Wednesday, January 17, 2018

The Price of Babies

It’s nearly impossible to put a price tag on giving birth in America, since costs vary dramatically by state and hospital. But one 2013 study by the the advocacy group Childbirth Connection found that, on average, hospitals charged $32,093 for an uncomplicated vaginal birth and newborn care, and $51,125 for a standard caesarean section and newborn care.

Another estimate from the International Federation of Health Plans put the average amount insurers paid for a vaginal birth in the US at $10,808 in 2015. That is quintuple the IFHP estimate for another industrialized nation, Spain, where it costs $1,950 to deliver a child. (The amount insurers pay for births in America is lower than the amount billed by hospitals because insurers negotiate lower prices)

According to Hsia’s 2013 study, a “California woman could be charged as little as $3,296 or as much as $37,227 for a vaginal delivery, and $8,312 to $70,908 for a caesarean section, depending on which hospital she was admitted to.”

But spare a thought for Stella Apo Osae-Twum and her husband. They went to a hospital covered by insurance, saw an obstetrician in their plan, but when her three sons – triplets – were born prematurely, bills started rolling in. The hospital charged her family $877,000 in total.  Private insurance covered most of the $877,000 bill, but her family was responsible for $51,000.

There are few studies that estimate the number of families who go bankrupt from this type of unexpected expense. One of the best estimates is now outdated – conducted 10 years ago. But one of the authors of that research, Dr Steffie Woolhandler, estimates as many as 56,000 families each year still go bankrupt from adding a new family member through birth or adoption.

America is the most expensive nation in the world to give birth. When things go wrong – – from pre-eclampsia to premature birth – costs can quickly spiral. Despite these high costs, the US consistently ranks poorly in health outcomes for mothers and infants. The US rate of infant mortality is 6.1 for every 1,000 live births, higher than Slovakia and Hungary, and nearly three times the rate of Japan and Finland. The US also has the worst rate of maternal mortality in the developed world. That means America is simultaneously the most expensive and one of the riskiest industrialized nations in which to have children. In 2015, Norway ranked as the best-performing country in the world in terms of healthcare for new mothers, according to Save the Children, and was found to have an infant mortality rate below two percent, compared with the U.S. rate of 7.9 percent.

American families rarely shoulder the full costs of childbirth on their own – but still pay far more than in other industrialized nations. Nearly half of American mothers are covered by Medicaid, a program available to low income households that covers nearly all birth costs. But people with private insurance still regularly pay thousands of dollars in co-pays, deductibles and partially reimbursed services when they give birth. Childbirth Connection put the average out of pocket childbirth costs for mothers with insurance at $3,400 in 2013, more than the total cost of childbirth in other countries including Spain and South Africa.

https://www.theguardian.com/us-news/2018/jan/16/why-does-it-cost-32093-just-to-give-birth-in-america

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