We got the bill for having a baby – $37,000. Welcome to life in America

Baby got bills
For the last couple of months my wife and I have been playing a quintessentially American game of Guess the Baby Bill. The rules are simple: try to guess exactly how much we would be charged for the birth of our daughter earlier this year. Last week the hospital bill finally came, putting an end to the guessing game. The cost of an uncomplicated vaginal birth? $37,617.69.

I won’t repeat what I said when we got this bill, because it is unprintable. My language became particularly colourful when, scrutinizing the bill, I noticed that the bulk of the charge was for three nights’ “room and board” in a semi-private room (containing two beds separated by a curtain) which was $10,350 a night. That’s five times more expensive than a completely private suite at the Ritz-Carlton by Central Park. The post-delivery hospital room, by the way, was more budget motel than the Ritz. It was barely big enough to swing a baby, and I had to sleep in an office chair squeezed by my wife’s bed. To add insult to economic injury, the hospital also marked me down as “male” on the baby’s birth certificate and we’ve spent the last two months trying – and failing – to get this changed.

Anyway, the good news is that we don’t have to pay the entire bill: our health insurance covers about $31,000 – leaving us with a balance of around $6,000. Although, of course, that doesn’t make the ridiculously high prices OK. We’re still covering the costs indirectly via our enormous insurance premiums. Which, we were recently informed by Oxford Health, part of UnitedHealth Group, are going to go up by 16% next year. But it’s understandable, I guess. They need that money to do the things health companies are supposed to do: maximise profits, boost the share price and pay their executives huge amounts of money. The UnitedHealth Group’s chief executive made over $50m in salary, bonus and stock option compensation in 2019.

It’s not just the extortionate prices in America’s health system that are problematic. It’s the lack of transparency. My partner called our insurance company multiple times before the birth to try to find out how much we would expect to pay. We were told on each occasion that we wouldn’t have to pay anything. Which was obviously baloney as nothing in the US healthcare system is free. Then again, nothing in the US healthcare system seems to have a fixed price. It seems like medical providers come up with the largest number they think they can get away with, charge you that, and then wait for you to spend three months of your life haggling about the bill. I’m not sure Franz Kafka himself could have envisaged a bureaucratic system as nightmarishly opaque and absurd as American healthcare.

America’s healthcare system isn’t just a nightmare to navigate – it’s inefficient and inequitable. The US may spend more on healthcare as a share of the economy than any other developed country, but it also has the highest maternal mortality rate in the developed world and maternal deaths have been increasing since 2000. And Black women are three times more likely to die from a pregnancy-related cause than white women.

Sadly, while there’s a growing desire among Americans for a single-payer system, it doesn’t look like healthcare in America is going to grow more affordable or equitable any time soon. Joe Biden campaigned on the idea of creating a public insurance option but plans for that seem to have fizzled out. Meanwhile, across the Atlantic, things are not looking much better: Britain’s NHS is slowly and stealthily being privatized.

Do you know what the saddest thing about my hospital bill is? In the grand scheme of American healthcare, the $6,000 we have to pay really isn’t so bad. Lauren Bard, an ER nurse from California, for example, got hit with a bill for $898,984.57 when her daughter arrived at just 26 weeks. You’d think a nurse would get pretty good health insurance from her employer but Dignity Health, whose motto is “Hello humankindness” refused to cover the costs until the media company ProPublica got involved. $6,000 is a lot of money but it could have been a lot worse.

Still, if we lose our minds and decide to have another kid in the US, then I’m hiring a midwife and popping the kid out at the Ritz.

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