Tuesday, October 18, 2011

I Didn't Know...Poor

Apparently there are a lot of things I don't know. I won't try to list them all here, but I will tell you about the thing I didn't know before today. And then I'm going to tell you how I really feel about it. Exploring my feelings, sounds fun doesn't it?

I ran into a new acquaintance (an interns wife) today who casually mentioned that she was working on an application to receive reimbursement for her insurance premiums from a state program that provides subsidies for families with children making below a certain salary who have employer sponsored benefits. My question to her was how did you hear about that!? She was taking her family off Medicaid, since they have benefits at the hospital now, and found this program online. She didn't know if they would be accepted or not but she was going to apply.

There are so many things I did not know.

One being that you could get on Medicaid in the first place as a medical student family. Seems pretty obvious right? Husband a student, wife not working equals no money. Well I didn't think about it, and no one mentioned it, because we had insurance through my employer when we married. When my husband took a year off to do research we got even better insurance through the University and our son was born. After that I stopped working. When his research year was up so was the insurance. He received insurance through the medical school, financed with student loans of course, and I know he asked the financial aid office about insuring his family and the verdict was he could use student loans to pay for his son's insurance but not for his spouse. So my husband and infant were covered, I wasn't.

And that is where I left it. I wasn't covered. Maybe a stupid mistake, maybe not... we didn't really need anything. Except that one time that I got really sick and didn't know what was wrong and a preceptor took a look at me for free and wrote a prescription. Thank you. I wasn't really concerned about not being insured myself. And then I got pregnant 4 months before we started our internship year. Again, not really worried about it. I'm not at risk for anything, I felt good, I was taking my vitamins, and I'm married to an almost doctor at this point.

My mother-in-law is a retired labor and delivery nurse who suggested that I get some prenatal care. She had a Nurse Practioner that she used to work with who was at a clinic that dealt mainly with patients that were on state aid, and she thought that I could get in and be seen without any trouble - because we have NO income. She talked to the NP and she said as much herself, that as students with no real income we shouldn't have any problems.

Well after the humiliation of sitting in the office and talking with their financial aid/enrollment counselors about how I was a poor medical student wife, it was apparent their idea of poor was not my idea of poor. They looked at the $1,800/mo we received from student loans the same they would as if he were working. And really isn't it the same? In the end I had 3 prenatal visits, but they weren't free. I think I paid $350 for all three visits. Visits I didn't really need in my opinion.

Yes I know prenatal care is important. But, having my blood pressure checked and my weight recorded, really? I could have saved $350 and taken care of it at home. I left that experience thinking that if I am not poor, what is poor? I don't want to know because what we were living at the time was hard.

So back to this encounter. At first I was jealous at the thought of her getting an extra $400/month rebate on her health insurance. THAT ISN'T FAIR my mind was screaming. Then I thought, well good for her for looking around and finding this program, I wish I would have been that savvy. Truthfully, I wouldn't have even thought to look. I have been on this journey blind. I just assumed that once you had a job you were expected to make it work, regardless of what that job was or how much it paid. That and my only exposure to people on "assistance" didn't look like me. Well, maybe they did but just weren't admitting it.

When I got home I looked the program up. Did you know in my particular state they make this claim about their program: "Some families pay monthly premiums for the coverage, but rates for middle income families are significantly lower than they are on the private market. A family of four that earns between $45,000 and $67,000 per year pays a $40 monthly premium per child, and a $10 copay per doctors visit." I wonder what the income range is for our now family of 6? I am sure we would probably qualify.

And here is where I get perplexed. Wouldn't it be great for me and my family to have cheaper health insurance? I have "needs" (ok, mostly a lot of wants) that could be paid for by that savings! If they make it available and I qualify shouldn't I take it? Shouldn't I at least try? Obviously they think I need it if they include income ranges like that? Why didn't they offer it to me in a mailing or search me out? How many other programs are there out there like this one? Could I get free food, too? Could I get discounts on my utilities?

I am not trying to judge anyone here... you do what is best for you family with the information you have. If that means finding every program you qualify for great. I am probably going to be jealous, but I would never felt comfortable with that. Programs like these I thought were for the poor and needy, not for people who just barely get by and can do it if they try.

