Giving birth in U.S. hospitals is prohibitively expensive compared to all other industrialized nations, according to a new analysis published in the New York Times. But those high costs don’t correspond with improved health outcomes for either mother or child; nor do they represent easier access to prenatal and maternity care services.
Maternity care prices throughout the United States for both conventional deliveries and cesarean sections are far higher in the U.S. than in any other industrialized country, according to the new analysis. For instance, hospitals charge about $30,000 for a vaginal delivery and newborn care — for C-sections, that amount is closer to $50,000. Although insurers don’t pay that full amount, they still dole out between $18,000 and $28,000 on average for the services, and insured women’s out-of-pocket costs have risen from little or nothing 20 years ago to an average of $3,400 today:
By contrast, women in other countries pay almost nothing for childbirth, and are even given addition post-birth care and maternal education for free.
The higher U.S. prices are largely due to the illogical way that Americans are billed for their medical treatment. A lack of transparency in health care costs allows hospitals to jack up rates with relative impunity and leave consumers with a hefty, un-itemized tab at the end of their stay. Furthermore, the U.S. system of “fee-for-service,” where patients are charged for each individual test and procedure they receive over the course of a treatment, presents a moral hazard by giving providers an incentive to perform as many of them as possible.
Those additional procedures and hiked prices don’t correspond with better health. A May report from Save the Children found that 11,300 U.S. babies die on their first day of life, which is a 50 percent higher first-day mortality rate than all other industrialized countries included in the study combined. That’s in line with other evidence that paying more for health care doesn’t ensure better treatment. The United States continues to spend more than any other developed nation on its health care sector, but U.S. patients aren’t necessarily getting any better care to show for it.
America’s broken medical care system also leaves millions of women without coverage altogether. Whereas public insurance programs pick up the tabs for women’s pregnancies in other nations, 62 percent of U.S. women with non-employer private insurance don’t have maternity coverage. That’s despite the reality that 25 percent of all U.S. hospitalizations are a consequence of pregnancy and childbirth, and out-of-pocket costs for women with inadequate insurance can reach as high as $15,000, according to the Kaiser Family Foundation.
Obamacare will help bridge a good chunk of those coverage gaps by requiring all individual private health plans in its statewide insurance marketplaces to cover maternity care services beginning in 2014. Women’s health groups have also begun challenging private employers that offer coverage to their workers’ dependents but don’t provide maternity benefits to employees’ female children — a tactic that the National Women’s Law Center (NWLC) contends is a violation of Obamacare’s gender discrimination protections. Still, standard maternity care in America doesn’t include benefits that would help new — and especially first-time — moms, such as breast-feeding education and basic training for newborn child-rearing.