The Rising Cost of Obstetrics and Pre-natal Care in the U.S - Research Paper Example

?Running Head: Rising Cost of Obstetrics The Rising Cost of Obstetrics and Pre-natal Care in the U.S. Number: of Name of Institution: Name of Instructor: 10 July 2013 The problem While costs for hospitalization and drugs have continuously gone up, costs of having a baby are even more expensive. Costs for maternity care and mother-and-baby care are continuously increasing and most private insurers do not want to cover pre-natal and new-born baby care. Pregnant women are getting the most expensive type of care even if they are covered with Medicaid. A study conducted by the Truven Health Analytics Marketscan showed that there are approximately four million childbirths in the United States annually, which cost more than $50 billion. The methods of childbirth are either vaginally or by caesarian section and the costs for these two methods differ. For employer-provided health insurance, the cost for vaginal birth is $32,093 and $51,125 for cesarean birth. For Medicaid covered insurance, the two methods cost $29,800 and $50,373, respectively. (Truven Health Analytics, 2013, p. 6) Studies have shown that childbirth is so expensive in the U.S. Pregnant women pay more for the services they receive. Women have to pay for ultrasound, blood tests, laboratory tests and much more, for a very high cost which have risen fourfold. (Rosenthal, 2013, para. 11) Analysis of the problem The problem has become complicated since women of child-bearing age have decided of delaying having a baby. A study sponsored by the “Fight Crime: Invest in Kids” showed that American women aged 18-40 have decided to delay having a family or not to have a second child because of expensive quality preschool and child care. On the other hand, police officials have called on Congress to invest more on child care since at-risk children who are provided quality health care become good citizens when they grow up. (PR Newswire, 2007, para. 3) The cost of delivery and other so-called “miscellaneous expenses” are causing the problem. Those who are insured even feel more the pinch since insurers do not provide more coverage for pregnancies. The charges for maternal care are stunning. For vaginal births, the charge is about 30% lower than cesarean births, and this is applicable to both commercial and Medicaid coverage. For commercial coverage, a pregnant woman to deliver by vaginal birth will incur average payments of $12,500 while for cesarean childbirth the patient has to pay $16,983. In Medicaid, payments are down: vaginal births cost $6,117 and $7,983 for cesarean births. For both Commercial and Medicaid, payments are 25% lower. Commercial insurers have a record of 100% payment than Medicaid. (Truven Health Analytics, 2013, p. 17) Payments for both vaginal and cesarean methods go to professional services, surgical fees, therapeutic fees, and so on. Payments for maternal care are higher than childbirth. These payments go to facility fees, professional fees, laboratory charges, and payments for drugs, among others. (Truven Health Analytics, 2013, p. 18) Will Affordable Care Act (ACA) solve this problem of rising cost of childbirth? The ObamaCare wants to expand the responsibilities and benefits of Medicaid by discarding the preconditions and cover more benefits for pregnant women. If the Obama administration is able to fully implement the ObamaCare, then this might solve the problem. The Medicaid program can solve the problem by expanding the benefits and by strengthening its imbursement rate. One of the complaints against the Medicaid was its imbursement rate which was too low (Chua, 2006, p. 2). Enrollees had to search for private insurance to have more benefits. But if this discrepancy is corrected, then American women might change their minds. Through the Affordable Care Act, the administration has put more investments for health insurance in the amount of $10 billion annually for the next five years. The first goal is to digitize the health information system. The next step is to scratch away the preconditions of insurance companies before they insure pregnant women. (Lachman, 2009, p. 256) The solution Generally, the U.S. healthcare system is one of the most expensive types of healthcare in the world. In 2011, each American spent around $8000 on health care alone. Statistics from the 2011Milliman Medical Index revealed that high healthcare cost is triggered by high cost of medicines and expensive services. In 2009, the Institute of Medicine reported that cost of medicine is triggered by industry waste which is about $765 billion of the $2.5 trillion dollars the country spent on health care. (Regence, n.d., para. 3) So, how can the industry lower down healthcare costs especially childbirths? The Affordable Care Act has focused on policies and this might be the most effective strategy to reduce childbirth costs and change the thinking of American women. By focusing on insurance coverage and the abuses and malpractices committed by private insurers, the government can correct the mistakes and pregnant women can have access to low-cost childbirth, either by vaginal or cesarean method. For overall solution to healthcare costs, the government and private sectors need a complex solution. This is also true with childbirth and childcare costs. There is no immediate solution; it may