This week’s post is by Carl Kerridge, who goes straight to the heart of one of the big issues surrounding the American collective maternity care and that of his lovely wife, the super intelligent Jessica Durivage of Where is My Guru?. Get to know them both, they are an amazing team!
Before you start reading, you may be interested in learning about the Maternity Care Crisis going on in the US today, how America’s Broken Health Care System Affects Women, and why we need a Mothers Declaration of Rights. With that information under your proverbial belt, you’ll be ready to fully appreciate the depth of Carl’s story.
Telling Our Story: The Dark Underbelly of American Maternity Care
Growing up in England I was entitled to free National Health Care (and when I say free I mean the costs were wrapped in to the taxes on everyday items and expenses not paid as premiums to insurance companies or extortionate bills by doctors/ hospitals). I believe this a great system over all and of course as with any system, certainly one that can be taken advantage of by individuals that take advantage of everything they can including social benefits and food coupons but those kinds of people are in every society.
I am now facing the exact opposite here in America – the land of the free – with the impending birth of my first child. I do not believe in health insurance and apparently make too much money for Medicaid so I am titled ‘self pay’. To date several things about this system have seemed incredibly wrong to me and so I am going to give my 5 cents of enlightenment here.
- My wife and I wanted to have a home birth, but unfortunately, due to her previous c-section 15 years ago, a home birth is illegal in South Carolina (note: a home birth would have cost under $5,000 and this would include more one on one care, compassionate care, and better maternal and infant outcomes that far outweigh what we are paying more than double for at the hospital.
- The costs of a birth through the traditional hospital system here in Myrtle Beach, South Carolina are high, and I mean high. The OBGYN was $3,500 which includes delivery and a monthly visit which lasts all of fifteen minutes. The ultrasounds, blood work and additional testing (many tests we declined due to a lack of necessity) were extra, total cost about $5,000.
- The upcoming hospital bill for birth is a minimum $8,000 for a traditional VBAC with 24 hr stay or $18,000 for a C-section (note that is minimum and does not include any medication as the hospital bills that separately. It does not include a visit from the in hospital pediatrician as that is also billed separately, not really sure why and its not clearly explained).
- When we went to the hospital to “pre-pay” our bill in order to receive a significant discount (65% off) we requested a itemized copy of the charges we were paying for plus an itemized copy of possible charges we may incur during our stay. This, we were told, was not possible.
Here’s where I really believe the scam of this system is fully exploited – there is no fee schedule and no itemized costs or menu of prices. To me this is amazing. I run a small business as a photographer and can not imagine telling my brides or commercial clients that I will bill them after and have no prior idea of the costs, just a ball park number. Here’s the real kick in the ass for me, if you can prepay for your hospital visit you are awarded an amazing 65% discount. Now how is that possible and legal? Something to make you go hmmmmm!! I mean, can you imagine sitting down for dinner in a restaurant and before you order that delicious surf and turf with a bottle of Pinot Noir throwing down your Visa and prepaying for a 65% discount…NOPE. Every business I know of would be out of business if that happened, I know as a business owner that I would. Yet the American Health Care system is apparently thriving and most of the doctors that I know, and I know a few, drive fancy cars and live in huge houses (yes that is a generalization and I know they work hard for years to get degrees and deserve it so don’t hate for the truth).
Now we have the introduction of Obamacare, which when I first heard about was relieved that America was leveling the playing field for the poor and the independently ‘unweathly’, to move towards a more rational system that did not just fatten the pockets of the big boys and insurance companies.
The entire report of costs is here: http://www.whitehouse.gov/sites/default/files/docs/marketplace_premiums_ib_final.pdf
I hope that some of you will read this with an open mind to that fact that without this many people would never be able to afford insurance, never get the care they need and deserve as humans and after all, we are all human no matter what is in our bank account. In writing this I hope to clear it from my mind before I enter the hospital, which could be any day now, free it from the system that I am forced to enter by living here in SC and free it from laws that make no sense to me.
In my opinion, this nonsense does nothing to support the natural order or mother nature herself (the simple fact that my wife, as a woman, cannot choose how or where she gives birth, has to create a three page birth plan and reinforce it during every week at her appointments, answering the same questions over and over again is a whole other ball of wax, and another blog post). I hope for nothing more than a natural birth (as that is what women having been doing for thousands of years) and to walk away from the machines and polished floors of the medical system with a healthy baby and a happy, smiling wife.
About the Author
Carl Kerridge
“What would you attempt to do if you knew you could not fail?” is stamped on the paper weight that my wife gave me several years after we started dating. My answer to her is that I am already doing it, I choose to live the life of an adventurer, traveling the globe for work and pleasure, capturing the beauty of life that surrounds us all.
