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Million-Dollar Babies

businessweek.com — The cost of care for preemies is sky- high —some 15 times the expense of full-term infants and rising. Is there such a thing as too young?

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  • donkz, on 06/16/2008, -24/+536 diggs/0 comments = main page?
    • JimmyDeanKNVB, on 06/16/2008, -2/+0How can you say no to Optimus Prime?
    • aaabatteries, on 06/16/2008, -1/+3Mondays are slow.
    • Beastmasta, on 06/16/2008, -3/+13Why is there always some one who says this?
      • cowsgonemadd3, on 06/16/2008, -2/+1Because everybody wonders why sometimes it takes almost 200 digs and sometimes it takes 30....
    • jamesdew, on 06/16/2008, -0/+8if its not good then bury it ffs
  • jmreid, on 06/16/2008, -11/+15I'm glad I'm Canadian
    • 3Den, on 06/16/2008, -3/+11Yup.. exactly.

      I've tried explaining to friends about our medical system... it's not that it's perfect, it's certainly not.. but it's not a disaster either.

      The main point is that medical costs are not something that's an important factor in how we live our lives - I don't refuse a new job because of the medical plan. I don't worry about having a kid and going bankrupt before we leave the hospital. Instead, I worry about not getting sick becuase I don't want to be sick, and I worry about having kids because I don't want kids (yet)
      • faizal5k, on 06/16/2008, -8/+3maybe that explains why there are long lines in emergency waiting rooms, less doctors, huge taxes (though that's not a huge problem), waiting for medicines to arrive, etc. So yes, medical insurance may be cheap or free in Canada, but there are side-effects (pun intended).
        • itsthebrod, on 06/16/2008, -5/+4And it also explains why so many Canadians come to the US for health care... The Canadian system is just as far from "perfect" as the American system.
        • rompom7, on 06/16/2008, -2/+6http://www.thebestpageintheuniverse.net/c.cgi?u=pu ...

          Braces for maddox link digg down.
        • jmreid, on 06/16/2008, -1/+5Huge taxes? I moved from Toronto to San Francisco and I pay almost the EXACT amount for income tax here as I did in Canada. If my work didn't pay for healthcare, I'd be paying more here. Sales tax is much less here mind you.

          Granted, because healthcare is run like a business here, you get in and out quickly. The system is good if you can pay for it.

          The point of my original statement was that, being Canadian, I don't have to worry about being able to afford to have my baby born. That idea that if my baby was born pre-mature it might bankrupt me is INSANE to me. But American's live that.

          I'd rather pay taxes and know that the system is there to support me without me worrying that I have the right coverage. As an added benefit, my fellow Canadians also get healthcare even if they might not be able to afford it. I know this way of thinking is strange to Americans, but it's the way most of the rest of the world thinks.
    • cowsgonemadd3, on 06/16/2008, -7/+4Yeah you like long lines?
      • thawkth, on 06/16/2008, -3/+10Better than nothing at all.

        Especially for Children...

        How any country can call itself civilized and not cover every child...how repugnant.

        I'll debate adults welfare/laziness/taxes as much as you want. Children deserve it no matter their parental situation. Anything less simply isn't civilized in the 21st century.
      • Zippo, on 06/16/2008, -0/+12Lines? For what?
        If you've got a cold or need a blood test for a regular check-up, sure, you'll be waiting a bit.
        If you're a priority, there's no wait. If you've actually have medical emergency you're taken care of immediately.

        And yes, I'm Canadian. I've been through the medical system a handful of occasions. Is it perfect? No. Is it the slow, painful, communist system some Americans make it out to be? Hardly.
        I've been in hospital for a couple of injuries when I was younger. I've had a couple surgeries. My sister has also had surgery when she was young to correct a rather serious case of scoliosis. If we had to pay for those out of our own pockets my family would be in the poor house.
        • DooM, on 06/16/2008, -0/+1Amen - I had a premie in 2003 in the US. She was 1lbs 11oz. I was distressed over the bills I started receiving while she was in the hospital for 3 months but after a while it just became funny; I started making daily trips to the mailbox so that I could officially collapse in hysterical laughter when we reached the $1 million mark. Luckily, we were insured - unluckily that still left us on the hook for $20k+ to the hospital which, regardless of what you may hear, does NOT work with you at ALL on getting an affordable payment plan. When a common condition can destroy a family economically you know there has to be a better way.

