not chance it and go to a doctor. If cost is a problem many communities also have doctors that see patients on a sliding scale good doctor offices can help you go to those resources if you need it. Remember a nurse may not have all the information so if they tell you something you feel is incorrect go see a doctor my fiancee has caught mistakes from nurses as a 3/4 yr medical student (mind you these nurses she had corrected were in practice for longer than 10 years). As Stated do not chance your health since you only have one life don’t mess it up because of money.

  28. kristine says:

    Some people just plain can’t afford it. Food or doctor. When I was newly married, with 2 babies, my husband was self-employed, and our insurance cost more than our rent and food combined.

    I want to address the 24 year old doing without health insurance as a budgeting choice. Anything can happen.

    I had a freak cooking accident, got burning butter on my hand, and lost the top of my hand. I was expected to lose 2 fingers as well. I as in the burn unit for 9 days. then had an operation, then a hyperbaric chamber for several days after that. I Kept my hand, and all fingers.

    In a second this happened. Just a tilted frying pan.

    My hand cost 60K, which was covered by insurance. (The hospital forgot to notify the insurance company in time, so they never got paid. I was not liable as I was a morphined up trauma patient, and as such the hospital is required to make that phone call, not the patient. NY state law forbids sticking the patient with the bill if the hospital makes that mistake-thank goodness!)

    Poop happens. You are taking a bigger financial risk than you know.

  29. Emma says:

    I’m not sure I understand what the OP had hoped to gain by refusing to pay $20 to the primary physician and going to the ER instead? Did she honestly think the ER would be cheaper?

    As a Medical Assistant we dealt with this scenario daily. Some people thought the wait would be shorter, so they skipped our office and went directly to ER. Other patients just panicked when they had pain (and I don’t mean chest pain) and went directly to the ER. ER called us and if it was not an emergency, and we could treat it, (such as a broken arm) we told ER to send the patient back to the office.

    There is a reason it’s called the EMERGENCY room. People try to skip their primary doctor all the time. Usually it is not for a good reason.

  30. Tammy says:

    When we made the choice to go without health insurance, we consciously decided to take that gamble so that we could eat and keep a roof over our heads. When you’re making $22k a year gross and paying almost a third of that for private insurance because your employer is too freaking cheap to contribute, there really isn’t much choice other than TO gamble. There are a LOT of working poor who have to make these hard choices. It’s not like we were choosing to make a BMW payment and take vacations instead. No. We paid the electric bill and bought groceries. For us, it really wasn’t a contest. Yes, we were worried something bad might happen medically speaking, but we managed to pay for our daughter’s broken arm, a pap smear every year, and a few little infections.

    We paid cash for all of our medical expenses and, yes, we got lucky, but sometimes folks have to crunch their own numbers and make their own decisions. Far better, I think, for us to be responsible for our own bills than to quit working, go on welfare, and suck off the government just to get their medical coverage.

    Yeah, K.sol, we had liability coverage on the car, and insurance on the house – both required by law here. And, frankly, both together cost a LOT less than paying privately for health coverage for our family.

  31. jay says:

    Life offers choices … babies but no health insurance, owning a car and house, but no health insurance… One illness and you would be bankrupt, AND depending on others to pay your bills.
    Guess what: hopefully it’ll also soon be illegal to go without health insurance.

  32. Pattie, RN says:

    Sue is right…ignoring symptoms and not going to an MD is silly and damned dangerous. It is just like ignoring bald tires because you money is tight and then wrecking and needing a new care. The difference is…you can get a new car, not a new body. In health care we get crazy with idiits who clog the ER for hangnails and colds, but ignoring health concerns is just as bad, if not worse. ALSO…ask for an itemized bill and see if you can get a payment plan, even if it is ony 10 bucks a month. Usually they will work with you and many give discounts for prompt…although tiny..cash payments.

  33. Kate says:

    First of all…my best to you, #4 Kathryn. I suffered from Chronic Fatigue Syndrome for about 10 years. I have to say that there is hope, though. I gradually got better and now function at full speed. Hope that you can have the same luck that I did.
    I have to disagree about the internet. I use it all the time, just like I used a medical book when my kids were little. Several years ago I saved a good deal of money when I had shoulder/arm pain. I looked up my symptoms on the internet and found that shoulder/arm pain is very common in women going through menopause. There were suggestions for stretches to help strengthen the muscles that I followed. It took awhile but I was eventually pain free. My coworker (same age as I am) had the exact same symptoms, but she went through a multitude of tests and then physical therapy where she did the same kind of exercises that I was doing. She told me later that she wished that she had followed my advice to try the exercises that I was doing because she spent a lot of money that she really couldn’t afford to spend.

