How Much Is One Baby Worth? Child Costs

Medicine is constantly changing on two important fronts. First, the way it has always changed, involves the very progress of better drugs, techniques, and instrumentation, usually involving higher costs. The other way medicine is changing is the newer phenomenon called "managed care." In an ideal world, the two would go hand in hand; but since we don't live in an ideal world, we're still sitting out the outcome of the inevitable conflicts between the two directions.

For example, the runaway costs of mammogram screening are contained by insurance companies based on limiting the tests to those who would gain the most benefit. This makes sense when we readily accept that a fourteen-year-old girl shouldn't get a routine screening mammogram. But it doesn't make sense if the ones paying a woman's mammogram bills say they won't pay for one because several hundred screens may only detect a few pre-cancerous breasts, so it's really not worth the cost of all of the negative screens. In this way we're now subscribing to medicine according to the bottom line. I suppose that something had to be done to curtail a medical testing world run amuck, but try explaining this to the few women who would have their cancers missed without all of needless testing on the rest.

In the July 18, 1996, issue of Medical Tribune, Obstetrician and Gynecologist Edition, the controversy over routine screening of pregnant women for group B streptococcal disease was the front page article. In it, the CDC, the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Pediatrics have finally come out with guidelines for screening for this common vaginal bacteria which is harmless to the mother but could cause fatal meningitis to her baby. The actual guidelines are not what this article is about. Guidelines are just that and will periodically change when this or that study indicates so. But what I found interesting was a statement in this article by Linda Carroll:

If physicians follow these guidelines, one million pregnant women each year may end up receiving antibiotics to prevent just under 300 infant deaths."

How Much To Raise A Child?

That figures out to 3,333 treatments for each infected baby that would die. If we multiply the cost of the antibiotic times 3,333, we soon will see how much some people feel a baby is worth. Or above which a baby is not. Try explaining that to the one mother who will have lost her child to this easily treated maternal condition. Suddenly, bottom line hits the brick wall of philosophy, for the bottom line refutes the idea that a baby is priceless. But it has to; otherwise, a bankrupt insurance company can't afford to pay for anything at all.

I really don't know if there's any better way to still make paying for medical care work. The old way of doing things has been maligned by everyone, from the fiscally responsible insurance companies to the politicians who feel that too many people delivering the care make too much money. But this pejorative term "runaway medical costs" is a little unfair, because at least half of the unbridled expenditures came about because of the inherent conviction that everyone is priceless. And the hardest job in the world will be the one in which someone somewhere has to decide how much that woman, this man, or that baby is worth.

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