          In regard to the article - my daughter is now 5 and completely healthy and I would've gone completely certifiably insane if they had delivered her and said "You know, society has decided that it's just not worth treating her because of the costs and the POSSIBILITY of long-term problems..."
    • jattea, on 06/16/2008, -4/+2There are no preemies in Canada?
      • Zippo, on 06/16/2008, -0/+2Oh, there are certainly preemies here, just like any other developed nation... but no body's paying millions of dollars just to keep their children alive.
    • AgentPayne, on 06/17/2008, -1/+0So do Doctors in Canada not get paid? Do nurses work on a purely volunteer basis? Do pharmaceutical and medical equipment manufactures give away their products for free? The fact is that preemie babies cost much more than full-term babies in Canada just like in America.

      You're attitude seems to be that since the government is paying for it, not you, price doesn't matter and the topic of this article doesn't apply to you. That's foolish and short sighted. The amount of money that the Canadian government has to spend on health care is finite and every million dollars spent of a preemie is a million not available for elder care, cancer treatment or anything else provided by the health care system.
      • jmreid, on 06/17/2008, -0/+2You couldn't be more wrong about my attitude.

        I know that the taxes I pay go towards paying for this. My point/attitude is that I'm happily paying those taxes for the security of the Canadian health care system.
  • mike17032, on 06/16/2008, -5/+19No, there is no such thing as to young. As long as the kid can turn out mostly "normal" in the end, its worth doing.
    • unreg, on 06/16/2008, -1/+11
      Who can determine "too young" without emotion?

    • GordonClass, on 06/16/2008, -2/+4Everything you do every decision you make involves emotion weather you realize it or not.
    • VeritasAequitas, on 06/16/2008, -0/+19Who determines "mostly normal"
      • mike17032, on 06/16/2008, -8/+1A chance at a normal life would be a good way to define it.
    • gryphon50, on 06/16/2008, -3/+6yeah, but they're saying that one third of all preemies have severe disabilities. I don't know what the answer is but personally I would rather not grow up that way...
      • DooM, on 06/16/2008, -0/+1That's 66% of preemies who you'd be dooming just to avoid having 33% of them with problems. My daughter is one of the 66% - my neice is one of the 33% and we wouldn't trade either one of them for guns OR butter.
    • Jashobeam5, on 06/16/2008, -1/+11Define "normal." My cousin is not "normal" and he was very tiny at birth. He is one of my favorite cousins, and a joy to be around. He has a good life, is very talented, makes good money and people accept him despite his handicap. I'm glad no one decided he was not "normal" enough to live.
    • CiXeL, on 06/16/2008, -1/+3except for the whole problem of 'selectively breeding' for premature births when in nature preemies would normally not survive.
      as cruel as it sounds, by allowing preemies to live you are dooming mankind to selectively breeding us towards medical-assisted births.
      which essentially dooms us as a species if civilization collapsed at some point and there were no machines and medical centers to deliver the babies.
      of course the positive side to this of allowing further development OUTSIDE the womb is it allows for larger and larger brain size cavities beyond what the birth canal is able to let naturally pass and due to that could potentially allow for greater intelligence in the long run.
      just as we wouldnt have the genious of stephen hawking today if we didnt have machines to keep him alive and communicating with us.
      • Terr01, on 06/16/2008, -1/+2"No, don't coddle your babies, and don't groom them so much! You'll lead us to a society of future apes who are all naked of hair and whose young spend most of their time helpless! You'll doom us all if we ever stop having as much time to nurture them!"

        Natural selection (and threfore evolution) is just the mathematics of tradeoffs. Medical technology is in many ways just an extension of the social systems we create.

        Of course, I may be biased, since I had an initial APGAR of zero.
      • laxidasical, on 06/16/2008, -0/+21) My wife has a uterine abnormality that causes her to have premature births. The abnormality is not genetic, but a hiccup during development if you will. Does this mean we shouldn't have children?

        2) Our first child together was 10 weeks early, weighed only 2.5 lbs. and was in the NICU for 68 days. She cost Kaiser over $340,000. Was she too expensive? I ask that because now she is doing just fine and an incredibly beautiful little girl. Would you of cut us off and told us that she was going to cost too much?

