The Philadelphia Daily News, November 13, 2006

Birthing A New Approach To Health Care: It's time to move to a system that takes care of everyone
Editorial

ONE POINT in the Democratic Party's "6-Point Plan for 2006" (notice how we're hearing more about this agenda now than during the election season?) is "a health-care system that works for everyone."

The utopian goal would be universal health care.

But in this country, such a dream has proved elusive. In 1993, then-first lady Hillary Rodham Clinton headed the National Task Force on Health-Care Reform. It failed, an underwhelming attempt to change a hugely complicated issue that is snared in a thicket of political, social, insurance and pharmaceutical interests.

And then there was President Bush's half-baked effort, signed in 2003, to change Medicare without hurting the almighty pharmaceutical firms.

The renewed call for universal health care led us to a report released two months ago by the Maternity Care Coalition, a social-service agency that works to improve maternal and child health, and provides help in high-risk neighborhoods.

Titled "Childbirth at a Crossroads," the report presents a glum picture of maternal health-care inequities in southeastern Pennsylvania. (See www.MOMobile.org for the full report.)

The report's key findings look at the areas of diversity, access, care, equity and support. For the mothers of the 50,000 babies born annually in southeastern Pennsylvania, these can be barriers to thorough, safe and timely care. For example:

Diversity: The many cultures, races, ethnicities and patients with various incomes in the region means there is a need for doctors with broad cultural and linguistic skills, health-care facilities sensitive to languages spoken in the area and personnel eager to work with such a cross-section.

Health-care inequities: They continue, with black infants in the area more than twice as likely to die as white ones, according to the report. And prenatal care is low for the uninsured, teens, Medicaid patients and black, Asian and Hispanic women.

Support: Childbirth is seen more as a medical condition to be feared than as an uplifting "family-centered" event to be celebrated and is part of a life cycle.

But in the report, the findings under "care" and "access" are the ones that stand out.

The number of doctors, nurses and midwives continues to shrink, thanks to fear of lawsuits, and an environment "where maternity care is considered unprofitable."

The region has 25 percent fewer maternity-care facilities than in 1990, the report says. Since 1980, med-school grads who specialize in obstetrics and gynecology has dropped nearly 50 percent.

Malpractice insurance for obstetricians in 2000 was $68,900. In 2003, it was $134,300, according to a Pew Charitable Trusts report.

And access to adequate health care before, during and after birth, is difficult. Not all health plans are accepted at health-care facilities, and the uninsured or underinsured may get different treatment in some areas, such as how quickly a patient can get a doctor's appointment.

"The road we're on leaves increasing numbers of women without access to care that meets their needs," the report says. "It is time to choose a road that will reach every woman's door, providing her with access to quality health-care services throughout her life cycle. Health-care providers across our region must be prepared to serve our changing and ever more diverse population. Universal health insurance must be a short-term, not a long-term, goal."

And it  should be a goal not only for the Democratic Party, but for the entire country.

Learn about the childbirth crisis through our Maternity Care in Southeastern PA pages, or visit our Maternity Services Advocacy pages to find out how communities are advocating and how you can take action!

MCC's full Childbirth at a Crossroads report can be viewed here.