
Kate Middleton’s ‘luxury’ birth cost less than the average U.S. birth - cmurf
https://www.marketwatch.com/story/kate-middletons-luxury-birth-cost-less-than-the-average-us-birth-2018-04-24
======
foreigner
The chart is really misleading. It's labeled: "Here are the average 2015
prices for a vaginal birth, not including costs for care before and after
giving birth" but for the UK it lists the price of the royal baby's fancy
birth. A normal birth in the UK is free!

My daughter was born by C-section in the UK. Mum and baby stayed in the
hospital for a few days to recover from the C-section. This would have been
completely free but they would have had to share a room with 3 other mums and
newborns. That's not so nice so we opted to pay for a private room.

The cost for a private room in a hospital in the UK was the equivalent of $100
per night! In a HOSPITAL! Coming from the US that blew my mind.

~~~
dogma1138
Cost out of pocket and actual costs aren’t the same thing.

The overall health care is likely cheaper but you do pay for it your entire
adult life.

So while they charged you $100 during birth (btw that’s extremely cheap a
private room in a central London hospital without insurance copay is a few
£100’s a night) you pay for that room from your first paycheck to the last.

~~~
mathw
Yes we do, and that's fantastic, because that's also paying for my sister's
cancer treatment, my Mum's thyroid medication, the drugs Dad had to clear up a
fungal infection in his toenails, the surgery my friend had to reassemble his
ankle after he smashed it up slipping down a grassy slope...

~~~
dogma1138
Don’t know without my ~£3000 a year insurance I’ll have better luck with
pubmed than with the NHS unless I’m bleeding out of 2 or more holes with one
of them not being native to my body.

The only problem I have with it is that unlike say Germany I have no option to
go completely private. I

------
mmikeff
The point I rarely see discussed in these ongoing debates about the best way
to pay for healthcare is the benefit of knowing what you have to pay. As I
understand it in the US even with health insurance there is likely to be an
additional payment required by the patient for treatment, and the cost of that
payment is generally unknown upfront.

With the NHS is the UK I can be pretty confident that no matter what
medication my doctor prescribes that when I collect it from the pharmacy it
will cost me exactly £8.60

I can also be confident that when I go for an appointment to see my GP that it
will cost me nothing. This doesn't mean that is is free, as my National
Insurance contributions are substantial, but that I know that I don't bear any
financial risk from going to see a doctor.

I can't imagine what it would be like to have to worry about whether going to
see a doctor about this mole that's changed a bit might land me with an
unknown bill. Or to worry that my daughters peanut allergy could see me paying
hundreds of dollars when her adrenaline pens expires.

~~~
johnday
> This doesn't mean that is is free, as my National Insurance contributions
> are substantial, but that I know that I don't bear any financial risk from
> going to see a doctor.

In fact, it's more important than that. Because you pay NI upfront, it
relieves the feeling of burden that you might otherwise feel towards the NHS,
which actually makes you _more_ willing to go to the doctor. This means you're
more likely to catch minor things before they become major problems (further
reducing NHS costs).

~~~
mmikeff
Exactly. It's bad enough to be worried that you might have skin cancer, then
to worry so much about the cost that you don't go see the doctor can only
compound the issue.

I would guess (and don't know) that if you had super amazing insurance then
maybe it covers all these unexpected extras. But for those that do not have
that level of cover the decision must go something like:

I'm worried that this mole looks bad,

if I go and see a doctor then I might get a nasty bill,

but if I don't go and see a doctor then it might get worse and when it does
I'll have no choice but to go,

oh and the cost of the treatment could bankrupt my family

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indemnity
We paid NZ$75.

This was for the hospital car parking for 3 days to visit my wife while she
recovered in maternity ward in a private room.

Everything else was free, from the first scan, through to delivery, and the
standard of care was good.

Didn't need specialists, but if we did that would have been free too.

We have private health insurance as well (NZ$300/month to cover the family),
but in public health care is good enough, private is for when you want to get
treated faster for less critical things.

~~~
lostlogin
And that car park is a disaster. I’m guessing you refer to Auckland Hospital.
If you are, wait until midnight and the gates open and it becomes free. You
can tell when it’s going to be free soon as half the cars have people sitting
in them.

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nealdt
Also worth pointing out that in the UK, we were offered three choices of
births. Home, water or hospital. We started off in the birthing pools until
mum decided she wanted the epidural after all. I thought all three of options
were quite luxurious and service by the midwives was second to none!

