Government-Mandated Health Insurance – Could It Be Any Simpler?
The proposal: Everyone must purchase health insurance. The government will help offset insurance costs for those who cannot afford it. Insurance companies will not deny anyone coverage or increase premiums based on an individuals’ health status.
Could it be any simpler? Such a system would not only provide health care coverage for every American, it would do so in a way that does not jeopardize the quality of care received. Because insurance and health care would remain privatized, Americans would not have to suffer through long waits for inadequate care – a fate that has riddled international universal health care systems with hassles and hold-ups.
Yes, Americans would have to make one concession: Everybody would have to purchase insurance or suffer a tax penalty. This keeps premiums low for everyone, and is the key selling point to get the insurance industry on board. Some say that this type of system will only work to keep insurance executives employed. Yes… and so what? If they’re giving Americans – and especially pregnant women – what we want and what we need, they should be able to keep their jobs. It’s funny how people will complain about universal health care coverage, yet sit idle while Congress passes a stimulus bill that, among other things, will spend half a million dollars on a fruit fly facility, millions for land acquisition, and many more millions for infrastructure updates.
Universal health care is not socialism – it is people taking care of people. That principle has nothing to do with economic systems, social classes or geography. Every one of us depends on someone else for survival, from the baby suckling from her mother’s breast to the CEO cashing in on consumer spending. Classes might be divided; but our country – and humanity – is united.
The proposed universal health care system is simple, and provides for everyone. Under it, disadvantaged pregnant women would no longer have to suffer the indignity and stress of begging for maternity services and fair and equal treatment. All pregnant women would have access to proper prenatal care, and all children would receive proper medical care.
Taxes that cover Medicaid, Medicare and a slew of other federal, state and local health care assistance programs would no longer be necessary, not to mention the taxes that currently assist hospitals in covering the costs of government-mandated emergency services for the uninsured and unable to pay. These are taxes we’re already paying.
Some have said that universal health care would cost $1.5 trillion, which might be true. What they’re leaving out of the argument is that Medicare spending alone is expected to exceed that mark within the next 20 years. By consolidating all of our health into one program, we can reduce redundancies, increase efficiencies and provide much-needed high-quality health care for everyone – including pregnant women – while still saving money.
Or, are we being set up???? I want your thoughts?
Deadbeat Dads… Here’s What The Good Guys Do
We hear a lot about deadbeat dads. Here’s a story about one of the good guys:
Macon.com published an interesting article about Kevin Lyons, a baker who, after work, spends a few hours selling drinks to motorists before going home to see his family (http://www.macon.com/news/local/story/632114.html). Why does he do this? To afford health insurance for his family.
Kevin’s wife lost her job after missing too many days during her high-risk pregnancy (pregnancy discrimination, anyone?), and she has struggled to find another since the couple’s daughter was born. So Kevin began moonlighting to earn about $20 extra a day – which he says is just about what health insurance costs.
Uninsured and underinsured pregnant women are often left alone to struggle with locating access to affordable maternity care. Too many deadbeat dads leave the family or refuse to help – but there are so many more who work hard to provide for their families. Heroes like Kevin can be found in every nook and cranny in this great nation, though often unsung.
Some might think that peddling Gatorade on the streets is humiliating or demeaning, but not me. I think that Kevin Lyons is on an admirable quest and is providing for his family. He should be very proud – no doubt his family is.
You Can Get Pregnant Playing Video Games…SERIOUSLY!!!
A More Realistic SIMS, Please
If you’re at all familiar with the gaming world, you’ve undoubtedly at least heard of the SIMS, a role-playing game where you live the life of an on-screen character. One of the goals of the SIMS’ developers is to make the game as realistic as possible – which is why the SIMS 2 (and the upcoming 3) characters can become pregnant and have babies (http://kotaku.com/5149307/knocked-up-a-look-at-pregnancy-in-video-games).
According to the Kotaku article, the SIMS characters become pregnant, are housebound, go into labor writing in pain, and then a baby is born.
Pregnancy Magazine Managing Editor Clary Alward doesn’t think that pregnancy in the SIMS is very realistic: “It’s like Guitar Hero… You play Guitar Hero and it’s nothing like playing guitar.”
Some worry that misrepresenting pregnancy in video games could have a negative impact, especially for young mothers-to-be. If pregnancy and child rearing are depicted as being easy, the gravity of responsibility could be lost. Conversely, if pregnancy and child rearing are depicted as too painful, difficult or frightening, it could cause pregnant women to fear maternity and childbirth and cause undue anxiety.