  34. Barb says:

    You know, the more I think about this, it seems to me that frugal folks DO go to the doctor, especially if they have any kind of insurance at all. One of the reaso costs are so high in this country is because of the “wait and if I cannot stand it I’ll go to the ER mentality”. So what might have been curable bronchities turns into the flu, a uti infection that could hve been treated with a cheap anitbiotic goes into other organs, you name it.The basis of cost effective health insurance is among other things good preventive and basic care. So if you’ve got it, use it for heaven sake.

  35. TODHD says:

    I think that the government should just give everyone free healthcare

  36. Debbie M says:

    My company has a nurse hotline, and this is what I use.

    Also, if I’m thinking, “If my mom found out that I knew about this symptom that I just found out about and didn’t see a doctor, she’d kill me,” that’s another sign to see a doctor.

    The problem is you cannot have all the facts ahead of time–sometimes you need help in getting the facts. No one is perfect, but you need to manage your own care because no medical professional (who doesn’t know you) cares about your health as much as you do. I do use the internet, nurselines, and doctors. If your doctor just doesn’t get some of your problems, change doctors. And keep changing doctors until you get one who will listen to you.

    Note: I am stereotypically male in the stoic not-wanting-to-go-to-the-doctor way, so if I’m wondering if I should go or not, I know that’s a good sign that I should probably go.

  37. Hope D says:

    I am one of those people who look up ailments on the internet. I do not always come to dire conclusions. I will say I have a son that was having trouble at 8 months. He was having seizures. They were hard to see. They looked like he was wincing. The doctor didn’t see it even though we taped it. I researched online and found the problem. It made me really push the Dr. My son ended up having a life threatening problem. Early treatment was paramount. Every seizure was harming his little brain. Because it was caught early and treatment was successful (it isn’t always) he has no lasting effects. I believe knowledge is power. I think the internet is a great tool.

  38. Nicole says:

    I second the nurse hotline option. I have medical insurance (a pretty decent one since getting married) but am also really on a budget. I’m a medical student so I am a. poor and b. have a pretty good working knowledge of the health care system. I know how often I see patients in clinic that I tell that whatever they have is self limiting and will go away and there isn’t anything I can do to help, and also see patients that should have come in ages ago. If I am unsure about whether or not to come in, I always call the hotline (unless I’m bleeding or something life threatening!). I’ve been able to treat hot tub folliculitis (random, but non harmful rash) and a UTI (had antibiotics called in to the pharmacy for me) and avoided an appt copay and was able to be treated appropriately. Prevention is key, and deferring the triage of your symptoms to a professional (who can decide if you have any red flags or not) is important!

  39. Dagmar says:

    Here in South Africa you can get free advice from the pharmacist at a pharmacy/chemist (I believe they are called drugstores in America).

  40. Naomi says:

    The best advice I’ve had is to find a good doctor and stick to
    that person so that they know your history and can see where
    A situation could be of an issue and also know your medications.

    Also I live in Australia with a mixed private/ government system and it works well. When you have a job you go private or get penalized with a tax levy. As a single person I pay $102 a month including an upfront payment of $400 per year if I go to hospital. This is the top coverage I can get. If I’m unemployed or earning a low wage it’s free and I pay only $3.30 for each medication I need which is on the government benefit list

  41. Kathy says:

    (Not the same Kathy #10)

    I have a Health Savings Account, which is part of my health insurance. I am very thankful I have it because I’ve had back pain that was so bad, it kept me from going to work. I was having it treated at the chiropractor, but when that wasn’t helping, I ended up going to the doctor. I’m thankful I have this HSA because if I hadn’t started it, I don’t know how I would be paying for all of this. I have a bone that is so out of alignment, it’s going to take physical therapy to help fix this. The chiropractor alone isn’t helping.

    Even if your employer doesn’t offer an HSA or you can’t get the high deductible insurance that goes with it, start a savings account that is just earmarked for medical expenses. Do this even if you’re not sick.

  42. What a geat topic.

    Its a tough call, because if you go to the doctor every time something “hurts” you’ll be wasting a lot of co-pays.

    But, if you don’t know when to go, then a similar sitation could happen as did to the author.

    Its a tough call. For men, they need to get over their egos and know when to go. I thnk that’s the obstacle a lot of times with guys.

    Women I think have a better understanding of when a doctor is needed and when you can do without

  43. I love, love, love, love the free nurse line our hospital has…that has saved me from many an unecessary doctor visit.

  44. Jane says:

    I disagree about not consulting the internet. Sure, you should read critically, but I think internet medical sites and articles can provide you with good information so that you come into the doctor’s office informed. Many times I have diagnosed myself correctly by typing in my symptoms into google and finding the illness. Of course I wouldn’t diagnose cancer or anything serious that way, but it makes sense to research minor ailments before you go to the doctor.

  45. It seems like this comment from Jennifer which you write about was based on a financial limitation. This is a good example of when it’s okay to use the emergency fund that we should all have.

