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Money Out-of-pocket cost of having a baby skyrockets, largest rise in out-of-hospital obstetrics

15:52  13 january  2018
15:52  13 january  2018 Source:   abc.net.au

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Some Australian parents are paying 1,000 per cent more out of their own pockets to have a baby than they did 25 years ago, a new report says, with experts predicting the high cost will push people away from private treatment and put more pressure on the public system.

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New research from James Cook University analysed data from the Medicare Benefits Schedule from 1992-3 to 2016-17, revealing how out-of-pocket costs have changed for care both in and out of hospital.

Researcher Emily Callander said obstetric care had the highest out-of-pocket costs of any service covered by Medicare.

"Between 1992-3 and 2016-7, the largest average increase in any [service] was for out-of-hospital obstetrics, which rose by 1,035 per cent," she said.

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But the blitz of invoices that followed made me question whether my UnitedHealthcare insurance was worth it. Anyone who’s been treated at a hospital or had an imaging scan in the last few years knows that out - of - pocket costs have spun out of control.

"Out-of-pocket costs for obstetric care in-hospital rose by 77 per cent."

After adjusting for inflation, the 1992-93 out-of-pocket charge for out-of-hospital obstetric services was $23.35. In 2016-17, the average cost had risen to $265.

The 1992-93 in-hospital charge was $442.00, rising to about $782 in 2016-17.

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Researchers found that out-of-pocket costs increased in all locations, but the charges were consistently above the national average in major cities.

The research, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, calls for greater transparency when it comes to costs for patients.

"There is a strong need across all the medical professions for greater transparency of fees, allowing patients to make use of the free market system and choose providers based on value," she said.

The costs of providing obstetric care have risen significantly, according to leading doctors.

Australian Medical Association (AMA) president Dr Michael Gannon is an obstetrician and gynaecologist who ran his own private practice.

"Twenty-five years is a long time, and there are things about delivering a baby that look remarkably different today than they did 25 years ago," Dr Gannon said.

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During that period, out - of - hospital births rose from less than 1 percent to 1.5 percent of U.S. births. “Other factors that improve patient safety are having an experienced and properly trained midwife who has an existing relationship with an obstetrician or hospital in case a patient develops complications

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"Back then, only a few obstetricians would have an ultrasound in their office, but today an overwhelming number would.

"That's a piece of machinery that costs tens of thousands of dollars."

He said obstetricians faced one of the highest professional indemnity insurance costs of any medical specialty — 20 times higher than a GP.

"I myself was paying around $100,000 a year in insurance, and I think cost to obstetricians would be one of the biggest changes of the last 25 years," he said.

But consumer groups say the increase in out-of-pocket costs should be a wake-up call to doctors and the Government.

Chief executive of the Consumers Health Forum, Leanne Wells, said high out-of-pocket medical costs would drive people away from private treatment, creating pressures for both the public and private health systems.

"This report finding an increase of more than 1,000 per cent in out-of-hospital obstetric charges in the past 25 years is only part of the picture," she said.

"Obstetricians may also be charging thousands of dollars, not covered by the study's statistics, to 'manage' pregnancies."

The Federal Government has set up a taskforce to look at out-of-pocket healthcare costs.

"The review into medical costs has come not a moment too soon and the Consumers Health Forum will be pressing the Government for consumer-friendly measures to make clear to all the costs patients now have to bear themselves," Ms Wells said.

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