        3) Denying medical care due to costs is a VERY slippery slope. I don't think we really want to go down that road any further than we already are. What if the couple you deny would of given birth to the next Einstein or Hawkings?
        • CiXeL, on 06/16/2008, -1/+1personally i wouldnt do any of the above but i really fear for the future of our species if we continue down this route.
          your wife could have genes that make her genetic line more susceptible to that uterine abnormality-- it may not be entirely due to environmental conditions just as schizophrenics are more susceptible to developing schizophrenia but an environmental condition triggers it.

          its just like how there are more and more eye problems in civilized societies as people with eye problems continue to reproduce. we're basically ruining our genetics.
          in many third world world countries the women have zero problems with childbirth or fertility.
          i actually worked on the genome project years ago studying how artificial insemination may contribute to male fertility problems. the jury is still out.
  • Owned1Up, on 06/16/2008, -7/+6Wow, only submitted 6 other times with the EXACT same title? Good job on the research there buddy.
  • doctordbx, on 06/16/2008, -5/+12What about the sworn oath to protect life?
    • Jashobeam5, on 06/16/2008, -14/+7They turned their backs on that oath with the legalization of abortion and the acceptance of euthanasia of the sick and elderly and infanticide of children who doctors tried to abort, but lived to be born anyway.
      • harmil, on 06/16/2008, -2/+10Actually, the oath is not to protect life, but to do no harm. When protecting life violates that oath, doctors have a very hard decision to make, and I don't envy them at all for having to make it. People who try to paint matter of maternal medicine as black-and-white choices are, IMHO, doing a serious disservice to all concerned.

    • harmil, on 06/16/2008, -2/+6Protecting life is not a black-and-white affair. At some point, you have additional moral concerns to consider. Franky, anyone who tries to paint this in such stark terms is doing a disservice to the mother, the child, the family as a whole and the doctor who has to make the call.

      There's always the question of how you define life. You're talking about a situation that would have been termed a miscarriage some years ago (not a simple early labor, but labor initiated in the 20-30 week range). This is a case where the woman's body has simply aborted the pregnancy. The fetus is not fully developed, and it may never become so, even with the aid of high technology. In many cases, trying to keep such a child alive is not a kindness to the child. The further you go from normal term, the less chance the child has to develop close to normally. Heart and brain disorders are extremely common, and even if you can keep the fetus alive long enough that it reaches its nominal zeroth birthday, it may not live much longer.

      Then, there's the mother. Losing a pregnancy can be devastating, but to compare that to seeing a child develop to near-normalcy and then die... nothing compares. The bond that is formed when a mother first sees her child is unlike any other human attachment, and the loss is not something that non-mothers can comprehend. Many never recover fully.

      A mother will, of course, fight to keep their child alive. This is a good and reasonable reaction. However, a doctor has to consider the consequences in a more objective light, and can't simply do what will make the mother feel good in the short term, at the expense of the child and the mother's long-term well-being.

      I was an unusual pregnancy, but in the other direction. I fully understand that my potential life was in jeopardy as the doctors considered what their options were. As it stood, I was delivered normally, but had I posed a risk to my mother or had keeping me alive been a monumental and almost certainly doomed affair, I'm comfortable in knowing that it would have been a trained professional who understood the consequences making the call. Life is precious, but ultimately a parent can have a second child. Once you decide to raise an under-developed child or to risk the mother's life in a complicated pregnancy, you can't go back.

      • DooM, on 06/16/2008, -0/+2At the same time, the mere act of trying means that we make medical progress so that in the last generation a 28 week child is guaranteed dead, then they found a way to keep them alive, then they'll find away to keep them alive and healthy.

        My wife had a 1lbs 11oz preemie who is now 5 - happy, healthy and normal. We just had a full-term child because in the intervening 5 years just TRYING helped them identify the cause and the (actually very simple) solution to what her body was doing.
  • sandiegodude, on 06/16/2008, -2/+51My cousin was born at 24 weeks. None of the doctors expected her to survive. They said she'd be retarded, have severe health problems, be crippled, etc. if she lived. Our family never gave up hope. My aunt pretty much lived at that hospital for the 6 months she was there, most of that time in the Infant ICU unit.

    ... That was 23 years ago. My cousin is a happy, healthy and brutally smart young woman who is working on her master's degree in music. Those undeveloped lungs she was born with which the doctors said would give her respiratory problems her entire life now belt out some pretty damn good sound when she's singing semi-professionally.
    • Jashobeam5, on 06/16/2008, -4/+5I trust hope over doomsday predictions when a life is involved.
    • blackinthmiddle, on 06/16/2008, -1/+20Awesome! My oldest daughter was born at 26 weeks 5 days and 1 pound, 9 ounces. I have a picture of her with my wedding ring up to her shoulder like a large bracelet! She was in the hospital for three months. When she came out, most of her organs weren't even working yet. Because of that, she needed six blood transfusions. I was told with each blood transfusion all of the doomsday scenarios, until one time I told them to just do their work and not tell me about the details. I know how grim they are.

