Posted on 07/24/2009 8:32:45 AM PDT by truthandlife
If the House of Representatives passes the health-care bill approved by the Ways and Means and Education committees, midwives--who sometimes deliver babies in place of doctors--will receive the same level of government reimbursement as obstetricians.
Section 1304 of the Affordable Health Choices Act of 2009 (H.R. 3200) would raise government Medicare and Medicaid reimbursement for certified nurse midwives to the same level as the reimbursement for doctors who perform the same services. Under current law, midwives only receive 65 percent of what a doctor receives for equal services.
Originally introduced in February as the “Midwifery Care Access and Reimbursement Act of 2009” (H.R. 1101), the proposal by Reps. Edolphus Towns (D-N.Y.) and Fred Upton (R-Mich.) was later added to the larger health reform package.
In a press release issued by the American College of Nurse-Midwives (ACNM) on Feb. 19, Towns said that the legislation “will not only advance women’s health services--particularly among those most disadvantaged--but it will give midwives the recognition they have long deserved.”
“A certified nurse midwife is basically an advanced practice registered nurse, similar to a nurse practitioner,” Lorrie Kline Kaplan, executive director of the ACNM told CNSNews.com, “but they go through their own program of study, typically it’s a graduate – a master’s degree program, and they are trained in providing all kinds of women’s health care throughout the life span, basically from adolescence through menopause, but obviously midwives have kind of a specialty in maternity care services.”
According to the midwives’ group, certified nurse midwives were involved with 317,168 births in the year 2006 – an increase of 33 percent over 10 years.
Asked about the criticism that the legislation might encourage people to use nurse midwives more and doctors less, Kaplan asked, “Why is that criticism?” She added: “Basically we’re talking about equal pay for the same exact service.”
“OB-GYNs have, you know, very favorable views of working collaboratively with midwives,” Kaplan noted. However, she said that the current reimbursement rate is a “disincentive to have a midwife on staff to provide those services.”
“This becomes kind of a barrier to access,” she said, “because the reimbursement is so depressed that, you know, because as I said, that physicians are less willing to have a midwife on staff, and it’s just not economic to have midwives provide the services, even though the c-section rates for midwives for, you know, a woman who has received care from a midwife and other kinds of medical interventions are usually a lot lower.”
Kaplan said it is “actually typically more cost-effective overall to work with a midwife during pregnancy and childbearing.”
Rep. Michael Burgess (R-Texas), chairman of the Congressional Health Care Caucus, expressed support for the idea – with conditions.
“When a nurse midwife practices under direct physician supervision in a hospital, I’m very comfortable with that being reimbursed at a rate that would be similar to a physician reimbursement, but a nurse midwife who’s practicing in a birthing center becomes a little bit more problematic for me,” Burgess, a member of Congress who is also an obstetrician, told CNSNews.com.
“The availability of physician backup, the availability or the ability to perform a caesarian section urgently, I think, is going to be the critical feature for me,” Burgess said.
Burgess was unequivocal, however, in his opposition to midwives performing home births.
“I don’t think that’s a good idea in general, and I wouldn’t be in favor of that being reimbursed at the physician rate, because you’re just simply not able to provide the same level of safety as someone who’s practicing in the hospital,” Burgess said. “But it has nothing to do with credential. I‘d probably feel the same way about a physician who’s delivering a baby at home.”
Kaplan estimated that 96 percent of births attended by certified nurse midwives are in hospitals, with others occurring in birthing clinics – and a much smaller number in homes.
The American College of Obstetricians and Gynecologists (ACOG) also supports the idea.
“Although we have not commented specifically on the Section 1304 provision in HR 3200, ACOG supports reimbursement equity for certified nurse midwives, as it has for many years,” the organization said in a statement issued to CNSNews.com.
As an obstetrician, Burgess also spoke very highly of nurse midwives from his professional experience and said he suggested that his former obstetrics practice partners hire one.
“I encouraged us to look at hiring a nurse midwife,” he said. “We didn’t do it when I was still in practice, but after I left they did indeed. The hospital did give them a little bit of difficulty with credentialing, but they eventually allowed it, and now the practice is quite satisfied and quite happy that they incorporated a nurse midwife into their obstetric practice.”
