I'm betting most of these Medicaid-covered births are to single mothers. If there is anything the past 40 years have taught us, it's that the 1960s notion of "free love" isn't exactly free.

Marriage: it's not just for gay people.

Why does the United States insist on treating childbirth like it's a medical emergency? Perhaps the cost of delivering a child would go down if we -- I don't know -- put it in perspective maybe?

Patrick:

1) Treating childbirth like a medical emergency is a decent defense if you get sued, and, in the U.S., you WILL get sued if the baby isn't perfect.

2) We have more people for whom childbirth is a potential medical emergency. Me, for example -- over 35, pregnant with multiples through high-tech means. My doctor treating my pregnancy as a potential medical emergency saved my life and definitely led to better outcomes for my kids, who are now perfectly on track despite comIng early. The U.S. has more pregnant women with gestational diabetes, which can turn into a nightmare on various fronts. Etc.

3) In quite a few of the other countries you're alluding to, interventions such as epidurals are much more rare and more discouraged. Speaking as the childbearing half of the species, I'll take medicalization of childbirth for $800, Alex.

If you're a healthy woman with a low-risk pregnancy, you will probably be fine with low/no interventions. The problem is, when something goes wrong from an OB perspective, it goes wrong FAST. U.S. OBs are anticipating that, because if they don't, 1) they get sued and 2) hospitals have much less leeway than in Europe to stop care to very sick babies when futility of situation is perceived.

What this really means is that this is just the tip of the iceberg. Taxpayers footing the bill for the birth is just the start of a lifetime of mooching.

I agree with Patrick... If we didnt treat birth like an assembly line procedure/medical emergency the costs would go down dramatically! As I am sure would infant mortality and maternal mortality that the US leads industrialized nations in! For all our "advancements" and "procedure" we kill more women and babies this way. Also I agree with Amy maybe people would be more careful they HAD to pay for it! After saving for a year careful budgeting and getting pregnant because we planned to it makes me see red when people keep popping out kids for the state to raise and pay for.

If you're a healthy woman with a low-risk pregnancy, you will probably be fine with low/no interventions.

Things can go wrong even when everything looks fine at first. I was under 35 and had a super-easy pregnancy. I didn't get so much as heartburn. I still needed a c-section because my daughter was transverse and got stuck shoulders first. The US has such good outcomes, relative to history, that it's easy to forget that until recently it was common for women and babies to die in childbirth.

Thanks to Medicaid and other government welfare programs one of the few things poor single women can afford is getting pregnant and having a baby.

Lrj - " . . . infant mortality and maternal mortality that the US leads industrialized nations in!"

Sorry, Lrj, I don't mean to contradict you; so please consider this as just an FYI. But, the statistics used by other nations are "fudged."

In the US, if an infant shows ANY signs of life, it should be counted as a "live birth." And if it then dies within minutes it will be included in the infant morality rate.

Many other nations, especially in the EU do not do this. Often, if an infant is born live; but dies within a couple of minutes it is counted as a "stillborn." And therefore, not included in the infant mortality rate.

WHO has often said that it cannot fairly compare one nation's infant mortality rate to another precisely because of the way different nations count their live births.

Interestingly, many on the left and most of the news media don't mention this difference-in-counting-live-births fact when "damning" the US's infant mortality rate.

Thanks to Medicaid and other government welfare programs one of the few things poor single women can afford is getting pregnant and having a baby.

And a good thing, too! Without enough people, where would the future tax mules, serfs, and debt slaves come from?

It takes a certain mindset to care whether you can afford something, and to plan ahead for it. I'm willing to bet most of the people on Medicaid having babies would have them with or without insurance. It's not like they can be MORE indigent, so those bills from the hospital will go into the circular file.

We're not the kind of culture that will allow a poor woman and her child to die on the sidewalk outside the ER if she can't prove she's covered, so she's going to get care one way or another.

We should certainly try to solve this problem, because it's an expensive one. But the motivation for these people isn't financial, so taking away the bennies won't solve it.

The Goddess writes: If I were pregnant, I'd for sure give birth in the hospital. There's a lot that can go wrong. It's not a nosebleed.

You're right. Giving birth is a normal and natural process. A nosebleed is an abnormal condition, an injury.

I love Patrick's comments about a process he can-by nature and orientation-never be a part of in any intimate or meaningful way. Death by staph infection was a normal and natural process too. But I'm betting you'd pop all the meds available to stop it if you had it.

Babies should be born in medical centers. Period. When something goes wrong, it does go wrong very quickly and it often goes wrong in a way that an operation can easily fix if one can be done in time. I know, it happened to me. So I'll take medicalized births for $800 too, and my opinion counts more than that of someone who will never be affected by this either way.

US infant morbidity and mortality is not comparable to any other country. You and your baby have a better chance here than in any other country in the world (our rates are also skewed by all the fatties and their preexisting diabetes etc). And you are kidding yourself if you don't think babies are judged "unsavable" and intervention stopped just because it's going to be an expensive and long process over in the EU and other countries where birth is cheaper. Easy to say "well, there's only so much money" but here in the US we regularly save infants that would be given no chance elsewhere.

But yeah, the entitlements are going to bury us. This is just one of them.

Babies should be born in medical centers. Period. When something goes wrong, it does go wrong very quickly and it often goes wrong in a way that an operation can easily fix if one can be done in time. -- momof4 at September 9, 2013 4:49 PM

m4,

I can agree to a certain point. But I have heard of too many stories where a mom gave birth on the way to the hospital (in a private vehicle) and then the only thing the hospital does is run a few standardized tests and write up the birth certificate. The hospital still charges the family $15K+ for the birth.