While video game creators are free to depict pregnancy, or anything else, as they’d like, if the goal is to make a game as realistic as possible then pregnancies should be depicted with realism.
How about necessary prenatal care for a healthy child? Or what about the inability to get insurance or to afford treatment, or being forced to compromise your dignity just to get care for your character and her unborn child?
If the SIMS was more realistic when it came to pregnancy, many women would struggle just to get the care they needed for their characters and digital babies to live healthy and prosper. In fact, many players would get quite the opposite: game over.
The Family Medical and Leave Act Rendered Worthless Especially for the working Class Pregnant Mom
The Family Medical and Leave Act protects the rights of mothers to take up to 12 weeks off from work for childbirth (see the fact sheet here: http://www.dol.gov/esa/whd/regs/compliance/whdfs28.pdf). Despite this, more and more new mothers are returning to the workplace sooner than they wanted to help stabilize family finances, as reported by Dana Mattioli in the Wall Street Journal (http://blogs.wsj.com/juggle/2009/03/11/new-mothers-cutting-short-maternity-leave/).
The current economic climate has put a strain on American families – especially when a mother is out of work and a father is laid off. Our need to earn has forced women to give up their rights and the precious bonding that only mothers and babies can share.
The FMLA requires that employers with at least 50 employees allow for 12 weeks of unpaid workleave – but allows mothers to waive that right. And that’s exactly what many mothers are doing. The FMLA is now essentially worthless.
If the government really wants the FMLA to do some good, it would require that maternity leave be paid. We’re expected to give 30 years of our lives to the workforce, profiting CEOs exponentially. Can’t they be expected to help cover the bills for a few months out of three decades? Or should the government pick up the tab with all the paper money it is printing?
Perhaps originally intended to help disadvantaged mothers invoke their right to recovery and bond with their newborns, a lack of foresight has now made the FMLA relevant to the advantaged. If families can’t afford maternity leave, then the Family Medical and Leave Act does little for them. It benefits the advantaged, yet leaves the disadvantaged to struggle for survival.
Perhaps the Obama administration should revisit the Family and Medical Leave Act and not only provide time, but also the means to survive while women care for their children.
MEMORIAL DAY
I Need Your Help
Advocate Aaron Supporters:
As you all are aware I fight every single day to help make sure moms can have affordable access to prenatal care. Prenatal care is VERY serious and without it “babies born to mothers who receive no prenatal care are three times more likely to be born at a low birth weight, and five times more likely to die, than those whose mothers received prenatal care.” –US department of Health & Human Services
Three weeks ago I was in Washington, DC lobbying and fighting for this very cause. I had the pleasure of working with Karen Fennell, one of the top lobbyist in the women’s health arena. Karen contacted me today and asked me if I could enlist the Advocate Aaron Army. I responded with an ENTHUSIASTIC “YES”, and told her it would be impossible for our moms, friends, family, relatives, etc. to NOT come through with flying colors. The task is SIMPLE, but, I need you to do it NOW and I need you to forward it to EVERYONE you know. This isn’t about us. It is MUCH bigger. This is literally about life and death for the innocent babies whose mothers CANNOT access affordable prenatal care.
Please see the message from Karen below and then TAKE ACTION NOW!!!!
PRO MOM!!!
AdvocateAaron
A Healthy pregnancy for a Healthy baby
Dear Mothers and Friends:
Pregnant Women’s Access to Care is in danger in many States. Over 43% of women’s pregnancy care is paid for by the Medicaid program; an additional 18% of pregnant women have no health insurance.
Action by the Federal Government has jeopardized the financial stability of our birth centers. I am asking you and your friends to sign on to a letter to the United States Congress to fix this problem. As a Mother and Grandmother of twin girls, I cannot stand back and let pregnant women be left with no care.
We need 10,000 signatures by May 31st to ensure that all pregnant women have access to quality, affordable health care. Stop the Federal Government from excluding pregnant women from receiving the care they deserve.
Go to the American Association of Birth Centers website at www.birthcenters.org/news/breaking-news/?id=82 and sign our consumer letter. You can make a difference!
Sincerely,
Karen S. Fennell, MS, RN
Consultant
Healthcare Advisory Solutions
Childbirth: Can the U.S. improve? C-sections are expensive. Doctors ask if we are doing too many.
Ruby Wales holds her newborn, Carson. Her first doctor worried more about the risks of vaginal delivery than of cesarean, so she found a different one.
