My family has been lucky in the illness department this school year. While other moms were reporting viruses and colds galore in their offspring, my household has, for the most part, escaped. So I guess we were due when, a few weeks ago, Junior woke up with a sore throat and fever. Now this is a kid who does not ordinarily complain, unlike his sister who could win an Academy Award for Drama, therefore I took his lamentation seriously. I suspended my usual skepticism (hey, I learned my lesson from watching Ferris Buehler) and let him stay home. Junior rested, watched way too much TV, gargled with salt water, and honestly did everything he could to feel better. When his throat was even more painful on Day 2 and the fever was still at 102, I called the doctor who, of course, said to bring him in for an examination.
In the past I would have gladly done that. Your kid is sick, you take him to the doctor, right? That’s what we, in America do. Not this year. My husband’s company has new insurance. Whereas before we paid a modest $20 co-pay per doctor’s visit, we now have to pony up the first $5,000 per person before they’ll cover anything even though my husband pays toward health insurance every month.
That’s huge blow to us and the other thousands of families in my husband’s firm. Just for simple ailments that will necessitate a doctor’s visit to get a prescription, we’ll have to shell out a few thousand dollars more per year. That’s a struggle for us to afford. It means no more doctor visits when I’m on the fence about how serious an illness is and more guesswork on the part of Dr. Mom. The implications are even scarier.
If, as I suspect, other families in my town are being hit with insurance stipulations like this, parents won’t be able to afford to take their kids to the doctor when a child is showing symptoms of an illness. They may send their kids to school even sicker than some already do figuring the nurse will flag anything serious. With some schools already cutting back on nurses due to budget cuts, that means more kids will get sick as illness spreads without proper treatment. And lots of children will go through unnecessary suffering because their ailments will be around longer while more adults will get sick and probably go untreated as well. It’s a nasty, dangerous cycle.
So I waited it out, hoping Junior would get better. On Day 3, his fever was gone but the excruciating sore throat remained. Because he was concerned about missing too much school and since he was fever-less, I sent him armed with Chloraseptic lozenges for his sore throat. An hour later, the school nurse called me saying he was not allowed to take the lozenges (because they’re medicated) without a note from me AND a one from his doctor. She bent the rules slightly because Junior was suffering so much and his throat was extremely inflamed. She further allowed him to take one Chloraseptic but the doctor would not cough up a note without seeing the kid first. Since, to me, it sounded like my son at this point might have had strep and because he was still in a lot of pain, I bit the financial bullet and took him to the pediatrician.
$200 later we found out he did not, in fact, have strep but probably did have a virus or allergic reaction to New Jersey’s rainy spring. Oh, and we walked out with the precious note allowing him to take the lozenges if his throat did act up. In hindsight, the visit was not a total waste because when my daughter caught the same thing a week later, I gambled that she did not have strep and she recovered without seeing the doctor.
Ok, so this time the malady was nothing. But what if it HAD been something dangerous that, without early treatment, could have become much worse had we waited a couple of days? Instead of the illness being just a nuisance, it could have become hospital-worthy. It could have progressed and proven far costlier than had it been caught and treated earlier with a quick visit to the pediatrician.
In the future, when I’m on the fence regarding whether to take a child to the doctor or not, I’ll probably consider taking my kids to one of CVS’ Minute Clinics which, I understand, is somewhat cheaper than my pediatrician. Plus I’ll work harder to make sure they stay healthier (if I was a drill sergeant about handwashing before, you should see me now!). We simply cannot afford, in dollars and cents, to get sick.
And the real good news: we only have $4,800 more to spend upfront on any ailments my son has before health insurance will kick in. Lucky, lucky us.
This is an original post for Jersey Moms Blog.