Monday, October 19, 2009

If This Is a Birth Blog, Why so Much Health Reform?

I hear this question a lot from people that read my blog. The answer is rather simple, but tells all. I write this blog to attract people that don't read birth blogs! I of course welcome and want all the so-called "birth people" and I know that at the early stages the “birth people” are the only people reading this. However, there are many wonderful birth blogs to rile the blood of any birth advocate. This may be the only blog that people that are involved in birth, but are not considered part of the "birth world." may actually read. In other words, if VBAC is your issue, there are blogs that deal with VABC everyday. If homebirth is your issue, go to Dr. Amy. If natural birth or unassisted birth is your issue, tere are multiple places you can go to. However, if you are among the vast majority (over 90%) of obstetricians, nurses, pediatricians, hospital administrators, etc. I doubt you have ever been on a birth blog, nor have you ever been to a birth conference. Birth is a tiny part (approximately 2%) of healthcare spending. I know that labor is the greatest reason for hospital admissions, but that has more to do with coding the actual number of people having babies. In fact, there are approximately 4.5 million births in the United States and 85 million hospital admissions. The claim of single greatest admission is overemphasized because there are multiple ways of coding chest pains but only one way to code labor. Birth care cannot be performed in a vacuum. Doctors midwives and hospitals do not get paid enough to deliver babies. Any talk of reducing their reimbursements reduces the number of doctors and hospitals and midwives who wish to continue delivering babies I will tell you the secret that everyone knows but no one is will say: “Many decisions in birth are made for financial reasons." Although everyone knows this, they can't admit to it. Just like the Congress has to deal with the budgetary effects of the healthcare reform bill, birth care providers are constrained by the reimbursement of the insurance company. A scheduled C-section takes 15 minutes in the middle of a workday. Whereas a "normal" birth can take hours at 2 AM on Sunday morning, you the obstetrician would be paid the same. Health care reform is about money and the medical system. How the money is distributed and/or allocated will have a major effect on birth practices. That is why this blog focuses on financial issues, because that effects ALL birth issues. Alan

1 comment:

  1. Thanks for a great post. I only have a pinky toe in the birth world, and it seems to me that what you say is absolutely true. Money runs the world and birth is no different. Birth centers close because they cannot fund malpractice - doctors leave, hospitals shut down all for financial reasons. We've got to fix the money if we're going to improve the situation for birth in the US. Bravo.