After an emergency cesarean with her first baby, Ruby Wales was holding out for a vaginal birth with her second one.
With a toddler underfoot, the 33-year-old Mission Viejo woman wanted a faster recovery. But finding a physician to deliver her second child wasn’t easy. Her first obstetrician turned her down flat. “She said, ‘No — no way,’ ” Wales recalled.
Once reserved for cases in which the life of the baby or mother was in danger, the cesarean is now routine. The most common operation in the U.S., it is performed in 31% of births, up from 4.5% in 1965.
With that surge has come an explosion in medical bills, an increase in complications — and a reconsideration of the cesarean as a sometimes unnecessary risk.
It is a big reason childbirth often is held up in healthcare reform debates as an example of how the intensive and expensive U.S. brand of medicine has failed to deliver better results and may, in fact, be doing more harm than good.
“We’re going in the wrong direction,” said Dr. Roger A. Rosenblatt, a University of Washington professor of family medicine who has written about what he calls the “perinatal paradox,” in which more intervention, such as cesareans, is linked with declining outcomes, such as neonatal intensive care admissions. Maternity care, he said, “is a microcosm of the entire medical enterprise.”
As the No. 1 cause of hospital admissions, childbirth is a huge part of the nation’s $2.4-trillion annual healthcare expenditure, accounting in hospital charges alone for more than $79 billion.
Because spending on the average uncomplicated cesarean for all patients runs about $4,500, nearly twice as much as a comparable vaginal birth, cesareans account for a disproportionate amount (45%) of delivery costs. (Among privately insured patients, uncomplicated cesareans run about $13,000.)
Pregnancy is the most expensive condition for both private insurers and Medicaid, according to a 2008 report by the Childbirth Connection, a New York think tank.
“The financial toll of maternity care on private [insurers]/employers and Medicaid/taxpayers is especially large,” the report said. “Maternity care thus plays a considerable role in escalating healthcare costs, which increasingly threaten the financial stability of families, employers, and federal and state budgets.”
The cesarean rate in the U.S. is higher than in most other developed nations. And in spite of a standing government goal of reducing such deliveries, the U.S. has set a new record every year for more than a decade.
The problem, experts say, is that the cesarean — delivery via uterine incision — exposes a woman to the risk of infection, blood clots and other serious problems. Cesareans also have been shown to increase premature births and the need for intensive care for newborns. Even without such complications, cesareans result in longer hospital stays.
Inducing childbirth — bringing on or hastening labor with the drug oxytocin — also is on the rise and is another source of growing concern. Experts say miscalculations often result in the delivery of infants who are too young to breathe on their own. Induction, studies show, also raises the risk of complications that lead to cesareans.
Despite all this intervention — and, many believe, because of it — childbirth in the U.S. doesn’t measure up. The U.S. lags behind other developed nations on key performance indicators including infant mortality and birth weight.
And in at least two areas, the U.S. has lost ground after decades of improvement: The maternal death rate began to rise in 2002, and the typical American newborn is delivered at 39 weeks, down from the full 40. Public health experts view the trends with alarm.
At a recent conference held by Childbirth Connection, physicians, employers, insurers and hospital operators wrestled with the disappointing data and discussed thorny questions, such as whether insurers should stop paying more for cesareans than for vaginal births.
“Cesarean birth ends up being a profit center in hospitals, so there’s not a lot of incentive to reduce them,” said Dr. Elliot Main, chief of obstetrics for Sutter Health, a Northern California hospital chain.
But there is a lot that hospitals can do to reduce them, as illustrated by the wide variation in cesarean rates. Among California hospitals, cesareans range from 16% to 62% of births.
Such variation means a lot of women are getting unnecessary cesareans, Main said. “There’s no justification for that kind of variation.”
The surge in cesareans may owe more to celebrity magazines than medical journals. After word got out that Victoria “Posh Spice” Beckham had three, physicians reported a surge in requests for such deliveries, dubbed the “too posh to push” bump.
Physicians, too, have been blamed for failing to make women fully aware of the consequences of cesareans, and for promoting them for convenience.
But change is underway. The Institute for Healthcare Improvement’s Strategic Partners program trains hospitals to implement a set of guidelines, such as the careful use of oxytocin, and a ban on elective deliveries before 39 weeks. In four years, 60 hospitals have signed on.
“It’s a culture change,” program director Frank Federico said. “We’re at a tipping point. . . . It used to be that we spent more time defending the 39-week rule. Lately, there’s no question about that. It’s, ‘How can we improve the process to support that?’ ”
WellPoint Inc. and UnitedHealthcare Services Inc., the nation’s largest health insurers, also are trying to curb cesareans.
