Friday, January 17th, 2014
The cost of having a baby ranges from $3,000 to $37,000 in the state of California, a new study published in the journal BMJ Open has found, with no apparent logical explanation for the wild range or the high costs. The study highlights some of the issues with soaring health care costs in the U.S. More from NBC News:
“Even after adjusting for patient characteristics like their length of stay and their age and even adjusting for hospital characteristics and things like the cost of living, we found significant variations in price,” said Dr. Renee Hsia of the University of California, San Francisco, who led the study.
For a simple, uncomplicated vaginal delivery, prices ranged from $3,296 to $37,227, Hsia’s team found. For a C-section, women were billed between $8,312 and nearly $71,000.
“This is, unfortunately, the appalling state of affairs of health care in the United States,” Hsia said.
Even getting the prices wasn’t easy. Hsia’s team had to tease it out from state data on each patient admission. They figured out which ones were for childbirth, and then eliminated any complicated cases.
“Of course we would expect that if woman is in the hospital for six days as opposed to for two days, she would have larger charges,” Hsia said. “And if you deliver a baby in San Francisco, it will be more expensive than if you deliver in a cheaper suburban area.”
But the prices her team found — they are not naming individual hospitals — varied way more than these differences should account for.
The main problem is that patients do not know how much their insurers are paying on their behalf, and they certainly don’t know the price up front, Hsia says.
“This study shows that the market doesn’t take care of health care the way that we would like,” Hsia said in a telephone interview.
“If I go to buy a dozen eggs at the grocery store, I know if they are cage-free,” she added. “As a consumer, I know what I am buying and why there might be price differences. But as a patient, I don’t even know what things cost.”
Health experts say this is one of the main reason U.S. health care is so much more expensive than in other countries — $8,915 per person in 2012, for a total of $2.8 trillion. Of that, $882 billion is spent on hospitals services, like giving birth.
In May, the federal government said it would start publishing data on hospital charges. Their first numbers confirmed what health reform advocates complained about for years: The charges vary enormously, and for seemingly unclear reasons.
The Obama administration hopes that publishing prices will help force health care providers to be more consistent in their billing.
Image: Woman giving birth, via Shutterstock
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Monday, December 30th, 2013
Dreonna Breton, a Pennsylvania nurse, is alleging that she was fired from her job after refusing a flu shot because of concerns that the vaccine would cause her to suffer a miscarriage. CNN.com has more on the story, which emerged even as a growing number of states are reporting widespread flu activity to the CDC:
“I’m a healthy person. I take care of my body. For me, the potential risk was not worth it,” Dreonna Breton told CNN Sunday. “I’m not gonna be the one percent of people that has a problem.”
Breton, 29, worked as a nurse at Horizons Healthcare Services in Lancaster, Pennsylvania, when she was told that all employees were required to get a flu shot. The Centers of Disease Control and Prevention advises that all health care professionals get vaccinated annually.
She told her employers that she would not get the vaccine after she explained that there were very limited studies of the effects on pregnant women.
Breton came to the decision with her family after three miscarriages.
The mother of one submitted letters from her obstetrician and primary care doctor supporting her decision, but she was told that she would be fired on December 17 if she did not receive the vaccine before then.
Horizons Healthcare Services spokesman Alan Peterson told CNN affiliate WPVI that it’s unconscionable for a health care worker not to be immunized and that pregnant women are more susceptible to the flu.
The CDC website states that getting a flu shot while pregnant is the best protection for pregnant women and their babies.
Image: Pregnant woman about to get vaccine, via Shutterstock
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Thursday, December 12th, 2013
A new study from Dartmouth University researchers has found that kids who grow up in different cities and towns are more or less likely to receive different types of health care such as tonsil removals or CT scans. The research paints a confusing picture of standards of care for young patients, as Reuters reports:
Children in Lebanon, New Hampshire, are more than twice as likely to have their tonsils removed as those in Bangor, Maine. Kids in Lewiston, Maine, are 50 percent more likely to have a CT scan of their head than are kids in Portland, Maine, or Lebanon and Burlington, Vermont.
Lebanon’s children don’t have especially infection-prone tonsils, and Lewiston’s don’t fall on their heads more than kids elsewhere do. Instead, according to a report released on Wednesday, the glaring variation means that in some cases “children are not receiving enough good care,” said pediatrician and health policy analyst Dr David Goodman of the Geisel School of Medicine at Dartmouth University, who led the study for the Dartmouth Atlas Project. But in other cases they “may be receiving unnecessary care that is harmful.”
