Saturday, February 8, 2014

Scary Lack of Options in American Maternity Coverage

The cost of health care is quite a bit higher in the United States than in other developed countries. As well as being unfairly expensive, the American medical infrastructure has come under fire as of late due to a number of factors. Perhaps the greatest influence is the imminent presidential election in late 2008, and candidates from both the left and right have been scrambling to find plausible solutions to the glaring deficiencies left as a legacy of the Bush era. Another cause for the pressure to change comes from Michael Moore, a controversial political moviemaker whose recent work, a documentary film titled "SiCKO," highlights the many flaws in the United States health care system.

Faced with limited options, mothers-to-be are often stuck between a rock and a hard place in terms of covering their prenatal and childbirth costs. Traditional insurance providers, with high premiums and deductibles, sometimes have additional out-of-pocket costs that families are unable to shoulder. Other options, such as traditional health methods, aren't very reliable so women are forced to face the rising costs without attractive solutions. What other alternatives do they have?

One solution that has arisen comes in the form of non-traditional health coverage. Consumer-driven health plans (CDHPs) are becoming popular for Americans seeking a cheaper route to medical insurance. CDHPs, which incorporate cost-sharing and fairly low deductibles in combination with Health Reimbursement Arrangements (HRAs) or Health Savings Accounts (HSAs), have the potential to yield high tax benefits that could offset costs and make CDHPs considerably less expensive than traditional insurance providers. The likelihood of these benefits coming to fruition, however, remains in question. Desperate individual policyholders are nevertheless turning to CDHPs to lessen the financial burden that comes with childbirth.

The Kaiser Family Foundation, a California-based, health-related think tank, recently tested the viability of CDHPs as an affordable option for high maternity costs. In the least expensive scenario, it was found that a new mother could pay barely US$6,000 for out-of-pocket costs to cover prenatal treatment and a straightforward childbirth. While US$6,000 is starkly less than the costs paid by other CDHP policyholders, it is still similar to or more expensive than would have been paid out-of-pocket under a traditional medical insurance plan.

In a second scenario, a family spent US$21,000 on out-of-pocket maternity fees when using a CDHP. This is quite a high value, despite the family having had coverage for more than two years and the pregnancy and birth being relatively free of complications. In a third (and quite extreme) example, a family was forced to pay more than US$287,000 in medical fees during the birth of the family's second child. In this case, a woman experienced a rocky pregnancy, coupled with gestational diabetes, pre-term labor that resulted in a c-section birth, and comprehensive neonatal intensive care.

The vast divide between the out-of-pocket charges for maternity care is the result of inconsistent cost-sharing across CDHPs. The conclusion, therefore, is that pregnant women with coverage from CDHPs could face costs that are extremely higher those incurred under traditional insurance providers. The risk of accumulating ridiculous hospital bills is too high in the face of the steep costs of raising an infant. The rising popularity of CDHPs could therefore potentially damage the health of less wealthy Americans who turn to CDHPs and then suffer from inferior health care and heavy financial losses as a result. On the other hand, CDHPs can, in some cases, provide comprehensive health care options to those who have been exposed to health insurance plans that are incomplete parcels of larger plans designed to suit a broader base.

Despite a much longer list of pros and cons, it has clearly emerged that CDHPs are a much riskier alternative to complete health care plans. Though American health care is pricey and often insufficient for the cost, the safest choice is to acquire coverage from a trusted insurance provider. The lack of reliable cost sharing and the rookie mistakes made by the new CDHP organizers can result in disastrous effects to the health of those insured. And the health of a pregnant woman or newborn should not be gambled with.

1 comment:

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