The Cost (Of Treatment)

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wis·per·ing /ˈ(h)wispər-ing: verb to turn up the volume of our reproductive & sexual health conversations

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Why no "h"? We're changing the conversation around sex, our bodies and reproductive health.

Welcome to The Wispering Podcast where our goal is to change the volume on some of life's most difficult conversations. This podcast is brought to you by Wisp, an online telehealth community for women and men looking for reliable and discreet online care for their sexual and reproductive health needs. Log on to hellowisp.com and get same day, prescriptions for UTI, yeast infections, bacterial vaginosis, oral herpes (AKA, cold sores) and many more. Medication can be picked up at a local pharmacy or you can have meds shipped in discreet packaging directly to your home. Online consultations only take a few minutes and all medication is prescribed by US licensed doctors for all fifty states.

What's up, ya'll? Welcome back again, this is The Wispering Podcast and I am your host Symone Elena. So I think today's going to be super informative. So I really want you to go grab a piece of paper, some pens, markers whatever you need, we're going to kind of just dive into finances. And when I'm saying finances more-so the cost of reproductive treatment and how it statistically affects a lot of people who do not have insurance, but also who still need that care at the same time. Every year millions of people in the US are diagnosed with an STD and, honestly, each year those transmission rates, they reach an all new time high, especially in the United States, which was kind of shocking, but at the same time it's not 'cuz hot girls summer really just originated here, but we not finna put any of this on women!

But honestly this means there is a bigger need for regular screening, as well as better treatment and prevention methods, and if you're very sexually active, meaning, like, ya'll if you're having a lot of sex and I'm not saying just with like one person, if you're really active with a lot of people, this also means that you're more likely to get an STD and to have medical bills for that treatment. And the way they kind of keep track of this — of course, the CDC who pretty much just runs everything at this point — they actually collect data for STDs. So, it's basically called a Sexually Transmitted Disease Surveillance Report and a recent report found that three nationally reported STDs hit a record high of roughly 1.9 million cases. I- hmm, I'm just thinkin' — so during this time the number of chlamydia cases rose 5.9% to more than 1.5 million, and the number of gonorrhea cases increased 12.8% to nearly 400,000 cases. I'm not really sure why chlamydia is just out here taxin' over gonorrhea, but yeah, that's, that's what's happening right now and unfortunately, as the need for testing and treatment continues to rise, budget cuts are forcing the closure of a lot of these STD clinics every year, which is a lot of places that people need who can't afford, you know, insurance or just don't have that capability of getting it, and there's a huge economic cost of treating STDs, and it's around a total like 94 million dollars per year in just the US alone, but it really boils down to: what's the cost for just an individual, like just for yourself, especially to those of us who do not have the luxury of health insurance and are forced to pay out of pocket. And yes, I did say "us," like, I was including myself, but I do have insurance, but I can say that because I haven't reached my out-of-pocket max or reached my deductible and I'll talk about that at a later time. But since I haven't reached that, I'm technically having to pay the difference or even having to pay out a pocket what my insurance isn't paid, so it's basically like I'm still having to pay out-of- pocket even though I have insurance.

This shit just doesn't make any sense sometimes, but anyways yeah, STD prescriptions — they can be really expensive when there's no help so, for many, the only option is to avoid treatment and hope things get better, or ya'll start googling stuff or going in your kitchen looking for remedies — and I know I say that in a lot of episodes, that you can't find your cure in the kitchen and for the most part you really can, but for situations like this, where it could possibly take weeks or even longer to cure what you're having based on you know, herbs and different things like that: you're not going to stop having sex until that you know goes away if it takes a couple of weeks. That's why I prefer going to a clinic, going to your doctor, getting that prescription and getting that cleared up within a couple days to a week, but the reality is that without medical care, ya'll, your STD won't just go away on its own. Like, it's not going anywhere, it's going to be living rent free in your body for however long it needs to, and it's going to get worse. So, the first thing to know is that prevention is cheaper than treatment, ya'll, okay? That's, that's the phrase for this one: prevention is cheaper than treatment.

