One factor contributing to the high birth cost is the “charge for service” policy of U.S. hospitals, whereby patients are charged for each service they receive during their stay.
There have also been claims of a lack of transparency and regulation in the pricing of services provided by hospitals. Hospitals are able to set prices extremely high with little fear of retribution. Charges for delivery have nearly tripled since 1996 and out of pocket costs are four times higher. Some women have reported that they are very reluctant to have a caesarean due to the hefty price attached.
American commentators have reacted strongly to the report. "It's a truly sad state of affairs," wrote Sasha Brown-Worsham of The Stir. “There is something so damaged about a country that claims to support families and wants people to procreate and then does absolutely nothing to support them once they do.”
CMDA Executive Vice President Gene Rudd, MD: “The cost of healthcare has become a plague in and of itself. The burden of paying for healthcare is the leading cause of bankruptcy with childbirth-related costs, resulting in seven percent of those bankruptcies. Too many young families face lifelong economic marginalization due to these excessive costs.
“Why is U.S. healthcare so costly? There are many reasons: overutilization, for example. The threat of malpractice adds many ‘routine’ but unhelpful tests and procedures. There are too many cooks in the kitchen—business entities waiting in line to make profits. And the uninsured are most severely affected. They are expected to pay the chargemaster costs while those with third-party payers pay discounted rates often at one-third of the chargemaster.
“It is further disturbing to know that we are not getting a good return on our healthcare investmenti. Shameful, in fact. We pay a higher amount of our social and family budgets than any other developed country, but rank well below in outcomesii.
“Personally, I oppose the current healthcare reform plan, but not because I oppose reform. Reform must occur. I oppose the current plan because it does not adequately address our economic burden of health care as reflected in the cost of childbirth. Starting with already unacceptably high costs, the planned reforms only exasperate the problem, likely collapsing the system. Was this intended by social engineers as a means of getting what they ultimately want, a single-payer, universal system? I do not know, but I am growing suspicious.”
iHealth care spending, delivery, and outcome in developed countries: a cross-national comparison. American Journal of Medical Quality
ii For Americans Under 50, Stark Findings on HealthThe New York Times