    But if Jennifer’s husband is going to view this (whether or not to go to the doctor) as a financial decision, it’s important to time our financial decisions for maximum impact. A small copay at a doctor’s office would have been less than going to the emergency room. Waiting to save money probably cost even more money in this scenario.

    A good analogy for this (or, actually, a terrible analogy when talking about health concerns) is a used car. You may wait to trade in a used car because it’s not costing you much to keep it running. But if you wait too long, and something major happens (enginge, transmission, etc.) you may actually cost yourself more money because now your trade doesn’t run and isn’t worth anything.

    Timing financial decisions is important.

    But to Jennifer’s story, timing health decisions is more important – there’s hardly a reason to wait.

  46. suz says:

    @Vicky, I was your age and in perfect health, never sick, ate nearly vegetarian and was diagnosed with cancer. So your feeling about being infallible and not needing insurance certainly is a gamble, I can tell you that from experience (as have others here.) You never know what might happen.

  47. Ajtacka says:

    I live in Europe, and reading all the comments about choosing between paying for health insurance or food frankly shock me – as does the sense that it’s “just the way it works”.

    My story is this. I’m not a citizen of the country where I live, but I’m working which meant my employer pays for public insurance for me (unemployed citizens have it paid for by the state). I went to a hospital about midnight, after several hours of acute abdominal pains. We had no wait at all to see the doctor. He handed me off to a urologist, gynaecologist and for an ultrasound. All with minimal wait (I think the longest was about 20 minutes). Back to the original doctor, and he wasn’t 100% sure it was appendicitis but wanted to admit me just in case. The next evening I had ‘exploratory’ surgery, during which they removed my appendix, and I stayed in hospital for almost a week. Total cost (converted to USD)? About $5 for the ER, which was refunded because I was admitted. The stay was about $5 per day. When I considered going to the hospital or not, in the middle of the night, cost was not a factor in the slightest.

    Without wanting to insult anyone or derail the general discussion, does any American see the current health situation (as observed from outside) as sane and reasonable?

  48. Stephanie says:

    @Jay (#21) It shouldn’t be up to the government to take away people’s choice to go without healthcare. You should be nervous about what other choices the government will take away as well…this is just the start. Don’t let your agreement with this cloud your judgment…your choices and freedoms are being taken away!

  49. littlepitcher says:

    I’ve been uninsured for over 15 years and have a pre-existing condition. I use the Internet only to check antibiotic doses for infections, and utilize veterinary products. I visit the doctor once a year for medication refills, which I purchase through a Canadian pharmacy, and have cholesterol tests run one more time during the year.
    My last ER visit was unnecessary, and every procedure which was run could have been performed at the doctor’s office and saved my employer $600 for treatment, but the doctor’s office insisted on the ER. An informed patient can always write a letter to the physician detailing the most economical means of treatment, questioning problems, and (in this particular case) suggesting improvements which will benefit public health care delivery.
    Any condition which persists for more than 24 hours may need a doctor’s visit. That pain in the side could be a ruptured appendix, perforated ulcer, or torqued intestine. That (enviable) $20 copay is far cheaper than any mortuary.

  50. @Vicky(#1) I was in a similar situation – young and hardly ever sick. But b/c I was a financial planner, I knew that health insurance was important.

    I found a cheap major medical policy via http://www.ehealthinsurance.com/. I paid around $35 a month.

    Thank GOD! I was on a skateboard and knocked myself unconscious (long story). I was only in the hospital for 5 hours but it costs $24,000 b/c it was a head injury.

    Thanks to my policy, I only paid $5,000. Otherwise it totally would have taken all my savings and probably borrowing from family to pay it off.

    So I suggest to everyone covered in case you get in a serious accident.

  51. Johanna says:

    @Stephanie: Should it be up to the government to take away people’s choice to go without police protection? How about paved roads? Aren’t you worried that these choices have been taken away from you?

  52. KAP says:

    My younger brother chose not to pay for health insurance since he was young and healthy. Then at age 26 he was diagnosed with colon cancer. His treatment options were severely limited because he had no health insurance, and he died 10 months later. Going with health insurance is not a risk that I am willing to take.

  53. Michael says:

    For those who want affordable protection: consider medical expense sharing programs. Because they are non-profit and members pay each other directly, premiums and deductibles are very low. A husband and wife would pay something like $250/mo with a $300 deductible, with no worrying about networks or alternative treatment coverage. The catch is most of them take some kind of moral stance against abortion, birth control, cosmetic surgery, etc, and won’t cover them.

  54. Annie says:

    I haven’t been to a doctor since 2006 and don’t intend to go anytime soon!

    The last time I went to the doctor I had insurance–you know how much they paid? Nothing! That was the last time I wasted my money on insurance. Every single time you went for a “covered” item they would find a reason NOT to pay and there you are hit with an even larger bill plus your normal insurance fee!

