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Toddlers: 12 - 24 Months
Why I Care About Your Unnecessary Medical Procedures
I never get on here anymore, but I just got pregnant again (wahoo) and have gotten on a couple of times now. I just saw the post from earlier on c-sections, and how it turned into a big discussion on why anyone should care how you birth your child.
Let me tell you why.
Hospitals are profit making enterprises. A c-section is a lot more expensive than a normal birth, in terms of the surgery and the typical extended hospital stay. Who pays that? Your insurance company. Now say a 1/4 of the U.S. baby-making population is getting c-sections all of a sudden, because they've become "medically necessary" (or so says a Dr., so that the insurance company will actually foot the bill). The insurance company has to get the money back--it's a profit making enterprise too. So who ends up paying? Everyone, through increased premiums. I should not have to pay for someone else to have an elective c-section.
Same concept with epidurals and every other medically unnecessary procedure. The hospital is getting their money back, and the American public ends up footing the bill for the unnecessary procedures.
This discussion has been closed.
Re: Why I Care About Your Unnecessary Medical Procedures
Roughly half the population is female. Roughly 20% of women never have kids. Of the difference, then, roughly 30% have c-sections. This resulting number is not dramatically influencing your premium, lol. Especially in comparison to the nearly 70% of overweight Americans. Moreover, NIH stats demonstrate only a 2% elective c/s rate. So what you suggest about costs isn't happening.
If you'd talked about the potential side effects on kids (like asthma) and how those drive up costs, you might have more of a leg to stand on. But I don't know that such data exists, since no one can definitively prove c/s cause asthma or anything else.
ultimately, what most drives up insurance costs is the fact that insurance is a for-profit entity. I notice a bit of suspicion in your post directed at doctors... This ideology is as much to blame as anything, since it fuels lawsuits that turned ob's trigger-happy with c-sections.
Also, since when is pain management (epidural) elective? Is it elective for cancer patients, too? Surgical recoveries? Or is it just women you throw under the "I don't want to pay for you" bus? Eta: I have some mean insomnia tonight. Boo.
I bet if you found actual data related to what drives up insurance premiums, you would find that elective c-sections are probably a pretty small percentage if they're even on the radar.
Now overweight Americans and smokers? They drive up healthcare costs.
And epidurals? Give me a break.
I agree with the above posters in regards to healthcare.
To add on to what they said, not all c-sections are unnecessary. I'd say the majority are absolutely necessary. We have an obesity epidemic in this country. Obese/overweight women having babies=more complications that are more likely to result in c-section births.
Agreed. If I didn't have an epidural, I would have ended up with a c-section because I was making no progress with just pitocin. I got my epidural, my body relaxed and I went from 3cm to 10cm in 20 minutes.
I think Heather pretty much covered it. I'm having an extra hard time with your theory surrounding anesthesia. How do you determine when something is painful enough to warrant the meds? Women having c-sections is not the culprit here. People using the ER as a doctor's office are, among the other issues mentioned.
This is the problem with the internet. People are able to spew misguided opinion as fact.
This was me too - I have no doubt I would have had a section without the epi, and nearly did anyway, but my doc (who obviously didn't get the memo about needing to make a profit) let me labor longer than others would have done, and I was able to deliver without needing a section.
I can guarantee the American public was in no way affected by my epidural and c-section.
<-- Canadian
Seriously though, Heather R nailed it.
If we are going to "go there" and start pointing fingers on who is driving up insurance, it's really split between those who are actively making choices that are negatively impacting their health (the obese, smokers) and those who have health issues beyond their control (those genetically predisposed to cancer, babies born prematurely, etc). Not to mention people showing up at the ER for non-emergent care items.
How are you going to deny coverage to the former group? I don't oppose doing so, but it's a slippery slope- next thing you know anyone with a pre-existing condition is screwed, maternity is considered elective and not covered by anyone, etc. I experienced this bias first hand when I was laid off 5 months into my pregnancy, by a company too small to have to offer COBRA or state continuation. Good times (*heavy sarcasm*).
The latter group- how are you going to tell them they are only worth "X" number of $'s spent and after that they are cut off? I obviously don't have the answers.
The system is broken in our country, and every time sometime proposes fixing it people FREAK out. Newsflash- we already have a [semi]universal plan, it's just not everyone is lucky enough to qualify for it- only the poor and the elderly benefit. The rest of us better hope we can pay for it on our own or that our employers provide something we can join- and in the meantime our taxes fuel the very programs we don't qualify for. yay!
You know what else causes insurance costs to rise? Cancer treatments and extending end of life care. Let's just let everyone die when they have potentially fatal diseases, it'd be way cheaper.
Oh, and FTR, my c-section was $1,000 more than a vaginal delivery in terms of my doctor's fee, so he isn't making bank on cutting people open. And this time around I won't be laboring all day first, so that should save some money, no?
