My daughter’s birth was scheduled, which helped lessen the stress. For a few weeks, we knew there would soon come a day when we woke up, showered, got dressed and drove to the hospital to change our lives forever.
That morning itself was entirely familiar and entirely strange. I remember taking a few photos — one of our quiet living room, one while sitting in the glider chair in the nursery — that I now look back on with envy. Everything was quiet and still. Peaceful.
When we arrived at C.S. Mott Children’s Hospital in Ann Arbor, it was just my wife and me. The gentleman at the reception desk, as he checked us in, asked if either of us were sick. Then he asked if we had left the country recently or come into contact with anyone who had been diagnosed with the novel coronavirus. Thinking this question about the virus was a bit odd, we politely told him we had not.
On the delivery floor, we were greeted by another receptionist who asked the same questions. “I get it,” I said to my wife as we took a seat. “It’s a hospital so they have to ask those things.” On February 28th, we were still nearly two weeks from the first confirmed case of COVID-19 in Michigan. To us, this was still a new virus that was spreading in foreign lands, not here in the US.
Two weeks later, I sat anxiously thinking about having to go back to work, about exposing myself — and my wife and daughter — to this disease. More than a dozen cases had now been confirmed in Michigan. Store shelves had been ransacked. Schools were being temporarily closed. That’s when I got a text from my boss telling me not to worry, that I could resume work remotely.
I was relieved. My worries began to subside.
A couple weeks later, the hospital bills started rolling in.
Our daughter is a miracle who arrived a couple weeks early. Had she made it to her due date, my wife would have been delivering as the world entered meltdown. Instead, everything went smoothly. Due to the caesarean delivery, we spent the first two nights in the hospital with our daughter before taking her home.
Within weeks, new coronavirus cases began emerging in Michigan. Hospitals quickly saw a surge in patients with the illness. By mid-March, hospitals began ceasing all “non-essential” procedures, such as elective knee and hip replacements, to focus on the COVID-19 pandemic and keep the community safe. These elective procedures, of course, are major money-makers. Hospitals depend on them to stay in the black.
I sat on the couch, holding my newborn daughter, watching all of this unfold. Our pantry was stocked. We had plenty of bottled water and toilet paper. All we could do was play it safe and stay put.
Not long after, I was on the phone with a friend who works for the University of Michigan. We were talking about the pandemic and its impact on the economy, and he mentioned that Michigan Medicine — how the university refers to its hospital system — was losing millions of dollars every day. That was a very real consequence of these shutdowns.
According to MLive, “The Michigan Health and Hospital Association estimated hospitals [were] losing more than $300 million a week” during the months of March and April. Revenue was cut in half at many hospitals. Entire systems, such as Trinity Health, were forced to layoff thousands of employees, even as hospitals were overrun with severe cases of a new and deadly virus.
It was an unprecedented moment in history that I witnessed from as far away as I could, like most, clinging to my family.
Before my daughter was born, we had already tallied quite a few bills from extra appointments to make sure she was safe. Then there are all the things you amass when expecting your first child — the crib and the stroller and car seat and all the other gadgets they have for kids these days. Fortunately we were blessed that so many friends and family came together to help with many of those expenses.
Having a baby is not cheap. Aside from all of the new things you need for that first year, it changes your life forever. Insurance goes up. Grocery bills increase. There’s college savings — a particularly terrifying thought as you try to pay off your own student loans.
In December 2019, Business Insider compiled the average costs of having a baby, breaking it down by state, type of birth (vaginal or c-section) and whether or not the mother has insurance. In the US, the average cost of having a baby is $10,808. In Michigan, the breakdown of average costs looks like this:
- Vaginal birth with insurance: $6,545
- C-section with insurance: $9,696
- Vaginal birth without insurance: $11,211
- C-section without insurance: $15,107
These costs reflect the total hospital bills, not necessarily what the patient pays out-of-pocket. Still, these are not small sums. Given these numbers, my wife and I expected our bill to resemble the $9,696 figure above.
