Wednesday, September 30, 2009

Should Healthcare Be a Right?

One of the tenets of universal healthcare is that it is a right supplied by the government. If Americans really believe this, we would not have deductibles or co-pays. Even Medicare (covers people over age 65) has deductibles and co-pays. More importantly, how can healthcare be a right, when a physician comes out of medical school with $250,000 in debt? Nurse midwives may have debts of $100,000 and floor nurses may have debts near $75,000. How can healthcare be a right, when an obstetrician pays over $250,000 for malpractice insurance? How can healthcare be a right, when the government or insurance companies put out lists of approved drugs and procedures? How can healthcare be a right, when some proposals actually put Americans in jail for not having health insurance? I keep looking for the media to ask these questions of Congress and the President, but so far, these tough questions are not being asked How can healthcare be right, when a parent has to sue their obstetrician and hospital to get their newborn’s medical bills paid, because she was born with a birth injury? Alan

Tuesday, September 29, 2009

Universal Healthcare, No One Has Proposed It!

Did you know that there is not one proposal before Congress that offers universal healthcare. All the proposals are about, requiring people to have health insurance. So what's the difference? In countries with universal health care, the patients do not make a payment when going to the doctor or the hospital. With our proposed mandated health insurance, you can still have a policy with a huge deductible. The original Senate Finance Committee proposal, called for up to a $6000 deductible/co-pay for individuals and $12,000 for families. An entire election campaign was run on the fact that people are not getting needed healthcare because they can't afford it. We heard, “Americans should not have to make choices between paying rent and getting healthcare”. But, the fact is, that everyone in Washington knows that our system would be unsustainable if Americans could access healthcare and never worry about a bill. So how does this translate to birth? The fact is, for prenatal care and labor and delivery Medicaid reimburses providers so little that it would not add up to a $5000 deductible. It is quite possible that even with health reform, a large percentage of the costs from un-complicated birth would still be paid for “out of pocket”. I am just pointing this out as a reminder, that with the massive reform bill pending through Congress, the devil is definitely in the details Alan.

Thursday, September 24, 2009

Con’t- Why the Controversies in Childbirth Conference?

I am continuing the last blog entry which was rather lengthy. During the months before the first, Controversies in Childbirth Conference, which was held in Fort Worth, Texas (Feb 2009), I had a conversation with a family physician who had obstetrical privileges. She was explaining all the obstacles that she felt were put in the way of her giving the best care to patients. I asked her if she'd gotten any birth advocate groups involved since she and they were trying for the same result. She informed me, that she did not know what a birth advocate was. You would think that birth advocates would be shocked at of this lack of knowledge. However, for the most part the birth advocate attends conferences of people that agree with them, such as; midwife conference, doula conference, breast-feeding conference, normal birth conference, etc.. Generally birth advocates don't go to conferences that are mostly inhabited by physicians. From the outside, it seems that most birth care professionals want to go to a conference to hear that they are right and what a great job they're doing. Rarely, at a conference do we find formats with presenters that vehemently disagree with each other. And that is what makes the Controversies in Childbirth Conference different. Professional, respectful, debate, information, and disagreements. At the 2009 conference, the attendees were shocked at the arguments that were made by speakers whose point of view was different from theirs. Quite frankly, they never heard the other side of the story. And this ladies and gentleman is why we have the Controversies in Childbirth Conference. Please go to our website for more information Alan

Wednesday, September 23, 2009

Why the Controversies in Childbirth Conference?

Why the Controversies in Childbirth Conference? As my profile says, I have been the administrator of a number birth centers and also have a background in the insurance industry as well as marketing expertise. I know firsthand the day-to-day challenges that are faced by birth care providers and facilities. I know how most providers try to do the best job possible for patients/clients with huge malpractice premiums, low reimbursements and crazy work hours. Besides working with the various different types of birth care providers, I have also had the opportunity to go to the conferences of almost all the professional organizations involved in birth. This included the obstetricians conference, nurse midwives conference, homebirth midwives conference, doulas conference, hospital executives conference, insurance executives conference and a birth advocate conference. What I have found is what amounts to an adversarial relationship between the various professions. Some of the things that happen at the conference are antagonistic to other professions if not downright ugly. An example would be a bumper sticker at an obstetricians conference saying “home delivery is only for pizza”. Likewise, at a birth advocate conference, obstetricians are portrayed as evil psychotic control freaks, whose sole desire is earning lots of money while abusing their patients. Of course, all these conferences are singing to the choir. For the most part, an obstetrician’s conference doesn't have midwives and a midwife’s conference does not have obstetricians. The purpose of the Controversies in Childbirth Conference ( is to begin a conversation at the practitioner level between the various disciplines to see where their common problems are and if the various disciplines might be able to help each other. More next time Alan

Tuesday, September 22, 2009

What Are Birth Issues?

There are approximately 4.4 million births per year in the United States. Everything from beautiful low risk natural birth, to high risk calamities. There are obstetricians, family physicians, midwives, doulas, nurses, childbirth educators, hospital administrators, and a host of others with divergent and sometimes opposing needs and viewpoints to the other professionals. There are pregnant women who want to schedule a C-section at convenient times and theere are others who have a baby at home, alone, without any medical professional, just so they can avoid having a C-section they do not want. There are women who cannot get pregnant and there are others who cannot refrain from getting pregnant. Almost half of the births in the United States are paid for by Medicaid. The delivering of a baby may be one of the least expensive procedures in a hospital, yet the caring for a premature or injured baby are probably some of the most expensive procedures that occur in a hospital. There are women who fight for the right to have their baby at home and others who think that having a baby at home is child neglect. Then there are birth advocates that feel that NOT having a baby at home is child endangerment. The breast-feeding advocates and the formula companies look at each other with disdain. We haven't really talked about the issues yet, just the players, but you may now get the idea that this is a very crowded field. Pregnant women and newborn babies deserve the best possible care. What "best possible care" really is, is a subject of great debate. Alan

Monday, September 21, 2009

Welcome to the Birth Issues Blog.

As the conference coordinator for the Controversies in Childbirth Conference, ( this blog will give you behind the scenes views of what is going on with the conference, why the conference exists, what the issues are, how the media reports the issues and how each side spins the issues and the media reports.. This conference is neutral territory, which means that conference management does not have an agenda to show that any one side is better, but rather tries to allow all relevant sides to be presented professionally with clarity,. This blog hopes to do the same. This blog will also look at health care reform and will try to ask questions that the media is not asking. Also, we asking questions the media does not know how to ask or refuses to ask on birth issues. The date for the Controversies in Childbirth Conference is February 19-21, 2010, at the Westin Harbour Island hotel in Tampa Florida. We hope you can join us. Alan