Saturday, June 24, 2017

Holly

My vision is all hazy and cloudy from salt deposits on my contacts. Life has kept going, but these tears won't stop.


I scroll through her Facebook page to remember. Just a week earlier, she posted that she's praying for us.


Man, did Holly ever pray for us.

She prayed when I went into labor at 28 weeks, and she said, "It's okay. They're not coming until September." The doctor laughed at her. But those twins were born on September 24.
Holly, praying over her godson on September 25
She prayed when Wally needed a more stable job. And the next month we were selling our house and moving to Houston for his new job. She jokes that she didn't pray specifically enough and meant to keep us in town. But Houston's been good for us.

She prayed when I was stuck at the ER with our baby and no answers. Minutes after her reply text that she was praying, the doctor came in and started a whole new course of action that got us back home that evening.

When we had twin newborns, a 2-year-old and a 3-year-old, she showed up to Mass every single week to help. She would hold her godson, rocking him in the pew, often pacing the narthex or the back aisle when he grew fussy. He would eventually lean his face into hers, and fall asleep, a funny and endearing pose, repeated week after week.
Holly at Jonathan's Baptism
When we moved to Conroe and added another baby, we didn't go to Mass together as a family for a whole year, except when Miss Holly was visiting. Otherwise Sundays were a patchwork of separate services with the older kids, while one of us stayed home with all the little ones.
Twin 1-year-olds, a newborn, a 4-year-old, and a 6-year-old; Miss Holly holding her silly godson.
I'm not sure why we thought the front row balcony would be a good spot.
She took the one decent family photo we have of all of us. None of us look like this anymore, but we can't seem to gather in one place, in simultaneous good moods, with a camera present.



She was always texting encouraging articles or checking in to see how things were going. She knew when things weren't going well.



The first thing that moved into our new house was a framed photo of our family motto, made by Holly.


"Pray, Hope, and Don't Worry" on an empty mantle in an empty house

She did countless other small and big things that I would only underestimate if I tried to enumerate them.


Our oldest son had a dream as a preschooler that Miss Holly "walked him up the steps when he became a priest." He currently wants to be a math teacher, but I can't let go of that phrase. Holly's supposed to walk him up the steps.


Holly with our oldest son, Joseph
We're supposed to meet for coffee when I'm in town in July.

We're supposed to take all the kids and go visit Father Joe for Mass at his new parish.


video
Here's Miss Holly coaching Jonathan to say "Father Joe." She had taken him out for ice cream and library time, and it was probably the best day of his 2-year-old life. 

She's supposed to take her godson out on "Adventures with Miss Holly" days when we visit this summer.

I keep scrolling through Facebook, seeing her love of baseball, love of Church, love for friends, love for family. I see all the places where I "liked" or laughed at her posts, and I want to change all of the emojis to sad faces. She would laugh at that, if she were here. Mourning in the era of Facebook.

I take screenshots of everything. Our funny text exchanges are now memorials.



She was there the night we found out we were pregnant with Andrew. After a riotous night of laughing with friends, holding babies, watching baseball, and catching up on [then-Deacon] Father Joe's adventures in Rome, we shared with Holly what we had only known for a couple of hours.


This photo was taken the day we found out about baby #5. Holly brought Father Joe over to visit, and it was such a fun day. They're holding their godson, Jonathan, in this photo.
Eight months later, Holly was drinking coffee next to me when my water broke at the kitchen table. I got up to call the doctor, and she reminded me to call Wally too, who was at work three hours away. As I waited on hold with the doctor's office, Holly offered to call Wally for me. I overheard her tell him that Andrew was on the way, as my mom and I walked out the door for the hospital. Andrew was born two hours later.


Holly with baby Andrew
Her Facebook feed is all about others. It's encouraging words, friendship reminders, congratulations to her sister, her parents, and a myriad of friends whose only connection to each other is a love for Holly Tripp.

When we found out she passed away, suddenly, unexpectedly, and thankfully, without suffering, our group of texting friends began a spontaneous rosary. From our homes, hundreds of miles apart, our fingers worked through familiar beads and our hearts prayed through familiar prayers, even as our minds processed this unfamiliar reality. I meant to meditate on the sorrowful mysteries, of Jesus' suffering and crucifixion, but I unintentionally, maybe intuitively, began the rosary's joyful mysteries. 