Similar research from the project has shown that the rate of medical procedures performed on older Americans covered by Medicare varies enormously depending on where they live.
The new report, which focused on northern New England, is the first to show that geographic variability exists in children’s healthcare, too, raising questions about why tens of thousands of kids are not receiving recommended care such as screening for lead poisoning and why tens of thousands of others are subjected to potentially unneeded treatments such as CTs for stomachaches.
The Dartmouth Atlas was able to examine geographic variations in the medical care provided to children in Maine, New Hampshire and Vermont from 2007 to 2010 because those states are among the few that collect data on all health insurance claims, which the researchers analyzed.
“This suggests that there is a significant amount of overuse of medical services in some areas,” said Dr Vikas Saini, a cardiologist and president of the Lown Institute, a healthcare think tank in Boston. “Especially because unneeded care can expose children to harmful side effects, this is very troubling.”
Image: Child having throat exam, via Shutterstock
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Tuesday, September 24th, 2013
Over the past 15 years, the cost of delivering a baby vaginally in a hospital has more than doubled, and the cost of Cesarean sections–which have also increased in frequency–have skyrocketed by 70 percent during that period. More from NBC.com:
Over the last 15 years, the cost of vaginal deliveries has practically doubled in the United States, shooting up from $4,918 to $9,294, while the cost of C-sections has increased 70 percent from an average of $8,268 to $14,055, according to Truven Health Analytics.
By contrast, the average cost for an uncomplicated vaginal delivery last year in Switzerland was $4,039 and the average cost in France was $3,541, according to the International Federation of Health Plans (IFHP). That’s nearly half to a third of what it cost in the U.S.
In fact, the United States is the most expensive place in the world to give birth, according to the IFHP. The reason, experts say, has to do with the way hospitals calculate our bills.
“Every time you walk into the hospital, they look at everything that happens to you and say, ‘Can I bill for that?’” explained Gerard Anderson, director of the Johns Hopkins Center for Hospital Finance and Management.
“So, if you get an aspirin, they’re going to bill for that. If you get seen by a specialist, they’re going to bill for that.”
Even when families do have insurance, their portion of the bill can be staggering.
Image: Pregnant woman in the hospital, via Shutterstock
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Thursday, April 18th, 2013
The new health care rules initially seemed to apply differently to children who were part of the foster care system past the age of 18, but provisions that are coming into effect next year will change that, enabling former foster kids to be covered the same way as other young adults. More from CNN:
While many young adults are now covered by the Affordable Care Act, able to remain on their parents’ insurance until age 26, the rules are different for those like [22-year-old Nathan] Cox-Reed, who grew up in the foster care system.
There are more than 400,000 children in foster care in the United States, the Department of Health and Human Services said last year. All are provided with health care coverage as long as they are wards of the state.
When foster kids turn 18, they age out of the system and instantly lose their coverage.
That’s about to change, when another part of Obamacare takes effect on January 1, 2014. Medicaid coverage will be extended for former foster youth until they reach 26, as long as the individual was in foster care and enrolled in Medicaid until the age of 18.
“I definitely think it would be a big relief, and I would definitely feel more secure as far as my health goes,” Cox-Reed said.
But there’s a catch. Cox-Reed has dreams of traveling across the nation and becoming a filmmaker. A future relocation could jeopardize his medical coverage.
States will only be required to keep former foster children on Medicaid if they continue to reside in the state where they were in foster care originally.
This part of the provision is “an incredibly troubling aspect,” said Washington attorney Brooke Lehmann, who founded the child and family advocacy group Childworks. Young adults can be highly mobile as they move for educational purposes, job opportunities and a host of other reasons, she said.
“You can’t be on a film set if you are uninsured,” Cox-Reed said. “You could get hurt. I definitely think [being uninsured] is limiting and it’s a letdown, because what if I do get a job out of state? I might not be able to take it.”
While “it’s a great provision,” said Joan Alker, co-executive director of the Georgetown Center for Children and Families and a professor at the Georgetown University Health Policy Institute, limiting extended Medicaid enrollment because of relocation could threaten the provision’s effectiveness.
Image: Teenager at doctor’s office, via Shutterstock
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