Strollerderby : insurance

Mom Says Hospital Fouled Childbirth - Twice

JeanneSager — Sat, 17 Jan 2009 19:15:00 GMT

What would you do if you thought your OB/GYN caused your baby irreperable harm during delivery? Would you go back?

A mom from Queens returned to the hospital where she'd delivered her first son to deliver her second - and once again, she says the doctors "yanked" on her child, causing a debilitating nerve injury that may lead to permanent paralysis.

The boys, a year apart, are both suffering from ERB's palsy. It's a condition Annemarie Dhana's lawsuit claims is caused by malpractice at childbirth.

"In both cases their shoulders became stuck after the head was delivered. In both cases excessive force was used to deliver the babies, resulting in ERB's palsy," according to a sworn affidavit, signed by Dhana.

The trouble is, during childbirth, how do you know if the doctor is using excessive force or doing what is necessary to get that baby out? Every delivery is different, and so is every doctor or midwife - and their preferred methods for delivery.

Despite repeated (Ok, obsessive) viewings of The Baby Story before delivering my daughter, I had never seen a mom being handed a towel by her doctor so she could pull and he could pull - offering her leverage. It's a practice my OB/GYN apparently uses (successfully, I might add) with a lot of moms - as other women whose children were delivered by him shared the same story. But none of us had ever heard of it before.

What jumps out at me about this case was Dhana's decision to go back to the same hospital where her lawsuit says prenatal care from her first pregnancy was lacking. Throw in the botched delivery, and I would have been running from in the other direction - especially considering she is in Queens, where it has to be easier to find another healthcare facility than it would be in rural upstate New York (where I live, and frankly got lucky considering my lack of options for obstetrical care).

Most of the commenters said as much over at the New York Daily News, where this story first appeared. But let's consider this mom's options:

If this were a case of a health insurance company forcing her to return to the same medical facility where she'd received substandard care, it's could be another example of the failings of our healthcare system in this country. In-network versus out-of-network should be set aside in favor of "good for patient" vs. "bad for patient."

If this were Dhana's own choice, however, I wonder, could she have known that the first case, the ERB's palsy in her elder son, wasn't just a fluke? Was this a case of a mom who didn't bother to do her homework on her medical choices, or more a case of a mom who simply didn't know? Her children are just a year apart, so she was struggling with a child who had a severe medical condition and a pregnancy at the same time.

Would you call this fishy or do you think this mom has a case?

Image: The Daily Mail

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Airing the Parental Dirty Laundry

Brett Singer — Fri, 02 Jan 2009 17:00:00 GMT

If you blog, you presumably want readers. And one way to do that is with a snappy headline. One could borrow from supermarket tabloids and go with something sensational and completely fake -- "Sarah Palin Gives Birth To Three Headed Alien" – that would do it. But if you blog about family matters, the truth can work just as well.

For example: this post on Yahoo! Shine.

My son is home!!! And I am really mad at his father.

The title got me to click and see what the heck was going on.

The first sentence was a grabber:

I recently wrote a blog about how I hate it when my son goes to his father's for Christmas.

Then it got better:

So many of you left very nice comments about my tough time while he is gone. There were a few that said I was being petty. Let me Go deeper into this........

I started to feel like a voyeur. This was pretty personal stuff. But it's not like I'm looking in the author's window. I'm reading something she posted on the Internet.

I'm not sure what the initial post was about, but this one tells the tale of a father who brought his son home after Christmas with an injured thumb. The mother was mad because the kid should have gone to the emergency room, and thinks that pop was too cheap to pay the seventy-five dollar co-pay. The injury is described in "ER"-level detail: "When I picked him up, it was black and purple and he could not bend it. We went immediately to the ER. After 2 shots of pain killer, they drilled 2 holes in the nail to relieve the pressure." Presumably the couple is divorced and the boy was spending the holidays with his father, although the post doesn't say that explicitly.

