Hacker News Reader

Comment by gleb | Hacker News Reader

Except that US does have universal healthcare for pregnant women. Most pregnancies and births in United States are covered by Medicaid. And Medicaid pays well for that.

View on HN

Technically true, however, like much of the US safety net there are significant gaps, like co-morbidities, bureaucratic hurdles, restrictive time windows, delayed care, etc.

ProPublica, Vox and Texas Tribune did a great in depth article on this last year, "The Extraordinary Danger of Being Pregnant and Uninsured in Texas". Most of what they found is applicable across the country, Texas just happens to be particularly horrific.

https://www.propublica.org/article/the-extraordinary-danger-...

edit: "And Medicaid pays well for that."

> In Texas, as in other parts of the U.S., providers are paid only about half as much for Medicaid patients as for privately insured ones.

It really isn't the same though. In most developed countries you don't have to worry about turning up to a hospital, for pregnancy or any reason. When a pregnant woman turns up to hospital in the UK (for example) she is absolutely not stressed about the potential cost of the care. If something goes wrong, she gets world class care at no cost to her. If some other medical problem is discovered while she's there, it will be diagnosed and treated and she doesn't have to stress about the cost.

Not so in the US. It would be surprising if that alone didn't account for a significant number of adverse outcomes.

Health care is not free at the point of use “in most developed countries.” The UK NHS is an exception. Also, you’re comparing apples and oranges a bit. In the US, an epidural is standard, which requires the expensive services of an anesthesiologist. Meanwhile, the UK NHS is famous for steering women away from epidurals. In the US, getting a private room after giving birth is standard, while in the NHS you’ll be in a maternity ward.

I think the exception for the NHS is that it is a single government organisation fully paid for by regular taxes. Think about your armed forces, for comparison.

While there are many that don't have this kind of setup I don't know any country where care isn't free at the point of use. (Except for maybe your deductibles).

Many countries have cost sharing and co-insurance: https://www.sciencedirect.com/science/article/pii/S016885101...

> The UK NHS is an exception.

Also, Canada.

> Not so in the US

Yes so in the US. That's literally what the person you replied to just told you: For pregnant women, children, and poor people, it's all fully covered.

It's really only the middle class that has it hard (i.e. expensive).

No, it isn't literally what they told me. In many other countries, there is no possibility of being charged for any medical treatment you require when you visit hospital to give birth. It is free as in you don't need to have any money or any way to pay and you can be diagnosed and treated for any medical condition that might become relevant while you're there giving birth, and give birth and have any related issues handled, and you never have to pay anything at all. In the US, that is just not true [1].

1: https://www.theatlantic.com/health/archive/2020/01/how-much-...

this is a common pattern I see in discussions, the idea of "going to the hospital and not worrying about bankruptcy" is just unintelligible and so you end up with discussions like this, about how "pregnancy-related-costs are often covered by Medicaid" which completely ignores the conditioning and fear and logistics that means that loads of people in the US simply don't go and get routine preventative care, even if they have what they consider to be "good" insurance.

That link talks about people with employer provided health insurance. For those on Medicaid I would not expect them to pay anything out of pocket for pregnancy and birth. Do you have information that says otherwise?

Reply on news.ycombinator.com