I ask Jesus to let me see her. She is gazing, supremely happy, undistracted at our Lord. She's distant though, maybe a prayer away, but no longer a text message away.

Even with tears that won't stop, my heart knows Holly is more fulfilled, more at home, more in her element than she could ever be in this world. 

But I still want her here. 


It's always a party when Holly comes over!

Saturday, May 13, 2017

We Saved Babies But We're Losing Their Moms: Women's Healthcare in Texas

We knew defunding Planned Parenthood would mean more babies, and we were right. 

27% more babies!

Following through on anti-abortion campaign promises, Texas legislators cut the state budget for family planning by two-thirds in 2011, while simultaneously diverting funds away from women's clinics that provide abortions, and poverty birth rates increased 27%.* (The state-wide birth rate decreased.)

As our poverty birth rate increased, so did our maternal mortality rate: doubling in just 3 years. Texas can now boast one of the highest maternal mortality rates in the developed world.

While maternal mortality isn't terrifyingly high (30 per 100,000 women), we should be concerned -- or at the very least, curious -- that the maternal-mortality rate in our state doubled in just three years, even as it decreases throughout the rest of the world.

What does it mean?

Well, it's not rich moms who are dying. And for the most part, it's not women dying during prenatal care, labor, or delivery. It's not immigrants crossing the border illegally and dying in the ER as they give birth to anchor orphans. (In fact, Hispanic maternal-mortality rates are lower than white maternal-mortality rates in Texas, so if anything, immigrants are helping our stats.)


Our problem is the state of Texas has no healthcare available for the poor.

Subsidies and tax credits through the Affordable Care Act were designed to serve the middle class, those earning from 138% - 400% of the federal poverty level ($33,949 - $98,400 for a family of four).

For those earning less than 138% FPL, states had the option to expand Medicaid, which the federal government would cover at 100% for the first three years, and 90% thereafter.

The same Texas legislature that sharply increased regulations for Planned Parenthood clinics, in the name of women's healthcare, opted out of expanded Medicaid.

Prior to the Affordable Care Act, not a single independent health insurance plan in Texas offered maternity coverage, even if purchased prior to pregnancy. 

This meant, for many poor women, whose employers would never think to offer health insurance, their only access to healthcare was a limited program called Medicaid for Pregnant Women, which cut healthcare coverage 2 months after a baby was born. 

Maternal-mortality rate is measured from pregnancy to one year after a child is born. Most maternal deaths in Texas occur in the gap between a child being 6 weeks - 1 year old.

The common denominator? Poor mothers losing health insurance coverage, being unable to obtain healthcare, including mental health services, and dying.

Maybe it's not an astronomical number of moms dying in Texas -- 30 per 100,000 -- but it's an upward trend, and indicates part of a bigger problem: inaccessible, unaffordable healthcare for poor women.

Interestingly, Medicaid for Pregnant Women pushes new mothers at birth to obtain permanent sterilization or longterm contraception. While Medicaid pays for a woman to have her tubes tied a day after giving birth, or to have an IUD inserted at her post-partum check-up, this same woman loses access to healthcare soon after, and has no recourse should problems occur -- and with IUD's, complications are common. (There are online threads about how to remove your own IUD, despite all medical advice to the contrary, for the many women who are sterilized by the state, in the name of healthcare, and then left without care.)

We can wring our hands about not having children we can't afford, about absentee fathers, about healthcare being fine the way it is, about drug-addict mothers, about poor people "abusing the safety net," about an over-burdened CPS system, about the working poor being ungrateful for minimum wage, maybe even wondering if it's a blessing-in-disguise for these babies that their mothers died...

...but who are we as a state and as a people, if we go to any legislative stretch to save a child, only to shrug at the loss of its mother?

Maybe Obamacare is failing. Maybe we hastened its failure by encouraging instability in the marketplace. Maybe it was never a good plan to begin with. But we need something. And it needs to be affordable and accessible for everyone, even and especially, the poor. 


Texas' maternal-mortality rate is at just over 30 per 100,000.
*The 27% birth rate increase is in counties with a Planned Parenthood that closed due to decreased funding and increased regulations. Birth rates in counties without a closed Planned Parenthood clinic remained constant or slightly decreased. 

