While the Obama administration tries to hammer out healthcare reform -- one based, necessarily, on reducing costs -- surely (SURELY!) they are taking a hard look at childbirth in the U.S.
According to a 2008 report from the think tank Childbirth Connections, pregnancy is the most expensive condition for private insurers and Medicaid.
A recent article in the LA Times business (!) section puts together numbers that insurance companies and some doctors are starting to look at, as the former attempts to lower its costs and the latter attempts to improve outcomes.
Ahh, but what a thorny issue for a president to become involved in!
First, the surprises:
Childbirth is the No. 1 reason for hospital admission in the U.S.
Childbirth accounts for $79 billion in hospital charges alone of the nation's $2.4 trillion annual healthcare expenditures.
Cesarean sections are the most common surgery in the U.S.
Though one-third of all U.S. births are c-sections, rates among hospitals have mind-boggling variation. Among California hospitals, the c-section rate can be anywhere from 16 percent to 62 percent.
All those surgeries cost a fortune -- at an average of $4,500 for a c-section, that's twice as much as a vaginal birth in the hospital. For the privately insured, that number reaches an average of $13,000 for uncomplicated sections.
All these c-sections haven't improved outcomes. In fact, maternal deaths have risen since 2002.
Also, 48 percent of newborns
admitted to neonatal intensive care units were from scheduled
deliveries -- sections or inductions -- many of them before 39 weeks.
Miscalculated dates for inductions intended for 39 weeks gestation are also sending a growing number of newborns to the NICU until they can breathe on their own.
From the LA Times:
"We're going in the wrong direction," said Dr. Roger A. Rosenblatt, a
University of Washington professor of family medicine who has written
about what he calls the "perinatal paradox," in which more
intervention, such as cesareans, is linked with declining outcomes,
such as neonatal intensive care admissions. Maternity care, he said,
"is a microcosm of the entire medical enterprise."
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Photo: LA Times
