Out of pocket?

Reader question:

Please explain this passage, particularly “out of pocket”: We spent 12 days in Hong Kong staying at five-star hotels. The trip was worth thousands, but I only spent $250 out of pocket.

My comments:

That kind of trip, from, say, New York to Hong Kong should set you back by thousands of dollars, or tens of thousands of yuan. But the speaker only spent $250, a little over 1,000 yuan, out of his or her own pocket. All the rest of the expense was paid for by other means.

What other means?

The speaker could have, for example, won the lottery somewhere awarding them air tickets to and fro plus a stay at five-star hotels for free.

That’s a simplified answer, I know. But that could be exactly what happened, right?

Anyways, $250 out of pocket means that $250 is their own money.

Out of pocket, literally, means out of their own pocket, i.e. directly and in cash.

I have a friend who still carries a wallet around, paying everything in cash. We joke a lot about this, about how old fashioned he is to be exact. The jokes are good natured, of course. I myself, yours truly, are not much better in the advance-with-the-times department. I wasn’t able to use the smartphone for payments years after others had been happily doing exactly that.

My friend acknowledges, though, that it is incredibly neat that one can now get round and about in town carrying nothing but a smartphone.

Anyways, “out of pocket” means out of your own pocket – either the money is paid by you directly by pulling cash out of your pocket or indirectly via, say, a debit or credit card. It is not money paid in your name through, for example, insurance.

Clear?

Well, I hope so. If not, please read the following media examples for a better idea:

1. It’s rare to turn on the TV or scroll the internet these days, without hearing about some kind of weight loss drug.

“You see celebrities talking about them, taking them. It’s on late night talk shows,” said Stacie Dusetzina at Vanderbilt University Medical Center.

Lots of regular people are getting their hands on them too, she said. “The companies are selling so much product that they’re having a really hard time keeping up with manufacturing.”

It’s been a big year for weight loss drugs: Prescriptions for Wegovy from Novo Nordisk have increased by 100%; meanwhile, prescriptions for Zepbound from Lilly have increased by 300%, according to a recent report from GoodRx.

Thing is, these drugs are expensive – list prices are generally $1,000 to $1,500 a month, Dusetzina noted. And that expense is often paid out of pocket, pointed out Cynthia Cox at the health policy nonprofit KFF.

“Most health insurance will either not cover the drug or will significantly limit it,” she said. That includes Medicare, Medicaid and private insurance.

Less than 20% of employer-sponsored plans cover these medications. “And in the ACA marketplaces or Obamacare markets, almost no plans cover them for weight loss,” Cox said.

And the plans that do cover them don’t necessarily guarantee affordability, per GoodRx’s Tori Marsh.

“People tend to assume, ‘I have insurance, I’m covered, I’m going to be paying my normal co-pay.’ And that doesn’t seem to be the case, unfortunately, for these medications,” she said.

With insurance, she added, the weight loss drugs can still cost over $2,500 a year.

- Demand for weight loss drugs is rising, though many insurers won’t cover them, MarketPlace.org, December 12, 2024.

2. Like many Americans who voted for Donald Trump, Jason Rouse hopes the president’s return will mean lower prices for gas, groceries, and other essentials.

But Rouse is looking to the federal government for relief from one particular pain point: high healthcare costs. “The prices are just ridiculous,” said Rouse, 53, a retired Michigan firefighter and paramedic who has voted for Trump three times. “I’d like to see a lower cap on what I have to pay out-of-pocket.”

Government regulation of healthcare prices used to be heresy for most Republicans. GOP leaders fiercely opposed the 2010 Affordable Care Act, which included government limits on patients' costs. More recently, the party fought legislation signed by former President Joe Biden to cap prescription drug prices.

But as Trump begins his second term, many of the voters who sent him back to the White House welcome more robust government action to rein in a healthcare system many Americans perceive as out of control, polls show.

“That idea that government should just keep its hands off, even when things are tough for people, has kind of lost its sheen,” said Andrew Seligsohn, PhD, president of Public Agenda, a nonprofit that has studied public attitudes about government and healthcare.

“We’re wandering around the country with a set of old, outdated frameworks about what ordinary Democrats and ordinary Republicans like,” he said.

Republican voters strongly back federal limits on the prices charged by drug companies and hospitals, caps on patients’ medical bills, and restrictions on how healthcare providers can pursue people over medical debt.

Even Medicaid, the state-federal insurance program that Republican congressional leaders are eyeing to dramatically cut, is viewed favorably by many GOP voters, like Ashley Williamson.

Williamson, 37, a mother of five in eastern Tennessee who voted for Trump, said Medicaid provided critical assistance when her mother-in-law needed nursing home care. “We could not take care of her,” Williamson said. “It stepped in. It made sure she was taken care of.”

Williamson, whose own family gets coverage through her husband’s employer, said she would be very concerned by large cuts in Medicaid funding that could jeopardize coverage for needy Americans.

For years, Republican ideas about healthcare reflected a broad skepticism about government and fears that government would threaten patients’ access to physicians or lifesaving medicines.

“The discussions 10 to 15 years ago were all around choice,” said Christine Matthews, a Republican pollster who has worked for numerous GOP politicians, including former Maryland governor Larry Hogan. “Free market, not having the government limit or take over your healthcare.”

- Republicans Once Wanted Government Out of Healthcare. Trump Voters Are Different, MedPageToday.com, March 2, 2025.

3. Holiday-makers have been left thousands of dollars out of pocket – and others stranded overseas – following the collapse of an Australian travel company, prompting warnings from industry experts about the risks of booking through unaccredited agents.

Melbourne-based Traveldream, which operated solely online, has been placed into administration, leaving customers scrambling for refunds on pre-paid holidays.

The company, registered as Australian Travel Deals Pty Ltd, sold discounted flights, cruises, and international tour packages.

It is owned by Melbourne businessman Christopher Banson, who also operates another travel-related business, Saltwater Hotels and Resorts, which remains unaffected.

The ABC has contacted Mr Banson for comment.

Traveldream ceased trading in late April, but news of the collapse is only now filtering through to some customers, many of whom say they weren't informed.

…

This month, Chris Broughton and his wife Viki were supposed to be celebrating her 70th birthday with the trip of a lifetime this month, exploring Yellowstone National Park, the Canadian Rockies, and cruising through Alaska.

Instead, the Sydney pensioners have been left more than $12,000 out of pocket, after discovering their pre-paid tour through Traveldream had not been secured.

Despite having travel insurance with Allianz, the couple has learned it doesn’t cover losses related to agency insolvency.

“My wife is feeling very dejected. We just hope we get something back and can start again.”

- Travel company collapses leaving holiday-makers stranded and out of pocket, ABC.net.au, May 15, 2025.

本文仅代表作者本人观点，与本网立场无关。欢迎大家讨论学术问题，尊重他人，禁止人身攻击和发布一切违反国家现行法律法规的内容。

About the author:

Zhang Xin is Trainer at chinadaily.com.cn. He has been with China Daily since 1988, when he graduated from Beijing Foreign Studies University. Write him at: zhangxin@chinadaily.com.cn, or raise a question for potential use in a future column.

（作者：张欣）