The March of Dimes has released a report card on the nation’s premature birth rates. Colorado got a D. Not good, but we’ve got a lot of company: the whole country got a D overall. Only nine states earned grades higher than a D, and not one state got an A.
Colorado is a pretty healthy state. It’s the thinnest state in the nation, and fewer residents here have diabetes compared with the rest of the country. The same holds true for heart disease. And yet when it comes to babies being born too early, we’ve got nothing to brag about. The premature birth rate here in Colorado is 12.3%, compared with 12.7% for the entire country. The Health People 2010 goal is 7.6%, so we’ve all got work to do.
The March of Dimes analyzed the rates of preventable factors that influence premature birth, and in Colorado the two biggest culprits were smoking (19.8%) and lack of health insurance (21%). In case we need another reason to make health insurance more affordable and available, here it is.
Quality prenatal care – provided by a doctor who works closely with women to help them quit smoking, eat well, and generally take care of themselves while pregnant – plays a huge role in the health of women and their babies. And programs that assist pregnant women in getting prenatal care would almost certainly have an impact on the number of premature births.
In Colorado – as is the case in most states – most individual health insurance policies do not cover routine maternity care. This includes all prenatal care and the delivery, although complications of pregnancy are covered. While I understand the fact that health insurance is a for-profit industry and covering maternity on individual policies has not proven to be cost effective, it occurs to me that covering prenatal care (even if the delivery isn’t covered) might be a good investment for individual health insurance carriers. If more women knew that they could go to the doctor during their pregnancy and have the costs covered by health insurance, they might be more likely to seek prenatal care. If paying for prenatal care prevents a premature birth, the health insurance company would come out far ahead, since the charges a preemie incurs in NICU are covered by health insurance, regardless of whether the plan had maternity coverage or not.
While individual health insurance that doesn’t cover maternity care is a factor, a far bigger issue is women who don’t have health insurance at all. If an uninsured woman gives birth to a preemie, she stands a good chance of qualifying for Medicaid or ending up bankrupt. One way or another, tax dollars usually end up picking up a good chunk of the cost of caring for the tiny baby if the parents are uninsured. And the costs are staggering. An expansion of state health insurance plans (that cover maternity) to all uninsured pregnant women would seem like a good investment if it reduces the number of women who give birth before 37 weeks.
I doubt that we’ll reach the goal of reducing the premature birth rate to 7.6% by 2010. But hopefully our new administration’s commitment to expanding access to health care will have an impact, and we’ll be headed in the right direction. Since 1990, the premature birth rate in the US has increased by 20%, which is truly shameful considering all of the advances we’ve made in medical science in the last 20 years. We can do better than this. But in order to do so we have to make affordable access to health care for women of childbearing age a priority.