And so, with the rise of STDs across the country screening is just more important than ever, and STD testing is just not a routine part of annual check-ups or Pap smears and must be requested specifically by the patient. So when you do go get your check-ups, even when you go get like a physical- or also with your Pap smear, you have to ask for that separately, because all they're checking for just to make sure that you know, your vagina is in working condition, make sure that there's no cancer cells or anything like that. They're not worried about whether or not you have gonorrhea, chlamydia, any of that. Now when they do the swabbing, some gynecologists do tell you what they see, like, "Oh your discharge looks a little off," things like that, but to make sure that you just have a clean bill of health, please just make sure you're requesting those blood samples completely separately. And just to make things just a little bit more complicated, STDs often have symptoms that mirror other diseases, making it difficult to diagnose an STD without thorough screening, so they might think it's one thing when it's really not that 'cuz it be like, "Oh you probably you just have, like a yeast infection," and it's just like, nah sis, you got full on chlamydia. We don't want to deal with that, so just get just get the screening. And a lot of STDs are accompanied by flu-like symptoms, so examples like sore throats fever, muscle aches, and even just swollen glands. These common symptoms can mask an STD or an STI and cause health providers to mis-diagnose the patient with the cold or a flu (i.e., the patient being you).

So other STDs are completely asymptomatic, meaning they show no symptoms at all, and we all should be completely aware of what asymptomatic means, especially with the height of COVID. So asymptomatic STDs are particularly harmful because they're just like, silently progressing and increasing the likelihood that the carrier will spread the disease while not knowing. So you just be doing your own thing, not thinking, you know, anything's wrong, because you're not showing any signs, but that doesn't mean that's, that there's nothing there. And the person transmitting the disease and the person contracting it can be completely unaware that they're sick at all, so Person A, Person B doing their thing, not knowing that Person A has it. Then, Person B gets it. Then you stop fucking with Person A, and then you move on to Person C, D, E because you know you livin' your best life, and at this point now it's just like, a cesspool of sin and everybody got somethin' so just yeah. Let's just not have that happen. So you may be thinking, but if I don't feel sick, then what's the problem?

Everything is the problem. The problem is that the untreated STI often leads to infertility in both women and men. Ignoring the problem for a few months or longer, can do serious problems to your reproductive health, and you know, sometimes we think age has something to do with why it's harder for you to have kids and just like, no, there could have been a point in time where you did have an infection, and you waited too long to cure it, that it caused some form of infertility, caused you to become sterile, like there's just so many different ways that this can affect you having kids. And for some people it might not matter to them, but it's just like you're now losing that choice and that opportunity even if you decide to change your mind one day. And the cost of an STD test in a doctor's office ranges from like around $50-$200 and that's just like a nice range, and that just depends on what is included. The best course of action for anyone looking to get an STI screening, but does not have insurance, is just to find a free testing center, and this can honestly just be done through this website called freestdcheck.org.

So definitely just keep that in hand and keep that in mind, because a great example is, I want to say, like a month ago, I went and got tested and of course you know, I have insurance or whatever through my job, and I went to urgent care and she was like, "Hey, I know you have HSA," which is basically like me, setting money aside in this medical account to where I can use it for anything that I need health-related. And she was like yeah, "Whatever your insurance doesn't cost we're just going to charge it to this card, car, but as of right now the fee for just this visit, just to get a screening all was $245." I was like BRUH. And remember I told you all earlier how I hadn't reached my out-of-pocket max or my deductible, meaning until I hit that limit — and I think mine is at like, $1400 — until I hit spending out of my own pocket $1400, I either have to pay half of what my insurance doesn't pay, or I have to pay everything. So I was like, "Yeah, go ahead and run it," knowing damn well I don't even have that money on the medical card because I normally just take around $40 out of my pay check like every pay period, and it just goes into that HSA account, that health savings account and I'm like, I know I just use that money to buy like pads and stuff like a month or so ago, I know ain't shit that account, but yeah go ahead and run it. And so, they ended up sending me a bill like a couple weeks ago, like two separate bills: one for, I think they was for the HIV testing, or whatever. I think that one was like $49 and then they sent me another bill for the other test, that was another like $43, so basically like a little over $88 I'm having to pay out of pocket, and that was just for them to tell me what I already knew. But still I have wanted to make sure I was fine.

But its that shit that I'm talking about. It's like, even if you have insurance, you have to spend money for them just to want to spend money back on you, so it's just better just to go ahead and go to one of these free clinics and I'm low-key mad that I didn't realize to do that beforehand, but whatever. And also a quick note about that, my friend West, he, um, he's in the medical field. He told me that you can actually find an LGBTQ center and they typically always have free, um, free testing, all of that, and if you do need treatment, they offer free treatment as well. So that is definitely something to keep in your pocket and you don't have to fall under this category to go to one of those centers unless you're homophobic and then we just don't care about you.

