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Published March 23, 2013, 11:35 PM

Hospital bills for having a baby significant compared to past

HAWLEY, Minn. – Beverly Rolland’s birth on June 12, 1939, cost $30.55. Rolland recently found the old bill and was shocked at the price of her delivery.

By: Anna G. Larson, INFORUM

HAWLEY, Minn. – Beverly Rolland’s birth on June 12, 1939, cost $30.55.

Rolland recently found the old bill and was shocked at the price of her delivery.

“Oh my heavens, can you imagine? Only $30!” Rolland says.

That $30.55 was paid out-of-pocket since Rolland’s parents didn’t have insurance. With today’s inflation, $30.55 is equivalent to $510.26, according to the Bureau of Labor Statistics’ inflation calculator.

But the cost of birth in the modern world is far more expensive than $510.26. The typical pre-insurance cost of a no-complications vaginal birth at Sanford Medical Center ranges from $5,800 to $8,300, says Roberta Young, Sanford’s vice president of women’s and cancer services. Essentia Health declined to comment on birth costs for this story.

The average pre-insurance cost of delivery by Cesarean section in the Midwest is $17,262, according to the U.S. Department of Health & Human Services.

“You would think that the cost should still be around $30, but of course, it’s not,” Young says.

Rolland’s bill listed only three charges: $25 for seven days of room and board at the hospital, $2 for an anesthetic and $3.55 for drugs and medicines.

Present-day bills typically include similar charges plus others, although the cost has increased and new moms usually don’t stay in the hospital for longer than two days after the birth.

“Those seven-day stays were glorious in some ways. It was certainly a different day and age,” Young says. “Also, we know today that sometimes, longer hospital stays aren’t the best.”

Young also notes that in 1939, new moms probably had generations of women caring for them and their new baby at home. She says that modern families are prepared for the baby’s arrival but grandparents might move in for a week to help.

“In this fast-paced age, it’s interesting how we bring a new baby into the world and who we bring in to help us and support us during those really formative days and weeks,” Young says.

Additional factors that affect cost include sterile medical supplies, hospital rooms, technology and drug costs, Young says. The cost of professional staff is also higher than it was decades ago.

“We want to hire the best and the brightest of nurses and physicians and technicians to care for our patients – and then we want to pay them fairly,” she says.

The national annual salary for an OB-GYN is $186,060 to $365,180, with a median salary of $255,507, according to reports compiled by Salary.com. WebMD’s Medscape listed a mean income of $220,000 nationally for OB-GYNs, $232,000 for those in the North Central region, which includes North Dakota, and $245,000 for OB-GYNs in the Great Lakes region, which includes Minnesota.

“The cost of having a baby follows the health care trend costs like anything else,” Young says. “Overall, how we do things today with the advancements we have is making this again, a health model. We expect things to go great, but we have the high-tech waiting if something isn’t going well.”

Health expenditures in the U.S. neared $2.6 trillion in 2010, more than 10 times the $256 billion spent in 1980. The growth rate in recent years has slowed compared to the late 1990s and early 2000s, but The Kaiser Family Foundation says it’s expected to grow faster than national income in the foreseeable future.

Alicia Schlenner of Fargo gave birth to her third child on Oct. 7. The no-complications vaginal birth cost $4,714.55 before insurance. The price includes the delivery and the baby’s exam after birth.

Schlenner estimates that she paid about $1,500 to $1,600 of her bill, and insurance took care of the rest.

“If I didn’t have insurance, we would not have had our third child. The cost was stressful even with insurance,” Schlenner says.

In 1939, the median annual household income was $1,389, according to the U.S. Census Bureau. A hospital bill of $30.55 would have taken about 2 percent of a family’s annual income.

The median household income in North Dakota today is $49,415, so paying off a delivery bill ranging from $5,800 to $8,300 would take about 12 to nearly 17 percent of the family’s annual income. In Minnesota, it would take 10 to 14 percent of the household’s annual income of $58,476 to pay off a $5,800 to $8,300 bill.

For households with only one income earner, the impact of a bill ranging from $5,800 to $8,300 is greater. In North Dakota, they’d pay 21 to 30 percent of their annual income of $27,305 for the delivery; in Minnesota, 19 to 27 percent of their annual income of $30,310.

The 84.3 percent of Americans who have health insurance likely won’t feel the impact of delivery charges on their wallets as much as the uninsured.

For instance, Blue Cross Blue Shield of North Dakota members typically pay 12 percent or less of the hospital’s charge for a “normal” delivery and 9 percent or less of the hospital’s charge for a delivery with complications, according to a spokesman from Blue Cross Blue Shield of North Dakota. C-sections are included in the “birth with complications” category.

Based on Sanford’s average cost numbers and the information from the U.S. Department of Health & Human Services, insurance takes the vaginal birth cost down between $870 to $996 and C-sections to $1,553,58.

The total amount paid out-of-pocket varies based on a member’s specific plan, says Sharon Fletcher, senior vice president of Health Network Innovation at BCBSND.

Kelcie Quiel benefited from insurance when she gave birth June 9. Her son was delivered via a planned C-section but he came early, which she says probably upped the cost of his delivery. The delivery had a pre-insurance price tag of $30,026.25.

“I didn’t realize it was going to be that much, but I knew it was going to be quite a bit,” she says.

Quiel paid about $3,000 out-of-pocket for her four-day stay and the delivery. Her two other children were also delivered via planned C-sections, and she paid $6 after insurance for each since she was on a different insurance plan.

The Centers for Disease Control and Prevention says births by C-section account for nearly 33 percent of all deliveries nationwide. Sanford says its monthly C-section rate is 26 to 28 percent.

“If I had to pay that whole thing out-of-pocket, there’s no way I would’ve been able,” Quiel says.

When Rolland learned the price of a present-day birth, she was surprised, just as she was when she saw the 1939 birth bill. She reminisced about cheaper hospital bills and long hospital stays that were common even in the 1950s, when she had her first child.

“Even though it cost less back then, there was luxury in hospitals, in a different way,” she says. “It was all we knew.”


Readers can reach Forum reporter Anna G. Larson at (701) 241-5525

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