Pro-Life...High Cost of Childbirth/Delivery

[randomuser]

Thank you for raising the issue. Having had three children and been treated for miscarriage all at no cost on the British NHS I find it hard to comprehend a developed nation without a ‘free at the point of delivery’ (in both sences !) health service.

I find it hard to comprehend as well, and I wish I could understand how or why childbirth and delivery isn’t an essential pro-life issue. What a novel concept: lower delivery costs for mothers who choose life, regardless of circumstance. How is that not a pro-life issue? Why don’t more pro-life organizations actively lobby insurance companies and hospitals over the obscenely high costs of delivery? “Pro-life” doesn’t end once the mother goes into labor.

 

[Xantippe]

I find it hard to comprehend as well, and I wish I could understand how or why childbirth and delivery isn’t an essential pro-life issue. What a novel concept: lower delivery costs for mothers who choose life, regardless of circumstance. How is that not a pro-life issue? Why don’t more pro-life organizations actively lobby insurance companies and hospitals over the obscenely high costs of delivery? “Pro-life” doesn’t end once the mother goes into labor.

US hospitals are mostly non-profit or government-run, you know.

kff.org/other/state-indicator/hospitals-by-ownership/

Have a look at that chart–the composition varies from state to state, but only roughly 1 in 5 US hospitals is for profit.

Likewise, health insurance companies do not make a lot of money. Have a look here–their profits are literally in low single digits.

forbes.com/sites/theapothecary/2014/06/27/profits-in-health-insurance-under-obamacare/#458322a44c42

I suggest learning more about US healthcare before weighing in on who the villains are and who ought to do more. There was a lot of good stuff in previous pages that it doesn’t sound like you’ve absorbed yet.

To lower US health costs substantially, it would be necessary to slash US healthcare salaries. I was reading recently that German primary care doctors make an average of $52k while US primary care doctors make nearly three times as much. Along with the shell game of US medical charges (which we discussed previously–these are all sticker prices) those high salaries are one of the things driving high US medical costs.

 

[UbiCaritas]

US hospitals are mostly non-profit or government-run, you know.

kff.org/other/state-indicator/hospitals-by-ownership/

Have a look at that chart–the composition varies from state to state, but only roughly 1 in 5 US hospitals is for profit.

Likewise, health insurance companies do not make a lot of money. Have a look here–their profits are literally in low single digits.

forbes.com/sites/theapothecary/2014/06/27/profits-in-health-insurance-under-obamacare/#458322a44c42

I suggest learning more about US healthcare before weighing in on who the villains are and who ought to do more. There was a lot of good stuff in previous pages that it doesn’t sound like you’ve absorbed yet.

To lower US health costs substantially, it would be necessary to slash US healthcare salaries. I was reading recently that German primary care doctors make an average of $52k while US primary care doctors make nearly three times as much. Along with the shell game of US medical charges (which we discussed previously–these are all sticker prices) those high salaries are one of the things driving high US medical costs.

And to be fair, those high salaries are in part because of the obscene amounts of loans that the average doc has to take out to go to medical school–it’s not just “I want to be a doctor so I can make lots of cash,” it’s “even with what I’m being paid, I’m not feasibly going to be finished paying off my school debt before I’m in my mid-to-late 30s, and I’d like to retire, too.”

Interestingly, they handle things rather differently in France. As I understand it, if you get into medical school, it’s paid for, free and clear. After you graduate, though, you’re assigned to a clinic or hospital for five years at a decent (not fantastic, but quite livable) salary, in order to pay back the country that gave you all that education–sort of a civil service thing.

 

[MaryT777]

Add in the cost of malpractice insurance, especially for obstetricians and that doesn’t help costs either.

Mary.

 

[Xantippe]

And to be fair, those high salaries are in part because of the obscene amounts of loans that the average doc has to take out to go to medical school–it’s not just “I want to be a doctor so I can make lots of cash,” it’s “even with what I’m being paid, I’m not feasibly going to be finished paying off my school debt before I’m in my mid-to-late 30s, and I’d like to retire, too.”

Interestingly, they handle things rather differently in France. As I understand it, if you get into medical school, it’s paid for, free and clear. After you graduate, though, you’re assigned to a clinic or hospital for five years at a decent (not fantastic, but quite livable) salary, in order to pay back the country that gave you all that education–sort of a civil service thing.

That sounds a lot like the “underserved area” programs that we have in the US.

 

[UbiCaritas]

Add in the cost of malpractice insurance, especially for obstetricians and that doesn’t help costs either.

Mary.

You’re not kidding.

I used to work as an assistant to a blind professor. Among other duties, I’d schedule appointments and such for him. Every so often, he’d ask me to “make an appointment with his OB”–it was a running joke. His regular family practice doc had been an OB until he realized he was, although he’d never even had a claim against it, paying more in malpractice insurance than he was taking home, said “this is ridiculous, I can make more money with less stress, better hours, and lower premiums,” and became a GP.

And then we wonder why there’s a shortage of OBs…

 

[MaryT777]

You’re not kidding.

I used to work as an assistant to a blind professor. Among other duties, I’d schedule appointments and such for him. Every so often, he’d ask me to “make an appointment with his OB”–it was a running joke. His regular family practice doc had been an OB until he realized he was, although he’d never even had a claim against it, paying more in malpractice insurance than he was taking home, said “this is ridiculous, I can make more money with less stress, better hours, and lower premiums,” and became a GP.

And then we wonder why there’s a shortage of OBs…

Yes, an OB in Nebraska where malpractice was (20 years ago) reasonable because there was a cap on legal damages one could collect. I can’t remember what it was, but 1.3 million comes to mind. He said that people don’t accept that sometimes something goes wrong with the delivery that is no fault of the OB and regretfully and sadly some babies die during delivery. He told me back when his Dad was a Dr in the "olden days "making house calls that people accepted that as a part of life. Now, anytime anything goes wrong with a delivery of a child or a child dies through no fault of the OB there is a lawsuit.

Mary.

 

[UbiCaritas]

Yes, an OB in Nebraska where malpractice was (20 years ago) reasonable because there was a cap on legal damages one could collect. I can’t remember what it was, but 1.3 million comes to mind. He said that people don’t accept that sometimes something goes wrong with the delivery that is no fault of the OB and regretfully and sadly some babies die during delivery. He told me back when his Dad was a Dr in the "olden days "making house calls that people accepted that as a part of life. Now, anytime anything goes wrong with a delivery of a child or a child dies through no fault of the OB there is a lawsuit.

Mary.

It seems like there should be a happy and reasonable medium. I do not like that in, say, the UK, a doctor or midwife is responsible only to his or her peers (and in the case of midwives, sometimes not even those, but I digress), and not to a mother they’ve badly treated or a baby they’ve killed. That’s not a good thing. There should be repercussions for genuine malpractice, and they should include financial payouts for, say, a baby who will need long-term care who wouldn’t have if it weren’t for incompetence on the part of a caregiver.

On the other hand, the insurance companies here generally won’t go to court, and instead settle out of court even for the silliest claims imaginable. I once knew someone involved in a case where an indigent mom of a baby who’d been in the NICU–read, had received hundreds of thousands of dollars in free care, and rightly so–then threatened to sue the hospital because her kid had a mild rash at one of his IV sites from the tape when he was discharge months later. We’re talking about the sort of rash that’ll go away in a couple of days with a bit of cream, but mom got over a million bucks out of that threat. Total madness, and that’s also part of the reason that healthcare costs are so high.