published Thursday, July 25th, 2013

Childbirth in America costs a princely sum thanks to lawyers

How much does it cost to deliver a prince in England? About half as much as it costs to deliver a pauper in America.

The most highly anticipated birth in modern history occurred this week when Britain's Prince William and his wife, Catherine, welcomed their newborn son, George Alexander Louis. The Daily Mail estimated the price tag for delivering His Royal Highness Prince George of Cambridge at perhaps the poshest, most technologically advanced hospital in the United Kingdom at about $15,000.

A Truven Health Analytics report released earlier this year found that in the United States, the "average total price charged for pregnancy and newborn care was about $30,000 for a vaginal delivery and $50,000 for a C-section." Costs to deliver a child have roughly tripled since 1996, according to Truven. Average out-of-pocket costs for childbirth increased fourfold from just 2004 to 2010.

A New York Times series on the cost of childbirth in America earlier this summer, which heavily cited data from the Truven research, pointed out that "despite its lavish spending, the United States has one of the highest rates of both infant and maternal death among industrialized nations."

Why does childbirth cost so much in America, yet provide so little bang for the buck?

It seems pregnant women in the U.S. often receive a substantial number of unneeded procedures, such as additional ultrasounds, blood tests and even induced labor when such steps are unnecessary. That overutilization of services costs individuals, insurance companies and taxpayers billions of dollars annually.

Further, American hospitals perform cesarean births at a rate more than twice as high as what is considered optimal by the World Health Organization. The WHO determined that 15 percent is the "optimal rate" of C-section births. According to Truven, C-sections now account for 33 percent of births in America.

C-section births not only cost much more than vaginal births, but, as Truvent points out, C-sections are major surgeries that "use more medical resources and pose a higher risk of complication to both women and infants, resulting in more care overall." As a result, the U.S. could save lives and roughly $6 billion a year if the number of medically unnecessary cesarean sections dropped to the WHO's recommended level.

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Why do doctors and hospitals push for unnecessary tests and too often perform unneeded C-sections? Sure, there are a certain number of unscrupulous actors in the medical field who try to bilk patients for every last penny. But the most common reason for the litany of unneeded expenses is that doctors and hospitals are trying to ward off lawsuits.

As the New York Times reported, "obstetricians face the highest malpractice risks among physicians and pay hundreds of thousands of dollars a year for insurance, fostering a 'more is safer' attitude." As a result, doctors often order every test the hospital has to offer for expectant mothers, even though much of the poking and prodding is unnecessary and does little to make the mother or the baby safer or healthier.

Former U.S. Senator and Democratic vice presidential candidate John Edwards helped create the litigious environment obstetricians now deal with and played a part in the steeply rising cost of childbirth in America. As a tort attorney, he pocketed more than $50 million bringing questionable lawsuits against doctors and hospitals in which he claimed that children were being born with cerebral palsy because doctors did not perform C-sections when needed.

As a result, according to investigative reporter and TV news man John Stossel, "C-sections increased from 7 percent of all births to over 30 percent" in America. Depsite this increase in C-sections in an attempt to avoid lawsuits related to cerebral palsy, rates of cerebral palsy have not fallen at all.

It seems Edward's cerebral palsy claim was as bogus as his promise of monogamy.

The cost of childbirth in America is unnecessarily high -- and lots of people deserve the blame. The hospitals and doctors aren't going to turn down money when it's available. Insurance companies and government programs (namely Medicaid), do a terrible job of educating expecting parents on ways to keep costs down during pregnancy.

The easiest way to begin cutting the exorbitant expense of childbirth in America, however, is to enact tort reform and other policies that reduce the incentives for money-hungry attorneys to bring baseless and unnecessary lawsuits against doctors and hospitals.

Getting lawyers out of the delivery room is the first step in making sure the birth of a baby is a reason to celebrate, instead of a money-devouring fiasco that sends American families to the poor house.

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