So here's my question. Is this fair to the kid, the father, and everyone else involved? Most of us who blog, whether for pay or play, reveal certain details. But it's one thing to talk about a goofy thing your three year old told you. It's another thing to reveal personal details like the ones on this particular Shine post.

It could be a generational thing. I'm selective about what I share with the world, and I think most folks are. Other people don't mind putting it all out there. (That's why Facebook is so successful.) In this case, I imagine that posting these personal details is therapeutic for the author. It is also interesting to other people; the post has over 100 comments. But if I'm the father, I'd be irritated.

Of course, if I'm the father and I really didn't take my son to the emergency room because I didn't want to spend seventy-five dollars, I'm also a major league jerk. Part of the problem, of course, is that we don't know what the father did or didn't do. It's possible that he weighed in with a comment; I haven't read them all. Still, judgments will be made – by me, the commenters on Shine, and commenters here. That's the nature of blogs. Once it's out there, it's out there. But is there a line that we shouldn't cross when kids and/or our significant others are involved? Can there be such a thing as too much sharing online?

Source: Yahoo Shine

Image (which is completely unrelated to this topic): sas.org.uk

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Woman Induces to Beat Health-Insurance Cancellation Date, Fails

Miriam Axel-Lute — Sat, 20 Dec 2008 21:40:00 GMT

It's a story painful in every way: Starla Darling was only days from her due date when she heard from a fellow Archway employee that the company was going bankrupt, they were being laid off, and their health insurance was being canceled in two days.

She panicked, ran to her midwives, had them induce labor, and ended up with an emergency c-section. She had been planning a water birth and natural labor. (Granted, there's no guarantee she would have had one anyway, but induction does increase the likelihood of c-section dramatically.)

The worst part? Insurance didn't cover it anyway and newly laid-off Darling has an $18,000 medical bill. She would have been better off to wait. But there was no way for her to know that and no one can blame her for taking what she thought was the cautious route.

It seems Archway was behind on its premiums and apparently the insurer has been denying a bunch of claims from that week, before the employees were told their coverage was ended. Frankly, at the least, someone ought to be responsible for making sure that claims made while employees still believed they had coverage are paid. After all, they had paid their share of the premiums. In fact, it's really Archway's fault more than the insurer, though I would hold Blue Cross Blue Sheild responsible too. That's just not OK.

I'm afraid we're only going to be seeing more of this stuff.

More by this author:

Rural Hospitals Dropping Maternity Care

Amy Kuras — Mon, 24 Nov 2008 22:06:00 GMT

Living in a pretty good-size city and having good health insurance, I pretty much had my pick of hospitals to deliver my kids. The one we chose had opened a new wing with an incredibly nice mother-baby unit shortly before I delivered my daughter – and went all private rooms in the intervening three years before I gave birth to my son. Faaancy.

But in rural areas, some hospitals are dropping childbirth care altogether. While it’s usually a pretty big profit center for hospitals, according to this article from Northeast Georgia, some small hospitals are finding the expense of providing obstetrics exceeds what they could make from the small number of patients they see.

Kevin Bloye, spokesman for the Georgia Hospital Association, said, "It’s a tough time to be a rural hospital. The important factor is payer mix. In rural areas especially, the base of insured patients is shrinking. You need to have enough insured patients to offset the cost of treating Medicaid and uninsured patients."

That’s right, the healthcare crisis rears its ugly head again.

It’s not that pregnant women will have nowhere to go – two fairly nearby hospitals just opened new obstetrics units – but for people who maybe wanted a smaller, closer to home experience, that’s got to be a blow. And not only that, but they just announced this month that they’d stop delivering babies on Dec. 9. I was pretty amped up on hormones near the end, and if someone announced I would have to go elsewhere very close to the end of my pregnancy I would have lost it. Waiting out a due date is hard enough without wondering if your hospital will still be open.

N-Word Flies at Palin Rally

Brett Singer — Wed, 29 Oct 2008 21:00:00 GMT

This is really ugly.

