When the Duchess of Cambridge last gave birth, though she had access to certain amenities usually not available to the average person, the cost was the equivalent of $18,000. While the cost of childbirths in the US are very hard to determine due to various rates in different states and different hospitals, one study estimates them at about $32,000 for a vaginal delivery and $51,000 for a caesarean section. Although insurance may cover most of the costs for those who are insured, the average out of pocket cost for a delivery is estimated at $3,400. While many deliveries are covered by Medicaid, many are still uninsured. And when things go wrong from pre-eclampsia, to premature births, then the costs are even higher. Childbirth costs in the US are the most expansive of the developed world. In Spain for example, the average birth costs less than $2,000. Add to this the fact that infant mortality is higher in the US, 6.1 for every 1000 births, a rate that is higher than that of Slovakia and Hungary and about three times the rate of Japan and Finland. What compounds these numbers is that the US also has the highest rate of maternal mortality in the developed world. Thus the US is not only the most expensive nation in the developed world in which to give birth to a child, it is also the riskiest. The unexpected costs have driven many to bankruptcies. One woman in New Jersey who gave birth to twins prematurely and who had insurance went to a network hospital but it turned out the ambulance and some doctors such as anesthesiologists were not. Her bill was $877,000. With the help of a Medical Cost Advocate—I didn’t even know they existed—whose services I am sure are not free, she was one of the lucky ones, the bill was whittled to $1,300.
Given the structural problems of the US health care system, such realities may not be surprising, and yet they are an acute reminder that we should not ignore them.