    If they ever come up with a reasonable rate schedule and medical payments then I will consider having insurance again. Until that day comes if I feel ill enough to go to a doctor I will pay the full fee but I will not go unless I absolutely need to.

    Yes, it bites to have a large medical bill, but know that it would have cost a LOT less to have taken him to an emergency treatment center or to a private doctor instead…Never, never go to the emergency room if you have money but no insurance–they will fleece you good! If you can eek out until business hours always go to a regular doc or ETC instead. You would still have a bill, but a smaller one than the emergency room hit you with–a much more reasonable option.


  55. Kelly says:

    Valleycat said
    “Even 20 year olds get significantly ill or injured – I wouldn’t be too blase about not having coverage.”

    I totally agree with this! Just because you are currently healthy right now, doesn’t mean that you won’t get sick or get cancer or get injured in an accident.
    I’m pretty healthy. I don’t even think about paying health insurance, I’m lucky that I only pay $138 every two weeks for full coverage for my family. Since becoming an adult, I’ve had a baby, which had it not been for my health insurance coverage would’ve cost me a lot because I developed gestational diabetes and was subjected to weekly non-stress tests and biophysical profiles from week 33-delivery..those tests were $1000/week!! He didn’t require NICU care but if he had it would have been covered. There are no guarantees in life. I have a coworker who is 34 weeks pregnant with twins and has been on bedrest for the last month. She is an RN like myself but if those babies are born early and require NICU care, the bills will surely bankrupt her family.

    I also had my gallbladder removed in 2005. Woke up one night in severe pain. It would NOT go away. Ended up in the ER that night and was told the gallbladder needed to come out. The pain that night was worse than giving birth. I was thankful for my insurance coverage because that was all covered.
    Last year, I had gastric bypass surgery to deal with my obesity. The bills for that easily add up to 100K, including all the pre-operative tests that are required by most bariatric surgeons. Because of my health insurance, I ended up only paying about 5K out of pocket. I’m now 90lbs thinner and much healther. My diabetes is gone, my cholesterol levels are within normal limits as is my blood pressure.

    In my area, there are walk-in clinics..like an ER for minor emergencies but they only charge a Dr’s office copay..for me that would be $25 as opposed to the $75 ER Co-pay.
    Last November, I found myself pregnant. Unfortunately a week later, I started bleeding heavily, ended up spending 7hrs in the ER undergoing some expensive medical tests and thanks to my insurance, it only cost $75(my ER copay). Heavy bleeding IS an emergency. Young women of reproductive age just don’t know when they’ll end up pregnant and possibly miscarry, Birth control is not 100% effective.

    Most states have an insurance plan for those that are considered low income, even for adults that’s not considered Medicaid. My sister was on it working part time at a bank until she got her full time position within that bank. It was pretty cheap.

    I think it’s foolish to take that kind of gamble on your health

  56. Rachael says:

    I am thankfull I have health insurance through my employer. Last year I was a healthy 25 year old who for some reason was very sick every morning. After 2 months I finally went to the doctor only to discover my gallbladder needed to be removed immediately. I didn’t have the typical pain in my side so I had no idea it had stopped working. 6 months later in my usual cancer screenings (it runs rampant in my family) it was discovered that I had the early stages and needed immediate surgery again. You can be the healthiest, skinniest, young person in the world and still have emergencies. It is not worth the gamble. After insurance I only paid $1000 total for both surgeries.

  57. Christine T. says:

    I agree that prescription meds are often not the best way to resolve whatever is wrong with you. Lately it seems like you can’t walk out of the doctors office without a new prescription for something. However that is not a good reason to avoid the doctor. The doctor performs 2 functions: diagnose AND treat the problem. Just because you don’t want to follow their treatment plan does not mean you shouldn’t get their help in diagnosis. The doctor can order blood tests and other diagnostic tools that I can’t order myself (and have insurance still cover it). I listen to what they have to say about their treatment plan but often I’ll choose my own treatment plan using, yes, the internet. I also get copies of the test results myself and do research on what the test is measuring and what the result means. For example I was tested for gluten intolerance but what the test is actually measuring is an inflammation response to gluten (antibodies to gliadin) which means if you have already stopped eating gluten for a while you will not test positive for gluten intolerance. (It’s actually more complicated than that, if the gluten has not already caused enough damage to your villi then it probably won’t show up in blood tests even if you are still eating gluten. So lab tests aren’t the end all be all either.)
    You absolutely need to be your best advocate and educate yourself on health issues and the internet is a fantastic resource for that. My dad has Chronic lymphocytic leukemia (CLL) and is part of an online forum where he has learned a ton of information from people that have actually been through it. I agree just doing a random search on some random sympton will yield alot of useless info but once you think you have a diagnosis it’s vital that you find out as much as you can about it. But even random internet searches can be useful, my dog started having muscle trembling in his mounth and I did a search with that symptom and his breed and Addison’s disease came up in one of the online forums in the search results. The symptoms fit, the vet tested for it even though he thought I was wasting money (200$ test!) and it turns out that’s what it was. Kinda funny that it’s ok to use the internet for financial information but not for healthcare :)

