{"id":6246,"date":"2017-03-11T18:33:24","date_gmt":"2017-03-12T00:33:24","guid":{"rendered":"http:\/\/admin.patheos.com\/blogs\/janetheactuary\/?p=6246"},"modified":"2017-03-11T18:33:24","modified_gmt":"2017-03-12T00:33:24","slug":"much-childbirth-cost","status":"publish","type":"post","link":"https:\/\/www.patheos.com\/blogs\/janetheactuary\/2017\/03\/much-childbirth-cost.html","title":{"rendered":"How much does childbirth cost?"},"content":{"rendered":"<!DOCTYPE html PUBLIC \"-\/\/W3C\/\/DTD HTML 4.0 Transitional\/\/EN\" \"http:\/\/www.w3.org\/TR\/REC-html40\/loose.dtd\">\n<html><head><meta http-equiv=\"content-type\" content=\"text\/html; charset=utf-8\"><meta http-equiv=\"content-type\" content=\"text\/html; charset=utf-8\"><\/head><body><p><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-6248\" src=\"https:\/\/wp-media.patheos.com\/blogs\/sites\/533\/2017\/03\/2200020857_9d23e7f4a6_b-1024x698.jpg\" alt=\"from flickr, https:\/\/www.flickr.com\/photos\/davidswiftphotography\/2200020857; Creative Commons 2.0\" width=\"478\" height=\"326\"><\/p>\n<p>Just a quick link here: \u00a0NPR published an article, \u201c<a href=\"http:\/\/www.npr.org\/sections\/health-shots\/2017\/03\/11\/519416036\/im-pregnant-what-would-happen-if-i-couldnt-afford-health-care?utm_source=facebook.com&amp;utm_medium=social&amp;utm_campaign=npr&amp;utm_term=nprnews&amp;utm_content=20170311\" class=\" decorated-link\" target=\"_blank\" rel=\"nofollow\">I\u2019m Pregnant. What Would Happen If I Couldn\u2019t Afford Health Care?<\/a>\u201d that claimed that<\/p>\n<blockquote><p>All told, my prenatal care with all visits and tests included would be over $10,000. This is not counting labor and delivery, which in my area is estimated to be up to $30,000 for a vaginal birth and $50,000 for a cesarean section.<\/p><\/blockquote>\n<p>Is this legit? \u00a0My understanding had always been that childbirth costs ran about $10,000 or thereabouts. \u00a0Many years ago, when I was pregnant with my now-9 year old, I used to follow the discussion boards on sites such as babycenter.com, and remember threads on costs of childbirth not being unusual, particularly for women who had individual insurance that didn\u2019t cover maternity, so they needed to manage the costs themselves through careful budgeting, planning, and arranging. \u00a0There\u2019s no way this would be possible with a $30,000 \/ $50,000 rate.<\/p>\n<p>So I googled a bit and found a summary of childbirth costs at <a href=\"http:\/\/www.cnbc.com\/2016\/06\/30\/costs-of-delivering-babies-vary-widely-in-us-california-cities-most-expensive.html\" class=\" decorated-link\" target=\"_blank\" rel=\"nofollow\">cnbc.com<\/a>; the average is indeed less than that, at\u00a0$8,775 for a vaginal birth and $11,525 for a c-section. \u00a0This takes into account the amount that the employer\/insurer pays and the amount that an individual pays out-of-pocket, so the numbers wouldn\u2019t be directly applicable to an uninsured patient (though perhaps an individual insurance policy without maternity coverage still included the negotiated discounts, and it\u2019s my understanding that it is possible to negotiate bills down if you are fully-uninsured). \u00a0These numbers are still high, but they put it in the range of possibility that one could imagine paying for this, in the same way as you\u2019d pay for other large expenses. \u00a0After all, it\u2019s still less than a year\u2019s worth of daycare.<\/p>\n<p>But here\u2019s the other thing that this CNBC report revealed: \u00a0the differentials across the country are astounding. \u00a0For a vaginal birth, of the nation\u2019s 30 largest metro areas, Kansas City came in the lowest at about $6,000; Sacramento and San Francisco both were $15,000. \u00a0And even within a given metro area, prices varied considerably by provider:<\/p>\n<blockquote><p>[Study producer] Castlight Health\u2019s home city of San Francisco had the highest observed price for a routine vaginal delivery, a whopping $28,541.