Monday, March 16, 2009
If I Were an Insurance Company, I Would NEVER Pay For an Elective C-section
If I were an insurance company, I would not allow women to choose to have a C-section for no medical reason. It would cost me twice as much money as a vaginal birth. I would, however, be happy to pay for out-of-hospital births, as it costs me a fraction of the money a hospital birth does.
Oh wait, the only people I actually listen to, as an insurance company, is doctors and hospitals, who have a financial interests in these policies. This is not about evidence-based care. It's about putting the doctor on a pedestal and ignoring the midwife. The doctors are thrilled to allow a woman to selfishly choose to have a C-section because it fits nicely into the doctor's schedule, and, oh yeah, cha-ching, it's twice as much money! The doctors have done a great job of convincing me, the insurance company, how dangerous, reckless, and incompetent a midwife, especially a CPM or LM, is -- the smear campaign rages on against midwives.
How can I, as an insurance company, in good judgement, take the advice of people who stand to gain financially by their recommendations? The majority of doctors are trained to believe that birth is dangerous and needs to be managed. The only place this can be done is in the hospital. They are convincing the insurance companies that homebirth is unsafe and women who choose to do this are placing their babies lives at risk. (But let's go ahead and make abortion legal and accepted.) Birth is safe for mothers and babies, as most midwives know and believe, because they see it and live it, day in and day out.
I have had a number of students who have wanted to have their baby at home or at a free-standing birthing center, only to be told that, no, they may only give birth in the hospital. They have a choice of several doctors but only one or two midwives. But if I am an insurance company, and I am in this for money, why am I ignoring a viable option -- homebirth? Why, from a financial standpoint, am I covering a woman to have surgery to remove her baby because she is too scared to go through labor and give birth vaginally? (I am not even going to address the moral and physical reasons why this woman is an idiot.) I am paying thousands of dollars for a procedure that in 100% unnecessary. The irony is so thick, it makes me sick. And women who want to spend a fraction of what they would be allowed to spend if in the hospital are denied that option? Unbelievable.
When will the insurance companies begin to listen to midwives and to informed consumers who want to birth their babies at home? We have to speak up to be heard. Insist on options from your insurance companies. They have to provide you with options. I actually had my first homebirth reimbursed by our insurance company because they failed to give me all the information when I insisted that I needed options. They could not make me give birth at that one hospital. There was another hospital they were contracted with, but I was not given that information until the baby was 5 weeks old. After 3 appeals, I had a hearing where we all sat around a big conference table listening to the recording of the phone conversation where I was told that I had no options. Needless to say, we were fully reimbursed for our entire homebirth. But we didn't know that would happen at the time we hired our midwife and we still made the choice to pay, out-of-pocket $2500, instead of our $100 co-pay at the hospital.
I am not a fan of going into debt, but I do believe that sometimes we have to take our healthcare into our own hands and not leave it to the insurance to make all our choices for us. Fight for your right to birth your baby where you see fit. Maybe, just maybe, we'll be heard. It's more important now than ever, as the AMA is on a campaign to make it impossible for homebirth midwives to practice. If a woman wants a homebirth, she would have to illegally hire a midwife to attend her birth. This is wrong. Women deserve this choice in childbirth. They can legally kill their babies through abortion and choose to have them surgically removed from their bodies, but they can't lovingly and fearlessly birth their babies in their own homes and beds with midwives who believe in the natural process of birth.