Friday, May 12, 2017

Do You Have What It Takes To Survive The Bader House?

I'm often asked, "How do you do it?!" 

"We have systems," I say. 

But the truth is, systems only take us so far. No matter the structure, preparation, or discipline of our family, there will be chaos. 

If you're curious how you might respond to the regular chaos of our home, check out this quick survey! (Answers and Survival Score below.)


1. Your kids are eating breakfast in the kitchen, when the pediatrician calls. You don't get cell reception in the kitchen. Do you: 

A. Answer your phone in the kitchen and hope for the best.

B. Answer your phone in the living room, while whisper-singing "The Wheels On The Bus" with dynamic hand motions through the open doorway, while talking to the nurse.

C. Do not answer the phone. 

D. Your children can handle a few minutes without you in the room. Step outside and take the call. Not sure what the hype is about. 

2. You must mail a package TODAY. Your 2-year-old is tantrumming at the post office. The other toddler and baby are fine. Do you: 

A. Ignore the tantrum and finish mailing the package at the self-service machine.

B. Hold up the line at the self-service machine to console your 2-year-old.

C. Leave with your other two kids, because surely the crying 2-year-old will follow. Paying attention to a tantrum is the worst way to feed it. 

D. Never allow a child to tantrum in public. Demand that he stop.  

3. Your family is getting ready for church. What is the best order to load the car, if you want to make it to church on time? 

A. Big kids first. Then toddlers, then baby. The big kids are self-sufficient, and you can multi-task buckling little ones at the same time.

B. Baby first. Then toddlers. Then big kids. 

C. Send the toddlers out to the garage first. It takes them forever, so this will allow plenty of time, while the big kids go potty, and you put shoes on the baby. 

D. Just tell the kids to get in the car and buckle while you take a moment for lip gloss and mascara. How hard is this?

4. Your 5-year-old needs to go pee during church. You're holding the baby, your spouse has the toddlers. Who takes the 5-year-old potty, with the least disruption to everyone else? 

A. You, of course. Just carry the baby to the bathroom to help the 5-year-old.

B. Your spouse, with the toddlers, can take the 5-year-old to the bathroom. They need a walk anyway. 

C. You send the 5-year-old to the bathroom with the 7-year-old, who is pretty much a 12-year-old in maturity.

D. You don't allow the 5-year-old to leave during church. It's disrespectful. And besides, no kid should have to go to the bathroom twice in two hours. 

5. It's 4 p.m. Prioritize these needs: baby is crying, dog vomited on carpet, dinner is not ready, the mail has arrived, laundry in washing machine needs to move to the dryer, 5-year-old just spilled ice all over the kitchen floor, 7-year-old wants to play high-low, toddlers both have poopy diapers. 

A. Baby, Toddlers, 7-year-old, 5-year-old, Dinner, Dog, Washing Machine, Mail

B. Mail, Washing Machine, 7-year-old, 5-year-old, Toddlers, Baby, Dog, Dinner

C. Sit down to drink some coffee.

D. My house would never be that crazy. I am far too organized. 

ANSWERS

1. Your kids are eating breakfast in the kitchen, when the pediatrician calls. You don't get cell reception in the kitchen. Do you: 

A. Answer your phone in the kitchen and hope for the best.
  • The children behave like perfect angels while you're on the phone. But the call is dropped just before the nurse comes on the line. You'll play phone tag with the doctor's office for the next 24 hours. Eventually, your child's prescription will be refilled. 
B. Answer your phone in the living room, while whisper-singing "The Wheels On The Bus" with dynamic hand motions through the open doorway, while talking to the nurse.
  • Your kids threw their breakfast on the floor and ran into the living room with sticky fingers, because they need to be near you at all times. The nurse can't hear you over the noise, and she hangs up. You'll play phone tag with the doctor's office for the next 24 hours. Eventually, your child's prescription will be refilled.
C. Do not answer the phone. 
  • The doctor knows your family well enough that they didn't expect you to answer the phone anyway. The pharmacy will text when your son's prescription is ready.
D. Your children can handle a few minutes without you in the room. Step outside and take the call. Not sure what the hype is about. 
  • Best of luck to you, friend. Your kitchen's on fire. (But yes, the call went great, and your son's prescription is refilled.)

