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Tuesday, May 8, 2007 12:00 AM

Maternity care is a money loser

Over the past 10 years, 11 of Philadelphia's 19 obstetrics units have closed their doors.

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Tuesday, May 8, 2007 03:20 PM

this is yet another example to add to the almost infinite pile of examples of how the magical marketplace

cannot and will not perform many of the functions of a civilized society and why govt is needed to do many many things, this obviously being one of them. Oh right, if people are just prevented from suing anybody no matter what then everything will be ok. Keep swiggin the cool aid, Brazil will soon have a higher quality of life for poor people than we do, Bangladesh here we come!

Tuesday, May 8, 2007 03:22 PM

maybe if the de facto ban on males entering the field were lifted

this would help with the number of practitioners.

Tuesday, May 8, 2007 03:27 PM

what?

I don't have time to research this more thoroughly, and I hope someone will, but I was under the impression that maternity care is the *moneymaker* for hospitals.

In my area, hospitals advertise their maternity services--on the sides of buses and even on sports radio-- giving me the impression they were competing for those patients. I suppose I see ads for other hospital divisions occasionally--am I only focusing on the ones with cute babies?

Also, have you ever been in a hospital room on a maternity ward? it's usually three times more spacious and ten times nicer than one for an actual sick person, and the actual sick person has to stay in it longer! Again, I thought they were competing for maternity patients.

Somebody enlighten me.

Tuesday, May 8, 2007 04:02 PM

Access and Disparity - Maternity Services

The only money makers are likely to be community hospitals who see a high proportion of patients who are covered by thir party payer insurance and who have low risk prenancies.

As an FYI - healthcare insurers, third party benefits administrators and HMO's add up to 35% of purely administrative, claims and "paper shuffling" costs for every dollar spent in healthcare. Eliminate healthcare insurance, add everyone in the US (which spreads the risk) to the Medicare pot, and the administrative overhead dromps from 33% to about 3.5%. Since physicians and nurses are in critical short supply, there are ample opportunities to retrain and reducate displaced insurance industry workers as direct care providers.

The HR676 bill, sponsored by John Conyers, incidentally, does just that in covering everyone under a Medicare For All single payer plan. And before anyone can say it, no this is not socialized medicine. It is a plan that puts everyone in a risk pool, eliminates the middle administrative layer, frees up physicians and nurses from submitting claims and appeals (which account for massive time and dollar resource allocation - and adds overhad costs to physicians and hospitals) - and keeps the patient/physician relationship off limits to interfering healthcare insurers and HMO's.

Now, that's a win-win situation.

Tuesday, May 8, 2007 04:07 PM

re: maybe if the de facto ban on males entering the field were lifted

According to an earlier Broadsheet article there are still more male OB-GYNs than females.

See: http://www.salon.com/mwt/broadsheet/2007/01/29/sweden/index.html

"Here in the United States, there are still more male OB-GYNs than female ones. In 2003 -- the most recent data -- there were about 25,000 male and about 16,000 female OB-GYNs, according to the American College of Obstetricians and Gynecologists. Yet, nurse-midwives also provide gynecological care, and there are about 6,200 of them currently in practice in the U.S., according to the American College of Nurse-Midwives. Fewer than 1 percent of those -- about 70 total -- are men."

In "Modeling the Future Workforce of Obstetrics and Gynecology" (available at

http://www.greenjournal.org/cgi/reprint/92/3/450.pdf) the authors found that women are expected to become the majority of practitioners in 2014.

Please provide proof that there is a secret cabal of females trying to take over the OB-GYN biz. If women are more comfortable with a female OB-GYN then, so what!

It never ceases to amaze me how the male crank respondents of Broadsheet and other columns in Salon are so eager to begrudge the average women (female monarchs, etc. do not apply here) the little bit of progress and relative power we've begun to experience in the last hundred years or so. When you've experienced what it's like to walk in our shoes for centuries and experience our level of suffering with our lot in life, then maybe I can be patient with your ridiculous snipes about unfairness toward men. Give me a break.

Tuesday, May 8, 2007 04:08 PM

Illegals?

I didn't see the cost of maternity care for illegal immigrants addressed in the article. Wondering how hospitals are reimbursed for the cost of maternity care for illegal immigrants, such care isn't covered by medicare/medicade (?).

Tuesday, May 8, 2007 04:21 PM

Moneymaking program or not

In response to the poster above who thinks that the programs are moneymakers due to ads -

The reason for advertising might not be that the programs themselves are moneymakers, but more that the ads are effective in reaching women who actually have the money to pay - women with insurance, or with sufficient personal funds. Poor women probably go to whichever hospital is closest, while women with more social/financial capital can make a choice as to which hospital they go to. By advertising, the hospital may attract enough paying women to defray the cost of those women who would go to the hospital anyway. A program that would have been a HUGE money loser might be turned into one that is only a slight money loser, which, if you're going to have the program at all, is a better proposition.

Tuesday, May 8, 2007 04:22 PM

Midwifes

Think of what women would gain if midwifes and home birth were more accepted. The medical profession and insurance companies have resisted them and here we are. Only women who have high-risk pregnancy should be treated like they have a disease. Women should take back this natural process augmented by all the medical science has learned about a safe birth. Let's combine science with the experience and care of midwifery. This may turn out to be a blessing in disguise.

Tuesday, May 8, 2007 04:34 PM

entrering the field get it? no male in his right mind will ENTER THE FIELD

obviously those already in it are stuck (and old)

Tuesday, May 8, 2007 04:39 PM

Talk to your Philippino OBGYN

Ask her why she does what she does. She will probably tell that at home Women are not allowed to be surgeons, so if they want to practice that they become OBGYNs and do a lot of C-Sections.

Tuesday, May 8, 2007 04:41 PM

Is it a staffing problem

Where I live, sky-high malpractice premiums have made OBs and Nurse Midwives very hard to find.

Tuesday, May 8, 2007 05:14 PM

When you've experienced what it's like to walk in our shoes for centuries and experience our level of suffering with our lot in life, then maybe I can be patient with your ridiculous snipes about unfairness toward men. Give me a break.

Just so it's clear that you actually mean what you are saying: as a matter of logic your statement necessarily means that it doesn't matter what women do men will have no right to complain for at least centuries. That is literally what you are saying. So I guess that must be what you mean. You wouldn't want me to not take you at your word on the assumption that you are an hysterical irrational woman would you? Welll, I guess men can't claim not to have been warned.

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