If you think that a single-payer health care system is not here yet, think again.

If you’re uninsured and pregnant, it is likely that by the end of this year – or definitely by next year –the federal government will be paying your bill.

As of 2010, Medicaid paid for nearly half of all births in the United States, according to a study from the George Washington University School of Public Health. Under ObamaCare, Medicaid will continue to expand its reach, inevitably causing the number of births covered by the federal health care program to grow.

As this happens, I’m confident that the federal government will begin dictating precisely what type of prenatal care women should receive – and from whom they should receive it.

Now, I do believe that putting high health care standards in place and identifying risk factors in obstetrical patients do yield better neonatal outcomes. As a matter of fact, in many countries where single-payer maternity services have been provided, there are much better health outcomes – both for the mother and child.

Most women in these countries are given very strict nutritional guidelines, and they must be compliant during their visits with their health care provider. In other words, their nine months of prenatal care has to be an open book to their health care systems.

However, having the government foot the bill for pregnancies in the United States does not seem to be yielding better outcomes.

In some southern states like Louisiana, as many as 70 percent of births are covered by Medicaid, according to the George Washington University report.  Sadly, these states continue to have some of the highest complication rates in terms of maternal obesity, premature deliveries and smoking rates among pregnant women.

So my question is: If the federal government is covering most of the deliveries in these states, why have the outcomes been so poor? Now that we have this grand Medicaid expansion under ObamaCare, what’s going to happen to the quality of childbirth in this country?

If the federal government continues to offer aid to pregnant women without doing anything to change the status quo, then the outcomes will continue to worsen.

I’m writing this not because I want to fight the system.  Rather, I am looking for answers. To me, many federal bureaucrats in the health department only know how to quote statistics and put those statistics into fancy, colored graphs. But when I ask many of my obstetrical colleagues what to do about bettering pregnancy outcomes, many of them have very bright answers.

As we move closer to a federal system of health care, we keep going backwards in quality and innovative ideas. I hope that someday, the children born under ObamaCare will be inspired to change the future for their own children.