The folks at The Big Push for Midwives are organizing to try to get upcoming HHS Secretary Sen. Daschle to make one of the community meetings on healthcare he attends one that they are holding in Missouri to discuss reforming maternity care.
There's good reason for this: Maternity care is one of the areas where the U.S. healthcare system exemplifies the lose-lose proposition of spending tons of money for piss-poor results in terms of maternal and infant mortality rates. There are better ways. As the Big Push folks report, "A recent Washington State study, using conservative cost estimates, estimates that the state's licensed midwives program, over two years, resulted in recoveries from Medicaid Fee for Service (FFS) alone at more than $473,000. Cost savings to the health care system (public and private insurance) is estimated at $2.7 million." That should catch any budget-minded appointee's attention.
On the other hand, I do have to quibble a little with the activists when they write: "The first step in maternity care reform centers on recognizing that our problems go beyond the secondary issue of insurance coverage and access to care." Yes, access to a broken system is a mixed bag and our problems go beyond insurance. But lack of health insurance isn't secondary. As much as I adore the midwife model of care, I'm willing to bet that lack of any prenatal care at all, health complications in mothers that went untreated because they didn't have insurance pre-pregnancy, and the stress of working extra jobs/hours to pay for unaffordable insurance total to a bigger problem for babies' health than even intervention-happy OBs. Besides, people without insurance won't get to see midwives either.
But nonetheless, Daschle should talk to the midwives at some point. Their message of better, cheaper, common-sense care is just the kind of thing the Obama administration might be able to see the value of.
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