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For Therese Allison, the pain of childbirth didn’t end in the hospital delivery room. Now that her baby’s born, she’s dealing with another kind of pain: coming up with the cash to pay for the delivery.
Allison, who gave birth to her third child three weeks ago, runs a business with her husband and is one of many self-employed Americans with no insurance. Once she became pregnant, Allison tried to sign up for health insurance to help lighten the financial load.
But the insurance companies balked. “They said, ‘Well, we’re sorry, but you have a pre-existing condition and we can’t insure you,’” Allison said.
It didn’t take long for the New Jersey mom and her husband to learn the daunting costs of having a baby when you don’t have insurance or government assistance.
Over the last 15 years, the cost of vaginal deliveries has practically doubled in the United States, shooting up from $4,918 to $9,294, while the cost of C-sections has increased 70 percent from an average of $8,268 to $14,055, according to Truven Health Analytics.
By contrast, the average cost for an uncomplicated vaginal delivery last year in Switzerland was $4,039 and the average cost in France was $3,541, according to the International Federation of Health Plans (IFHP). That's nearly half to a third of what it cost in the U.S.
In fact, the United States is the most expensive place in the world to give birth, according to the IFHP. The reason, experts say, has to do with the way hospitals calculate our bills.
“Every time you walk into the hospital, they look at everything that happens to you and say, ‘Can I bill for that?’” explained Gerard Anderson, director of the Johns Hopkins Center for Hospital Finance and Management.
“So, if you get an aspirin, they’re going to bill for that. If you get seen by a specialist, they’re going to bill for that.”
Even when families do have insurance, their portion of the bill can be staggering.
Marguerite Duane delivered her third child, Ellis, vaginally within 12 minutes of arriving at the hospital with no medication, and stayed only one night.
“Got him out right away,” the Washington, D.C., mom said. “Before they could even get my name and information to admit me, he was born.”
Because her policy stated that she was responsible for 20 percent of the costs, she carefully kept track of every service she received.
Duane, a physician herself, was stunned when she saw the bill, riddled with mistakes, for $6,000.
“I was billed for two hospital nights, each was charged to $2,241.60,” she said. “I was charged for medications I didn’t receive, such as oxytocin. And it was $958 for his nursery stay — and he didn’t spend one minute in the nursery.”
Even after Duane got the delivery bill corrected — after 15 months of negotiations — the total cost of having Ellis was huge. When she added it all up — including prenatal vitamins, radiology, midwife bills, labs and hospital fees — the final tally was $9,442.41, with Duane’s share a stunning $1,912 out of pocket.
Duane had tried to estimate the costs beforehand so the family could put aside money for the entire pregnancy — but that proved to be impossible.
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And it’s not just a case of one woman and one hospital. NBC News called a number of hospitals around the country at random and was able to get estimates for delivery costs. But, here’s the daunting part: When NBC News called the same hospitals at different times, the prices quoted were different.
Worse yet, there was a huge variation in costs for the same services from hospital to hospital. Estimates for the cost of a C-section, for example, ranged from $6,000 to $28,000.
Anderson isn’t surprised. You’re just seeing capitalism at work, he says.
“There is no logical reason why one is more expensive,” he explained. “It’s because they can charge more. Nobody is asking questions, and so they do and they get away with it.”