2. You must mail a package TODAY. Your 2-year-old is tantrumming at the post office. The other toddler and baby are fine. Do you: 

A. Ignore the tantrum and finish mailing the package at the self-service machine.
  • It was rough, but you did it! Back to the car with all the kids, who are now happy, and you will never see those strangers again! Wait, did you leave the package on the scale of the self-service station? 
B. Hold up the line at the self-service machine to console your 2-year-old.
  • You're a great mom. Your son feels loved. Your package is mailed. Everyone in line hates you. Wait, where did your other toddler go? 
C. Leave with your other two kids, because surely the crying 2-year-old will follow. Paying attention to a tantrum is the worst way to feed it. 
  • It worked! He stopped crying! But he didn't follow you out of the post office. You return for him, leaving your other toddler holding the stroller just outside the door. In three seconds, the outside toddler has pushed the stroller down the handicap ramp into the parking lot.
D. Never allow a child to tantrum in public. Demand that he stop. 
  • Best of luck to you, friend. 

3. Your family is getting ready for church. What is the best order to load the car, if you want to make it to church on time? 

A. Big kids first. Then toddlers, then baby. The big kids are self-sufficient, and you can multi-task buckling little ones at the same time.
  • Good job! You are on time! Wait, one of the big kids forgot to go potty. You are late.
B. Baby first. Then toddlers. Then big kids. 

  • Yes! Everyone is in! Baby was upset at having to wait and spit up all over his church outfit. You are on time, but smelly.
C. Send the toddlers out to the garage first. It takes them forever, so this will allow plenty of time. 
  • The toddlers hit the garage door opener on their way out. The dog escaped and is chasing the neighbor's handicapped dog half a block away. Your kids are laughing maniacally. Your neighbor hates you. You are late for church.  
D. Just tell the kids to get in the car and buckle while you take a moment for lip gloss and mascara. How hard is this?
  • Best of luck to you, friend. 

4. Your 5-year-old needs to go pee during church. You're holding the baby, your spouse has the toddlers. Who takes the 5-year-old potty, with the least disruption to everyone else? 

A. You, of course. Just carry the baby to the bathroom to help the 5-year-old.
  • The toddlers lose it when you leave the pew without them. Your entire family ends up standing at the back of the sanctuary for the rest of Mass. Wait, where is the 7-year-old?
B. Your spouse, with the toddlers, can take the 5-year-old to the bathroom. They need a walk anyway. 
  • Your spouse, toddlers, and 5-year-old never return to the sanctuary. You find them in the courtyard picking flowers 30 minutes later.
C. You send the 5-year-old to the bathroom with the 7-year-old, who is pretty much a 12-year-old in maturity.
  • Everything is calm, baby and toddlers are happy, 5-year-old and 7-year-old return quietly to the pew in about 5 minutes. As you leave Mass, you exit by the bathrooms. The carpet feels soggy. You keep walking. 
D. You don't allow the 5-year-old to leave during church. It's disrespectful. And besides, no kid should have to go to the bathroom twice in two hours. 
  • Best of luck to you, friend. 

5. It's 4 p.m. Prioritize these needs: baby is crying, dog vomited on carpet, dinner is not ready, the mail has arrived, laundry in washing machine needs to move to the dryer, 5-year-old just spilled ice all over the kitchen floor, 7-year-old wants to play high-low, toddlers both have poopy diapers. 

A. Baby, Toddlers, 7-year-old, 5-year-old, Dinner, Dog, Washing Machine, Mail
  • Your children will arise and call you blessed! They know you love them. And Bonus! The dog cleaned up his own vomit! You forgot the clothes; they will mold in the washer overnight, and your mail is now suspended indefinitely from failure to empty the box too many days in a row. 
B. Mail, Washing Machine, 7-year-old, 5-year-old, Toddlers, Baby, Dog, Dinner
  • The solo trip to check mail did your heart good. Go conquer the rest! 
C. Sit down to drink some coffee.
  • Yes.
D. My house would never be that crazy. I am far too organized. 
  • Best of luck to you, friend. 

SURVIVAL SCORE

Mostly A's: You'll be fine. 

