Monday, July 1, 2013

American exceptionalism and child birth

Posted By on Mon, Jul 1, 2013 at 6:42 AM

HIGHER PRICES: A chart in New York Times compares cost of childbirth.
  • HIGHER PRICES: A chart in New York Times compares cost of childbirth.

Talk with any teabagger about the advantages of universal health care — considered a right in most western countries — and you'll get a litany of the imagined horrors of French, Canadian, British, German, etc. health care and ringing testimonials to the superiority of the U.S. system.

The cheerleading overlooks the facts: We spend more money on a patchwork system with generally worse results (such as shorter life expectancy) than any number of other countries.

A reminder of the folly of beginning every public policy debate with the presumption that every other country is inferior to the U.S. comes from today's New York Times:

Childbirth in the United States is uniquely expensive, and maternity and newborn care constitute the single biggest category of hospital payouts for most commercial insurers and state Medicaid programs. The cumulative costs of approximately four million annual births is well over $50 billion.

And though maternity care costs far less in other developed countries than it does in the United States, studies show that their citizens do not have less access to care or to high-tech care during pregnancy than Americans.

“It’s not primarily that we get a different bundle of services when we have a baby,” said Gerard Anderson, an economist at the Johns Hopkins School of Public Health who studies international health costs. “It’s that we pay individually for each service and pay more for the services we receive.”

Those payment incentives for providers also mean that American women with normal pregnancies tend to get more of everything, necessary or not, from blood tests to ultrasound scans, said Katy Kozhimannil, a professor at the University of Minnesota School of Public Health who studies the cost of women’s health care.

Financially, they suffer the consequences. In 2011, 62 percent of women in the United States covered by private plans that were not obtained through an employer lacked maternity coverage...

The New York Times article deals with costs.

Outcomes? The Henry J. Kaiser Foundation compiles infant mortality rates worldwide. This factors in more than delivery issues, of course, but it's instructive. The U.S. falls far behind all the countries the 'baggers abhor.

How about maternal mortality rates? Here's a U.S. government compilation that puts 57 countries (including all the familiar names with government-provided health care) with lower death rates for mothers related to pregnancy.

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