Cost of Giving Birth Varies 10-Fold, Study Finds

PHOTO: The cost of having a baby in California vary more than tenfold.
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While you can now determine the sex of your baby before he or she is born, figuring out what it costs to give birth remains a mystery. That's the conclusion of a University of California at San Francisco study that looked at more than 75,000 births in California.

The study found that healthy women who gave birth normally with no complications could be charged anywhere from $3,296 to $37,227 depending on which hospital they visited. The price of an uncomplicated C-section ranged anywhere from $8,312 to nearly $71,000.

Pricing seemed to follow no rhyme or reason. For-profit hospitals in wealthier areas and facilities that treated a greater number of seriously ill patients did tend to charge higher rates, but those factors only counted for about a third of the pricing variation, according to Dr. Y. Hsia, MD, an associate professor of emergency medicine at UCSF and the study's lead author.

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"The majority of the discrepancies couldn't be explained and there was no consistent pattern," she said.

For example, the study found that at Alameda County Hospital, in Northern California, the average adjusted cost for giving birth is $11,251. Just a few miles down the road at Alta Bates Medical Center, the average cost was $27,001.

An uninsured or underinsured family welcoming a new member could potentially be hit with the entire bill, which could total a few thousand dollars or tens of thousands of dollars, she pointed out. Even in a state like California, which passed fair pricing laws in 2006, discounts for the uninsured aren't regulated and hospitals can charge whatever they want.

Patients with plenty of insurance are impacted by cost variations too, Hsai said. As insurers shift a larger percentage of health care costs onto consumers, new families are increasingly sharing the burden of these unpredictable costs. Higher averaged pricing is also reflected in skyrocketing premiums.

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"The issues become masked as more people become insured," she said. "They think they aren't paying, but they are indirectly through their premiums."

Worse, there seemed to be no way to avoid the sticker shock. Comparison shopping was virtually impossible, Hsai found. Doctors and hospital staff often have no clue what the charges will be and patients have no way of finding them out until they receive the bill.

"It's not part of the physician culture to worry about costs, but it's going to have to be," she said.

What all the inconsistent pricing found in the study means, Hsia said, is that the system is broken. And with virtually no regulation, there doesn't seem to be a way to get it under control.

"Unlike other industries, the way health care is priced doesn't appear to be influenced by market factors or consumer demand. That makes it difficult for patients to act as educated, price-comparing consumers," she said.

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