If I think about our decision making process for a car-seat (oh god, let's go
for the best - just in case), I am glad that no-one has put a monetary value
on giving birth.

~~~
oliwarner
I'd never thought of it like that, but we did exactly the same thing with the
child seat. I daren't imagine what would happen to the state of neonatal care
if it were privatised here.

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Symbiote
Here's the price list for the private hospital they used.

Note things like "If your baby requires transitional or specialist care, this
is free if they are entitled to NHS care and is chargeable if they are not."
\-- British (and EU etc) patients can pay for the luxury private room and so
on, but if they unfortunately need significant extra care, public healthcare
will cover that.

[https://2ic5hf2u26uo1u64w43h7rt0-wpengine.netdna-
ssl.com/wp-...](https://2ic5hf2u26uo1u64w43h7rt0-wpengine.netdna-ssl.com/wp-
content/uploads/2018/01/The-Lindo-Wing-maternity-prices-2018-1.pdf)

------
kjgkjhfkjf
What do folks in the US with health insurance have to pay? Insurance companies
get huge discounts on the artificially inflated listed prices.

~~~
chx
In "normal" cases, roughly, 500 USD or less if you have insurance.

But it's really awfully complicated -- often the baby gets a separate bill too
to muddle the waters. The ACA ("Obamacare") set a cap on in-network yearly out
of pocket payments on family plans which, if memory serves, was around 11k in
2017. A complicated birth can hit this! Consider the costs of NICU, for
example. (Oh and if an NICU nurse reads this: thank you, thank you, thank you
for the life of my niece.)

As to what the insurers pays, I do not know.

~~~
smcl
The _baby_ gets a bill?

~~~
ubernostrum
For services provided to the baby, yes.

The expectation is that the baby will be added to the insurance plan effective
as of birth, so it's correct to bill services provided to the baby as...
services provided to the baby.

~~~
smcl
Oh I understand how the situation arises ... but billing a baby for being born
is never going sound normal to me.

~~~
TomMarius
I think it's not the birth itself, it's the post-birth services.

~~~
Symbiote
To most Europeans, _billing a child_ is never going to seem normal.

And that includes dental and optical treatments. Braces and glasses are free,
at least the basic type.

(I've generalized all of Europe; there may be exceptions in some countries.)

~~~
alxlaz
Am European, can confirm. The idea that the first thing a kid gets in this
world is a bill for healthcare services is amusing in a chilly sort of way. I
mean, it's not like the poor kid had a choice in the matter of whether he's
born or not.

What happens if the parents can't afford it? Does he, like, get to go back in
until the parents pay? If he had an ailment, and it got cured, do they give it
back to him? Do they put him in suspended animation :-)?

~~~
TomMarius
It's the same in Europe though. The hospital will send a bill to the insurance
company (usually there is one default and you can switch your children to
another any time) in the name of the child.

~~~
Symbiote
There is no "insurance company" in Britain or Denmark, the two countries I've
been/am eligible for state healthcare as a resident.

I've never seen any paperwork in either country regarding billing or other
costs, and that's as an adult.

~~~
TomMarius
Yes, the paperwork is hidden from you, but its present, the hospital still
needs a way to obtain funds from NHS, see:
[https://en.m.wikipedia.org/wiki/Healthcare_in_England](https://en.m.wikipedia.org/wiki/Healthcare_in_England)
\- "The National Health Service (NHS) is free at the point of use for the
patient though there are charges associated with eye tests, dental care,
prescriptions, and many aspects of personal care."

Please note that you basically listed two exceptions (plus other Nordic
companies), most of EU countries have a system that combines private insurance
companies with a combination of public, semi-public and completely private
health providers.

------
readhn
Usa here, with decent health insurance at the time.

C-section birth, plus 4 day stay at the hospital (Max included allowed by
insurance). Total billed by the hospital was something crazy around 11-16k? I
forget actual number. It was a decent stay/food but nothing crazy over the top
about it.

After all said and done we paid $1100 for our hospital stay. I was happy it
was this "cheap".

P.s. oh yes, also hospital car parking -I think I was there total for 5 days
so $12x5=$60.

------
nkkollaw
My American ex-wife was afraid about this, then she found out that in Italy
you pay 0.

We are really lucky.

------
HenryBemis
I remember a similar article [1] discussed a few months back here in HN. And I
have found the dialogue of the community [2] to be very informative.

[1]: [https://www.theguardian.com/us-news/2018/jan/16/why-does-
it-...](https://www.theguardian.com/us-news/2018/jan/16/why-does-it-
cost-32093-just-to-give-birth-in-america)

[2]:
[https://news.ycombinator.com/item?id=16189976](https://news.ycombinator.com/item?id=16189976)

------
kjgkjhfkjf
Sales tax in the UK is 20%. A gallon of gas is >$7. Salaries are miniscule
compared to the US. SF/NYC real estate is a bargain compared to London. And
the NHS, well hmm...

