Monday, June 2, 2008

Did the NYT get it right?

The multi-level issues of the insurance crisis in US Maternity care made it into the NYT this week. The issues at hand:
1. Women are being denied maternity or health coverage by local health insurers and national health insurers for preexisting conditions like cesarean.
2. Women who have cesareans are being denied payment to their care providers, despite their care provider's insistence on the surgery
3. Obstetricians are perpetrating insurance fraud by refusing to offer safer vaginal birth or forcing women into cesareans without indication and causing cesareans through nonmedically indicated induction.
4. States with legal midwifery coverage and medicaid reimbursement are not giving out midwives names as a part of the plan because the medicaid providers don't have them in their "plan" despite the legality and safety.
5. Malpractice insurers are determining whether or not obstetricians can do VBAC and therefore, whether or not hospitals or care providers are causing more women and babies to be harmed by elective cesarean without indication.
6. Many insurance organizations have OB's in the industry helping to advise them or owning the insurance policies driving these acts, such as PLICO in Oklahoma.
So what does this say? The entire insurance industry from top to bottom is a mess in regards to the health of women and babies and are completely complicit in the cesarean crisis.

For more on the NYT article, go here:
http://www.nytimes.com/2008/06/01/health/01insure.html?_r=1&th&emc=th&oref=slogin

2 comments:

Gretchen said...

well, I'm not sure if this is level C or not, but I'm pretty sure the NYT did a good job opening the discussion....its all about the benjamin's and who can blame the health insurance providers for not wanting to shoulder the cost of ACOG's desire to cut as many women as they can....while I think its absolutely horrid that a woman can be denied coverage because of a decision that may or may not have been made with the REAL best interest of her and her baby in mind...it still isn't HER fault that she got lied to, or coerced into something she never wanted from the get-go.

And what wasn't clear from the NYT piece (and that I know because I fielded the original reports, as did you, in many cases) these denials of insurance were NOT necessarily based on "elective" c/s...sometimes it is just any c/s at all, medically necessary or not...and that REALLY sucks, since sometimes, a c/s really IS the best choice...thank you ACOG for making it hard for the women who really DID need your intervention, because you couldn't keep your hands off the scalpal...

Mitchell Clan said...

Amen!