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Julia Barnes for Fatherly

What If Helicopter Parents Are Just Trying to Avoid Bankruptcy?

Accidental childhood injuries in the U.S. adds up to $8.7 billion in costs each year. So who, exactly, is footing this bill? Let the paranoia set in.

By now the helicopter parent has become a fully formed caricature and oft-maligned parenting type. There are plenty of reasons for the ridicule. Research has shown rather conclusively that extremely risk-averse parenting doesn’t set kids up for success later in life. In fact, it can backfire, producing indecisive, anxious, codependent, and cautious-to-a-fault children, teens, and adults.

We often blame parents for hovering because they selfishly don’t believe their kids can survive for one second without mommy or daddy lording over them. But what if their true motivations for keeping kids on tight leashes are very different? What if parents wish they could let their children tackle the monkey bars unsupervised? Then, when they think critically about what would happen if their child got seriously injured — how they’d pay for the treatment, how much unpaid sick time they’d need to take, who’d watch the child if they couldn’t stay home from work — they decide that letting their kids take risks is just too risky.

The reality for many Americans is that handling the ordeal of, say, a fall from a tree can trigger a cascade of other problems for the entire family. Namely, it causes severe financial strain. A broken arm heals faster than the financial damage imposed on families with inadequate insurance, who aren’t prepared for hidden costs, and assume that a safety net exists where it does not (America ranks a lowly 23 for social spending by GDP). Financial strains so often metastasize — leading to anxiety, depression, and food insecurity that impact families across the nation. They also inevitably and permanently strain parent-child relationships.

What’s so wrong with a little helicoptering?

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Parents’ fears of their children suffering a life-altering injury aren’t unfounded — 9.2 million babies, children, and teens are treated in emergency departments for nonfatal injuries each year, according to the Centers for Disease Control and Prevention. Whether placing pins in a shattered leg bone, fixing a broken nose, or treating a child for hypothermia, these injuries cost some $87 billion every year. Your read that right: The associated medical and societal costs of accidental childhood injuries and their treatments is equivalent to the GDP of Sri Lanka.

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Of course, it’s tricky to gauge exactly how much that impacts parents because health care costs differ dramatically depending on where you live, what types of services are available, and what your circumstances are. Furthermore, many parents have health insurance which absorbs some if not most of the costs of their kid’s injury. 

But rarely do plans cover the whole shebang.

“If a parent gets health insurance through their employer or through the Affordable Care Act, then their kids can be covered through their parents at some level,” says Marjorie Rosenberg, a professor of actuarial science, risk, and insurance at the University of Wisconsin-Madison School of Business and a fellow of the Society of Actuaries. “But the [breadth] of coverage differs depending on what type of plan they have.”

And no matter how great the insurance, when it comes to a major incident — or if an injury occurs while the family is traveling and forced to seek care out of network — parents still may be asked to fork over a big chunk of change. “Parents who have good coverage through a union or who work for the government or a large company [that offers decent insurance] will likely have a deductible and an out-of-pocket maximum that limits their exposure to risk,” says Rebecca Owen, consulting actuary for HealthCare Analytical Solutions in Bend, Oregon, and a fellow of the Society of Actuaries. “So, if a very serious injury occurred, they won’t get a $100,000 bill — but they could receive a $6,000 bill, just for the copay and coinsurance. And for many families, $6,000 is a lot of money.”

More likely, though, short of sending a family into total financial despair, treatment for a child’s injury could steal funds away from mortgage installments, utility bills, and other costs. And depending on the family’s comfort level before the incident, they may or may not be able to absorb this unexpected burden or avoid accruing major debt. 

These burdens have real health consequences. Financial burdens and changing socio-economic status have been linked to clinical depression, anxiety, and even suicide. On a less extreme level, financially burdened families have strained parent-kid relationships. In other words, the kids suffer for that arm for a month or two — but a financial fallout from the bills can last throughout their childhood.

 

As of 2017, about 91 percent of Americans were covered by some form of health insurance, thanks in large part to the Affordable Care Act. Children are even better protected. According to the Kaiser Family Foundation (KFF), 95 percent of kids in the U.S. are insured. Owen says that almost half of these children receive coverage through either Medicaid or the Children’s Health Insurance Program (CHIP). While the allotted dollar amounts vary by state, she says a family of four using CHIP should be covered up to at least $50,000 a year. Therefore, through these programs, all foster kids, as well as children of parents with stretched means, should be taken care of.