Jessica Durivage says
September 27, 2013 at 9:15 amGinger – thank you so much for sharing this post written by my husband that tells about our experience. We can only arm ourselves with knowledge and the courage to ask questions – and to know that it is our right to have these answers about how “our state of health” will be treated!!! Thank you!!
Ginger Garner says
September 27, 2013 at 9:20 amThank you Jessica and to Carl as well – for being willing to share your personal story. Knowledge is power.
Ginger Garner says
September 27, 2013 at 9:20 amI am sharing the more than 90 comments made on Carl’s original post on FB –
Obviously his story is a shared experience that resonates with many folks!
Ginger Garner says
September 27, 2013 at 9:22 amAmnesty International, among many organizations calling American maternal health care a “crisis,” says this: http://www.amnestyusa.org/sites/default/files/images/50_maternal.jpg
Jeff says
September 27, 2013 at 9:39 amThe upcharge that medical providers add to a patient’s bill to compensate for the drastic shortage in what insurance companies will actually reimburse them completely annihilates the self-pay patient. Since the US healtcare system is more directed toward getting their money from insurance companies instead of individuals, those without insurance get charged what the medical provider would submit to an under-paying insurance company (However, there are some providers that will adjust their fee schedule for self-pay patients…worth researching if this applies to you). Since the self-pay patient is not protected by the contract agreement between a healtcare provider and the insurance company, the patient is responsible for the entire amount. As a result, healthcare providers stand to profit more from the self-pay patient than the patient covered by a big box insurance policy.
This doesn’t even start to address the issue surrounding my extended family members with chronic illness that under the current system cannot get health insurance.
Something has got to change because on the other end of that medical bill is a human…and soon in Carl’s case, a child.
Ginger Garner says
September 27, 2013 at 9:58 amWell written and well said Jeff. Thank you for your invaluable contribution to this incredibly important discussion. Now, can we get a federal audience for this?
Matt says
September 28, 2013 at 11:22 amI have to say that Jeff’s contribution “nails it on the head”. While I’m not saying that there are not significant problems with the US healthcare delivery system, I believe that healthcare providers take excess/unnecessary blame from the public that should fall more squarely on insurance companies (and others, read on…). In the state I live in, once a year the profits and statistics of “non-profit” organizations are published in the newspaper. Typically, the highest net profits are shown by insurance companies (and it drives me a bit squirrelly that they are “not-for-profit”???), not the organizations delivering the healthcare (and in fact there have been a few years in the last ten where healthcare delivery organizations were in the red (at least in my state), all the while organizations like BCBS are paying CEO’s exorbitant salaries and bonuses, while simultaneously not paying for a pair of custom foot orthotics for my patients with foot deformity and pain). Billing at higher rates continues to rise as insurance companies pay less on the dollar, and it is not easy to sustain a healthcare practice. This also falls back on other areas of the corporate world – namely medical supply companies – noting that the equipment and technology (that patients demand, I might add) costs exorbitant amounts of money, adding to the costs. Is this the fault of the physician, or the much larger corporate, profit-driven environment?
I am not a physician, but I believe physicians, generally, are paid fairly for the level of responsibility, training, etc. that the profession demands. In some states, such as Texas, where public litigation has become so out of hand, some physicians can’t even afford to practice in certain specialities because the malpractice insurance precludes the ability to earn a living. This adds another financial dilemma to understanding the cost of healthcare.
If we are going to criticize medical provider salaries, how about criticizing hundreds of other professions that are paid far more (for things that in my opinion, on the schema of healing, wellness, empathy, spiritual meaning, etc. are far less admirable than the work healthcare providers are charged with…) In other words, why are we singling out doctors and medical delivery systems here (if that is part of what this discussion alludes to, which I think I sensed as I read the thread)?
And finally, what about adding blame to the educational system. Even in PT (my profession), students are coming out with 100,000-200,000 in debt for the 7+ year college degrees… recent analysis has suggested it is not a financially viable career given the pay to educational cost ratio, yikes… this is, in some cases, is even worse with physicians… a colleague of mine is now 10 years into training to be able to practice as a specialty physician and in fellowship is getting paid about 60,000/year. Just adding more perspective… Bottom line, money – which speaks to the larger structure and design of the human world, experience and levels of ego and higher Self consciousness itself – as Dr. David Hawkins has written so extensively on.
