$8k to Give Birth | Hacker News Reader

$8k to Give Birth

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35 pointsjigglypuffs38 comments

Yeah, so what? I think we have often enough discussed that the US healthcare system is broken.

People should never have to worry whether they can financially manage to go and see a doctor when they are in need of one. Doesn't care if you've broken your arm, am expecting a child or if you're chronically ill.

I don't know what else to say about this. Get that shit together and become a first world country.

> Yeah, so what? I think we have often enough discussed that the US healthcare system is broken.

You think giving birth is free? There are usually 3 or 4 professionals present, along with a bed for the day, instruments to measure various things, drugs for (pre) and post delivery, etc... it's far from being like a regular doctor visit.

And?

Sure, someone has to pay for it, but why not all together?

Because kids are a private luxury only rich people should be able to afford? Sounds kiiinda fascist to me.

> fascist

When did "fascism" became a tag for "things I don't like" again ?

edit: I can't reply to your reply but you should research more on fascism, it goes way beyond "bad people are bad", most of these regimen were actually pro healthcare/welfare. I'd be glad not to make it meta but every single controversial article turns into that kind of lame "oh that's fascist!" thing when it almost never is related to fascism.

Fascism is just exreme elitism and only allowing the elite to breed sound rather extreme to me.

Also, could we please not make this meta?

perhaps don't be hyperbolic then?

_Fascism_: political ideology and mass movement. The name comes from the Latin word fasces, a bundle of elm or birch rods (usually containing an axe) used as a symbol of penal authority in ancient Rome. Although fascist parties and movements differed significantly from one another, they had many characteristics in common, including extreme militaristic nationalism, contempt for electoral democracy and political and cultural liberalism, a belief in natural social hierarchy and the rule of elites, and the desire to create a Volksgemeinschaft (German: “people’s community”), in which individual interests would be subordinated to the good of the nation.

If anything fascist states want their citizens to get more children, not fewer. More children means more workers, more soldiers, more future mothers for yet even more children, all to propel the State (with a capital 'S') to greater heights.

Theory of Justice. Assume being born into the world, as a baby you would want to have the same rights and possibilities no matter which parents you have.

> You think giving birth is free?

This is a straw man argument. Nobody is suggesting public healthcare is without cost. Civilised societies provide services like policing, fire and rescue, criminal legal defence, and education, because these are deemed rights. The United States is an outlier in not regarding healthcare a right to be supplied as a public service.

It's as much of a strawman argument as the Twitter image is, then, since the image is literally a picture of a hospital bill.

One argument doesn't mention the subtext of socialized medicine, and the other doesn't mention the subtext of insurance.

You can support public spending and yet not necessarily think of it as a "right". For example, I support tax-payer funded education because it's a bargain; an educated citizenry is much more productive.

> You think giving birth is free? There are usually 3 or 4 professionals present [...]

Of course it's not free. It's about who takes care of the costs. You should not see a bill from the hospital as your health care provider should fully take care of this.

Story time: When I was a little kid, I stumbled with a glass jar in my hand, fell into the shards and cut my right hand open. Half a centimeter more and I'd have lost three fingers of my right hand completly. Tendons and nerves were cut and the fingers were immobilized immediately.

Never did anyone worry about what it might cost to fix this. Not my family, not the hospital, possibly not even the health care insurance provider.

Instead I was taken to the best hospital for this kind of damage and several high trained professionals operated for 8 hours to fix it. After my hospital time I got movement therapy to get my hand fully working again.

This is a real indicator for a developed, first-world state: Whatever happens to you, professionals will take of you and you won't have to worry whether your family will go bankrupt because you stumbled as a kid or not. Because the society as a whole has build a net that will catch you when things like this happen.

>Whatever happens to you, professionals will take of you and you won't have to worry whether your family will go bankrupt because you stumbled as a kid or not. Because the society as a whole has build a net that will catch you when things like this happen.

Why?

Who builds the net?

In case of Germany those laws are in effect since 1884, not sure what your favorite translator might make out of [0], but it's been established for a long time and therefore a well respected and valued achievement of the earlier times.

So, obviously since 1884 the society has build this net with their monthly dues. Currently it's around 15% of your loan.

[0] https://de.wikipedia.org/wiki/Geschichte_der_Sozialversicher...

> People should never have to worry whether they can financially manage to go and see a doctor when they are in need of one. Doesn't care if you've broken your arm, am expecting a child or if you're chronically ill.

I live in Sweden. Sweden has socialised health care so in theory it should be possible to go and see a doctor when [I am] in need of one. That's right, in theory. In practice the waiting times can be so astronomical that many people - my partner included - are on private health care insurances to make sure they actually go and see a doctor when they need one instead of in 4 months time, if you're lucky. This does mean they pay twice for health care, once through provincial ('landsting') taxes, once through the private health care insurance. It is the latter which ends up paying the bill, the question is where the former money goes. When she needed to see a doctor a few months ago she first tried to go the normal route through the public health care system. The response was 'we can book you for this-and-that date in 6 months time'. Right. When she called the private insurance it only took a few days. These waiting times accumulate, e.g. the doctor wants the patient to get a CT scan - wait for 2 months. MRI, wait 3 months, etc. The private insurance has bought (time on the) machines so they can offer a time next week.

For acute problems the public health care system is still the go-to place even if waiting times in emergency rooms are now so long that some hospitals (e.g. Sunderby, between Luleå and Boden in Norrbotten) have called upon visitors to 'make sure to take food and any needed medications with them as the waiting time can exceed 24 hours'.

