Saturday, July 14, 2012

The High Cost of Birthing

Why Health Care Reform Is So Important

In order to allay any fears that I might have been born in Kenya or somewhere like that, I am today releasing, not my birth certificate, but the bill for my delivery.

This little piece of paper, which I found among my late father’s effects, tells an astonishing story. It’s not only evidence of how health care costs have grown during my lifetime, it reveals some of the major changes that have been made in medical procedures.

As you can see, I was born on December 20, 1947, and my mother and I remained in the hospital for ten whole days! No, it wasn’t a caesarean delivery, and my mother didn’t have complications. It was just standard procedure that women who had given birth stayed in the hospital for a long time.

But, to us, what is most astonishing is the cost of that stay. It only cost $5.50 to deliver me and $8.50 a day for my mother to recuperate. (She must have just about gone mad lying in bed that long, I’d think.) Anesthetic for childbirth was standard, and that cost $3.00, as did circumcision. (I know: way too much information.) The total was $119.25.

In 1947, all the dimes, quarters, and halves in your pocket were made of 90% silver, and that continued to be the case through 1964. Now, a bag of those silver coins with $1,000 face value and no numismatic value will set you back almost $20,000. But even at 20 times the cost, $2,385, you can’t get born today for anything close, and your mother will probably be discharged from the hospital by dinner time.

That’s why reforming health care is so important. Here’s another graphic, from Wikipedia, showing the cost of health care in this country as a percentage of Gross Domestic Product. Back in 1947, people spent less than 5% of their income on health care. I might add that doctors made house calls back then.

I realize that there have been incredible changes in medicine during my lifetime. There were no hugely expensive CAT scan or MRI machines back then, and a whole panoply of wonder drugs has been developed in the meantime. Lots of people who survive major illnesses and traumas today would have died from them in 1947.

But there are other factors. St. Joseph’s Hospital was a Catholic institution and wasn’t in the business for the money. Blue Cross-Blue Shield, when it started, was a non-profit organization. There were no for-profit HMOs adding another layer of cost. There were few drugs available, but those there were relatively cheap.

Whatever the causes, and there are many, we have been paying an increasing portion of our income on medical care. As you can see from the graph, it reached 16% in 2007, and there has been no reduction in the rate of increase since then.

This increase was the impetus for Barack Obama to make health care reform a major plank in his platform when he ran for president in 2008. It was also the impetus for many voters who supported him.

He was true to his word. When the Affordable Care Act finally made it to his desk, it was probably a lot less than he had hoped, but it was a good start. It didn’t promise to reverse the trend, but the non-partisan Congressional Budget Office reported that it would reduce the rate of increase by a substantial amount over time.  

We need to give this new program a chance. The best way to do that is to vote for President Obama and the Democrats running for Congress and local offices.

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