On April 23, the Duchess of Cambridge gave birth to her third child in a posh London maternity center called the Lindo Wing inside St. Mary’s Hospital, where a small army of attendants looked after her and Prince William for 24 hours in a secluded, luxurious room at a cost of $8,900, according to the Economist. Mother Kate and her 8-pound, 7-ounce baby boy are hale and hearty by all accounts.
Most Western Europeans and Canadians, of course, don’t deliver babies in the Lindo Wing. Otherwise, however, their treatment and outcomes are pretty much consistent with the royal couple’s. Parents pay nothing for their maternity care and delivery, with low risks of maternal and infant mortality.
Americans, by contrast, are saddled with the worst maternal health care in the West. If they do not realize their system is in scandalous disrepair, it is only because they have become inured to it.
The average American woman gives birth in a noisy hospital with few frills or amenities and for an average cost of $12,290. Everything is quite average, in terms of quality and aesthetics in the birthing environment, except, on a worldwide scale, the costs. Should she require a cesarean section (an average of $16,907) or any emergency services, her bill could swiftly soar above $30,000. Have premature triplets and costs top $870,000. Young parents, at the beginnings of their careers and earnings, are on the hook for thousands of dollars, regardless of what health plan they may have.
Meanwhile, the U.S. infant mortality rate in 2017 was 6.1 deaths for every 1,000 births, which is about three times higher than Japan’s and is one of the worst death rates in the entire Organization for Economic Cooperation and Development (OECD). America leads the wealthy world in maternal death rates by far. According to the Institute for Health Metrics and Evaluation at the University of Washington, 26.4 mothers died of pregnancy-associated causes in 2015 out of every 100,000 births, which is three times the rate of the next worst, the United Kingdom, and more than six times the maternal mortality rates of Finland, Denmark, and Italy.
According to the National Academy of Medicine, the United States lags far behind the rest of the OECD for a long list of health problems, including maternal and infant mortality. In the OECD, only Turkey and Mexico had higher infant mortality rates than Mississippi, and the state with the best infant mortality in the United States — New Hampshire — would still rank way down at 28 in OECD stature. From 2001 to 2010, compared with the rest of the OECD, “the risk of death in the US was 76 percent greater for infants and 57 percent greater for children ages 1-19.” For the last two years, average life expectancy in the United States has fallen backward, now at a male/female combined 78.7 years. The average for the rest of the OECD? 80.3 years.
Americans also pay for the privilege of these terrible results. In 2016, Americans spent $3.3 trillion on health care, almost 18 percent of GDP. One study found that Americans used health care services at about the same rate as Europeans — perhaps even less — yet paid nearly twice as much for just about everything. As health economics analyst Martin Gaynor put it to NBC News, the whole health system is on an upward spiral, ultimately hurting patients the most: “When health care costs more, that means health insurance premiums are higher and when premiums are higher, employers pay more. Employees indirectly pay for most of that,” with higher deductibles, copays, and premiums.
Thanks to the Affordable Care Act (ACA), also known as Obamacare, fewer Americans are uninsured in 2018, though the Congressional Budget Office estimates that changes made by Republicans to the ACA will lead to loss of insurance for 9 million Americans by the end of 2019. But even the so-called fully insured quickly discover the U.S. system’s inadequacies as soon as they suffer a serious illness. A teacher in Andover, Massachusetts, says she was fired when the school board discovered her son’s cancer care cost $1 million. A woman recovering from back surgery was slapped with a $17,850 bill for lab tests that her insurer, Blue Cross and Blue Shield of Texas, refused to cover. Even Medicare recipients are suffering, with a third of them in 2013 spending at least 20 percent of their total annual income on out-of-pocket health costs.
Today, tens of thousands of Americans are crowdfunding their health care, searching for help to offset the costs that their insurance companies refuse to cover. The crowdfunding website YouCaring has a special section for medical fundraisers, through which strangers are asked to help pay for, for example, a teenager named Edoardo’s stage 3 cancer care or the treatment and physical therapy for teens Angel and John — he, shot by an unknown assailant and left paralyzed, while she is in a coma after having been run over by a vehicle fleeing the scene. Another popular crowdfunding website, GoFundMe, also has a special medical section, where Orla raised $80,000 for a lung transplant; Janie, $19,000 for Lyme disease care; Dave, $43,000 to deal with his brain tumor; and Tara, $30,000 for post-stroke rehabilitation.
It has come to this. America is a nation of beggars, forced to seek the pity of strangers who may, in turn, choose who shall live based on charity and who shall die for lack of financial support. A blonde 2-year-old girl in a ballerina tutu may garner more such kindness than a black 10-year-old boy in a Black Panther suit, who in turn gleans greater compassion from the online masses than a 50-year-old gunshot victim or an elderly Latina dying from diabetes. It’s like a macabre version of the 1950s TV show Queen for a Day, in which needy women pleaded for a fridge, dishwasher, new flatware, or a smart set of work clothes and an “applause-o-meter” was used to measure studio audience choices.
In a sensible health care system, there are no applause-o-meters; insurance actually covers patients’ costs; drugs and medicines are purchased in volume to bring down those prices; and life expectancy is independent of personal income. But America never had anything approaching such health care, and many on Capitol Hill would like to see the role of government as both a financer and regulator of health further diminished.
Prince William is estimated to be worth $40 million, and he stands to inherit some of his grandmother’s estate valued at well over $1 billion just in real estate. He can afford to spend the $8,900 for the best maternity care available in the U.K. Sadly, that is a burden few American couples aged 20-24, earning on average $27,300 per year, or 25- to 34-year-olds, with an average household income of $40,352 per year, could manage. But, of course, none of them can hope to find a hospital that will provide such a princely birthing bargain in the first place, as costs in the United States, for everything from basic to high-end care, are far higher. Even if they are fortunate enough to be well-insured through an employer plan, young Americans are likely to face deductibles of $3,000 to $5,000.
The results is that the royal couple paid about 0.000025 percent of their wealth to have their third child. For the less grandly wealthy young couples in the U.K., the National Health Service bears most of the costs of vaginal childbirth. Costs for a typical young couple having their first child in the United States are 13 times more than those shouldered by their U.K. counterparts. A typical set of U.S. parents puts out about 10 percent of their wealth to pay the uncovered portion of maternity costs.
It may be an overstatement to say that every American baby deserves to be born in the equivalent of the Lindo Wing, costing just $8,900. But it damned well ought to be true that every mother goes through labor in a safe, clean, comfortable setting, her baby caught by a competent caregiver, without parents fretting over how in the world they will pay their newborn’s medical bills.