And soon, a hack with a rag saturated with chloroform will be paid the same as a board-certified anaesthesiologist. Its the same service, as long as the patient wakes up, isn’t it?
More accurately, doctors will be receiving the same fees as midwives. Nothing against midwives, but the doctors have a wee bit more training....
Wow. An RN gets the same pay as an Obstetrician. I retired too early. These people are imbeciles. No other word for it.
Funny how the midwives always have a doctor on speed dial.
Knowing the relative expertise of midwives at avoiding the problems too often caused by obstetricians and that the price of the insurance they have to pay is about the same, I'm not sure I oppose this for any reason other than that the government has no business controlling people's wages. IMHO, midwives are under-compensated because physicians control hospital organizations.
wow. way to destroy the medical profession!
Obamacare pushes us backward toward 19th century medicine. BO is turning this magnificent nation into Third World country before our very eyes. 21st century medicine, transportation, standards of living and a host of other benefits of modern life are being destroyed in his efforts at LEVELING. This is what Lenin and Stalin did to Russia.
I saw a statistic that 85% of children delivered by midwives are minorities.
This is obviously a ploy to give birth to more democratic voters.
Has ANY Medical Professional looked at the section of this Health Killer Bill, that states. Third Parties ie:Doctors Hospital, midwives etc. can be SUED as long as Medicare is named as a party. And Medicare doesn’t even have to participate. HELLO....Doctors Do You Hear THAT?
The leftist concept that the value of all labor is equal. I'm anxiously waiting to have one of these fools poised for neurosurgery. Send the surgeon home and call the janitor. All labor is of equal value, so the results will be the same. Nobody will notice the difference as the lefty brain was already damaged goods.
I have a friend with a Russian wife. He tells me just how little doctors make in Russia. His wife is an aeronautical engineer. Her standard of living in Idaho is much better than it was in Russia when she worked at her profession.
Even if lip services starts out on the high-end to buy votes, the reality will quickly be "the rich will have to pay their fair share here."
HF
Yes. But, I can't help but ask why. Lenin thought it would be better for the masses, eventually. Stalin didn't care. BHO is race-driven, but he should be able to see that it won't help his chosen people to run the country into the ground. And what is it with Rahm?
The midwives are a comfort to have around for a mom with a normal delivery because they (1) spend more time with you; (2) have a better bedside manner; (3) to some people, are more 'real' in the hippie tradition, the wise-woman tradition, whatever you want to call it.
But a friend of mine who had a midwife almost bled to death. My sister in law had a midwife and almost died when the baby rolled over and constricted her vena cava. And another friend has a child with brain damage due to the midwife's failure to recognize cord strangulation. She says, "I wanted the midwife and the rocking chair. What I needed was a fetal monitor."
I had a completely uneventful, rapid delivery under the supervision of an obstetrician (who was a charming and highly entertaining guy to have on hand), but I had post-delivery complications (retained placenta) that he handled with complete aplomb. Thanks, I'll take the guy with the residency and the board certification. And with all the time he spent getting board certified, he deserves better pay.
The list, ping
I guess that means that I, with a hammer, chisel and pliers rinsed in isopropyl alchohol, would bet paid the same as an oral surgeon.
Of course, if it will improve my chances, I'd be willing to add the use of fishing line, a heavy wooden door and a brass door knob to my list of services as well.
Funny how the midwives always have a doctor on speed dial.
...............
To clean up their mess.
Rahm, a socialist, is a power whore. He will do anything -- betray Israel, for instance -- in order to achieve and remain in the corridors of power.
It would be nice to have a couple of TEMPLATE letters posted somewhere where we can get and use to send to various elected officials. I know that I use the US Chambers letters when they send me a link.
Can we set up a site on Free Republic to have some canned letters that we can customize for our own use.
There won't be much wealth to spread, at this rate. Maybe thats more important to him than bettering the position of American Blacks, another theme of his. And you are right, Rahm is a power whore. Have you seen the side-by-side photographs of him and Goebbels? Eerie.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.