In an analysis of its claims, United found that 48% of newborns admitted to neonatal intensive care units were from scheduled deliveries, many of them before 39 weeks.
Cesarean deliveries by country
United targeted a group of Texas obstetricians with particularly high rates of deliveries before 39 weeks.
An analysis showed that the babies these doctors delivered were admitted to neonatal ICUs twice as often as the national average.
After being notified of the correlation, the physicians changed their practices and reduced neonatal ICU admissions by 46% in three months.
The rise in avoidable first-birth cesareans has had a multiplier effect. Most U.S. physicians discourage vaginal deliveries after a cesarean because of some widely publicized cases several years ago in which the uterus split disastrously along the prior incision.
That’s why Ruby Wales’ first obstetrician refused.
“She said it was because there is a 1% chance of a uterine rupture,” Wales said. “And I thought that was weird because there’s more chance of things going wrong with a cesarean section.”
But some obstetricians believe that new evidence supports allowing some women the option of trying for a vaginal birth.
“If the old incision was a vertical, then a trial of labor is not a good idea,” said Dr. David Lagrew, medical director for the Women’s Hospital at Saddleback Memorial Medical Center in Laguna Hills. “But what happens now in the United States is the low transverse, an incision in the bottom part of the uterus, from side to side. Those heal better. All the studies say, in those types of incisions, the risk is less than 1%, probably a half percent, that it will open during labor.”
Saddleback delivers about 3,000 babies a year. In March, it joined a few hospitals nationwide that are pioneering the “hospitalist” approach to maternity care, which adds a measure of safety to attempted vaginal births after cesareans. A hospitalist is a doctor who cares only for hospitalized patients.
Hospitalist obstetricians staff the maternity ward 24 hours a day, seven days a week. They are there to deliver babies when an attending obstetrician gets stuck in traffic, to monitor lengthy labors and to assist in emergencies.
Saddleback supported Wales’ desire for a vaginal birth. Nine days after her due date and after 30 hours of labor, she gave birth — the way she wanted — to an 8-pound, 11-ounce boy.
“I was so glad nothing happened at the last minute to have an emergency C-section because I’d gone through all this work,” said Wales, resting in her hospital bed with baby Carson in her arms. “I’m so relieved that I don’t have to deal with a [cesarean] recovery because I have a 2 1/2-year-old at home who is very active.”
Maternity Healthcare is in Crisis
The Prenatal Pandemic
While the world scrambles to understand and combat the swine flu, declared an imminent pandemic by the World Health Organization, another pandemic rages on in the United States – and this one is far deadlier.
The growing inaccessibility to proper prenatal care has caused a pandemic of enormous proportions in the United States. Consider that:
- A lack of prenatal care means a baby is three times more likely to be born premature, and five times more likely to die;
- The number of Americans without health insurance that would cover prenatal care has grown by nine million in the last 13 years;
- The March of Dimes gave America a “D” on its recent Prenatal Care Report Card – because a full 12.7% of the 4.3 million babies born in the U.S. annually are premature;
- Over 19,000 babies die within the first 28 days of birth each year in the U.S.;
- Of those deaths, a full 30% are directly caused by premature birth…
- Meaning that premature birth accounts for over 6,000 infant deaths in the United States annually.
A lack of prenatal care leads to premature birth. Premature birth leads to death. A lot of it. The bell sadly tolls for over 6,000 babies each year. That’s more than the death count from the World Trade Center attacks, and this wound is self-inflicted.
Many of these deaths could be prevented with proper prenatal care, yet the U.S. government is more concerned with the swine flu which, as of this writing, has killed one person on U.S. soil. In fact, President Barack Obama has even requested a whopping $1.5 BILLION from Congress to combat the spread of the swine flu.
That kind of money could cover prenatal care for nearly every uninsured pregnant woman for a year. It seems as those who can think for themselves are more interested in protecting themselves from a relatively mild flu than protecting the babies who are unable to think – or speak- for themselves.
Even though a pandemic is characterized by the presence of an infectious disease, how can we be more fearful of a relatively mild swine flu than an epidemic that, in a decade’s time, kills more than 60,000 babies? That’s more than the population of Carson City, Nevada.
Human life is too precious to politicize. It’s time to get our priorities straight. Yes, the swine flu needs addressed. But it’s also time to take care of our nation’s babies. http://www.youtube.com/watch?v=5P_dFD0J47I