Mostly B's: You'll be fine.

Mostly C's: You'll be fine. 

Mostly D's: You will not be fine. 





Subsidiarity Is Not Libertarianism

For anyone who's served on a committee, completed a school group project, or worked anywhere with anyone, there's a simple, proven way to solve every problem:

Just do it yourself. 

If it's a big task, maybe invite a partner to join. If it's more complicated than that, maybe, hesitantly, a few more partners. 

Whatever you do, don't form a committee. (Or at least don't call it that.) Committees' greatest accomplishments usually center around self-congratulatory socials and ensuring hot coffee with proper creamer at every meeting.



Starting small forms the basic idea of subsidiarity, an approach to social and economic problems that uses the lowest level possible to resolve problems. 

It originates from Catholic social teaching, and thanks to the recent, lively, presidential campaigns, "subsidiarity" has become quite the buzz word among amateur economist-theologian hybrid experts on social media comment feeds (present company included). 


In democracy, subsidiarity prioritizes local oversight and accountability as best-resourced to serve the common good, whether it's security, occupational safety, education, transportation, beautification, or health. 

However, subsidiarity only endorses low-level handling of social and political work to the extent that this level accomplishes the common good. 

If the local government is incapable, or unwilling, to sufficiently resolve the social or political problem at hand, it is a moral mandate of subsidiarity that the problem escalate to the next level up, until resolution is accomplished. 

My small, middle-class neighborhood doesn't have the resources to independently monitor crime. For the common good, we participate in the city police department. Many towns nearby don't have the resources to form their own police departments, so their problem of security escalates to the next level up, and they participate in a county-wide police department. 

Regarding the drinking water crisis in Flint and the principle of subsidiarity, it is the responsibility of local government to resolve this sanitation problem, in service to the common good of its citizens. 

However, by the same claim of subsidiarity, the rest of the nation cannot shrug and wish them well, if the local Flint government is incapable of producing safe drinking water. This crisis must escalate to the point of resolution, whether that occurs at the county level, state, region, or even national.

CNN's Timeline of the Flint water crisis demonstrates an escalation through levels of government in pursuit of resolution, which has yet to come.
Source
While subsidiarity focuses on the smallest effort necessary to accomplish a common good, it does not follow that subsidiarity in action must be small-scale. The World Health Organization tracks communicable disease outbreaks, coordinating international response efforts with local health programs. It is necessarily large-scale. 

Subsidiarity does not exist as a defense of states' rights; its end is social justice, not federalism.

Subsidiarity does not underfund legitimate social welfare initiatives, in the name of "subsidiarity." 

Subsidiarity does not innately prefer private or non-profit over public programs. 

Subsidiarity does not mandate all work for the common good be accomplished through voluntary charity as opposed to taxation. 

Subsidiarity does not believe that taxation is wrong.


Subsidiarity does not presume large-scale programs inherently less successful than small-scale programs. 

Subsidiarity does not mean "rugged individualism," every man for himself. 

Subsidiarity is not interchangeable with "small government." 

Subsidiarity favors decentralization of power, but does not necessitate it.


To the point, if a public good cannot be accomplished at a lower level of government, it obligatorily begs federal involvement.

Regarding healthcare, a legitimate argument can be made, in the name of subsidiarity, that a single-payer healthcare system would be a simpler, better use of resources than most citizens' current arbitrary, inaccessible, unaffordable patchwork of care, primarily provided via for-profit insurance companies that are more accountable to shareholders than patients. 

The New Yorker, calling it like it is.
Source
Granted, subsidiarity favoring a national healthcare initiative may not be the case; perhaps adequate healthcare provisions can be created and maintained at more local levels, without a single payer system. Nonetheless, if affordable, accessible healthcare for all cannot be accomplished at a low-level, due to disaffected politicians, lack of funding, lack of local health resources, geographically-concentrated disability needs, or any other incapacity, the problem must escalate to the next higher level. 

While left-leaning politicians might err on the first component of subsidiarity, that social and political work be done at the lowest level possible, right-leaning politicians might overlook the second: that a social or political problem must continue to escalate through higher levels of intervention, until it reaches resolution. 