  58. teresa says:

    To all the people without health insurance ie the 20/30 somethings:
    If your employers offer it at least cover yourself and get a catastrophic policy for uncovered family if you can’t afford anything else.
    I never needed it until “ONE DAY” ,a few days after my 30th birthday, I then racked up 80K in one year due to a emerging chronic disease. I had rare and normally fatal complications. NOW my medical treatments average 30K a year to maintain my health (effective drugs for Rheumatoid arthritis are expensive).
    If I hadn’t had insurance when I became sick I would not have been able to get coverage. I would have died because I could not have afforded to get treatment paying out of pocket.
    Insurance is cheap in comparison to health care costs. You may never need it but are you willing to take that gamble for you and your kids?

  59. Stephanie says:

    @Johanna….the government HAS taken away your choice to be protected by police as many police stations around the country are being cut to the bone. One county in Texas is being cut down to two officers, another in east St. Louis is laying off 19 out of 37 officers. This is in addition to other police stations across the U.S. that have announced that they will not send officers to respond to things like home invasions and theft—come to the station and file a report about it because they don’t have the manpower to do it anymore.
    The Wall Street Journal just had an article about how paved roads are being torn up in rural areas and replaced with dirt and gravel because it was too costly to repave it and fix the potholes.

    Still trust the government to take care of the citizens? Are you willing to give up more rights and hope for the best?? Or will you be complaining when the value of your healthcare shows up on your W-2 next year and you’ll be forced to pay taxes on it??? Don’t take your freedom for granted–they are slowly slipping away!!

  60. Elaine says:

    I assume that you do know that that “free” nursing service isn’t free. In my opinion, it is inappropriate for people who can afford to use their designated health care provider to use services which are established for those who currently have none. This is more than being frugal – it’s transfering costs from one’s self to other taxpayers. Not okay in my book.

  61. chacha1 says:

    Stephanie, you are taking this discussion off track. This is not a forum for political rants.

    Kelly noted that most states have low-cost insurance programs that individuals can buy into. This is true. In California, Blue Shield offers a “group” plan for people who would otherwise be uninsured. I was able to cover DH and myself for $300/mo on a high-deductible plan during a period when I didn’t have employer coverage.

    I realize not everyone actually has room in their budget for an insurance premium – I’ve been there myself. But I think an important takeaway from Trent’s article and this discussion would be that, whatever your financial resources, you allocate *some* of them to healthcare and don’t be afraid to spend on something you think is minor. It may prevent a much more costly event later on.

  62. A says:

    The best thing we can do is preventative care. Eating healthy foods, avoiding all the processed and sugared food. Taking supplements (yes, they are expensive – but less expensive than insurance and medical bills!) Drinking clean water.

    Learn acupuncture, herbs, QiGong, TaiChi, Meditation…these are all inexpensive compared to emergency medical care. When you learn these things you can avoid a lot of problems.

    Save money each month towards your PREVENTATIVE health care.

  63. Geoff Hart says:

    Trent’s advice is good, as always, but I recommend that you learn the warning signs for a heart attack or stroke:

    Heart attack: http://www.americanheart.org/presenter.jhtml?identifier=4595
    (Note that the signs in women are often quite different from the signs in men, so women are often underdiagnosed. Yes, we have a chauvinistic healthcare system. This surprises you?)

    Stroke: http://www.americanheart.org/presenter.jhtml?identifier=4742

    If you experience these signs, don’t wait for confirmation from anybody else or wait in the hope the symptoms will get better: seek professional help immediately. Your budget may be tight, but ask yourself whether avoiding a $20 copay is really frugal if it leads to a $10K funeral.

  64. At 8 months pregnant, I would LOVE to go to my chiropractor. If I stand too much during the day, I get sharp pains on my sciatic nerve. I know my chiropractor would help me, but I also know he would want me to come in three times a week, at $20 a pop. So instead I take a Tylenol and try to get off my feet for a while. I do know when its time to go to the ER, or to make an appointment for the doctor, and I am thankful for my good insurance when I do have to go. But my budget is too tight right now to spend all those co-pays just because I’m achy, and it might make me slightly more comfortable. That sixty bucks would make my budget more comfortable!

  65. Steven says:

    The thing to remember when gambling about your health is, that it’s not only your money, but your life that you put on the line. I may be overstating it a bit, but far too many people never realize they could be putting themselves at risk to save a few bucks.

  66. One of the key ways to save costs in the long run is to get an annual physical once you are in your 40s. While some may shudder at the cost, preventative medicine really is the best way to avoid very high costs for conditions that should have been treated. Just make sure to tell your doctor that you prefer to take steps to improve your health without medications and ask them what lifestyle changes you might make to maintain optimal health. If you take action in looking after yourself, you have the best option of maintaining good health.