Over the course of a couple months, bills trickled in. When we thought, finally, we had received them all, we totaled them up: $33,246.14.
Now, that $33,246.14 does not count all of the additional costs associated with our prenatal visits, which included several extra ultrasounds (for which the hospital billed thousands), and a few related postpartum visits. On the other hand, it is also not the total out-of-pocket cost — that was lower, thanks to our coverage.
Hospitals are businesses, and like any other businesses they are eager to recoup losses from during the worst of the pandemic. As a customer, they are asking me to help make that happen.
When the bills begin arriving, the worst action to take is simply writing the check. You should review each bill carefully, checking for inconsistencies and errors — or, more often, explanations.
For example, the hospital billed $2,852 for the nursery, even though our baby never left our room. But because it was offered and available, they said, they could bill for it.
The caesarean delivery and postpartum care was billed at $3,853, with the anesthesia billed at $1,792. That came in March. In April, we received another bill. On this one, we were billed for anesthesia again, this time for $1,743. There was also an operating room charge of $10,304. The room charge for my wife’s two-night stay was $4,622, and the recovery room charge — presumably the short time we spent back in triage before being wheeled to our room — was $1,963. This is not to mention a littering of laboratory, imaging services and pharmacy charges, all of which were nondescript.
As my wife was discharged, they made a follow-up appointment for her. Because of the caesarean delivery, they said they would send a nurse to our house while my wife recovers, rather than making her go into the office. It would cost $40 with insurance, they told us.
During this visit, which lasted about a half hour, the nurse almost exclusively focused on my wife. When we raised concerns that our baby might be having trouble gaining weight, she offered to weigh her, pulling out a tabletop scale.
Several weeks later, the bill arrived. The visit, which was coded as “Mom and Baby,” cost $245, and with our insurance we only had a $40 copay. But the following month, a second bill arrived. This was for a full $245 charge, coded as a second “Mom and Baby” visit from the same day.
The insurance company’s stance was that only one visit was covered under our plan, not two. The hospital’s stance was that the first $245 charge was for my wife, and the second was for the baby.
So we emailed. And we called. And we emailed. And we called. Eventually, we spoke with a representative who, very reasonably, understood the mistake in billing and said that she would have it removed. The next time we checked our account online, the second $245 charge had been removed with a “Patient satisfaction discount” code, a clever way to cover up an error.
Health insurance is expensive in this country. Having a baby is expensive in this country. On top of everything else, patients should not be tasked with scrutinizing every detail of these bills for fear of errors or complete falsehoods. We pay the insurers and hospitals enough to do that for us.
After reviewing all of our bills, my wife came across an article from Vice that highlighted women with similar experiences to ours — mothers being charged $1,000 for a 15-second doctor interaction, $4,800 for unused nursery care and $400 for generic pain relievers. It’s more than enough to start asking questions.
At the very least, is it too much to ask for more transparency in pricing? If hospitals couldn’t bill for some of these outrageous charges, then insurance companies wouldn’t have to pay them (or pass them on to us, the patients). This, then, begs the question, would healthcare costs drop low enough to be affordable for all?
We as a nation need to have this conversation. With that said, I realize that this is simply, likely, just a small part of a much larger issue regarding the health care industry in the United States. But it’s also a salient topic given the state of the country’s economy.
Please, parents-to-be, heed this advice. You are already having to wade through the new safety protocols that hospitals have implemented due to the COVID-19 pandemic, adapt to a transformed lifestyle and learn to care for a newborn. Do not allow yourselves to be taken advantage of financially.
When you receive your hospital bills, read them carefully. Ask for itemized copies, if you have not received them. Having a baby, particularly if it is your first, should be one of the happiest (and most exhausting) times of your life. You shouldn’t have to question, weeks or months later when the bills arrive, whether the hospital is exploiting your new family.
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