But, anyhoo, another option is to also check out the centers for- the CDC's website, which has a database of free and local testing sites, so yeah, oddly enough, the CDC does have a way for you to go on their website and just check out different locations to go testing. I think you just have to put in where you are and they'll just kind of give you a list of everything near you, and there are still centers now offering low and no-cost testing for patients without health insurance, so many also hand out free, or sometimes discounted high quality condoms, which I'll still need to be using.

In addition, registered college students can actually use, like you can get discounts at their university health center. So just please just utilize all of your resources. Like, if you don't know, ask somebody and I'm going to continue to stress using condoms like yes, we know how good raw sex feels, but it's like. But do you really know how bad it hurts to be burning and itching and twitching in your seat, because you might have something creepy crawling that you can't ever see because it's like microscopic at this point on you? You, don't, you don't, you don't want that, like I promise you it's not worth it.

I will say another option that you do have are home STD testing kits. Now I have my issues with that, but they have been really popular for those of you who are on a budget and they're also suitable for people who have limited access to transportation and can't even get into a clinic in person, because not only if you don't have transportation, now you're having to get an uber or give money to a friend to drop you off and that's just doing a lot. But in some cases, home testing for STD provides a convenient, or necessary alternative, but it does come with some drawbacks, which is why I was like, I don't really know how I feel about this, because the results greatly depend on how the samples are collected. So finger prick tests are pretty straightforward, meaning, like you'll literally have like this little tool, you'll prick your finger, some blood will come out, you'll put it on like, a little, I don't even know what, that little- the glass vials are, but you put that on there and then you'll send it back, or they might even have you tap some some of the blood on the paper and then send it back that way. But yeah, they're pretty straight forward, but tests requiring vaginal swabs are more likely to produce a false negative if they're performed incorrectly and you'll know, when we go get our Pap smears, they got that clampy-looking tool, ripping your insides open, and then they just like, "Okay, one second," and they just swab you. It's specific areas that they're swabbing, and I feel like if you don't have anything to fully open you the way that your gynecologist would, you're just really not going to be able to get the accurate of results that you want.

And also I don't know if people are doing this or if it was just something that one of my brothers did, but he told me that he went to a clinic to get like basically a prescription for one of his home boys who felt he had an STI, but he either didn't want to go and just get the test done himself or he, I don't know, I'm still trying to understand. So basically he went got the test and then got the prescription. But my thing is: How are they going to prescribe you something if your test, if you're supposed to be the clean one. Not like cleanliness-wise but like clean, meaning not- you don't have anything. How are they going to prescribe you something if your results are coming back negative? Like I get the concept, I don't understand, or I also don't see the logic and he ended up coming back and telling me that he had something. So I'm just like yeah, just ya'll go get your own test done, don't be doing no stupid shit like that 'cuz like that, that does not make any sense to me. Like, "Ay bro, can you go to the clinic and get some, some pills for me, because I think I got something going on." It's like, "Yea, bro, I got you!" It don't work like that. Go get your test done yourself.

Okay, any who! So now, let's talk about the emergency room and why it's so expensive and why you should just probably not go there unless you really have a medical emergency that requires you to be in an emergency room, because I promise you it will save you time and money if you avoid going there. And like many other health conditions, there are instances where an STD may require a trip to the ER, so if that is the case, then yes, please go. But if it's not like a life or deaf situation, maybe don't don't do it, because a visit to the ER can cost you more than an average month's rent. The ambulance alone be running around $2000-3000, depending on what hospital you're going to, so just don't. And according to a recent study by the NIH, the report examined around 8000 emergency room bills, the results were just ignorant. One patient was charged $73,000 for UTI. Like that was, I think, roughly my tuition for a quarter at SCAD, like yeah, I'm not paying that. If I was them, I wouldn't pay it. I'd fake my death at that point like where I'm not paying that for UTI, where that can definitely be treated over the counter to an extent, depending on how bad it is. You will definitely need antibiotics for that, but generally speaking, fees for just a single visit came out to just around a little over $1200, which top 40% above the average monthly rent amount of around $871. So sadly, in America, patients with insurance pay less than those without insurance, and like I was telling you earlier, yes, I have insurance and yeah, I'm not paying that $245. Do I want to pay $80? No, but I'm going to take that over paying over $200.