  67. jim says:

    Please don’t avoid medical care to save a $20 copay. That is not frugal, its just reckless. Its just lucky he didn’t have something worse that wasn’t beyond repair.

    I agree with Trent that diagnosing your illnesses by using the internet can be a bad idea. The internet is a good source for information but interpreting the information isn’t easy. Its far too easy to plug in a few symptoms and decide you’ve got cancer. Its OK to use the internet to educate yourself, but seek professional help of a doctor for a diagnosis.

    Vicky: Its only a matter of time before you or your husband is sick or injured. What happens when you’re faced with a $2000 or $20000 hospital bill? If you can swing it I’d at least recommend looking into a high deductible independent plan, you can get those for $50-$100 /month in many states. That will at least help keep you out of bankruptcy if one of you is seriously ill. Yes it does even happen occasionally to people under 30.

  68. jim says:

    “Or will you be complaining when the value of your healthcare shows up on your W-2 next year and you’ll be forced to pay taxes on it???”

    You won’t be taxed on it. Health insurance will not be taxable income.


  69. jim says:

    #33 Ajtacka asked: “Without wanting to insult anyone or derail the general discussion, does any American see the current health situation (as observed from outside) as sane and reasonable?”

    Short answer is that the vast majority of Americans feel our health care system is broken to some degree.

    I found a Gallup poll from a couple years ago. It said:

    Americans generally believe the system is highly troubled: 14% say it is “in a state of crisis” and 59% think it has “major problems.” Only 26% believe it has minor problems and a slight 1% say it does not have any problems.

    Keep in mind that the vast majority of Americans are insured with good quality care. So some people may be viewing it a bias based on their own individual positive situation.

  70. Sandra says:

    Excellent discussion going on here – just had to jump in and say while it’s important having some form of health insurance or health savings for those having insurance you need to read every teeny weeny word written in your contract! I was a healthy, active young woman only to staart having problems and it ended with a diagnosis of ALS (mostly known as Lou Gehrig’s disease). Shortly thereafter, the insurance company started strong-arming tactics with loop-holes pouring out of the contract to where it came down to my agreeing to be removed from the contract or the whole group lose coverage! Needless to say, I found myself un-insured. My mother had the same experience back in the early 90’s when she was diagnosed with Breast Cancer. She was dropped after “they” found a loop-hole – ended up costing her her life as she died 7 yrs. later due to poor medical treatment from having no insurance!

    I recently was diagnosed with Breast cancer and had to have a mastectomy; because we will just have to watch for signs of spreading I was given some guideines from my oncologist of when it’s time to go see a doctor. If you develope any symptoms that do not go away after 7-10 days then it’s time to consider there is a problem. The reason given is that most bugs,small injuries,minor infections, etc. will clear up between 7-10 days – the average cycle of benign ailments. Of course, any acute pain should be handled asap! Too, I think the internet can be a good source of information (make sure the site is reputable!) but is ONLY that – a good source of info. and in no way should be used as a way to self-diagnose, well, that’s in my opinion.

    I apologize for the long post – when I read the comment in the article about the internet telling everyone they have cancer, ALS … and though the internet didn’t diagnose me – as I said I was a healthy active person and suddenly found my life turned upside down with a diagnosis of ALS … I didn’t know what it was … so it can (and does) happen so please be discerning when it comes to your health because it just may mean your life!

  71. K.sol says:

    @Tammy – my apologies for coming off as too judgmental. I did not fully understand your situation, and I certainly did not intend that if it’s a choice between food & rent vs. health insurance that you should get health insurance. I understand that sometimes it’s a gamble you have to take. I think it’s appalling that as a society we put people in that position. What I just don’t want to see is people taking that gamble who don’t need to.

  72. Jennifer says:

    One thing I consider is the time of day and the day of the week. Especially if something is lingering. If suddenly one of my kids ear hurts and it is 7:00 am then I wait a few hours and then decide. If suddenly the ear hurts and it is already noon I will analyze the situation. If it is a Friday I will go to the doctor. If it is another weekday I might wait until morning.

    If there is a lingering problem (I had an infected finger that I waited on for over a week) I use the same guidelines. On MOnday I said to myself if it gets worse I will go in immediately. If it isn’t better by Friday though I will go in on Friday. Thinking like this has saved us ER visits many times because we are more proactive in getting care during business hours.

  73. Tall Bill says:

    Back in 2005, I felt a “bit off” & visited my Doctor 3 times complaining about not being right. Less than 30 days later, I entered the Emergency room, Had my first 19 surgeries while in a coma, transferred to another facility & underwent months of rehab leading up to surgery #20. In the following month I was finally closed up with a skin graft. Six more weeks of rehab & then home for the first time in 2 days short of 15 months! YES, I had insurance & they paid out more than $1.6 M. Am I worth it? ? ?