So where to go from here? Public health care is affordable but often not available. Private health care is available but often not affordable. How can these two goals - affordability and availability - be met in one system?

> Public health care is affordable but often not available. Private health care is available but often not affordable.

Well, we both know that those are the same in the end. It's not like there are seperate CT scanners for private insurance patients, but the later are treated with priority as they can be billed more.

> How can these two goals - affordability and availability - be met in one system?

I think this is a problem of prioritizing and financing.

For one, I would immediately stop and forbild all private health insurances in Germany and make being member of one of the public health care insurances mandatory. Also public employees would have to pay their share for all social services. All of them, just like any other employee.

This will right away stop this whole BS with prioritizing private patients over those with public healthcare and it will also fix lots of financing issues in the long run.

Once that is done, pay the same money for everything at all places and also pay all (equally qualified) doctors the same. Obviously some kind of expert council will have to decide a fair price for everything, but in the end a CT scan should cost the same around the whole country.

If we have established this, lots of problems will solve themselves: Doctors will move out to the rural areas too, because the money is the same. Also with more money, we can pay better prices, build up new medical infrastructure and what not.

We provide and finance so much infrastructure because we find this to be a fundamental part of our society, but we fail so hard on medical infrastructure. That just doesn't fit together.

I've lived in the US (fully private), Australia (universal healthcare) and Switzerland (a weird system somewhere in the middle of universal and fully private) and I've only had issues like you describe in the US. So based on this (very small) sample, it seems like there's little correlation between the funding system and the quality/access to care.

I don't even think it's a matter of funding. For good care, Australia has relatively low spending, while Switzerland has quite high spending. For bad care, the US and Sweden both spend quite a lot (per OECD [0]).

[0]: https://data.oecd.org/healthres/health-spending.htm

Sounds like Sweden have fucked it up, not that public healthcare is a broken concept. You should try the British NHS. It's not perfect but it's pretty fucking good, and free.

The problem in Australia is right-wing ideologues chipping away at public health to enrich their donors in the private health "insurance" scam industry, subsidising it and forcing people into it when it provides almost no benefit.

With our daughter, we shopped around and prepaid at a private hospital $5k, no insurance.

We ended up not making it to the hospital in time (35 min labor and delivery) and I delivered the baby at home (not recommended). We took mama and baby into the hospital to get checked out and were out of there 5 hours later.

I later contacted the hospital and asked for a partial refund because my wife and I did the hard part.

They refunded us $2.5k.

That sounds extremely interesting. I’d love to hear more details about this — e.g. Where do you live? How did you arrive at the decision to go this route? How did you even know it was an option? Is this common in your area/anywhere?

I’ve never heard of doing it this way. And that price would be cheaper than my deductible, hah!

At the time, we lived in Phoenix, AZ USA. We just called up the hospitals and asked what programs they had for private-pay child delivery. Most had post-paid financing but a couple had prepaid programs that were cheaper.

Note: that’s not what she owes, that’s just the ‘cost’. Interestingly she cropped that part out of the bill.

That's about how much it costs (after insurance) to give birth in a private hospital in Australia as well. This is in a country that has universal healthcare. The largest costs are the often the hospital fees.

I have insurance and it cost me close to $3k for my last kid. In the US

Incorrect, that's how much it typically costs to give birth in a private hospital BEFORE any private insurance is applied.

If you go through the public hospital system (aka universal healthcare) the cost is negligible. Around 70% of people choose the public option.

That doesn't match my experience. We have private insurance while on 457 and the only out of pocket expenses were the genetic extra test for autism and sex of the child and me staying couple nights in the hospital with my wife. About 750 in total. Everything else, pregnancy handling, hospital, midwives, cesarean, anesthetics were covered by the insurance company totaling around 20 000 AUD.

Curious why this particular tweet was submitted. That is probably the lowest bill I have ever seen for childbirth. My first son’s C-section birth was $25k.

Did you have to pay it yourself?

It cost me $4k out of pocket after having employer insurance in US. Absolutely absurd. Prolly one of the reasons i’m gonna stick with only one kid.

Kids are really really expensive in US. You wanna be rich. Don’t have kids.

I'm aware the prices are before insurance, but having just spent some time in TX, i'm amazed at the amount of young(ish) people walking around with some sort of "disability" that could (and would) be easily fixed if only they'd go see a doctor.

In a country with universal healthcare we simply don't see that. Notice something that isn't right ? go see a doctor - it's free.

Example? I live in Austin and don’t see this.

I was in downtown Dallas, and it was mainly while walking between downtown and Deep Ellum.

Maybe people forget the elaborate system of lies in which commercial payors tell providers “I’ll pay .6 on the dollar” so providers say “ok I’ll ‘charge’ you (cost + margin) * 3” because I’ve gotta make a healthy margin this one to cross subsidize the patient with a government payor who will only pay .3 on the dollar.

That's the bill. How much did she actually pay?

i think it should be expensive, if youre not willing to save up that much to have a kid then where do you expect to find the funds to support them?

as people already know by now, the US medical system is subsidising the rest of world, along with medical innovation (new drugs etc): https://www.youtube.com/watch?v=v7xmkzVU29Q

Oh do we? No one asks US to be drug martyr of the World. Economy is a living thing, just stop paying double or triple for drugs, and market will level itself across all customers in no time. IF, you can stop that is: because IMO whole thing rather smells corruption, not martyrdom.

it's not about asking the US to be the martyrs. it's about the state of the matter. right now, by asking US citizens to pay exorbitant prices, and thus boosting innovation and bringing new products to market, you are actually helping places like the EU get better and cheaper medication. of course you can change that.

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