Every political party likes to claim sole alignment with Catholic teaching, using adopted pop-culture words of subsidiarity, solidarity, pro-life, whole-life, and social justice. 

Despite this polarization of national politics, faithful Catholics must remain independent purveyors of truth. 

The Church cannot be contained by any American political organization -- Republican, Democrat, Libertarian, Green, or even the American Solidarity Party whose platform explicitly identifies as Catholic -- any more than a good cup of committee coffee could hold ocean.


Soli Deo gloria!

Monday, May 8, 2017

Fear and Homicide: Self-Defense, Andrea Yates, and Abortion

To hear someone describe the moments before pulling a trigger in self-defense, it's just terrifying.

"I was alone."

"I was afraid they would hurt my family."

"I feared for my life."

But then we find out the victim was unarmed, and everything turns upside down. We begin to question the shooter's fear. Is fear even a justifiable emotion, and is pulling a trigger justified, if the threat wasn't actually lethal?

Professionals gather in the police station and court room in an attempt to find justice.

"No one was here to help."

"I had no other choice."

And we-the-people gather on our tiny screens with fat thumbs, loudly calling out to Facebook, to Twitter, to everyone and no one, screaming at each other like it's the only way to figure out at what point fear might justify self-defense, might justify homicide.

Or can it ever?
...

It's been 16 years since Andrea Yates drowned her five children in her bathtub. I still start to cry, just reading the Wikipedia page.

Those precious souls, innocent children, trapped in circumstances not of their making, now dead, by the actions of their mother, and by the choices of everyone else around them. Andrea Yates killed her children by her own hand. But I believe God holds every person involved complicit:

Her husband kept pushing to have more kids, despite his wife's repeated suicide attempts and obvious unstable health. He believed the best cure for depression was a swift kick to the pants.

Her extended family knew they were going against psychiatrists' recommendations by insisting Andrea be alone with the children.

They worried she would become inexcusably dependent, a lazy mother, if they helped her any more, so they decided not to help.

She was released from in-patient psychiatric care before reaching stability, because her health insurance only covered 10 days, regardless of doctor's concerns.

Andrea Yates and her five beautiful, innocent, helpless victim children were left alone in an empty house. They were left alone by a father who had no tolerance for weakness. They were left alone by a family who feared enabling more than helping. They were left alone by an unknowing community, by an unconnected church, by a distracted psychiatrist. They were left alone by healthcare and a system that still, 16 years later, denies the gravity of mental illness.

They were abandoned to the mercy of a merciless situation, and she killed them.
...

My friend used to be a counselor in an abortion clinic.

She's pro-choice. I'm pro-life.

She walks the here-and-now with women who just read a positive pregnancy test, and it's a crisis.

I believe that positive pregnancy tests should always and everywhere be a reason to celebrate.

She's held women's hands who know the fear of being one rent check short of homeless.

I say we can resource for this mom from within our parish. Maybe someone has a room to rent?

She's heard it all: I'll lose my job, I can't afford daycare, no one can help me, if I don't work, my other children can't eat, I was raped, I don't have health insurance, I can't raise a special needs child, my husband is abusive, my parents will kick me out, I'm afraid my child would just be lost and abused in a broken foster care system.

I push that we're working to change all of that. We can network. Maybe a family can help with childcare. Maybe a local doctor will help with prenatal care. There are food pantries! We will petition the legislature for better support for special needs kids. I've heard families say that they'll personally adopt children who need a home, if the only other choice is abortion. I'll find them.

But all of my stammering is future tense and conditional. It's about stuff I want to see happen. It's about platforms I support that could enable moms in crisis to choose life for their children.

This is now, and she is scared, and even though the child within her is unarmed and innocent, she's afraid, she has no back-up, she feels she has no other choice, and she's ready to pull the trigger.

If only we could remove the fear from this situation, so she's no longer afraid of the baby she carries.

She needs job protections, affordable daycare, advocacy for sexual assault victims, healthcare, special needs support, affordable housing, a reformed foster care system...

This doesn't need to be a homicide of self-defense.
...

We can help remove the fear.




Thursday, February 9, 2017

Why Our FREE Wellness Check-ups Cost $199.15 (More Adventures In Healthcare!)

Perhaps I was naive to be shocked when we received bills for our "free" preventative care check-ups: a total of $199.15!