And untreated STDs can just be very dangerous, and some STDs lead to permanent loss of fertility like we talked about earlier, and in some cases just cause permanent damage or death, and the other thing to remember is that having an STI generally causes inflammation to your reproductive system. So this means that an active infection can make you more likely to contract another STD, like HIV and leaving something like that. untreated just makes a trip to the emergency room as certain symptoms can lead to shortness of breath, you could have general, like you can just have difficulty breathing, and if that's the case, you literally just have no choice but to go straight to the nearest hospital for help. So that's why just doing the basics of just getting it regularly checked out is so important because it'll end up turning into like a snowball effect. It'll just start out really small and then just downhill from there, just going to, it's going to keep getting bigger. And as a rule of thumb, breathing issues y'all should always be taken seriously. Like, I know we joke a lot about, why you breathing so hard, but the same logic applies for all symptoms related to STDs. If you've been diagnosed with an STD and you begin to feel like you might faint get yourself to the emergency room as soon as possible, just to like be checked out to be assessed, and this also applies to any dizzy, spells or like prolonged achiness or fatigue that you might be feeling. And if you don't know with any of these words mean like fatigue, because this is something we have to learn at work. You need to do your research on fatigue, because a lot of people experience it and they don't even realize it.

So next I want to talk about exploring your options, and that doesn't just apply with dating. That also applies with your sex life and taking care of yourself. There are other alternatives to the hospital that are worth considering if you cannot afford to go to the ER, and it's always best to have a plan before you need one. Like with my therapist, she and I have a plan where it's like. Okay, if you're having you know a certain issue or you're having one of your episodes like the game plan, is 911, ER and then your dad and your brother. Like, those are those are my two main people, because they always answer they phone. I love my Mama ya'll, but I already told her she's, definitely definitely not on my emergency contact list because she'll never answer her phone. But yeah, that's like my plan, even though like right now, I'm fine and I'm in a great mood, I have to have a plan before I even need it, and that goes for being sexually active. Take some time to get acquainted with your community, the testing facilities around you, and schedule your annual STI screenings. Like, I'm a planner I like to have stuff set up. So I like to plan my doctor appointments in advance, like all those little things that we just carelessly forget about, make that a part of your regular routine. And staying on top of your reproductive health also allows you to avoid those big medical bills and just take some time to look around your local area for specific things like pay-what-you-can clinics. Those really do exist. Many states do provide publicly funded clinics that perform routine sexual health screenings and provide treatment at a reduced cost, and these like sub headings that I'm giving ya'll, like literally, you can type it in to Google: "pay what you can clinic" — and you know it'll- do what it does and find you what you need.

There's also free standing ERs, and at a free standing emergency room you can expect easy access and significantly reduced wait times, and it's a one stop shot for all things health care, including your STDs, and there's also online STI consultations with COVID, the panorama, I mean the panda-da, see look, I can't even say the word. Basically COVID, just making everything in life more difficult, online telehealth platforms have stepped up, basically to help out with sexual and reproductive treatments. So it's just another way to give people an opportunity to get seen and to get heard without ever having to leave the house, and affordable online consultations and same-day prescription medicine is not going anywhere, so we can definitely thank the Internet for that type of access to something that quickly is still available, despite what's going on out here. And companies like Wisp, they offer private online consultations for some of the most common STIs, and they do list the main ones that they can treat on their website so you don't have to do any real guess work, but you basically can just privately message a doctor to get immediate STI treatment. And the convenience of online services is pretty obvious, but the real bonus is knowing that you won't have to pay a huge out-of-pocket medical bill just to get a prescription. Plus you save some extra money by not having to, you know, take time off from work, or even drive to the clinic or just sit in the waiting room because it's just awkward doing that. But I do again, of course, not just because I'm, you know we're doing this podcast, I truly do want to advocate how important Wisp is to the community and to the betterment of your health, because if you know that- okay, for example, I have a couple of friends who, every time around their cycle they get BV. With Wisp, like you can literally just have that coming in the mail discreetly, nobody has to know what it is, like it's a very discreet bottle. packaging, all of that. You can have that on a consistent schedule to where you don't even have to think about it, and you know you'll always have what you need to treat that at any time, and I know that sucks having to deal with that, but at least, 1) you know that you'll have your prescription right when you need it, 2) if you're constantly getting, you know, your screenings, you know that, you know okay, it's either because of my period or it's not because of my period, and you kind of just don't have to worry about trying to figure out where is this coming from when you know it's just happening because that's what your body does. It just likes to be your enemy sometimes.

