The expensive facts: Can you afford a baby? (1976)
By Richard Flaste
NEW YORK — Forget, for a moment, the buzzing confusion that greets infants at birth, and consider instead the rude awakening some parents experience — when they learn what childbirth costs.
Joan Weiss, who recently gave birth to a baby at New York-Cornell thought the charges would run, oh, maybe $1,000 from start to finish: and when her doctor told her the fee would be $830, she thought that was the total.
But that was only his bill. Then came the hospital’s, which was in the vicinity of $1,200.
“I just didn’t realize it would be up in the $2.000 range,” she said, “and that my insurance would only cover about $300 of it.”
HOSPITAL RATES have indeed been rising rapidly. United Hospital Fund representatives say that. in the last four years. daily maternity room rates in all New York City hospitals have gone up from an average of $108 to $161 for private accommodations and $86 to $122 for rooms with more than one bed. The average hospital stay is four or five days.
According to a spokesman for the Chicago Hospital Council, average basic room rates for maternity beds in the Chicago metropolitan area have gone up from $69.60 to 106.65 in the last four years for private rooms and from $63.10 to $92.35 for semiprivate.
But the average total cost per day for maternity care for mother and infant has risen from about $114.84 to $175.97 with the mother in a private room and from about $104.12 to $152.38 when the mother is in a semiprivate accommodation.
Representative physicians’ rates, according to Blue Cross-Blue Shield, have gone from $500 to $700 in the last four years; but many obstetricians charge as high as $1,000.
VARIOUS REASONS are offered for the increase in hospital costs. Hospitals have faced sharply rising employment costs, they have invested heavily in technological development, and they are large users of fuel.
Maternity costs at hospitals have climbed because each birth pays in part for all that technology and manpower, regardless of whether the birth was routine, requiring relatively little attention.
Dr. Philip Lee, director of the health program at the University of California in San Francisco and a former assistant secretary for health with the United States Department of Health, Education, and Welfare, has questioned recently why childbirth so frequently takes place in such highly sophisticated hospitals.
He noted that only 10 to 20 percent of pregnancies presented “serious problems” and those ‘can be identified if the mother is under professional care.” He urged the study of other childbirth settings.
DONALD RUBIN of the Consumer Commission on the Accreditation of Health Services, a watchdog group, attributes the high cost not so much to the nature of hospitals as to what he sees as inefficient management.
He points to statistics indicating that some hospitals regularly operate at 50 percent of capacity or less. ‘There are hundreds and hundreds of empty beds,” he said.
He recommends the shutting of more maternity departments, a trend that already has begun as maternity proves itself to be an unprofitable business.
Rubin says each empty bed, without providing any income, still costs the hospital about two-thirds of what it would cost if in use.
AS PRICES RISE, the insurance coverage most commonly purchased pays little of the cost. Blue Cross-Blue Shield hospital coverage, is the most popular plan among many, has gone from $100 paid toward the cost in 1972 to $200 now. Customers who also have physicians’ coverage received an additional $250 in the most popular plan, a sum that has not changed in several years.
That leaves the patient with a considerable burden, often totaling $1,500 to $1,800. And yet the patient frequently thinks there’s no chance to shop around.
But the fact is that there are a number of options. Doctors often are affiliated with more than one hospital. And it is also possible to choose a hospital first and then ask for a list of doctors associated with it.
OLDER, SMALLER hospitals can be several hundred dollars less expensive. One hospital has a semiprivate rate [with four in a room] that is $90 a day, $78 a day below the four-in-a-room rate at other hospitals. And the nursery charge of $35 a day is $79 a day less.
At yet another hospital, which has been struggling financially and trying hard to attract patients to its sparse-ly populated maternity section, the four-day rate, including nursery and delivery room, totals $475.
A common misapprehension is that natural childbirth at hospitals is less expensive because it attempts to limit or eliminate the use of anesthesia.
MANY HOSPITALS, however, add an anesthesia charge of $50 or more to their bills in any case, on the grounds that the doctor and equipment should be on hand if needed immediately.
Joan Weiss, who thought it would be a “ridiculous” extra charge if she turned out not to need an anesthesiologist, did end up requiring anesthesia.
The only thing that puzzles her now is why it took the anesthesiologist a half-hour to arrive.
The cost of having a baby, 1978
A baby doesn’t come cheap these days. The medical expenses alone can range from under $1,000 to well over $2,000.
To give you an idea of typical costs and how they add up, The Better Way contacted hospitals throughout the nation and asked them to cite charges for normal delivery of a full-term baby.
Naturally, if the baby is born prematurely or delivered by cesarean section, or if there are other medical complications, expenses will run higher. For example, a cesarean section can require an additional hospital stay of three to seven days, and increases all hospital costs. Most obstetricians also increase their fees for cesarean delivery. On the other hand, you’ll save money if you decide on a birthing room or midwife approach to giving birth.
In the birthing-room method, your hospital stay will be one day, instead of three or four, which cuts back on hospital-care expenses for both you and the baby. In the midwife approach, the midwife replaces the obstetrician and charges less money.
When planning for your new baby, be sure to check the extent of maternity benefits in all your health insurance policies.
Chart: Costs for childbirth in the hospital
Boston, New York City, Chicago, Kansas City, Houston, Little Rock, Denver, San Francisco