I hope that whomever you happen to be voting for, this isn't something you can condone.

As the blog We Are Respectable Negroes (the name comes from the Forty Acres and a Mule document) puts it: "It seems that Barack Obama was finally called a 'nigger' at a recent Republican presidential rally."

Palin will get a lot of flack for not responding, and while I can't argue otherwise, I don't know what she should have said. (In a Palin voice: "Oh, come on now! That's a bad thing to say!") Then again, how do you stand in front of a crowd that screams out something like that?

Michelle Malkin is claiming that the person was actually shouting, "Redistributor!"

Yes, of course. I make that mistake all the time.

(Aside: in case anyone is planning to leave a comment along the lines of, "What about that Sarah Palin hanging effigy? Why aren't you railing against that?" It's terrible and should be taken down immediately.)

I'll ask you -- what do you think you heard? I actually closed my eyes so I couldn't see the captioning on the video. Send the kids out of the room and tell us what you think was said.

Source: We Are Respectable Negroes, MichelleMalkin.com

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Babble Talk: The Candidates Health Plans

Brett Singer — Mon, 27 Oct 2008 20:00:00 GMT

Kim Mance breaks down some of the key points in the Obama and McCain health care plans. I have a few thoughts to add.

I didn't realize this, but the debate about a national health care system goes back much further than when Bill Clinton attempted to implement one when he was first elected way back in 1992. "Both Roosevelt and Truman called for health care to be an 'economic right.' Truman then proposed a single-payer health program to cover all Americans. But it was called a 'Communist plot' by a House subcommittee after the American Medical Association denounced it." Funny (not ha-ha funny) how one of the current digs at Obama is that he's a "socialist". I guess socialist is the new communist.

A key difference between their proposals is, "how to ensure that all Americans have access to health insurance. Both want there to be no 'state lines' as there are now, so families can shop around for the best plan. However, Obama will regulate and require insurance companies to cover patients regardless of pre-existing conditions, and McCain will not. McCain will instead work with Governors on (fifty separate) plans to optimize access to health care within each individual state."

One thing that I find very interesting, and encouraging, is that at least both sides are talking about getting more people covered. Back in the 1990's, it was much more of an "us against them" situation, with the Democrats wanting a national health care system and the Republicans wanting everything to stay the same.

To me, a sign that the McCampaign is out of touch on this particular issue is the notion that a family can purchase health coverage for $5,000, or even that they can purchase it at all. First, as Mance points out in her Babble article, $5,000 covers less than half of the typical family's yearly health insurance bill. Obama says that the cost is $12,000, Mance cites a study that puts the number at $12,680. Second, as someone who has run a small business and offered health insurance to employees, I can tell you that it is not that simple to just go buy a plan the way McCain says it is. For an individual, it is significantly more difficult. Health insurers simply don't want to talk to individuals about coverage, they prefer to deal with "groups", meaning employers. So while it sounds nice to say, "hey, here's five grand, you can buy whatever health plan works best for you", it's just not that simple.

There are more details discussed in Mance's article, which is very much worth a read. The bottom line? It's hard to tell what will happen no matter who gets elected, but they agree that the current system isn't good enough. "Neither presidential candidate's health care plan brings us anywhere near a true socialized medicine or single-payer system. But they do both point out the many ways our own health care structure can be improved." That's at least something.

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Florida law mandates insurance payments for autism

Brett Singer — Sat, 03 May 2008 19:00:00 GMT

Some good news from the south: Florida lawmakers have passed a bill that requires insurance companies to pay for treatment costs for autistic children – up to $36,000 per year, with a lifetime cap of $200,000. The bill was approved after another more complex piece of legislation that will offer inexpensive health insurance ($150 a month) to uninsured state residents.

Both programs are part of an initiative started by Florida governor Charlie Crist called "Cover Florida." Although the plan is being criticized by some for not being comprehensive enough, it certainly seems like a step in the right direction.

