York Hospital and Dispensary Bill For Delivery in 1922

A week ago I was leaving the hospital by way of the old original entrance.  I was a visitor, not a patient.  I had several surgeries there for cancer, and since my daughter was adopted I had not had the experience of the delivery room and the faded crinkled 3" x 6" bill in the historical display case caught my eye.  I was not expecting to be stopped by a slip of paper since I had gone to the hospital on a mission and I was focused on that.

I was there as a collector of colored plastic disks.  My niece, an anesthesiologist in Los Angeles, wondered why the brightly colored caps from the injectibles used in the OR were discarded.  Could they serve another purpose? she thought.  So she created "TheArtOperation.com."  The caps from the vials of medication that were used to put people to "sleep" (actually into a light coma, she corrected me) and then brought back to awareness could do service as art objects.  They could be saved and given to children and even established artists to inspire them to create something of beauty (or whimsy).  But as I carried the bag of these reminders of surgery back to my car I reflected on the simple hospital bill and the stories I've heard about the high cost and the anxiety of carrying and delivering a baby, and I was disturbed.


The carefully-itemized typed and then the hand-annotated bill was for a total of $49.75! Yes, $49.75.  The bill was transparent.  
There were no cryptic billing codes (one for this, another for that, and one for who knows what), only English words and a few straightforward numbers. (The only expense not on the bill might be for the daily two-cent newspaper.)  As I said, I've listened to women's stories and I wondered what today's deliveries cost and how they are billed and how they are paid for, and how this affects the birth experience.

So I googled.  In the US the average total price charged now for pregnancy and newborn care is about $30,000 for a vaginal delivery and $50,000 for a C-section, with insurers paying out an average of $18,329 and $27,866, according to a recent report by Truven Health Analytics.

And the bill itself?  A long list of sometimes carefully-itemized charges including those for the use of the delivery room itself, the recovery room if there's been a C-section, the mother's room and board before and after delivery, the nursery, the anesthesia or epidural charge and the separate anesthesiologist's fee, the specialized neonatal nursing care, the physician's obstetrical bill, the pediatric fee, the lab, medication costs, the imaging and then the radiologist's fee, and the routine hearing screening, among others.  We have come to expect something like this.  

But that might not be all.  We might be shocked to see a charge of $39.35 for a quick "skin-to-skin" baby-to-mother contact after a C-section that was on an actual bill posted on the Internet by a confused but still grateful new father from Utah (as reported by Vox on 10/4/16). And there may be other mysterious charges.

But when you finally receive the bills the fun begins.  What does your insurance "allow" and what is the deductible? And is there now another deductible, one for the new family member?  And what does "copay" really mean?  And is anyone responsible for the full "price" as listed, and if not, what meaning does "price" have?  And will there be a denial of coverage because you didn't tell your insurance agent (if you can get them on the phone) that you were headed to the hospital ahead of schedule?  And what if the on-call doctor covering for your own doctor isn't in the network?  And then the bills come from different zip codes and from unrecognizable billing services.  Can you still find the "Queen of Hearts" in this Three-Card Monte?  What's a woman to do?

It is likely that as she is blindsided by this confusing financial and book-keeping burden her vitally-important oxytocin levels begin to wane and her potentially-damaging cortisol levels creep up.  Is this the right way, the just way, to usher in a new life?  Is this the way to honor new parents?  I believe we deserve something better.

HAPPY MOTHERS' DAY