Sorry we'll have to agree to disagree on this one. The c section rate in this country is about 33%. Only about 5-max 10% of that is medically necessary. You tell me why the hell that happens. I realize that truly "elective" procedures have a very low rate, and many insurance companies don't cover it anyways (mine made me have preapproval unless a medical emergency). But what about the other 31%?? Why is that happening? Fear of lawsuits? Really? Then we need reform in the legal system (of course I'm ALL for legislative action on frivolous lawsuits as a defense attorney-lol).
And I figured everyone would roll their eyes about the epidurals--but don't even get me started on the economics of having anesthesiologists on staff--I've bothered to do my research. I realize alot of women love them. And I agree--it's nothing compared to the cost of a c-section.
I'm glad that a previous poster's c section only cost $1000 more but that is NOT the norm. It's generally $5,000 (more average) to $15,000 more.
As for the people just claiming I'm uneducated and spewing forth crap, go google it. There are alot of calls for reform on this, and to get the hospitals and insurance companies to work together to get the ridiculous c section rate down.
Lolz. OP is an idiot.
And once again, Heather FTW.
I utterly disagree with this statement. The US is reaching dangerously high c-section rates BECAUSE many c-sections are not medically necessary. The WHO recommends a c-section rate to be 15% or less. We're sitting close to 40%. Pretty terrible for a developed country with an advanced healthcare system.
However - to debate the topic at hand, I think some of this may play a part in rising insurance costs overall, but I doubt the out-of-pocket increase I see is a significant percentage compared to other factors.
Agree with Heather R entirely, especially this part. As long as most physicians are reimbursed under the fee-for-service model, this will continue to happen.
me three. With any other doctor, I would have had a section, but my doctor was patient and let me push for 2 1/2 hours.
This. Plus, my epidural was less than the legal fees and funeral expenses that would have resulted from me killing someone.
Agree with this. The c-section rate in this country is alarming and has to be contributing to our skyrocketing insurance/medical costs.
I did not have maternity coverage when I had my youngest. I had paid the Dr. and hospital out of pocket on a discounted payment plan before the birth, and it was assumed I would have a vaginal birth. I ended up with an emergency c-section under general anesthesia. Even with all the extra costs, it was STILL lower than what the insurance company would have been charged had I had coverage. Something is wrong with that....
An epidural is pain management. Not the same category.
www.metrobabyblog.com
This-OP, it's is difficult to argue your point with such broad generalizations and supporting those with your 'google searches.' In my case, I got stuck at 9.5 cm for 3 1/2 hrs, and pushed for 1 1/2. My dr flat out told me in most cases they would have performed a c-section after the first hr at 9.5cm, but both the baby and I were handling the stress well. And I was too far along for an epidural. The doctor was clearly not putting hospital profit over encouraging a 'natural' outcome.
<---taps foot impatiently waiting for medal for being such a bargain for her health insurance company.
www.metrobabyblog.com
FTW. Love you, KJ.
Ha ha, love you too!
Wow!
I went from 3cm to 9cm in 2 hours while taking a nap so I had strength for the real deal.
I think this is OP's thinly veiled "natural is the only way to go" agenda.
I'm not sure I understand. Insurance companies never pay the full amount that they are billed. They pay what is "reasonable and customary," which is always much lower than what is actually billed.
::walks in::
::feels infinitely superior for using a MW::
::Walks back out::
There is no altruism in charging non-insured less money, just higher premiums for the ones who do have it.
It's not an all-or-nothing thing, though. There's various factors that are causing the high c-section rate, The biggest being repeat c-sections (and that's mainly because VBAC is really hard to do in the US currently), fear of lawsuits, OBs becoming more comfortable recommending a c-section instead of TOL, etc. etc...
And even the WHO came out recently, stating that they aren't sure what the ideal c-section rate is. I'm sure it isn't 30%+ either, but it's probably higher than 5%.
And somewhat related: More c-sections (especially repeat ones) over a whole population means higher rates of complications for moms and babies. If anything, that's a better argument for why someone should care about unnecessary c-sections.
DS2 - Oct 2010 (my VBAC baby!)
You know the best idea I've ever heard for tort reform? Universal health care. Then there's (virtually) no need for malpractice suits against doctors. Those who screw up can be reported to medical boards and the issues addressed there. People who are physically injured by malpractice will receive treatment through the normal health care system.
(You may want to allow malpractice suits for loss of income in cases where people are unable to work due to the malpractice. But you don't need reimbursement of medical expenses or punitive damages. And a lawsuit to determine loss of income is MUCH cheaper to defend because you don't need so many expert witnesses with medical expertise.)
Sorry. I'll just kill myself now so I won't drive up your health insurance costs.
My bad.
Unable to even.
********************
You don't understand the appeal of Benedict Cumberbatch / think he's fug / don't know who he is? WATCH SHERLOCK. Until you do, your negative opinion of him will not be taken seriously.
Make sure you do it right so you aren't sent to the ER and raising our premiums even more.
Unable to even.
********************
You don't understand the appeal of Benedict Cumberbatch / think he's fug / don't know who he is? WATCH SHERLOCK. Until you do, your negative opinion of him will not be taken seriously.
::headdesk::