Ways to save millions of tax dollars in obstetrics

Seeing that there is a world wide quest for governments to save money right now, I am putting my mind to ways that I would cut waste if I were in charge of the medical budget.

I invite you to add to this list.  Just as the Wall Street tycoons are raiding the piggy bank with their inside deals, the obstetrics community wastes the medical budget with practices that are not only medically expensive but also harmful to the health of the population.

1. Take circumcision off the U.S. Medicaid funding.  California cut circumcision off Medicaid in 1982 and has not only saved millions of medical dollars but also contributed to the health and well being of boys.  15 other states followed suit.  What is taking the other states so long to come into the modern age?  It’s time to stop this barbaric torture of unconsenting minors.

2. End eye ointment treatment of newborns.  Britain and Australia do not put antibiotics in the eyes of newborns who don’t need it.  If a baby gets an infection, they treat it.  Who makes all the money from this unnecessary tribal rite?  Curious minds want to know.  When nurses, midwives and doctors continue these practises they line the pockets of the pharmaceutical companies at the detriment of babies.

3. End frivolous induction of the birth process.  Oh, the poor doctors have to do it because women want it.  Boo f____g Hoo!  Since when do doctors do what the patients want?  This is a crime against humanity.  Inductions and cesarean sections go hand in hand.  Every physician in America needs to get a letter from Obama himself about this one.  They need to read their own textbooks which say that a normal length of pregnancy can be anywhere from 38 to 42 weeks and stop inducing women before 42 weeks.  Now.  This will save millions in reducing the cesarean rate, reducing the nursing staff requirements, and reducing the number of premature babies needing special care.

4. Spend money on taking excellent care of the women who do have cesareans.  Make sure that they have intensive care in hospital or at home to get started breast feeding and healing their uterus.  Cutting women open and then expecting them to go home and cope is costing millions in return stays in hospital and post partum depression.  We have to take care of the mothers so they can care for the children.  Investing money in this area will save medical dollars in the end.

This is just a beginning list.  What a beginning it would be if just these 4 things were implemented.

13 thoughts on “Ways to save millions of tax dollars in obstetrics

  1. Here’s another one — add home birth and birth-center midwives to insurance and government reimbursement. I know that some states and insurance companies do this already, but if they all did, it would save millions if not billions. Last June, I wrote a post in which I ran some numbers about the cost savings of having home births as a Cesarean preventative. The bottom line I figured if 30% of American women gave birth at home instead of the hospital (figuring a 10% transfer and 5% C-section rate of planned home births), then that would save $11,000,000,000 per year. (That’s a lot of zeros!!)

  2. Hear, bloody Hear! Such utter sense, and a reversal of criminal and inhumane behaviour

    You should be the advisor to Obama. Where is Michelle having her next baby?

  3. Hi Kathy,
    I’m a bit wary of “midwifery model of care” these days because it can mean midwives getting absorbed by the medical system and practising exactly the same way as the drs. I would like to see registered midwives in my province (BC, Canada) doing my four suggestions in the blogpost. Unfortunately, many of them just say “Oh, it’s your choice.” when parents want to know about keeping their son intact. Even though they have the medical evidence that inductions are dangerous, they still “offer” induction at 41 weeks. . . why do they “offer” something that is dangerous? Erythromicin eye ointment and Vit K are pushed unless the parents emphatically decline. So, when looking at ways to save $$$$, I think we have to be very specific and make it an across the board “standard of care” or it won’t make a difference.

  4. I’d add that hospitals should be required to allow VBACs. I had one c-section 5 years ago and I had to fight to have vaginal births with my two younger children even though I’d already had two vaginal births before.

    I totally agree with you on the circumcision. Medicaid in my state still pays for it. Unfortunately so does my private insurance. Not that it mattered to me. Both of my sons are intact. The hospital asked at least a dozen times when I had my younger son and we were barely there 36 hours. I think they must make a lot of money off of them so they want you to do it.

  5. How about those involved have to conform to the legal requirement of obtaining valid consent for any procedure? You’d see droves of women opting out of ultrasounds, amnios, inductions, augmentations, IVs, narcotic drugs in all forms during labor, improper positioning, episiotomies, vaccum and forceps births, and cesarean sections: as well as early cord clamping, HepB vax, separation, VitaK, etc.