  74. Bill.Y says:

    @Tall Bill, you must have had good insurance. Most have a 1 million dollar life time payout limit.

  75. Victoria says:

    If you don’t have insurance, ASK FOR A DISCOUNT. I work as a medical collector for a major health care facility. For people without insurance, we can give you a discount off your bill if you can pay in full at time of service. We also have an assistance program to help the community that has trouble paying their medical bills. There are more people who cannot afford to pay for their health insurance premiums, they need to keep a roof over their head. So many people have lost their jobs and their insurance, they need to let the medical providers help them out, this is not reimbursed by the government, it is the mission of the facility to provide care, we have had a freeze on our wages instead. Aside from all this, you do neet to be proactive about your own health. More illnesses are being caused by our own inactivity and poor eating habits. Believe me, the only ones that would be making money from mandated health insurance is the insurance companies. They pay a negotiated discount rate to all the providers, that is when they want to cover anything at all. They keep raising premiums, deductibles and copays to the point where they sometimes don’t pay anything at all on claims.

  76. kathryn says:

    A good rule of thumb is that the older you get, the more attention you should be paying to ANY symptoms you have. Sorry, guys, but men are kind of notorious for pretending everything’s fine when it isn’t and not going to doctors. Regular checkups and bloodwork can make the difference between better health and a heart attack, diabetes, or stroke. And as that unfortunate couple found out, saving the co-pay ended up costing so much more.

  77. Leah W. says:

    #44 jim: Define “good quality care.” I am insured, and my policy looks great on paper. In practice, it really, really sucks. I’ve never — never — made a claim they haven’t denied. They will pay most or all of what they’re supposed to only after I appeal. I distrust the statistics that say most Americans have “good quality care,” because I am likely included in that statistic, and under no circumstance would I consider my insurance “good quality.”

  78. AnnJo says:

    The Internet combined with a Merck’s Manual are valuable self-diagnosis tools, and also valuable as “second opnion” sources to what my doctor may tell me.

    If I tended toward hypochondria or anxiety, I can see Trent’s point that “everything looks like cancer,” but I don’t, so I’ve found these sources have saved me a ton of money, avoiding two or three ER visits in the last four years and any number of doctor visits.

    I’m tempted to dive into the Johanna, Stephanie and Ajtaka health care debate, but that really is off point of this post. Regardless of what happens to our health care system over the next few years (my bet – quality down, price up), ultimately we will be individually and collectively better off becoming more knowledgeable and more rational about our health care choices for as long as we are allowed to continue making them.

  79. Sheila says:

    I used the internet to self-diagnose a rare neurological disorder after spending a year with my doctor trying to figure out what I had. I printed out the info, took it to my doctor and said, “I think I have this.” She’d only seen the condition once in med school. She referred me to a neurologist who did indeed diagnose me with the rare neuro disorder that I’d found on the internet. I could have spent a lot more time and money on therapies that wouldn’t have done me any good if I hadn’t gone on the internet. So while I understand what Trent is talking about, I believe that in many cases the internet can be a great tool.

  80. ysabet says:

    Every time I read something like this, I am shocked and horrified at the prospect of living in America.

    I mean … paying for ER? And … hospital stays after accidents? What the heck?

  81. Emma says:

    As the comments immediately prior to this have also said: don’t knock the internet, because it can be a great, simple, FREE diagnostic tool. All it takes is some common sense and not believing the very first website google give you.

    Perfect example: last week I had a strange rash on my legs. The first three websites I checked suggested it was a side effect of HIV. The fourth said it was probably from the heat, and gave advice how to sooth it. Using a tiny bit of logic, I was able to determine which website to believe.

  82. Michelle says:

    I’ve been thinking about this a lot too. I’m currently covered by my dad’s health insurance, but pretty soon I won’t be anymore, and I’ve been debating with myself & my fiance whether it’s worth it or not to pay for private health care. I am a self-employed musician, so it’s unlikely that I’ll be getting a job with benefits, and my fiance is in a similar situation. My own health care, since I’m young & mostly healthy, wouldn’t be too expensive, but since I hardly ever go to the doctor anyway, I’m not sure if it’s worth it! I can afford to take myself to a ready-care or clinic if I really need to see a doctor, and I trust that if I don’t admit myself that I need to see someone, my fiance or someone else around me will point it out.

    I like your point about not diagnosing yourself via the internet though. That’s a really good idea, and I’m constantly freaking myself out that way!

    I’m going to save this article for your ideas :)

  83. Matt says:

    I’m going to give one more vote for using the Internet to help with self-diagnosis. Anyone who uses the Internet for any kind of information should know to take it with a grain of salt. This even goes for financial advise on the web. ;)

    The point is, the Internet is a tool. You can’t rely on it to tell you everything you need to know, but typically you can quickly and easily get a lot of information. You can have a starting point; you can learn the terminology associated with your (potential) condition; you can learn what questions you should ask your doctor (if you end up visiting him). Using something between common sense and critical thinking will allow you to gauge all the Internet information accordingly.

