A Mother’s View: Value and Cost of Health Care

A Mother’s View: Value and Cost of Health Care

06.17.14 | By

Over the last three years, I have had two c-sections – one for the birth of my 3-year old daughter and the other for the birth of my six-month old twins.  Fortunately, I have good health insurance coverage through my employer and didn’t have to pay a lot out of pocket for these necessary procedures. The more than $20,000 price tag for the single procedure was almost fully covered and I was happy that I could focus all of my attention on my newborn babies rather than figure out how I’m going to pay my  bills.

For many insured patients who undergo expensive c-section procedures in the hospital they are probably in the same boat because a significant portion of these services are likely covered by most health plans.  The bad news is if problems arise from the surgery and patients need medications to help with recovery, they could end up with extremely high medical bills due to our existing outdated insurance model that covers a far higher percentage of the cost of hospital care than medicines patients need to get and stay healthy. 

To further highlight the inequities in insurance coverage: privately insured patients typically pay 4 to 7 percent out of pocket for inpatient hospital procedures but over 20 percent for medicines. 

I recently saw an interesting slide from the International Federation of Health Plans that showed the cost of c-sections in the U.S. vs. other countries in Europe.  In the slide, it highlights the fact that a c-section procedure in the U.S. typically costs over $15,000.  In a country like Spain it costs close to $3,000 and in the Netherlands over $5,000. 

 

Similarly, bypass surgery in the U.S. costs more than $75,000 and in Spain it costs around $16,000. 

We hear lately a lot about the cost of Hepatitis C medicines in the U.S. vs. Europe but what about the cost of liver transplant surgery that may be needed as a result of complications from Hep C, which can cost up to $500,000 in the U.S.? What does that cost in other European countries? 

In other words, health care across the board is more expensive in the U.S. than elsewhere around the world.  Simply focusing on the discrepancy in the cost of medicines is missing the larger picture.  And it ignores  the fact that many countries impose price controls that restrict patients’ access to medicines discourages future medical innovation.

It is unfortunate that medicines are so undervalued in the public debates around health care costs, which focus almost exclusively on medicines while largely ignoring the fact that these medicines are helping millions of patients SURVIVE.  HIV/AIDS, for example, is now a chronic disease and no longer a death sentence because of the medicines developed by biopharmaceutical research companies.  The same can be said for many cancers and other diseases. 

As a mother of three healthy daughters – thanks in many ways to successful c-section surgeries – I think we need to have serious conversations about what we as a society value in health care and what we want our future to look like.  For my daughter’s sake, I surely hope that we don’t stick with the 1960s insurance model that undervalues medicines or put into place policies that restrict patient access to life-enhancing treatments. 

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