With health care making headlines this political season, maybe this news will inspire a debate about the specifics of how to get insurance to people who need it most, and also how to help families with autistic children get the treatment they need.

image: lacounty.gov

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Probe Uncovers Bad Behavior at Bootcamps for Kids

Kelly Mills — Thu, 24 Apr 2008 22:37:00 GMT

A federal probe has evidence of shady marketing practices at "bootcamps" for kids, also known as residential treatment facilities or behavior modification centers. These places, in case you don't know, claim they can "rehabilitate" children and teens with serious behavior problems such as violence, defiance, and drug abuse. Since no kid in his or her right mind would willingly check into one of these joints, some centers "abduct" the kids with the parents' permission. Oh, and the federal investigation began with thousands of allegations of abuse, sometimes resulting in death.

What did the probe find? The Government Accountability Office investigators, posing as parents, contacted some of these bootcamps. They found instances of deceptive marketing, including one program rep who urged the fictitious father not to tell his wife he'd be admitting their child to the program, and another facility that claimed the family could receive insurance reimbursement following treatment, but that they should not contact their insurance company in advance. Ick. This is on top of the verified claims of abuse, and the investigators plan to detail eight individual cases in which children were abused and in some cases, died, with untrained staff and horrific operating practices at a minimum contributing to the deaths and abuse. In addition, folks who went through these centers will testify. Hmm, maybe we could get these bootcamp-based treatment centers (or at minimum their abusive practices) banned?

Weekly Check-Up: Don't Get Sick, Kids, Cuz You Aren't Covered For That

Kelly Mills — Wed, 11 Jul 2007 16:15:00 GMT

Let's see: Democrats want to expand the State Children's Insurance Program with increased federal funding. Republicans don't want to. In fact, they are looking for some cuts. In particular, the White House opposes possible expansion of the program through an increase in the federal tobacco tax and cuts in Medicare payments to insurance companies. On the one hand, we have sick and injured children who receive medical care; on the other, we have those poor tobacco and insurance companies. Awww, it's a Sophie's Choice situation here.

The White House opposes the Democratic plan for “philosophical and ideological” reasons, because it would steer us towards “a single-payer health care system with rationing and price controls.” Perhaps they'd like to deliver their ideological reasons to chronically ill children whose families can't afford treatment? But just to be safe, tell every kid you see to wash their hands, eat healthy, and try not to develop asthma from the polluted air or cancer from pesticide exposure. Because you know, there's some insurance executives who might end up having to get the basic Mercedes with the V-8 rather than the V-12 engine if this all goes through, and that would be a tragedy.

The Sad State of Infant Mortality Rates in the South

Jessica Ashley (Sassafrass) — Mon, 23 Apr 2007 14:04:00 GMT

This is what makes me tear up and scream at the monitor all at once: Many of us have iPods, strollers that cost more than our first car, food that spoils before we ever eat it and peds appointments always just around the corner. And yet, right in our own backyard, the infant mortality rate is climbing. Babies born, mostly to impoverished women of color in the South, are dying in alarming numbers of causes that should be simple to treat.

Many of these families experience a perfect storm of low birth weight, inadequate prenatal treatment, lack of information about basic baby care. As a result, 11.4 deaths per thousand infants born occurs in Mississippi alone. The U.S. average is 5.4. In this and neighboring states, mother-care is deeply embedded in this crisis, with many women who smoke, have hypertension, are diabetic or are obese having children early and without adequate support or information.

There have been hopeful and steep declines in infant mortality rates in areas where privately-funded organizations send local women door-to-door to counsel pregnant women and post-natal mothers. It is clear that racism, poverty, insurance bullshit and limited (if any) access to medical treatment is working against effective interventions.