Yes, the profession of MD has lost site of integrative, whole-person healing, in that it is largely procedural, pharmaceutical, etc., but I also feel that this issue is already on the radar of healthcare delivery in general. Unfortunately, as it’s been said, it takes up to 30 years for the prevailing paradigm of medical practice to change, AFTER the evidence supports that…
Let’s not shoot the provider, at least not yet…
As I often say, “Everyone wants good healthcare, but no one really wants to pay for it”…
As I am not versed on the issues surrounding labor and delivery in America, I am unable to comment to that aspect of this discussion, but felt inclined to contribute the above thoughts as that was what came up for me as I read it…
Ginger Garner says
September 28, 2013 at 2:50 pmHi Matt,
Your comments are very appreciated, and your observations about the profit-mongering of insurance companies should be seen more in the mass media. If we had those profit analyses of hospitals and insurance companies comparatively sitting beside the inversely proportional poor birth outcomes in the US – the public would (and should be) enraged. Then perhaps – we may begin to see the winds of change…
Combine that (profits of insurance companies) with the lack of evidence-based interdisicplinary, integrative medical education (which I am working on right now through many universities and the program http://www.professionalyogatherapy.org) offered to students in medical schools (which includes us as PT’s) – and we have a losing combination for mothers.
Docs don’t know that mothers need women’s health PT before and after birth, and PT’s don’t get to see the patients for preventive and proper care. I am an advocate for Caring Economy theory (www.caringeconomy.org), of which I am a coalition member, blogger, and conversation leader for, which advocates for properly valuing caregiving and caregivers – and promotion of Partnership relationships instead of Dominator relationships in health care and business. This is a progressive groundbreaking, glass-ceiling shattering, and integrative approach which would value mothers, their caregivers (MD’s, RN’s, PT’s, and the like) – and facilitate a stronger economy at the same time.
Thanks again SO much for stopping into BITL and commenting. You are appreciated!
Ann Bentley says
September 27, 2013 at 3:54 pmYes cost, yes rip off, but what about your wife and upcoming baby. Whatever you do you cannot attend an American hospital for the birth. They will have you medicalised and in theatre within the blink of an eye. They know nothing about normal birth. You need to learn how to labour so that the contractions do not cause the sensation of pain during the first stage. This way the old healed wound that everyone is so worried about will not be put under too much stress and not break down which is the common fear with VBACs. When you have mastered the relaxing in my blog and how to keep yourself upright then go see Ina May Gaskin at her farm in America and have your baby there. America is a bad scary place to give birth, it is legalised torture and no one cares. Good Luck, Ann Bentley, Midwife from Manchester.
http://painfreelabour.blogspot.co.uk/2012/05/vbac-at-home.html
http://painfreelabour.blogspot.co.uk/2013/04/letter-from-danielle-thank-you-for-pain.html
http://www.painfreelabour.blogspot.co.uk
Ginger Garner says
September 27, 2013 at 5:19 pmThank you so much for your invaluable insight Ann. As a midwife, ESPECIALLY as a European midwife, and even moreso as a Britain midwife, your wisdom is valuable. America spends much of their time creating fear surrounding natural birth – pushing medications and procedures on mothers without informing them properly – which is a large reason why American’s birth outcomes are so poor. In contrast, the philosophies you mentioned – compassion, respect, of creating calm for the VBAC mother – are hallmarks of what make birth outcomes in the UK so wonderful! Thank you so much for taking the time to comment Ann. Your input is greatly appreciated by this American women’s health physical therapist.
Jessica Durivage says
September 27, 2013 at 5:46 pmHi Ann,
This is Carl’s wife – thank you so much for your response. Unfortunately, we were left without the option of home birth in South Carolina as I have had a previous c-section (it is illegal) and believe me, it was our first choice. Driving 10 hours to The Farm for the birth was just not in our plan. We have a doula and a birth plan and have been happy with the involvement of our obgyn and her support around a VBAC. I have educated myself and so had my husband. With the baby coming any day now, we are working towards erasing the fear that pushed us to get educated in the first place – so that we do not take fear with us into the hospital. Again, thank you, Jessica
Joan Garvan says
September 28, 2013 at 1:29 amHi,
You mentioned a need for a manifesto – a Motherhood Manifesto was published in 2006 – subtitled: What America’s moms want and what to do about it. A google search will find more information. The authors are Joan Blades and Kristin Rowe-Finkbeiner. This has been made into a documentary … you can see more about this at: http://www.bullfrogfilms.com/catalog/mother.html
The Motherhood Initiative for Research and Community Involvement (MIRCI) produce a journal and have a publishing house with numerous titles. There are also regular conferences. Change only happens when people get together and press for it.
I live in Australia but I have established an internet site and launched a professional development online course drawn from a humanities perspective on maternal health. The site works as a touchstone between the academic work, practitioners, women who are birthing and their partners. You can see this at: http://www.maternalhealthandwellbeing.com
Its amazing what women can do with the odds stacked against them, how much better our lives could be if women and the men who support them are empowered to live new and better lives.
Take care and best, Joan G
Ginger Garner says
September 28, 2013 at 2:42 pmHi Joan,
Thank you for taking the time to comment on this post Joan. Maternal health is a underattended topic in the US – and I hope that posts like this, as well as other blogs and sites like mine – can make a difference for the future. I am looking very forward to checking out the links you have mentioned. Thank you so much for your input!