<\/p>\n<p>Another city in California, San Diego, had the lowest observed price for a routine delivery \u2014 just $3,243.<\/p><\/blockquote>\n<p>and<\/p>\n<blockquote><p>The disparities were even bigger when Castlight looked at the costs of c-sections.<\/p>\n<p>Los Angeles had the top price observed for c-sections: $42,530.<\/p>\n<p>The lowest price for a c-section was seen in Pittsburgh, Pennsylvania, where it cost $4,419 \u2014 nearly 10 times less than L.A.<\/p>\n<p>For average prices for c-sections, Sacramento again had the most expensive average price, at $27,067. San Francisco again held second place, with an average of $21,799.<\/p>\n<p>Orlando, Florida, had an average c-section price of $12,232, putting it in the middle of the pack for the cities examined.<\/p>\n<p>The lowest average price was in Pittsburgh, at $6,891 \u2014 which was four times less than Sacramento\u2019s average.<\/p><\/blockquote>\n<p>These price variations are only partly due to differences in cost of living in these areas. \u00a0Even within a metro area, there\u2019s a lot of variation:<\/p>\n<blockquote><p>Castlight\u2019s report said that the \u201cshockingly higher\u201d average prices in cities such as Sacramento and San Francisco are related to the consolidation of health providers in those places, resulting in less competition for patients.<br>\nBut San Francisco also was one of the cities which has a very wide range of prices for deliveries.<\/p>\n<p>Castlight said the lowest cost seen for a c-section delivery in San Francisco was $8,399, which was five times less than the highest cost seen in the city, $41,191.<\/p>\n<p>In Los Angeles, the lowest cost for a c-section, at $6,232, was nearly seven times less than the highest cost c-section, at $42,530.<\/p><\/blockquote>\n<p>So I don\u2019t know in what world the NPR author can say that childbirth costs $30,000, especially since, at least in a metro area and other than emergencies, there are options to plan (though I also recall reading moms-to-be struggling to get hospitals to give out costs in advance). \u00a0Perhaps the $30,000\/$50,000 is a cost that assumes an uninsured patient with every possible potential expense at the most expensive hospital?<\/p>\n<p>But it is a useful reminder that this huge variation in cost across regions points to a need to figure out <strong>how to get costs down<\/strong>, rather than just figure out <strong>who\u2019s going to pay for them<\/strong>. \u00a0(It seems to me that I read a book about this, but I\u2019m not sure when \u2014 in any case, <em>Overtreated<\/em> is a similar book on healthcare costs. \u00a0I wrote about this <a href=\"https:\/\/www.patheos.com\/blogs\/janetheactuary\/2013\/09\/overtreated-why-too-much-medicine-is-making-us-sicker-and-poorer-by-shannon-brownlee.html\" class=\" decorated-link\" target=\"_blank\">quite some time ago<\/a>, though, I\u2019ll warn you, it looks like my planned \u201cpart 2\u201d never happened.)<\/p>\n<p>\u00a0<\/p>\n<p>Image: \u00a0from flickr, https:\/\/www.flickr.com\/photos\/davidswiftphotography\/2200020857; Creative Commons 2.0<\/p>\n<\/body><\/html>\n","protected":false},"excerpt":{"rendered":"<p>Just a quick link here: \u00a0NPR published an article, \u201cI\u2019m Pregnant. What Would Happen If I Couldn\u2019t Afford Health Care?\u201d that claimed that All told, my prenatal care with all visits and tests included would be over $10,000. This is not counting labor and delivery, which in my area is estimated to be up to [&hellip;]<\/p>\n","protected":false},"author":2209,"featured_media":6248,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[133,584],"class_list":["post-6246","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-healthcare","tag-healthcare-costs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>How much does childbirth cost?<\/title>\n<meta name=\"description\" content=\"Just a quick link here: \u00a0NPR published an article, &quot;I&#039;m Pregnant. 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