who pays for elective c-sections? - Page 2 - Mothering Forums

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#31 of 52 Old 08-26-2005, 06:58 PM
 
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OK, I'm confused today, what is the difference between elective and convenience?
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#32 of 52 Old 08-26-2005, 07:23 PM
 
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Personally, I see elective as someone who has had a previous section or has been given information that would lead a Mama to believe that a C/S would be safer for her birth.
Convenience might be someone whio has a C/S to deliver at a certain time, to avoid the pain/inconvenience of labor, basically a reason that is not a medical reason.
That is JMHO of course.
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#33 of 52 Old 08-26-2005, 07:51 PM
 
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Originally Posted by mara
OK, I'm confused today, what is the difference between elective and convenience?
The medical profession only classes c-sections as "emergency" and "elective". So, the two c-sections I was bullied into having for stupid reasons are both "elective"...even though the last one was under threat of losing my care provider - at 41w, 4d...and about four hours before I went into labour.

Technically, I suppose it was "elective", as I did sign the papers...but I wasn't really given any options.

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#34 of 52 Old 08-26-2005, 08:37 PM
 
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Originally Posted by Full Heart
The site is down but the hospital closest to me has a prepayment plan for birth. I think c/s was double what unmed birth was. But the site is down and I can't remember exactly but I think it was $1800 for unmed and $3600 for c/s. And of course this is for out of pocket not insurance companies. I am sure they get alot more from insurance co than they do from out of pocket since thats always the way it works.

Michelle
My unmed birth was around $4000 including postpartum care and nursery care. Even though my dd was never in the nursery. My out of pocket cost was about a grand.

Heather Mike Married 8/1/99 Mom to Charlotte Aug 04, Nov 06, and Katherine Oct 07
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#35 of 52 Old 08-26-2005, 10:20 PM
 
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The medical profession only classes c-sections as "emergency" and "elective".
Exactly. It is a great frustration of mine. When you hear the term elective, it leads you to think the person elected (chose) to do something. And the truth is a good deal of elective c-sections happen because the mother has no other choice. Consider a baby in a transverse lie--babies can't come out sideways; it's physically impossible. So mama has to have a c-section. That's going to be marked down on her paperwork as an elective c-section. I had two c-sections because of breech babies, and I really had no other choice at the time, as the hospital I was at only sectioned breeches. But it was still marked down as elective, as if I could have, I don't know, reached up there and yanked the kid out myself instead.

That's why I've got such issues with the attacks on elective c-sections. If you have a c-section because you have no real way to go against hospital policy (esp. in regards to a breech) or any of the other number of valid reasons, it's not the same as scheduling a c-section because you don't want to be bothered with labor.

And if you say that "elective" c-sections shouldn't be covered by insurance, you encounter the issue of why should any certain type of birth be covered by insurance. You want insurance to accept your desire for a home waterbirth, then you'd better be prepared for insurance to accept Mrs X's desire for a c-section.

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#36 of 52 Old 08-26-2005, 10:26 PM
 
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Originally Posted by Sagesgirl
And if you say that "elective" c-sections shouldn't be covered by insurance, you encounter the issue of why should any certain type of birth be covered by insurance. You want insurance to accept your desire for a home waterbirth, then you'd better be prepared for insurance to accept Mrs X's desire for a c-section.
This led me to an interesting thought. Maybe the birth climate would be better if we went back to when birth wasn't usually covered by insurance...

I'd be happy to pay for my homebirths out of pocket if everyone else paid for their births out of pocket...

-Angela
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#37 of 52 Old 08-27-2005, 02:06 AM
 
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Originally Posted by alegna
This led me to an interesting thought. Maybe the birth climate would be better if we went back to when birth wasn't usually covered by insurance...

I'd be happy to pay for my homebirths out of pocket if everyone else paid for their births out of pocket...

-Angela

Ah, but then what's the point of carrying more than catastrophic health insurance? I'm young and healthy - prental care and birth are the biggest healthcare expenses I'm likely to face for a while, LOL. A few thousand dollars is a large chunk of annual income for us paycheck to paycheck types. That would be a lovely way to turn the birth of a child into an enormously dreaded financial disaster I think. Which is why we're at where we're at I suppose.
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#38 of 52 Old 08-27-2005, 02:29 AM
 
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Originally Posted by JanetF
In the UK (around a 20% c-sec rate so slightly better than US and Australia) each c-sec goes before a peer review panel and the OB has to justify it. That would alleviate the problem of insurers having to do it.
This is what was done in the U.S. before 1960. Any doctor who had a higher than 12% rate of caesarean section delivery was considered a pariah.

