So what does the world of rugby have to do with childbirth? Other than the same amount of grunting, pushing, and pulling in either a scrum or labor, results in the desired object being retrieved from between a persons legs, childbirth and rugby should be worlds apart. Yet the headline from the Auckland based NZ Herald newspaper that ran shortly after we arrived brought them together.
Ms. All and Dr. Black did have a baby. The article took on regional interest to me, as Dr. Black is a US med/peds physician who has been working the past year at Whangarei Hospital, our referral center. Accompanied by a picture of the couple and their beautiful newborn, the story detailed the plight that the young couple faced in covering the cost of the birth of their child. Since their insurance only covered pregnancy complications to 28 weeks (I thought premature meant before 37 weeks, insurance fine print?), they were faced with a $12,039 NZD bill for neonatal care in Auckland. The Whangarei hospital had agreed to write off the cost of the emergency c/section since Dr. Black was employed there. Understandably the couple, who are facing the cost of returning to work back in the US (reestablish their home, pay medical school debt, physician fellowship income, etc), were having difficulty paying their Auckland hospital bill. Yet the story ends with a Kiwi happiness stating the negotiations for payment with the couple were proceeding well.
Bantering this story about during a lunch break with my practice colleagues and the medical students working at Broadway Health, offered an even bigger surprise to me. Since the Green Day song "American Idiot" has been popular on the radio here since our arrival, I was expecting some critical feedback about Americans taking advantage of the NZ medical system. Instead, around the table, no one could understand why the All-Black family should have to pay anything. Child birth is a responsibility to be covered completely, including complications, by the single payer health plan in this country! WHAT?!
Suddenly I was thrown into contradiction with my experience in the US health insurance system. A memory of a conversation with very good friends back in Idaho several years ago. I had the pleasure of assisting at the c/section delivery of both of their children. This couple's children are similar in age to Joel and McKeely, and subsequently the conversation took place between young expectant parents, rather than in a doctor patient relationship. Both families were expecting the birth of their second child when we got on to the topic of paying for the birth of our children. Our friends first child, delivered by c/section required emergency transport to the NICU in Boise due to blood sugar instability. Our friend lamented the fact that they still owed $20,000 on the birth of their first child while expecting their second! Seems that their insurer decided that emergency transfer of their child to the NICU would not be covered.
This from a couple who has done everything that the "American Dream" offers. Both college educated and professionally employed. Both properly insured with an employer sponsored health plan. Both extremely hard working. So hard working that during the following winter our friend took on extra manual labor work of shoveling snow off roofs during winter to help pay off their debt. A responsible parent taken away from his family for extra work due to the burden of health care costs.
I did not have to look far for the reason our health care is so expensive in the US. From the back deck of our home in Idaho where the conversation took place with our friends, I could look up to the mountain ridge line that contained some of the most expensive real estate in the resort community. The location of multimillion dollar homes that overlooked the community and lake. If I looked close enough, I could see the location of the vacation second (or third) home being built by the CEO of Blue Cross/Blue Shield of Idaho, the largest health insurer in Idaho at the time. A concrete example of how the dollars that we contribute to our health care literally flow uphill away from necessary medical care into the pockets of the self entitled "managers" of health care.
Two American families with the same medical outcome. Beautiful healthy children brought into the world successfully despite neonatal complications. Two countries with vastly different philosophies on how the management of health care should take place. The citizens of one country knowing that the money they contribute to health care is part of their tax dollars, and they have ownership of it. They have the right to say that payments for medical expenses and care take priority over the payments to the managers of health care. The citizens of another country unwittingly allowing insurance health care "managers" to greedily line their own pockets, at the back breaking expense of the young working families who need medical care.
The health care bill passed in the US currently has a provision to have insurance companies submit their "cost of managing care" to congress for review by October. So as the New Zealand rugby AllBlacks head off to South Africa for their final tests of the TriNation Series, I can only hope that the leaders of our Nation will Try to scrutinize those reports carefully. If members of congress attack those reports and weed out the unnecessary costs of things like expensive second homes for an insurance company CEO, much like the AllBlacks front line attacks a scrum, then maybe we can have a health care system we can cherish in America.
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