As Republicans in Congress scramble to pass their latest effort to repeal and replace Obamacare by the end of the month, it's worth looking at where American health care currently falls short — and why.
For example, pregnant mothers in the U.S. have a mortality risk that's three times higher than in the U.K., according to an investigation by ProPublica and NPR. Yet, while labor and delivery is vastly safer in Liverpool than it is in Louisiana, it's also vastly cheaper there.
In U.S. dollars, it costs $2,300 on average for a vaginal delivery or planned C-section in the U.K., or $3,400 for a more complicated procedure. By contrast, it costs $30,000 for the former and $50,000 for the latter in the U.S.
In other words, a straightforward birth costs about 13 times more in America, and a complicated birth costs almost 15 times more.
And that's despite the fact that American outcomes are far worse. "The U.S. maternal mortality rate rose by nearly 27 percent between 2000 and 2014," according to a study by the University of Maryland. "For every 100,000 live births, nearly 24 women died during, or within 42 days after pregnancy in 2014. That was up from nearly 19 per 100,000 in 2000."
Many differences account for the disparity in cost as well as quality in the U.S., both of which have grown measurably worse over the past five or six decades. American women mostly see OB-GYNs, for one, and U.S. doctors have a financial incentive to schedule more tests, scans and procedures, including C-sections. More medical interventions means more side effects and more potential problems.
Women in the U.K., by contrast, largely consult with midwives, who prioritize low-intervention pregnancies and natural childbirth.
A straightforward birth costs about 13 times more in America.
The main difference, though, according to the ProPublica and NPR findings, is that the U.K. maintains strict country-wide standards that help practitioners care for all of their patients before, during and after childbirth.
The U.S. does not have universal health care or strong federal standards. As a result, the results are wildly unequal: Women who can't pay for first-class care can receive substandard care — meaning that too often they, as well as their infants, die.
And while poor women (as well as African Americans and those living in rural areas) have higher mortality rates during and after pregnancy in the U.S., according to ProPublica and N.P.R., in the U.K., that's not the case: "[T]here is no statistically significant difference in mortality rates between women in the highest and lowest socioeconomic groups. All British women have equal access to public medical services," says the report.
However, in the U.S., the problem exists beyond inner cities and impoverished rural areas. The large and affluent state of Texas, for example, has the highest pregnancy-related death rate not just in the U.S. but in the entire developed world.
These are some of the reasons why, in a 2017 analysis of 11 rich, Western countries by the Commonwealth Fund, the U.S. comes in 11th. The U.K. comes in 1st.
Unfortunately, experts say, Graham-Cassidy will not improve either the cost of American health care or its quality. Indeed, they worry that it may make a bad situation worse.
In a joint statement released over the weekend, the major health insurance, physician, and hospital groups all pleaded with the Senate not to pass the bill.
"While we sometimes disagree on important issues in health care, we are in total agreement that Americans deserve a stable healthcare market that provides access to high-quality care and affordable coverage for all," reads the statement. "The Graham-Cassidy … bill does not move us closer to that goal. The Senate should reject it."
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