Maternity care is a money loser

Over the past 10 years, 11 of Philadelphia's 19 obstetrics units have closed their doors.

Published May 8, 2007 9:30PM (EDT)

I hardly claim to have a solution to the massive problems facing the American healthcare system, but this seems particularly messed up: According to the Philadelphia Inquirer, next month there will only be eight hospitals in Philadelphia that deliver babies, down from 19 a decade ago. Why? Because maternity care is a "money loser."

Yup. On May 31, Jeanes Hospital is closing its maternity ward, blaming "financial losses and a deluge of patients who previously might have gone to other, now-defunct, maternity wards." That makes 11 Philadelphia hospitals that have closed their maternity wards over the past decade.

Not to sound panicked or anything, but this seems pretty bad, no? As the Inquirer explains, "maternity care is a money loser for most hospitals, and there is no break-even point, hospital leaders and financial consultants say. Losses rise with the number of patients -- especially when those patients are poor. The culprits are high expenses for malpractice insurance and relatively low reimbursements from health insurers, the experts said."

Personally, I don't think the fault lies entirely with the hospitals (Jeanes claims to have lost close to $2 million this year on its obstetrics program, up from $200,000 five years ago). Insurance companies seem to be causing a bunch of the problems. But regardless of who's at fault, we still need to figure out a way to make obstetrics an appealing field for young doctors, lest today's financial problems scare off medical students who might otherwise have chosen that specialty. After all, maternity care may not be as sexy or lucrative as, say, plastic surgery, but it's also a business with a guaranteed demand -- women are always going to be having babies. I'm no businesswoman, but it seems as if there's an opportunity in there.

In the meantime, there are a couple of proposed solutions to Philadelphia's crisis. According to a briefing from the Kaiser Family Foundation, the Hospital and Healthsystem Association of Pennsylvania is lobbying for a state-supported "obstetrics stabilization fund" that would "increase Medicare reimbursements for intensive care for pregnant women and infants." The group also wants "state assistance in reducing malpractice insurance costs." And the Maternity Care Coalition is "urging Pennsylvania to identify hospitals that have shortages of obstetricians and provide them with extra funding."

By Catherine Price

Catherine Price is an award-winning journalist and author of Vitamania: How Vitamins Revolutionized the Way We Think About Food. Her written and multimedia work has appeared in publications including The Best American Science Writing, The New York Times, Popular Science, O: The Oprah Magazine, the Los Angeles Times, The San Francisco Chronicle, The Washington Post Magazine, Salon, Slate, Men’s Journal, Mother Jones, PARADE, Health Magazine, and Outside. Price lives in Philadelphia.

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