For the past five years, our family used Samaritan Ministries, a healthcare sharing ministry (HSM), which provides generous, affordable coverage for healthcare needs. I've shared several stories about how an HSM provided for ER trips, surgeries, and childbirth. Due to national increasing health costs, our monthly HSM contribution increased 40% over five years, similar to many families' experiences with health insurance premiums.*

We decided to transition from an HSM to an employer-sponsored plan, based on the financial impact of three possible health outcomes: 1. No problems, 2. Maternity, and 3. Catastrophic event. With Wally's employer's contribution, traditional health insurance was slightly less expensive for each of these scenarios.

One feature of the Affordable Care Act that most appealed to me was free preventative care. I happily called doctors at the end of December to schedule 2017 wellness check-ups for both Wally and me.

When Wally visited his doctor, the receptionist told him it would be charged as a "new patient" appointment, instead of a "wellness" check-up.

The office charged us $136 up front. 

Wally's doctor did a physical, said he looked good, and drew blood for basic lab work.

We received a bill from the lab for $54.49.

When I visited my doctor, there was no fee for the appointment; I received a physical, and the nurse did some lab work.

I received a bill from the lab for $8.66.

When I called the insurance company to ask about how preventive care billing works, they pulled up each of the claims for review.

For Wally's appointment, the doctor's office had billed insurance $250 for a "wellness" check-up, despite charging us $136 for a "new patient" appointment. By double-billing, the doctor's office collected full payment from both parties.

There was no record of our $136 payment in any part of the claim, and it hadn't been applied toward our annual deductible. Once the insurance company realized what happened, they reached out to the doctor's office on our behalf to secure a refund. Insurance has called the office several times and sent a letter, yet no refund has been issued. (I'll update this post if/when the refund occurs.)


Nowhere is the "new patient" appointment fee of $136 recorded.

When I asked about Wally's lab work, done as part of the wellness check-up, the insurance rep said none of it was covered as preventive care.


She also mentioned that many of the tests -- from cholesterol to Vitamin D screening to everything in between -- were categorized as "preventive" care prior to the Affordable Care Act. However, once the ACA made preventive care no cost to patients, these basic tests were re-coded as "diagnostic" care.

So we are responsible for $54.49 in lab tests from Wally's wellness appointment. Still, I'm grateful for the 90% insurance discount. As a previous self-pay patient, I can verify that no amount of negotiation will convince labs to discount uninsured bills more than 30%. Most labs would only offer a 20% discount, if paid in full.



Given that insurance paid $0 toward Wally's lab work, I didn't expect them to cover my lab bill for $8.66. But I'm glad I asked about it, because somehow, in the convoluted world of health insurance (which sometimes, possibly might lead to healthcare), the same customer service rep who denied Wally's lab work as "diagnostic" confirmed my lab work as covered 100%. 




Interestingly, when the lab that processed my test wasn't satisfied with the payment given by insurance, they just sent a balance of the bill directly to me -- instead of negotiating with insurance. I have no doubt that many patients shrug and pay the difference, probably because they value their time and sanity more highly than repetitive phone calls and emails with customer service departments. (I do not.)

So insurance cut a check to the lab for $8.66 and zero'd out my balance due on the claim.

Takeaways: 

1. If you're expecting free preventive care, keep a side fund to pay unanticipated costs. 

2. If you get bills from your medical providers, always double-check with insurance, because they might not be accurate. Our "wellness" medical costs were cut by 73%, just from a couple of phone calls and emails.

3. If you don't already use your health insurance company's website to track claims, it's worth settin up an online account. It's a great way to track spending toward your deductible, double-check claims, and grow increasingly despondent over the "charged," "negotiated," and "paid" rates that run the insider's club of healthcare in America.

*While our family's increased healthcare premiums and costs are indisputably linked to the increases in regulations, provisions, and coverage mandated by the Affordable Care Act, I remain in favor of comprehensive national healthcare reform. Whether that means fixing "Obamacare," or replacing it, I DO NOT in any way favor repealing the ACA without a viable replacement that continues affordable coverage for the many hardworking Americans with pre-existing health conditions or employers who do not offer health insurance. It is unconscionable that our first world nation has inaccessible healthcare for so many.