Giving birth is a costly affair. Hospitals won’t tell you how much

No time in the past, anyone could have imagined giving birth to a baby would cost a small fortune. Centuries ago, humans have been giving birth to children through many conventional methods with the lowest minimum costs possible. But the mortality rate was high in these methods. Giving birth was a risky issue and losing the lives of the child or mother seemed ‘sadly common’ during childbirth.

Thanks to the advancements in medicine and technology for eliminating the risks of childbirth to lower the mortality rates. But still, the ‘sadly common’ factor still exists and now it’s in the form of costs involved in childbirth.

Stats

Especially in the US, giving birth is a costly affair. Costs in giving birth are highest in the US compared to any other country. The average costs of giving birth, excluding the prenatal expenses, stand around $ 3,500 in the US. This is a huge cost compared to the livelihoods of people in average third world countries.

According to the stats, childbirth is the #1 reason why people get admitted to the hospital in the US. On average 4 million women give birth every year only in the US. A considerable percentage of this number is uncomplicated childbirths. So it’s natural to assume that there is a common range of fixed pricing structures in hospitals in the US.

But sadly again, it isn’t the case in the US.

An interesting video was made by a couple, Johnny Harris and Isabel in Vox.com. This video explains about the various difficulties faced by them in unearthing the costs involved in childbirth beforehand. Watch the video here. Johnny wanted to get an estimate of costs that could occur during childbirth. To get this information beforehand, he went on a quest that proved fruitless.

Johnny Harris has summarised his quest for finding the costs in the video and has just one sentence to conclude. ‘American healthcare, especially for childbirth, is broken and expensive’. In his research, he has found out that there is a huge variation in costs of childbirth across hospitals in the US.

These are backed by the stats from his research and reports released by Yale Medical School.

It is found that the variations in the cost of basic facilities in the US hospitals range roughly from $ 1200 to $ 12000.

Let’s dig deeper into the facts and procedures involved in childbirth to get an understanding of Johnny’s quest.

Chargemaster and hospital childbirth procedure

Every hospital in the US maintains a giant list called the ‘Chargemaster’. This contains the list of services and items that a hospital provides to the patients along with its pricing and code.

These codes are billing codes that are used in calculating the final price. Below is an example of an item in the Chargemaster

Item/Service : 20 minutes with the doctor

Code : 20522

Price : $ 109.32

A barcode scanner is used to scan the consumer at every section who has come for delivery.

This barcode scanner records each and every item, service that has been used by the patient.

On delivery, a final bill called a ‘claim’ is generated and the bills are sent to the insurance companies. Insurance companies usually negotiate for a lower price for each item on the list.

The negotiated price will be based on the relationship of the insurance provider with the hospital. A final bill or claim is agreed upon by the insurance company and the hospital.

The insurance company settles the percentage of the claim as per the policy terms. The remaining amount of the bill is sent to the patient weeks later for settlement.

This is the usual, precise childbirth procedure carried out in the hospitals.

(Non)Transparency in the rate card

Now let’s understand the difficulties faced by Johnny in getting the estimate for childbirth.

When Johnny began this quest for finding this estimate from chargemaster, little did he know that this effort is going to be useless

He made a list of hospitals and called each and every hospital in that list. The first round of responses was easy. The call attendants connected the calls to the so-called ‘relevant authorities’ like team leads, billing office people, financial coordinators, pricing coordinators, patient price lines, etc.

But. None of these ‘relevant authorities’ gave or were able to give a price estimate to Johnny.

But Johnny was persistent and pulled up his strength to call the next level authorities. This was a round of dead telephone lines that gave no answer to Johnny.

The clear take away from this quest is that the hospitals are not ready to share the Chargemaster information before the procedure. For whatever reason, there is no transparency in rate card before the childbirth.

Probable reasons

Johnny Harris believes that it can be due to these reasons.

• Usually, consumers involved in childbirth don’t go around comparing costs between hospitals, especially before the childbirth. It is not like buying a car. This is not a luxury. Childbirth is ‘need’ expense that can’t be avoided and hence people don’t dig the details before.

• The absence of proper regulations in childbirth pricing.

These may have given leverage to the US hospitals to have a varied, unstructured and sometimes unreasonable pricing.

Conclusion

Healthcare systems suffer from major price variation and there is no way for patients to find out it beforehand. It’s high time the US Government should take necessary action and enforce regulations to standardize a pricing range. Especially when the country is the swiping the most money compared to others to bring life on earth.