But overall, ya'll the cost of- well I'll just say the burden of STDs, is just so great that even small reductions and costs can make a big difference to our overall monthly bills. And if you think you may have an STI and your symptoms are just not life threatening, head to a free clinic, check out hellowisp.com, gonna say that again, as an affordable first step, and then you can build a plan from there. And remember, getting tested regularly and practicing safer sex by using barrier contraceptives like condoms or dental dams can provide a huge cost savings for people like me who are sexually active, and yourself. But ya'll just try to avoid any form of going to the ER unless it is life or death.

So per usual we did whisper secret, but this was just another community question that I wanted to dive into, and I asked you know, tell me about your experience managing the cost of reproductive health treatment even, and that includes, you know, STIs and STDs, and that's with or without insurance. And someone said, "I never pay it. I just let it go to collections, then I dispute it for being there because of HIPAA laws and my insurance lapses sometimes, so I've had bills that were like $25,000," and she's like who got that? I don't got that. I mean that's, that's, that's a flight attendant's yearly salary of job. No, but honestly, I didn't even know you could dispute something like that because of HIPAA laws, like I'm just learning so much, a lot of ya'll are scammers, ya'll be living a scammer life and I'm partially jealous, but at the same time I'm learning some things, but for those of you who do not want to live a life of scam, join the scammer, you know all that, I would definitely say West told me that you can also just go to those free clinics so you don't have to worry about stuff like that, but another follower told me that since her mom is a nurse, she said that you can just work out plans to where you're just paying a small amount. So say if you can afford only $10 a month towards a specific bill, then just put put yourself on a payment plan, because that way it will not affect your credit score, and I know this day and age with our generation like credit score. Is everything and financial literacy is so important, and some people just don't want to pay their medical bills, but ya'll, yeah they'll definitely go to collections. Some people can even get garnishings out of their pay checks, it just, it just depends on how things work out for you. But if you really do want to avoid just having your credit score hit and having them call you, just try to figure out a way, 1) If you've already got the bill, figure out a payment plan to just knock it down over time. Usually they'll even go into a settlement with you to where you don't have to pay the full amount back and they'll just charge you like a smaller percentage. So say if the bills are like $2000, just to get you out of their hair, they'll just be like, you know, if you can just pay us a lump sum of $500, we'll drop this and we'll let it go. And then you know over time, it'll come off your credit score. But again, if you want to go back to the scammer life, one follower said you can just basically Frank Gallagher them. If you've never watched Shameless, then you're not going to understand the reference and to me that was probably the funniest thing that I've read all day, but yeah trying to avoid them is just, it's not going to stop collections. They will call your mom, your grandma. They will do whatever they can define different ways to contact you and to get their money, and I just really don't want that for ya'll. But someone did tell me that they somehow got forced into getting x rays they didn't need and then that specific facility sent them a bill for $900 and she said she didn't pay it, but you also need to make sure what you're requesting is being done and you're not being charged anything that you did not request, like that's rule number one. So when you tell them hey, I'm only here for X, Y and Z, do not let them add on A, B, and C when you didn't want any of that, because they will do it. "Well, we think you should get this done or..." No no no no no, especially if you don't need it, and it's not even that you don't need it, if you don't want to get that done, you can come back another time to get it done, but not do not allow them to force you into something that 1) you're not needing in that moment, and then 2) you're not in the place to pay for. So again, I want you to focus on what is free. Don't focus on, "Oh well, I do got the money and I can't afford this," always go with what's free and then, if you want to build a plan to actually financially put some money into investing into like long term screenings and things like that, please utilize that, but I will say, check out the health place market place. I know for some people depending on what issues or things like that, that you have going on, even if it's after open enrollment and open enrollment for health insurance usually starts up around in November, December, before the New Year hits, and they may just waive you having to wait until that time to get insurance and you can actually get it there. You can either, depending on you know, your salary, your household, all that, you might even just get a full on 100% funded insurance plan to where you don't even have to pay any money. So don't feel like just because your job doesn't offer it, that it doesn't mean you don't deserve it and it doesn't mean that you're not capable of getting it. There are options out there outside of just finding free testing places, like we all want health insurance. We all should be allowed to have that. We all should be able to have access to that. So definitely the health place market place. It applies to anybody in the United States. You just fill out little questionnaire and they'll go through a couple things. They might request some more information from you, but again, don't sleep on what's out there like you have the choice to get help, and I want you to focus on on that and getting that done, but I think that is it for tonight.

I will say again, if you need to reach out to Wisp their website is hellowisp.com. Even with the social media handles. You'll have @hellowisp for Instagram and Twitter. For me, it's @symoneelena but until next time ya'll please be safe, make sure you take notes, be love, be light, wrap it up once, never twice.