take years. The ACA needs years to be fully effective. Childbirth is one of the beneficiaries to the ACA once it is efficiently implemented. Is ObamaCare in line with the long American dream of a National Health Insurance? Precisely, this is the aim and purpose of the ObamaCare – to provide insurance to everyone, especially the most vulnerable. The NHI has been a dream of many administrations since Theodore Roosevelt. It was revived during the Clinton administration in what was known as the Clinton Health Plan (CHP), then up to the time of the administration of George W. Bush and the present dispensation. The NHI is about concentrating the health-care financing system to be run by the government and not the present private and public sector partnerships. The U.S. health care program has to address the problems of high costs, unequal distribution of personnel and facilities, inadequate financing, not sufficient health promotion and illness prevention, high cost of medicines, and much more. (Goldsteen & Goldsteen, 2013, p. 236) From the time of its first proposal up to the present time, the tone of the NHI program has always been the same: expensive health care; the gaps of insurance coverage; unequal distribution of personnel and resources; healthcare is only accessible to the moneyed sector and the poor are always left behind; and NHI’s unpopular link to the health of the population. The reasons to revive the NHI and the present debate on healthcare delivery, to include the high cost of childbirth and mother and child care, have a familiar tone. Childbirth costs and mother-and-baby care costs are a part of the problem of the entire healthcare delivery system. As noted in the first part of this essay, on the definition of the problem, insurance for childbirths are not covered and women are at a lose where to go to ask for help. Quality of childbirth and financing are not part of any insurance coverage; so if you have to go for this kind of healthcare, you have to go your own way or belong to the moneyed class. The problem with the healthcare system can be solved by crossing the great chasm and this is dealing with quality and financing. Gordon Schiff and Quentin Young (as cited in Goldsteen & Goldsteen, 2013, p. 253) argued that to cross the chasm, a universal financing system must be instituted with the cooperation of all the parties who are going to shoulder the costs and benefits with fairness and efficiency. Reforms for childbirth, maternal and baby-care costs should focus on lowering the cost of services (laboratory and other tests), medicine and hospitalization. These can all be covered by insurance. Since the ObamaCare has focused on improving the Information System, with its first investment of $10 billion, childbirth costs must be incorporated in the program. The problem with cesarean births and the needed medicine has first to be addressed because of its high cost. The ObamaCare has also increased the coverage of Medicaid. This is one of the most significant phases of the law since Medicaid has a reputation of low imbursement rate. Added to this is the fact that it covers the poor and most vulnerable sector of society. Putting more emphasis on financing, the government can improve the performance of Medicaid and Medicare in order to improve quality of healthcare. High cost of medicine, hospitalization, and all the other allied expenses can be addressed adequately and fairly. The ObamaCare must provide immediate help to the four million childbirths every year. The cost for this human phenomenon can be lowered to ensure that our young mothers and new-born babies receive the best quality-healthcare possible. Young pregnant women don’t know where to go. The government should address this by redirecting local governments to help solve the problem. Present costs of vaginal and cesarean childbirths, from $32,093 and $51,125 respectively, have got to be reduced through government financing. The situation – that young pregnant women have nowhere to go and are struggling of the high cost of laboratory tests – can be reversed. The world must again feel that the American healthcare system is the best. That can only happen if Americans feel safe about their health. References Chua, K. (2006). Overview of the U.S. health care system. Retrieved 1 July 2012 from http://www.amsa.org/AMSA/Libraries/Committee_Docs/HealthCareSystemOverview.sflb.ashx Lachman, V. (2009). Ethical challenges in health care: Developing your moral compass. New York: Springer Publishing Company LLC. PR Newswire: One in five women are deciding against or delaying having a child because of the high cost of child care and preschool, poll shows. (2007). Retrieved 7 July 2013 from http://search.proquest.com.proxymu.wrlc.org/abicomplete/docview/450948600/fulltext/13F160F2813550B024C/2?accountid=27975 Regence: Health care reform. (n.d.) Retrieved 7 July 2013 from http://www.regence.com/transparency/regence-and-reform/what-drives-up-health-care-costs.jsp Rosenthal, E. (2013). American way of birth, costliest in the world. Retrieved 7 July 2013 from http://www.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the-world.html?ref=todayspaper&_r=4& Truven Health Analytics: The cost of having a baby in the United States. (2013). Retrieved 7 July 2013 from http://transform.childbirthconnection.org/wp-content/uploads/2013/01/Cost-of-Having-a-Baby1.pdf Read More