But even families who have health insurance face a harsh reality: Health care costs continue to rise rapidly in this country, especially when weighed against inflation and workers’ wages. As KFF’s Drew Altman wrote in a recent Axios article, in 2018, health care for the average family covered by a large-company plan cost $22,855 — more than a shiny new Hyundai Sonata.

Now, a good chunk of that $22K gets paid by insurers. But looking strictly at out-of-pocket costs for families, enrollees in large-employer plans now face higher premiums, higher deductibles, and increased cost-sharing when utilizing services, shows research from KFF and the Peterson Center on Healthcare. For these families, spending has increased two times faster than wages over the last decade. In 2018, the average family in this sector spent $4,706 on premiums and $3,020 on cost-sharing out of pocket, an 18 percent increase since 2013. Meanwhile, wages have risen just 12 percent and inflation has swelled by 8 percent.

Here’s another key factor to consider: More Americans than ever may have health insurance, but the quality and comprehensiveness of that care is often lacking. Employers may offer a range of plans to choose from, and the better the coverage each offers, the more expensive it probably is. Then, when parents weigh their options, the cheaper plans are often alluring, even despite their coverage limitations or sky-high deductibles, especially to families who don’t have much disposable income.

“When buying a car, a big-screen TV or another expensive object that might break, you may be offered an extended warranty,” Rosenberg says. “These are essentially insurance policies, because if something happens to the product, you’ll be reimbursed for your loss. But you might say, ‘Wow, that’s a lot of money and I’m not sure it’s worth it. I’m going to take the chance and hope nothing bad happens.’ ”

Parents often use this same line of thinking when selecting health insurance, leading many to roll the dice and choose a cheaper, less-than-stellar plan. This, in turn, can come back to bite them should catastrophe — or just a pretty darn unlucky fracture that requires reconstructive surgery — strike for them or one of their kids.

  

Aside from the exorbitant medical bills a child’s injury could yield (even after insurance pays its portion), there are other, less-obvious costs that can be incredibly hard for families to handle. For example, wounded and sick kids can’t exactly drive themselves to the ER or urgent care, nor can they authorize their own medical procedures or climb the front steps of their home while sporting a fresh full-leg cast. These responsibilities fall to their parents. Then there’s the time parents need to take off from work for the injury.

Many parents still struggle to get the necessary time off without jeopardizing their job, particularly those whose families are covered by Medicaid or CHIP. “It’s great that, down to the bottom, kids will get full medical care, but lost time at work still creates a big risk for the parents,” Owen says. “Even though we have FMLA, they often don’t have the type of employers that will say, ‘Sure, take time off.’ ”

And what about freelancers, contractors and other workers who don’t have official full- or part-time employment but instead pick up small jobs here and there? According to a 2018 Gallup report, 36 percent of Americans now participate in the booming “gig economy” either as their primary or secondary job. These types of jobs often allow flexible hours and more time off than traditional employment. But most gig workers face a hard reality: No work equals no pay. Therefore, if a freelancing dad can’t work for a month because he’s tending to his laid-up child or rushing back and forth from the hospital, his income for that period could be zero. 

If it’s just not feasible for a parent to miss work to care for their injured kid, ideally, family members and close friends would step up to help. But even these options may be more limited than they were in the past. Now that more people wait until later in life to have children, grandparents tend to be older than they used to be. Because of their advanced age, they may not be able to travel if they don’t live nearby, or they might not have the physical or mental capacity to care for an ailing child. A parents’ siblings, friends, and neighbors will hopefully assist however they can, but they too would likely have to miss work or income.

 

Taking all these elements into consideration, it’s no wonder parents are terrified of their child having an accident if they allow them to “just be a kid.” KFF-Peterson research supports this notion. Among insured non-elderly adults, 39 percent got slapped with an unexpected or unplanned-for medical bill in 2017, about 10 percent of which came from an out-of-network provider. Thirteen percent of these people’s bills were for $2,000 or more. Depending on the nature of services required — and where they were administered — there’s no telling how much a parent could owe if their child landed in the emergency room after clunking their head on a surfboard or slipping and breaking a bone during a family hike in the Rockies.

KFF-Peterson research also shows that, for obvious reasons, Americans fear receiving hefty unexpected medical bills. A whopping two-thirds of those surveyed said they are either very worried or somewhat worried about their ability to afford such expenses. How many of the respondents are parents is unknown, but it’s safe to say that plenty probably are. 

If you add up the very real fear of a child getting hurt during risky play, the very real realities of what treatment can cost and how much income can be lost, it becomes a lot easier to see why some parents appear to hover too close. They might hesitate to let their children run as free as they’d like to let them but maybe, after seeing this through a more financially practical lens, we might want to withhold judgement.