[photo credit: Nicole Bengiveno/The New York Times]

From the "Who Knew?" Department: Getting Life Insurance Before You Get Pregnant is Better

Karen Murphy — Sun, 18 Mar 2007 16:53:00 GMT

Before I had children, obtaining life insurance was one of the last things I thought of. After all, I wasn't yet a parent, right? So who did I have to support? Apparently, though, I went at the thing all back asswards, because according to this article, it's better to obtain coverage even before you get pregnant. Huh? No, really. And here's why:

1. Rates are lower when you're younger.

2. Potential medical problems during pregnancy, even relatively routine ones like gestational diabetes and high blood pressure can make rates zoom or even get you denied entirely from having coverage.

3. Having more undefinable issues like post-partum depression can really muck up your chances of being insured. If you have PPD, your insurance company considers you a suicide risk and jacks up your premiums accordingly.

Yeah, yeah, what a racket, huh? Just go get your insurance now. You can thank me later.

Independent Midwifery in England May Become Obsolete

Karen Murphy — Mon, 12 Mar 2007 17:06:00 GMT

Half my children were born attended by a midwife, and for me, having this choice made a huge difference in the birth experience both for me and for my children. I can't imagine having had this choice and then having it stripped away by well-intentioned but nevertheless not well thought-out (read: stupid) governmental regulations, but pretty soon if current government plans in England to require professional indemnity insurance for all midwives goes through, lots of would-be parents are going to be left with fewer choices when it comes to catching their babies. Midwives employed by the National Health Service (NHS: the U.K.'s publicly-funded, "free" health care system) won't be affected, but the NHS is overworked, underfunded, and understaffed, leaving a strong need for independent midwives to relieve the pressure and provide service for parents and babies. Efforts are being made to come up with a suitable alternative for the independent midwives, but it may end up being a case of "too little, too late". And I'd like to know what English parents will do then.

Indonesian Hospital Keeps Baby as Collateral for Non-Payment

Stefania Pomponi Butler (CityMama) — Fri, 26 Jan 2007 19:01:00 GMT

An Indonesian clinic is keeping a baby girl born on December 21 until her parents can pay their bill. The baby's parents have an outstanding bill of $250. The mother was allowed to leave the hospital without paying it, but was not allowed to take her baby with her. The clinic says the parents agreed to this arrangement.

The couple has already paid about half the bill by borrowing money from friends and family, but they have no idea how they will pay the balance since the baby's father makes approximately $1 per day as a bike-taxi operator.

Even more shocking, the clinic is adding the daily cost of caring for the baby to the bill. Every day, the baby's parents owe a little more.

Indonesia does have a program to help poor families with medical bills, but the parents did not have the relevant card. So until they can come up with $125, the clinic will continue extorting the couple and holding their newborn baby hostage.

[via Yahoo]

8-Year-Old Boy Sues Parents

Karen Murphy — Mon, 08 Jan 2007 23:00:00 GMT

An 8-year-old Minnesota boy is suing his parents in state Supreme Court, seeking damages for the grievous injuries sustained when he was thrown from his mom's SUV because of an improperly-buckled seat belt. Teddy Harrison, now confined to a wheelchair after suffering brain damage from the injuries that occurred in 2001, is suing his parents, Amy and Ted Sr., in a lawsuit filed on Teddy's behalf by his grandmother.

Teddy's parents are hoping they will lose the case, because that would hopefully force their insurance company to pony up on their $100,000 policy.

Wait. Is that my head exploding again?

The fallout from this case could be enormous. It "could make it easier for parents of injured children to collect from insurance companies in certain instances, but caregivers and insurers could find themselves facing financial responsibility if a child gets hurt while riding in an improperly installed car seat." And as many as 82% of car seats on the road today are improperly installed, often due to the confusing LATCH system, which was supposed to simplify installation. In addition, "motorists involved in wrecks with child-carrying drivers could try to skirt financial responsibility by pointing to a parent's negligent car-seat use".

So what are we to make of this? It looks like either way, it's a good time to check out your local car-seat inspection station, to ensure that you're not one of the 82%, or that your child doesn't become a statistic like Teddy and have to sue you one day.