Monday, December 21, 2009

A New Jersey Hospital Announces L&D Closure

Lourdes Hospital in southern New Jersey has announced that it is closing its L&D unit.

(Click here to read story).

The closure announcement starts to sound like a broken record. “They can no longer absorb the financial losses from low reimbursements!”

The state of New Jersey is concerned that more hospitals in the state are on shaky ground and could follow Lourdes’ lead and also shutter L&D.

Folks, we have to find a better model.


Friday, December 18, 2009

“Scrap the Health Care Bill -- Your Man Said So”

Over the past few months I have tried to give a unique perspective on the health care reform debate. Rather than take sides, I have asked questions about the bills, that neither the Democrats nor Republicans have addressed.

I have stated that we need healthcare reform, but that I do not believe that the current bills were getting us where we needed to go.

Yesterday, I introduced you to the time honored tradition of "Your Man Said So." Basically, when somebody on the other side agrees with you, the argument is over.

Democratic National Committee Chairman, Dr. Howard Dean M.D., has come out and said that it is time to scrap the healthcare bill.

In an editorial he said: (Click Here to Read Washington Post Editorial)

“If I were a senator, I would not vote for the current health-care bill.”

“In Washington, when major bills near final passage, an inside-the-Beltway mentality takes hold. Any bill becomes a victory. Clear thinking is thrown out the window for political calculus. In the heat of battle, decisions are being made that set an irreversible course for how future health reform is done. The result is legislation that has been crafted to get votes, not to reform health care.”

“I know health reform when I see it, and there isn't much left in the Senate bill. I reluctantly conclude that, as it stands, this bill would do more harm than good to the future of America.”

As you can see by reading the full editorial, there were some things in the bill he liked and others he could not stomach. However at the end of the day, he is concluded that this bill as written “would do more harm than good to the future of America.”

Because of, "Your Man Said So," I now will take a position and urge you to do the same. "Scrap the current health-care legislation and start over."

Have a great weekend


Thursday, December 17, 2009

"Your Man Said So"-- the Ultimate Debate Ender

Growing up on the streets of Brooklyn, New York, we did not play everyday sports with organized teams or umpires. Somebody had a football, somebody brought a rubber ball, maybe a softball with some bats, we chose the teams and we started playing.

Within a short time, a play would occur, and an argument would start. "It was fair!”No, It was foul!” or, "He ran out of bounds." “No, he was in-bounds."

People would yell, they would point, re-create, and deliver arguments that would make Clarence Darrow proud.

Inevitably, someone on the opposing team would pipe up and agree with you. Your team says “fair, ” their team says “foul,” and all of a sudden, someone on their team agrees with you and says, "FAIR!"
That's it! Argument over! It was “fair” “YOUR MAN SAID SO”

“Your Man Said So,” is the ultimate conflict ender. It didn't matter, who on the other teams agreed. Their best player? Their worst player? It made no difference! “Your Man Said So,” was more was more powerful than the 10 Commandments themselves.

So what does this have to do with birth? Tomorrow, I will point out the ultimate “Your Man Said So,” in the healthcare debate.


Wednesday, December 16, 2009

Is Midwife Care Superior to Physician Care?

Whatever shortfalls are pointed out in our maternity care system, the birth advocates sing the usual response, "Midwives, all we need is more midwives."

In England, where midwives are still the norm for delivering babies, it seems every day there is another horror story coming out of the maternity wards. They all revolve around midwife and funding shortages.

In the attached article, (click here to read MailOnline article), a former hospital midwife reveals what type of care women are getting in England by the midwives.

My take on the story is that the "midwifery model of care." that is extolled by advocates in the United States is no longer being given at NHS hospitals due to resource allocations.

I want to make clear, that I am a huge supporter of midwives and the midwives model of care. I also have no intention of EVEN trying  to answer the question: "Is midwifery care superior to physician care?"

I want to point out that if midwifery care were to become the norm in this country, the midwives would come under the same huge time and dollar pressures as physicians . It is quite possible that what what today is heralded as the standard that midwives give their patients, tomorrow could become a distant memory.

If tomorrow the physicians agreed that midwives (CNM's, CMS, CPM's, LMS, etc.) would deliver half the babies that are born in the U.S., and if there are 7500 practicing midwives (Dr. Robbie Davis-Floyd informs me that no one really knows the number of midwives in the US actually delivering babies) than each midwife would have to deliver almost 600 babies per year.

How much time do you think a midwife could spend with each pregnant woman if she had to deliver 600 babies per year?


Bean Counters Look at Only Half the Story

We often ask why Medicaid and insurance companies don't see the full results of their actions? Why do they NOT understand that their procedures and policies when it comes to childbirth, produces less healthy babies and cost them much more money in the long run?

A recent article about the single-mindedness of airline accountants has cost the airlines millions, yet they think they are actually making money. We are talking about baggage fees. A few years ago, the airlines (with the exception of Southwest and JetBlue) started charging for checking in. even one bag.

For the second quarter of 2009, this amounted to almost $670 million in baggage fee revenue. The bean counters were jubilant! Look how much money we've brought in, just from charging baggage fees.

Of course, the bean counters had no way of calculating how many passengers chose. NOT to fly the airlines that charged baggage fees. Second quarter revenue dropped by almost $130 billion. Those airlines that do not charge baggage fees suffered losses that were less than half of what the baggage fee charging airlines suffered. (Not to mention how hard it is to get back a customer that has left you for the competition)

(Click here to read article).

Very often when looking for solutions to improve birth, the bean counters, as well as the birth advocates view only one side of the financial equation. It is important to look at all sides when making decisions.


Monday, December 14, 2009

Yet Another Hospital to Close L&D in January

The Philadelphia area has had 18 L&D. closures since 1997, limiting women's choices and putting a severe strain on remaining L&D units.

Mercy Suburban Hospital in Norristown PA, will close L&D, January 18, 2010.

(Click here to read article).

To those birth advocates that believe L&D is a profitable part of a hospital's operations, I would ask one question: "Why would a hospital that interested in maximizing revenue. close a profitable unit?"


Friday, December 11, 2009

2.2 Million Reasons Not to Do a Vaginal Birth

An upstate New York jury awarded the family of a baby who died of seizures following the mishandled birth a $2.2 million verdict against, the obstetricians involved.

(Click here to read article).

It appears that a hospital nurse told the obstetrician on duty that she was concerned about the baby's heart rate, but rather than do an immediate C-section, the OB gave orders to monitor and continue the vaginal delivery.

The baby became stuck during the delivery, suffered oxygen deprivation and brain damage.

Does anyone believe that the next time the doctors involved are faced with a similar situation, they will not immediately say "C-section now!”?

Have a great weekend.