    An anecdote: I was getting really bad headaches while lifting weights (for strength training). Of course, there’s scary stories about aneurysms and strokes and tumors; but after reading related info across many different websites, I came to this conclusion: the chance of something scary is very rare, but get it checked out by a doctor just to be sure. I did just that, and thankfully the CT scan checked out OK.

  84. Georgia says:

    I do not understand why the insurance did not pay for the OP’s er visit. I don’t know if it is just a state thing or not, but in MO insurance must pay for er visits, as you are not a doctor and cannot diagnose your own symptoms. I think it took a higher court case to decide this. If it was not during office hours, we would hit the er.

    I did make one dumb mistake before I found this out. I came home from work one p.m. and my husband wanted me to take him to the er. I said I didn’t think the insurance would pay for a stomach ache at the er. Well, I was wrong on 2 counts. Insurance did have to pay and my husband wanted to go to the er and would have went on his own if I didn’t take him. How often does a man ASK to be taken to the doctor or hospital???

    I am extremely blessed. I worked for the State of MO and have very good insurance. My husband did not like HMO’s, but he had to admit they saved his life. He had a rare pancreatic cancer and he lived with it for 8 years. Not counting co-pays, our out of pocket expenses amounted to $113 for those 8 years.

    I have the same insurance in retirement. It costs me $210 a month. It also covers my meds, so I don’t need the Medicare program for meds. I am on a PPO. It is better than an HMO. If you go to a non-participating doctor or hospital, HMO’s do not pay. A PPO does. It has higher co-pays for non-network, but it does pay a good portion of the costs. Luckily we did not need that part. All our doctors were in-network.

  85. Diane says:

    @Georgia: Your experience is atypical. Many plans don’t cover ER for basic things. Also, most of us are not lucky enough to have the wonderful state-subsidized insurance you do. Buying on the private market is completely different from what is available to you. I am self-employed and have no dental, no vision, and minimal prescription drug coverage – a $5K deductible, and I pay what you do (I am probably at least 20 years younger than you too).

    Not all of us are lucky enough to work for the government.

  86. Marcia says:

    I am all for using the internet as a diagnosis tool myself. Sometimes.

    I also love the on-call nurse at my son’s pediatrician’s office. Very useful.

    I try to avoid the ER, but sometimes…when it’s 6 am and you’ve had pain in your ear for 8 hours…next time I’ll take at tylenol that will get me through to office hours. As $800 to be told “yep, ear infection” seems a bit much (but insurance paid for it).

    And with Vicky’s comment…that’s a tricky thing. One of the reasons why the health care issue is such a problem is that exactly…in order to make health insurance for the masses more affordable, you need everyone to participate. Not just the sick. You need healthy people like me who pay more into their premiums than they get out, while they are young, to make up for the sick and the old.

    Many young people decline to participate. And many others can’t/won’t pay their own way. So, on one hand – should the healthy people subsidize the unhealthy? On the other hand, what do you tell the 24-year old without insurance, who chooses not to have it, that they aren’t going to get that life-saving surgery unless they can come up with the $200k cost?

  87. jim says:

    Leah, sounds like you have poor insurance coverage that you are probably dissatisfied with. In polls the vast majority of Americans (70-80%) are satisfied with their own health care so you appear to be in the minority. Of course that leaves 20-30% of us who are dissatisfied including people like yourself apparently.

    Now keep in mind I’m taking about the quality of the health care overall. If you ask people if they are happy about the COST of their health care you get different results. If you ask people if they are happy with our nations health care system (as opposed to their own coverage) then again the numbers change.

  88. Kai says:

    *#7 Gretchen @ 2:56 pm August 2nd, 2010
    A problem lasting “several weeks” is not what the emergency room is for.
    I suspect it is meant that the problem lasting several weeks *turned into* something that later required an emergency room visit.

    *Thought 3: What’s the difference between an internet diagnosis and the diagnosis of your spouse or best friend? Nothing.*
    The idea is not to get your spouse or friend to diagnose, but to have them help you make the decision on whether it needs profession attention and diagnosis.

    We have a nurse hotline where I live as well. I think it’s a great resource – you can describe what’s going on, and basically be able to ask (for free) “Is this something I don’t need to worry about? or should I get it checked out? Or should I wait, and go in if things get worse?”
    Of course, any time I’ve decided an issue was bad enough to call health link, it’s been bad enough that they’ve told me to go to a clinic.. maybe I should skip the middle step.
    It would be great for hypochondriacs to get advice when they really don’t need to worry about something.

    It’s not gambling with your health if you choose to save your own money, rather than paying for insurance. It’s only an issue if you do neither and assume things will be fine.

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