    My oh my, all those unnecessary OB’s could then be transferred down to the emergency departments which are so understaffed right now. There’d be dollars enough for government funding in all 1st and 2nd tier hospitals for 24 hour in-house access to emergency only OB’s and anest.’s, making VBAC bans null and void, and hospital births safer. Even the shrinks would have less to do as slicing preventable birth traumas would cut the rates of PTSD and PPD. Babies as a group would be born healthier which would favorably impact long-term health and reduce lifelong healthcare costs.

    What a wonderful world it could be.

  6. Yes! Adding to the list:

    5) Universal Medicaid coverage for birth center and home births, including care by Certified Professional Midwives.

    6) A nationwide effort to respect normal birth and limit ALL obstetrical interventions to the small minority who really need them. This needs to be worked from both within the system and with a major PR campaign.

    7) Get serious about reducing c-sections. In 2000, the Centers for Disease Control and Prevention set a 15 percent c-section rate as a national goal for the United States by 2010. That should not be such a complete and utter joke.

  7. How much money would be saved if practitioners universally followed evidence based care during L&D, since the biggest expenditures occur during maternity “care”?

    This would include ceasing the demonization of midwives as seen on the HB Debate blog, run by one Harvard grad. It looks like she’s got a cute little girl with her in her blog photo, and I’d like to know if it would be OK for someone to fail to obtain consent, assault and batter, or perform a c/s or episiotomy for obvious non-medical reasons on that little one and her baby. If the answer from Harvard is a resounding “NO!”, then why is it OK for these thing to happen to other peoples daughters and babies?

    Why does Dr. A choose to persecute midwives instead of using her credentials to advocate for evidence based medicine? After all, she’s been educated as an OB, not a midwife, and it’s in every doctors list of things to do to keep up with the research, including the research which puts her peer group closer to jail sentences with every passing year.

    If Dr.s were doing their jobs, then women wouldn’t have to turn to midwives and doulas to avoid non-consensual sexual contact and grievous bodily harms. Some women of course, are more tenacious than average, do their research and actively choose a midwife the first time, but there is no denying that there is a growing community of women too scared to go back to the hospital after a previous experience with what constitutes routine care. By the time the institutions that be figure out that all they have to do is follow their own guidelines to keep their “clients”, it will be too late, midwifery care will be the norm.

  8. Until the profit is taken out of it (don’t C-sections cost an average of $20,000?), all these unnecessary medical interventions and procedures (circumcision, eye ointment, vitamin k, hep b shots, etc etc etc) will continue. They are solely profit motivated. I wrote and emailed the gov of Pennslvania Ed Rendell as well as the medicaid director of Pa. If they want to save money, they will end circumcision coverage of Medicaid.

  9. Another way to save money is to educate doctors and nurses about the foreskin.

    Many doctors still give the wrong advice that parents need to clean under the foreskin , some of them say don’t force it but gently retract it which makes it seem okay but it’s a Big “no no”– the only one needing to mess with the child penis is the child himself.

    Also, doctors don’t know how to differentiate Separation Trauma from Balantitis.

    I seen many posts of mom’s getting scared out of their mind because their son’s been put on antibiotics more than once for foreskin infections but when asked if it was swabbed they say ” no”.

    When you don’t know what ‘separation trauma’ is or what symptoms go with it, it can look really scary and problematic, but it’s not.

    My boy went through but I was prepared.  His whole penis and his foreskin were pinkish, reddish, inflamed, and swollen. It did hurt him, he had only a minor bit of smegma(normal), he got a sitz bath and all was better within 24 hrs.

    If I had taken him to the doctor, they proably would have diagnosed my son with balanitis without swabbing it because balanitis description is inflammation -right ? they might have prescribed oral rx and the antibiotic cream .

    The doc visit would been around 101 dollars, 60-90 dollars for the meds besides a required follow up within a week or after the other medicine was gone- possibly they might have tried to talk me into using a ‘steroid cream’ for a young child using excuses it’s not getting cleaned under there if you don’t do that then they will try and do the play of will need circumcision tactic for just separation trauma, normal ballooning, or many misdiagnoses of phimosis. Also, doctors do not know the alternative way to treat paraphimosis.

    If parents knew what is right with the foreskin, many would save money by keeping their son intact, avoiding unnecessary treatments, and unnecessary antibiotics.

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