Making babies pay

July 21, 1992

Is it cynicism or merely desperation that prompts the state's health insurers to limit hospital benefits for maternity stays to 24 hours? Whichever, the policy provides a textbook example of a health care system that is out of control.

Maybe it is too easy to attribute the new policies described by reporter Patricia Meisol in The Sunday Sun to the cynicism -- to the attitude that says sending new mothers home barely a day after delivery isn't likely to be the direct cause of any loss of life or to stir up as big a storm as, say, cutting benefits for heart bypass operations. Parents of babies who develop jaundice or other problems after leaving the hospital can see a doctor at their own expense. For families, this policy is further proof that the rising cost of their health insurance premiums doesn't guarantee better care -- or even adequate care and common sense.

It may well be that the policy simply illustrates how desperate insurers have become in the struggle to contain ever-rising costs. If so, this is an indication of how easy it is for cost containment to become a game of shifting the burden -- or, more accurately, dropping it.

For some women, 24 hours in the hospital is plenty of time if they have had an easy delivery, if they already have experience caring for infants, if they have household help and emotional support at home and if they have easy access to a pediatrician. But in many cases, rushing women home within a day of delivery can result in stressed-out families and, sometimes, in undetected health problems in infants.

Probably the most serious consequence -- and one that deserves the attention of health insurers -- is that very short hospital stays make it less likely that the mother will breast-feed her infant. The second and third days of an infant's life are the critical time for establishing a successful breast-feeding pattern, and without the support traditionally available in a hospital setting, new mothers are far more likely to give up and turn to the bottle.

Yet research consistently shows that breast-fed babies are less prone to infection -- especially the middle ear infections that can make infants miserable -- and they are far less likely to require admission to a hospital during the first year of life. Scientists even detect an effect on intelligence levels. A study of premature infants found that at age five those who were given breast milk scored eight to 10 points higher on IQ tests than those who were formula-fed.

If ear infections and IQ points aren't persuasive enough, health insurers may want to consider the benefits breast-feeding provides for the mother. Research now shows that breast-feeding for three months or longer can significantly decrease a woman's risk of breast cancer. In the state that leads the nation in cancer deaths, any policy that discourages a practice that helps protect women from cancer can only be described as foolish.

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