And here is my soapbox moment. We are a generation that is adverse to sacrifice and doing without. We just won't do it! We aren't entitled to movies and popcorn once a month, eating out once a week, or having a bedroom for each child. We think it is an injustice if we can't have everything we want and then complain about the things we have to pay for that we really need. I am guilty of it sometimes, too. Maybe a little too often.

I don't know what poor looks like anymore. If you eat out, go to the movies, have two cars, nice furniture, a flat screen tv, shoes and clothes without holes, food on the table, and money in your checking account can you really call yourself poor even if it means at the end of the month you have nothing left? Is that poor? I always thought poor was living in a house much smaller than your family needs, worrying about how to feed your family (not when will the pizza guy be here), and having nothing to sit on. Oh, and don't forget looking poor. Poor people don't get their hair highlighted every 6 weeks. For the record I don't.

Wow, this is turning into some kind of political statement. Is there any wonder that our nation is in debt? If we keep subsidizing people who are perfectly capable of making their budget work (thats the category I would put myself in - and we do make it work, barely) but would rather not so they can continue building a lifestyle that is acceptable to themselves we are going to be in trouble. If every person who actually qualified for the stuff the government seems willing to give takes it, what does that say about us?

I may complain about not having enough, but really I am complaining about not having as much as I want. We are able to provide for the needs of our family and some of our wants. Other wants just have to wait a little longer. Who really likes to wait?

Case in point. I want a new camera. My camera was given to me by my mother-in-law when she upgraded. It happened to be about the time our son was born. I'm sure it was so she could see pictures of him when we moved away. Fast-forward 6 years. The camera is 10+ years old but still works great. I don't need a newer camera. I want a newer camera. I take a lot of pictures so I actually could convince myself that I deserve a *NEW* camera. I've settled on looking for a newer used model that will be 1/3 the price of the current model. So in the end I'll get a camera that is 5 years old. How am I going to make that work? Well, I'm selling some stuff on Ebay, if you are interested, and maybe I'll sell enough to buy a camera. Wish me luck!

If you read this entire post I would love to give you a cookie, maybe a dozen. I tend to ramble and this one was bad, even I didn't know where it was going!


  1. Such an interesting post! I was actually talking with my dad just yesterday about friends who are having financial problems and how much it sucks to be stuck in a hole - how difficult it is to break the cycle. But I live such a blessed life, I don't think that anyone I know is someone I would consider truly "poor."

  2. Interesting indeed. My husband is a MS3. We're paying through med school with the Air Force commitment. His insurance is covered through the AF, mine is through my PT work (I'm pretty luck, since that's NOT the norm for PTers), and our 2 kids are on Healthy Families, CA's version of SCHIP, or something like that. Sounds like what your friend was signing up for. Middle income earners. We've been torn about using it, since it's a gov't program, and we're not into that - but we figure it's only for a couple years, and we'll eventually be paying enough taxes to more than make up for it.
    But our ward is full of PhD student families, mostly on MediCal (CA's version of Medicaid). And it does seem unfair sometimes. They seem to be doing as well as we are, with their tuition paid by the school and stipends, but on paper they're poorer. Even though we're the ones owing 4 years of our life to the AF instead of taking out student loans... Anyway, this comment is also rambling on, just food for thought I guess.

  3. This is a very interesting post.
    Me being from Canada I have a hard time getting the American system. I'm automatically covered by Pharmacare (which is the equivalent to medicaid) and I don't sign up for it. They look at my tax return and how much money I make - and if you make under a certain amount, they send you a piece of paper that tells you that you are covered under Pharmacare. I pay zero dollars for prescriptions. I pay zero dollars for my doctors appointments. As well as zero dollars if I needed to be admitted into the hospital.

    Poor. I am not sure that I could be considered poor though. I do have newer furniture, a flat screen tv, a roof over my head but I have to budget down to the dollar (and I do indulge with a bottle of wine and getting my nails done) so NO I am not poor.

    I don't know where I am going with this - but I like the conversation. And it is NO wonder both our countries are in major debt!

  4. I don't need a cookie. I enjoyed the very important and thought-provoking thoughts. Thank you.


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