But the Medicaid trend is also very scary as well. We need to get people to be responsible for themselves, and not the government.

One more time: if you get a bill for anything medical, dispute it. Blue Cross, Blue Shield runs the plan my company subscribes to, and they run every trick they can to pad the bill.

I was once charged twice for the same general anesthetic - on a bill that claimed it had been verified for accuracy. I pointed that out. Miraculously, "discounts" for the second service - which I didn't get - disappeared along with that second charge, raising the bill to the exact same amount as the doubled invoice!

I said I would point this out everywhere I could. The next day, I got an e-mail stating that there was no balance, everything was A-OK.

If you don't demand to know "Who is this guy? What is this charge?" - you're gonna be swindled.

Another favorite of hospitals is to claim they have nothing to do with charges levied by specialists. Hah.

In the state that I live in, it is almost impossible to get on medicaid if there is a daddy in the picture.

That said, i do believe that child birth is subject to the same inflationary bill padding as all other medical proceedures.
One of the things that needs to happen is to remove the incentive to bill uninsured patients double what the insured ones pay. I believe these are Hollywood accounting tricks designed to write off these uncollectable amounts against the very real huge profits, the hospitals are making.

MonicaP: I agree with you. Even if I hadn't been high-risk, I would have given birth in a hospital, attended by my awesome OB. As I said, the problem with obstetrics is that when things go wrong, they typically go wrong FAST. But if you're generally healthy, under 35, are having an uneventful pregnancy and are willing to play the odds, you have a good chance of ending up with a healthy baby. It's just that the U.S. tends to take a more aggressive approach to anticipating what could happen if you end up on the wrong side of the odds.

Also, American women often expect inductions and epidurals ( both of which I find to be wonderful examples of modern medicine). Adding one or both of those "medicalizes the process." The problem comes when you have people on Medicaid who are getting taxpayers to shoulder the cost. I waited to have kids until I was married to the right guy. My experience cost my fellow insurance-pool participants more than if I had been a 28-year-old having one naturally conceived baby, but it came after I spent years paying my premiums and after a generally healthy adulthood.

Also: http://www.newyorker.com/archive/2006/10/09/061009fa_fact

"We're not the kind of culture that will allow a poor woman and her child to die on the sidewalk outside the ER..."

I'm starting to think that we are going to have to become that kind of a culture in order to survive. We are being eaten alive by people who regard our civilized behavior as a weakness for them to exploit. They may not consciously think of it this way, but that is what they are doing. I for one have no interest in getting dragged down by a sinking ship.

Charles beat me to it Lrj, one thing I will add though is preemies. In many EU countries if a preemie does not survive PAST the expected normal due date it is counted as still born, even if it survived for months before dying

You're right. Giving birth is a normal and natural process. A nosebleed is an abnormal condition, an injury.

You know what else is abnormal? Clothing, clean parasite free water, shelter(houses, tents, apartments), agriculture, fire, cooked parasite free meat, antibiotics, toothpaste, soap, shall I keep going?

This reminds me of someone who put his dog to sleep -- himself. He told me (at a party) about doing this and how the dog struggled to stay awake -- and live. This is, I think, pretty horrible. I had my vet do it, though I had a drug at home I thought I could use. My vet is a professional. Lucy just peacefully went to sleep as I held her. It was not a bad process, given what I had to do.

My youngest brother rescued a homeless puppy, about a year later he resuced a full grown dog. I told my mother it was a bad idea. Sure enough the new dog attacked the puppy. The puppy retreated so far under her water bed I had to have her start draining it so I could lossen a few screw to pull the two halves far enough apart to reach it.

Given the amount of blood all over the house I had no idea how it was still alive, at least it had already passed out. Nearest vet was over an hour away so I had to take it outside and shoot it.

Sometimes a vet isnt an option.

Getting its throat ripped out was 'natural' a bullet to the skull was 'abnormal' which would you prefer Patrick?

"If I were pregnant, I'd for sure give birth in the hospital."

And I'd be looking for a halo somewhere, because that would be Of High Religious Significance!

Had I not been in a hospital, and fortunately with the OBand nursing staff in my room at just the right moment, my daughter and I would be dead. I had gone into labor at 35 weeks (preterm but normal for me and my blood clotting disorder). I was admitted at 5 cm, baby head down, engaged at +1. I wanted an epidural, which they had placed less than an hour from admission. When they'd finished setting up the epidural they wanted to check dilation again. I was now 8 cm and they could no longer feel baby's head. The doctor brought in the ultrasound to figure out what position she was now in and if I'd still be able to deliver safely or need a c-section. They had just started the scan when my water broke. My BP dropped, baby's heart rate dropped dramatically, and there was now blood everywhere. They rushed me to the OR and had her out within minutes. It turns out she had rotated to footling breech and came out feet first when my water broke and her hips got stuck in my pelvis. This also caused an umbilical cord compression and the placenta had abrupted, which explains all the blood everywhere. A seemingly normal labor and uncomplicated pregnancy became a life and death emergency for both of us within seconds.

I'll gladly take all the testing and ultrasounds and medical-ness I get for care in this country. Hell, in other countries I wouldn't even get to be seen by a doctor early enough in my pregnancy to get started on the different anticoagulants I need. Without them I have an 85% miscarriage rate and an equally high risk of defects if I keep taking the type I'm on normally.

Yes but Bunnygirl, the important thing is that wasnt normal and therefore doesnt count. Never disagree with Patrick on anything.

Radwaste, who else do you think could be trusted to bring Elmore's clone into the world? There's a reason Amy is suddenly interested in this subject... :)