Published January 16, 2014
Raising a child is an expensive undertaking, and new parents can get a severe case of sticker shock even before they've left the maternity ward, according to a new study that looked at the costs of having a baby in a hospital.
Researchers at the University of California, San Francisco, surveyed cost data for more than 109,000 hospital deliveries across the state in 2011. All of the cases involved women with private health insurance, and all were uncomplicated vaginal deliveries or uncomplicated Cesarean-section births.
The results showed a wild and completely unsubstantiated variation in costs throughout California, from $3,296 for a vaginal delivery to a high of $37,227. The cost range for a C-section was equally wide, from $8,312 to almost $71,000. [Baby Basics: 7 Facts About Home Births]
"This is unfortunately the appalling state of affairs of health care in the United States," said lead study author Dr. Renee Y. Hsia, an associate professor of emergency medicine at UCSF and a faculty member of the UCSF Institute for Health Policy Studies.
The study also revealed that hospitals charged more if they were located in areas with higher costs of living, were for-profit institutions or had a patient population with more severe illnesses.
A systemwide problem
"Childbirth is the most common reason for hospitalization, and even for an uncomplicated childbirth, we see a staggering difference in what hospitals charge, even for the same, average patient," Hsia said in a statement. "These charges affect not only the uninsured, but also the fee-for-service reimbursements by some private insurers, which can translate to out of pocket costs for patients."
The wide variation in health care costs isn't limited to the maternity ward, either: A 2012 study showed that hospitals in California can charge patients from about $1,529 to almost 120 times that amount $182,955 for removing an appendix.
The issue is compounded by the fact that patients generally have no idea what their bill will be until after their treatment, and doctors and other health care providers often have no real idea how much their treatment recommendations will cost.
Who's watching costs?
Is anyone assuming the responsibility for lowering health care costs? A 2013 survey of more than 2,500 U.S. doctors found that most of them believed they did not have the primary responsibility for controlling the costs of health care.
Most doctors instead believed that insurers, lawyers, the government and patients should shoulder that responsibility, while doctors should focus instead on providing excellent health care, the survey revealed.
"Physicians are most enthusiastic about strategies that are more focused on improving the quality and efficiency of care and bringing evidence to the bed side, but are very nervous about serious, potentially biting payment reform," author Dr. Jon Tilburt, a bioethicist at Mayo Clinic in Rochester, Minn., told LiveScience in an earlier interview.
The researchers analyzing the costs of hospital childbirth determined that health care pricing in the United States too often relies on outdated pricing structures, and charges for services don't reflect actual costs.
"At a time when out-of-pocket payments for health care are increasing, and the growing number of 'consumer-directed' high-deductible health plans put more pressure on patients to make cost-efficient health care decisions, the opacity of health care pricing is increasingly concerning," the study authors wrote.
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