HCI3 Update from the Field: Delivering Healthy Babies is Good for Everyone

Submitted by francois.debrantes@hci3.org on Friday, November 8, 2013 - 12:20

It should be self-evident that delivering healthy babies is good for everyone. Good for the child principally, but also good for the mothers, and good for society. And yet…two reports this week remind us of the chasm between what should and what is, between a few smart policies and the numbing stupidity of most others. With support from the Milbank Memorial Fund, CPR has published a report that outlines an innovative and good program in South Carolina to ensure that babies are born as healthy as possible. The evidence they cite is pretty clear and overwhelming. The costs, both immediate to Medicaid and other payers, and longer term to States and the federal government are significant when babies are not born healthy. The human cost, of course, is not measurable but even more significant. The SC policies to bolster baby health and, by consequence, bolster future resident contribution to society, are quite simple – educate moms on what they need to do and prevent early elective deliveries. It's so common sense that one wonders why it's not being done, and of course the answer is the numbing stupidity of all other policies. First, elective early inductions aren't punished, and they should be. Second, other deliveries that might hurt babies, such as elective C-sections, are rising because reimbursement favors them. Finally, the health care industry continues to tolerate sub-par performance. And the apologist's report card from HANYS published this week is a perfect example of that abject tolerance.

What this means to you – If anyone one of us saw a person punching a pregnant mom in the belly, we would be horrified, call the police and intervene. Why? Because we know that the punch could harm the baby, that precious and sacred new life. And yet we stand idly by as hospitals and obstetricians conduct early elective deliveries, or unnecessary C-sections. Even more shocking, we encourage them to do so by inflating their coffers. And when some try and counter the practice by, say, publishing report cards that give an F to facilities with bad records, the industry's apologists rush to the forefront with scorecards of their own to justify the poor performance. When HANYS criticizes the Leapfrog Group's Hospital Safety Score and instead points to this site as "good", let's understand the difference. The former gives a grade, the latter is neutral. The former warns of poor performance, the latter doesn't seem to distinguish good from bad. The average severity adjusted C-section rate for hospitals in NY State is 30.5% while the US average is 29.5%…so NY hospitals are at par with the country…that's ok isn't it? No, that's pretty bad because the Healthy People 2010 goal was 15%. By that measure all but one hospital in NY deserve an F. That would be the truth and might have an effect in changing policy to avoid unnecessary harm to babies. Instead, the apologists berate those that would warn consumers and prop up those that don't. It's more than just shameful, it's numbingly stupid policy. South Carolina is showing us a path forward, while NY is stuck in the past. South Carolina understands the critical social and economic importance of ensuring that babies are born healthy. NY seems more intent on turning its head away from those who are punching pregnant moms in the belly. What will you do?