At a certain price point (% of income), people stop buying insurance. You can buy a lot of healthcare services for $20K a year.
To your point, the meltdown is more on the insurance side. The normal, every day providers will just charge patients directly.
The issue is the people who get "left behind"--ones who have large numbers of issues. All our insurance money right now goes to provide for them. If insurance collapses, what happens to them?
The good news is that most people don't have a pregnancy every single year.
I know, I know, other conditions apply. But even with young kids (and related pregnancies), my family has not consumed anywhere near what I've paid in premiums the last decade. I'd be shocked if we "got back" 10% of what I've paid in.
It's about $2000 to $4000 for a non-hospital midwife with an assistant, toward the higher end of that range for at-home and toward the lower end for the midwife's office.
...if you have great insurance or live in a very, very cheap area. Our family was out of pocket over $10k with “standard mediocre” tech company health insurance. A UCSF study found that California women giving birth were charged from $3,296 to $37,227 for an uncomplicated vaginal delivery, depending on which hospital they visited. For a C-section, women were billed between $8,312 and nearly $71,000.
We had two home-births while living in Chicago and one in the suburbs. The fee of $2200 (cash price, without insurance) included all pre-natal care, the actual delivery, and several post-birth checkups. Four of the appointments (pre and post) were done at home, too. The delivery included the midwife (certified nurse midwife), assistant, and student. Across the street at Northwestern Memorial Hospital I was told the retail price was $30,000.
No, that is the bare price. Insurance drops it more. For a recent baby, my price went from about $3500 down to about $1000 due to insurance, though we had to prepay more and we're still trying to get back some of the difference. Back when I had better insurance and lived in an expensive location, the full cost was covered by insurance.
I've never heard of it being over $5000. I can imagine that an at-home birth in San Francisco might be that bad or worse, since the midwife needs to deal with the cost of living.
The problem here is "depending on which hospital they visited". There is no need to involve a hospital (full of exotic infections) for a normal bodily function. That is why your cost is so high.
It's insane to propose people should just forgoe a hospital birth because we can't figure out how to reasonably provide a very basic service, which has been figured out the world over.
Well, it isn't "figured out the world over". Hospital births are not the norm, generally and even in some developed countries.
It isn't even desirable that hospital births should be the norm. Besides the financial cost, directly to the consumer or spread out via higher taxes, there are reasons to prefer non-hospital births. Disease is one. Being able to calmly rest with the comforts of home is another.
To your point, the meltdown is more on the insurance side. The normal, every day providers will just charge patients directly.
The issue is the people who get "left behind"--ones who have large numbers of issues. All our insurance money right now goes to provide for them. If insurance collapses, what happens to them?