~~~
Max_Mustermann
How is the UK's 29k USD median income a year "minuscule" compared to the 31k
from the US?

[https://en.wikipedia.org/wiki/Income_in_the_United_Kingdom](https://en.wikipedia.org/wiki/Income_in_the_United_Kingdom)

[https://en.wikipedia.org/wiki/Personal_income_in_the_United_...](https://en.wikipedia.org/wiki/Personal_income_in_the_United_States)

------
hamilyon2
In Russia giving birth is free, as is whatever-long stay is hospital (in
shared room). Of course, you can have private room, where father, mother and
child can stay for as little as 100$ a night. Actually, state pays mother
about 7000$ for second child in addition to all normal allowances and
benefits.

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jlebrech
The Duchess of Cambridge: she no longer has her maiden name.

------
Xuper
Nah, just millions of people paid as well. It's like saying education is
"free".

~~~
realusername
In this case it's a UK private hospital not funded by the NHS so the
comparison is valid. The article compares one of the most expensive private
hospital of the UK to the cost of an average US hospital. Also the US spends
more in public taxes for healthcare than the UK so I don't see your point.

~~~
makomk
It's actually a UK NHS hospital which operates a private maternity wing on the
side. The email address in the brochure is even @nhs.net. They're probably
relying on staff and resources from the NHS side to handle more difficult
births too.

~~~
alicewales
Private companies who provide services to the NHS also get @nhs.net email
addresses. It's a secure email system so that patient and other confidential
data can be exchanged between providers without it going out onto random
internet mail servers.

An @nhs.net email doesn't mean "this person/organisation is a part of the
NHS", it means they provide services to the NHS and need to deal with patient
data.

------
rdiddly
A midwife delivered my kid in the bedroom for two orders of magnitude less
money.

Not to mention, thousands of years of doing it without even a midwife was
somehow good enough to keep the species alive long enough for hospitals to be
invented so people could think having a baby requires one.

EDIT: Sorry to distract you with that last bit. A midwife, you're paying for a
license and a sterile pair of scissors. It works fine. The idea that you need
a huge medical apparatus and to pay $10 grand for it, to do something humans
evolved to do, is pretty FUDdish.

~~~
eurleif
Which shows that a high infant mortality rate is insufficient to extinct a
species, not that home birth is safe.

~~~
mcv
Home birth doesn't have to be unsafe as long as you have well-trained mid-
people and easy access to a hospital in case of complications. An
uncomplicated birth doesn't need a hospital, and most births in Netherland
still happen at home. It works fine if your system is designed to allow it.

~~~
eurleif
Home birth is not safe. In the Netherlands, as elsewhere, it causes deaths:
[http://www.skepticalob.com/2010/07/netherlands-homebirth-
and...](http://www.skepticalob.com/2010/07/netherlands-homebirth-and-
high.html)

And the majority of Dutch births are not home births. Due to the safety
issues, the rate has fallen to only 13%:
[http://www.skepticalob.com/2017/02/dutch-homebirth-rate-
cont...](http://www.skepticalob.com/2017/02/dutch-homebirth-rate-continues-to-
plummet-now-only-13.html)

~~~
mcv
I stand corrected.

Although if birth-related mortality is rising while home births are dropping,
doesn't that suggest there's something else going on? The relatively high age
of Dutch mothers may also be a factor (I believe the average age at which
women have their first child is around 30).

Having read a bit more about the issue, it appears the jury is still out.

~~~
eurleif
>Although if birth-related mortality is rising while home births are dropping,
doesn't that suggest there's something else going on?

Huh, where do you see mortality rising? The link refers to a decrease:
"Historical data show that 7-day (28-day) mortality declined from 4.25 (5.35)
deaths per 1,000 births in 1980–1985 to 2.42 (3.18) deaths in 2005-2009"

>Having read a bit more about the issue, it appears the jury is still out.

I don't know how you can think that. Every statistical comparison shows home
births kill babies. Unfortunately, there are still people who claim otherwise,
but none of them have data to support their claims.