I seem to remember that pregnancy and delivery were not even covered by health insurance at that time also since pregnancy and birth were considered normal functions of the human body and not accidents.

I know I read that in one of my Father's many books.

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#39 of 52 Old 08-27-2005, 02:31 AM
 
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The title of this thread asks, "Who pays for elective Caesarean Sections?"

The answer is, "We all do."

WE all pay for them in the form of higher taxes, higher hospital costs and higher insurance rates.

If the baby is premature and has health or learning problems later in life, we pay for that also.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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#40 of 52 Old 08-27-2005, 02:31 AM
 
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You're exactly right that would make us only need insurance for big things too. We haven't used our insurance for ANYTHING except the birth- and we have good insurance. Paycheck to paycheck here too....

-Angela
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#41 of 52 Old 08-27-2005, 02:33 AM
 
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Quote:
Originally Posted by alegna
This led me to an interesting thought. Maybe the birth climate would be better if we went back to when birth wasn't usually covered by insurance...

I'd be happy to pay for my homebirths out of pocket if everyone else paid for their births out of pocket...
I second that.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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#42 of 52 Old 08-27-2005, 11:42 AM
 
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I've never heard of a c/s being refused payment by an insurance company, no matter the reason. I'm not saying it doesn't happen, but I think in general c/s are easy to justify.

Quote:
The title of this thread asks, "Who pays for elective Caesarean Sections?"

The answer is, "We all do."

WE all pay for them in the form of higher taxes, higher hospital costs and higher insurance rates.

If the baby is premature and has health or learning problems later in life, we pay for that also.
:

Quote:
I think I read that these days c-section and regular birthing costs at a hospital are comparable, therefore I don't think insurance companies have that large a stake either way a woman births.
In our area, the costs are quite different. The hospital costs are about $2000 for a vaginal birth versus $6000 for a c/section. Then there is also the difference in doctor fees--$2400 for a vaginal or $3100 for a c/s plus $500 for the second doctor who is required to be there at a c/s.

There has been a study done demonstrating that when insurance companies begin reimbursing a c/s birth at only the amount they reimburse for vaginal birth, the rate of c/s falls by 10% within a year.

Quote:
OK, I'm confused today, what is the difference between elective and convenience?
Obviously we need more descriptive terms. Generally emergency c/s means the decision was made after labor was in progress, and elective means the decision was made beforehand. The *reason* is not considered in either of these. IMO if the reason was a medically necessary one, then heck yeah it should be covered by insurance. If the reason was not medically necessary, then no it shouldn't. Obviously that's pretty open to interpretation though...

Quote:
Originally Posted by Sagesgirl
And if you say that "elective" c-sections shouldn't be covered by insurance, you encounter the issue of why should any certain type of birth be covered by insurance. You want insurance to accept your desire for a home waterbirth, then you'd better be prepared for insurance to accept Mrs X's desire for a c-section.
Ahh, see that's the biggest part of my gripe. My homebirth, which at $1800 is only a fraction of the costs incurred by any OB/hospital birth, was not covered at all. So, if my birth is not covered, then certainly I don't agree with a convenience c/s being covered. No births should be excluded from at least a basic coverage. Then if someone wants to go above and beyond the basic and doesn't have a medically necessary reason to do so, I think the difference should come out of their pocket and not mine (in the form of higher insurance costs).
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#43 of 52 Old 08-27-2005, 01:01 PM
 
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OK, regarding elective vs convenience, I guess I wasn't considering the transverse and such as "elective" c-sections. I know technically for charting and billing purposes those are elective. In this discussion I wasn't considering them because really, while it isn't a crash c-section, it ought be considered emergency IMO since at some point it would be an emergency situation, I mean otherwise the baby aint coming out, YK?

