Monday, November 9, 2009

Whose Job Is It to Prevent Premature Birth?

By now, everyone knows that the US ranks 30th in infant mortality. I could point to the fact that different countries report infant mortality statistics differently, to say that it's not as bad as it sounds. For today's post, let's accept that. #30 is very, very bad.

On Friday, November 6th, I said "Let's stop calling it, "Healthcare Reform" and let's call it "Health Payment Reform." I now propose we change the name From "Health Insurance" to "Sick Insurance!"

Why sick insurance instead of health insurance? Because our system pays the medical expenses for people who are sick or injured. There may be token payments for annual physicals, etc., but the bulk of the payment is for sickness or injury.

So the United States has this high prematurity rate? The media is in a tizzy! The birth advocates are in a tizzy! The health reform advocates are in a tizzy! My question is, "Has anyone proposed anything that will lower the prematurity rate?"

For years I tried convincing HMOs and health insurance companies, as I was negotiating contracts, that our birth center should receive a "Healthy Baby Dividend” because our prematurity rate was 1/2 of 1% (0.05%). Every premature birth that we prevented saved an insurance company at least $100,000.

Needless to say, no insurance company was willing to pay a “Healthy Baby Dividend.” If the baby was born premature, they would happily pay the $100,000 NICU bill, but they would not pay a dime as a reward for preventing prematurity.

If we really want to bring the prematurity rate down, we should pay cash incentives to physicians and midwives who can show a much lower prematurity rate than the national average, with of course a formula to compensate for  high-risk patients.

Only when we are willing to put our money where our mouth is, and pay incentive bonuses for healthy babies as opposed to sick babies, will we start taking steps toward reducing prematurity and making America healthier.


Tomorrow-amazing seminars being announced at Controversies in Childbirth Conference

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