So for the sake of this discussion, surely we aren't talking about who would pay for elective c-sections where a transverse baby or placenta previa is concerned, right? By elective in this discussion we mean pretty much the same thing as convenience otherwise I don't see there should be any question as to who should pay. If you need one you need one.
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#44 of 52 Old 08-27-2005, 01:09 PM
 
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Originally Posted by huggerwocky
There are states giving you the right to one? I am genuinely flabbergasted...Do other states have that law,too?
Suprised? If a woman has the right to choose an abortion, why would she not have the right to choose a C-section. Its her body! I do not agree with it, but you can not take one extreme and not accept another...
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#45 of 52 Old 08-27-2005, 01:18 PM
 
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Originally Posted by HeartsOpenWide
Suprised? If a woman has the right to choose an abortion, why would she not have the right to choose a C-section. Its her body! I do not agree with it, but you can not take one extreme and not accept another...
Exactly- but if insurance and the state don't cover one, why cover the other?

-Angela
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#46 of 52 Old 08-27-2005, 09:50 PM
 
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Originally Posted by alegna
Exactly- but if insurance and the state don't cover one, why cover the other?

-Angela
Because c sections are not the same as abortions. C sections enable life. If a woman is willing to bring life into this world, but wants it via c section, that's her right.

I have no problem with elective c sections being charged the extra money. In fact, it cost me more out of pocket to have a c section, even though I had placenta previa. I was fine with it.
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#47 of 52 Old 08-27-2005, 10:08 PM
 
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[QUOTE=leomom]Because c sections are not the same as abortions. C sections enable life. If a woman is willing to bring life into this world, but wants it via c section, that's her right. QUOTE]

Exactly - to compare C/S and abortions is actually quite offensive to me.
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#48 of 52 Old 08-27-2005, 10:16 PM
 
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[QUOTE=TCMoulton]
Quote:
Originally Posted by leomom
Because c sections are not the same as abortions. C sections enable life. If a woman is willing to bring life into this world, but wants it via c section, that's her right. QUOTE]

Exactly - to compare C/S and abortions is actually quite offensive to me.
Yes. I may have accidentally started that. I get a little defensive when people condemn elective c sections because most of those women are pro choice under the "it's my body" stance. I find it odd that those same women oppose elctive c sections.

Ironically, I am against abortion, but I think I should have the right to decide how I have my baby.

I brought it up to say that if you are pro choice, you might want to rethink your open condemnation of elective c sections. This of course is still off topic. We were talking about who should pay for it...I think?!?! :LOL
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#49 of 52 Old 08-27-2005, 10:39 PM - Thread Starter
 
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Quote:
Originally Posted by alegna
This led me to an interesting thought. Maybe the birth climate would be better if we went back to when birth wasn't usually covered by insurance...

I'd be happy to pay for my homebirths out of pocket if everyone else paid for their births out of pocket...

-Angela
No,sorry....like that the cost stays with the women, or do you want dads to be forced to pay 50%?
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#50 of 52 Old 08-27-2005, 10:41 PM - Thread Starter
 
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Originally Posted by HeartsOpenWide
Suprised? If a woman has the right to choose an abortion, why would she not have the right to choose a C-section. Its her body! I do not agree with it, but you can not take one extreme and not accept another...
Well, it sounded like you're legally entitled to one leading to the insurance therefore has to pay.
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#51 of 52 Old 08-27-2005, 10:43 PM - Thread Starter
 
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[QUOTE=leomom]
Quote:
Originally Posted by TCMoulton

Yes. I may have accidentally started that. I get a little defensive when people condemn elective c sections because most of those women are pro choice under the "it's my body" stance. I find it odd that those same women oppose elctive c sections.

Ironically, I am against abortion, but I think I should have the right to decide how I have my baby.

I brought it up to say that if you are pro choice, you might want to rethink your open condemnation of elective c sections. This of course is still off topic. We were talking about who should pay for it...I think?!?! :LOL

I agree a woman should have the birth she wants,regardless of what that actually contains

I'm just trying to learn more about the american health care system...and truly did not have an answer to this.
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#52 of 52 Old 08-27-2005, 10:53 PM
 
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[QUOTE=huggerwocky]
Quote:
Originally Posted by leomom


I agree a woman should have the birth she wants,regardless of what that actually contains

I'm just trying to learn more about the american health care system...and truly did not have an answer to this.
Right...I know...sorry... I just got all fired up in the debate that ensued off topic. I've got dh searching for the legalities now and I'll post a link when he finds something.
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