      Today, my oldest daughter is 8 going on 9 and has absolutely no problems. She runs, jumps, rides her bike and WON'T STOP TALKING! Black girls (we're black), for whatever reason, do the best when it comes to being premie. Then white girls. Then black boys. Finally white boys do the worst. This is what my doctors at Westchester Medical told me. Seems that statistics support this. Financially, things were hard but we've since made a full recovery. We learned that you had to apply for medicaid even if you have coverage (which we did) because people have gone bankrupt trying to pay for what their coverage doesn't, it's that expensive.

      My mother-in-law, who ironically is a neo-natal nurse said that a generation ago they wouldn't have even tried with my daughter and would have just left her to die. I think when it comes to determining how young is too young, the last thing that should come into play is, "Man, we can save the kid, but it's going to cost a lot of money!"
      • hafbaked, on 06/16/2008, -1/+4I was born 2 months premature, weighing in at 2lbs2ounces, 28 years ago. The doctors told my parents not to expect me to live, but here I am, not working at my IT job while posting on Digg, no health problems what so ever.

        Thank god it was in Canada though. Those costs are insane!
        • blackinthmiddle, on 06/16/2008, -0/+2Glad to hear you have no problems!
    • harmil, on 06/16/2008, -6/+3Sure, that can happen. I'm glad for your cousin. On the other hand, that same decision doomed many children to painful and often mercifully brief lives. How many children would you torture to get one like your cousin? It's a horrible choice, but it's a real one. You have to, hard as it is, draw a line at some point, and that line moves back with technology. Eventually, I anticipate that the line will go away entirely, but for now, our understanding of gestation is imperfect, and to play gods with the life of a child is reckless and in many cases inhumane.

      • blackinthmiddle, on 06/16/2008, -0/+2It sounds like you want to do the exact same thing; play God. While I was going to the hospital every day for my daughter, I met another couple there who's child was also born exactly 1lb 9oz. Today, that kid suffers from Asperger's syndrome, which screws with your ability to handle social situations. Should his parents have pulled the plug on him?

        I will agree, who want to torture a kid for their (possibly) brief life? Then again, you often don't know how a child will turn out.
      • DooM, on 06/16/2008, -0/+2How many children would you kill to prevent a child from having health problems..? The article says that only 33% of preemies have debilitating problems - is sparing them those problems worth dooming the vast majority of those children..?
    • look4alec, on 06/16/2008, -1/+1How hot is your cousin, on a scale of 1-10?
    • hairysandwich, on 06/16/2008, -1/+0I think that the doctors gloom and doom predictions are largely necessary for cover your ass / liability purposes. Your cousin probably had an excellent chance of survival. If the doctors were to say that though, then it for some reason didn't pan out that way. Your Aunt/Uncle likely would have sued the hospital into bankruptcy and filed malpractice against any and every doctor involved. To insulate themselves in modern america's rabidly litigious society, the doctors say "She won't make it, she'll be retarded etc." Then when she turns out fine as she was probably on track to do anyway, there's no worries, and if things don't turn out for the best... well you were warned, and they are safe (or safer) from lawsuits, sort of.
  • sodade, on 06/16/2008, -19/+24Once I am paying for this with my taxes, I will advocate setting some limits. It is not like we have a shortage of babies. Face it: YOUR child is not special.

    (awaits the massive digg down from the babies before logic crowd)
    • KineticShampoo, on 06/16/2008, -9/+7Wow. Aren't you a ***** tool.
    • meruru, on 06/16/2008, -2/+11It's not so much "babies before logic"

      By basically the same logic: Sodade, 40 year old male; a middle aged baby boomer, geez how many of those do we have already?! Why should we save his life?
      • SwingCorey, on 06/16/2008, -0/+4exactly

        Since he's past his peak performance age, he's probably getting paid too much for his job, right? (At least, by some metrics).

        Plus, isn't 40-year-old white male the typical profile of a serial killer? Maybe his life should be eradicated, in the hopes of preventing any more serial killers.

        Slippery slopes are so much fun, if you're not on it.
      • sodade, on 06/16/2008, -1/+4I sincerely concur meruru (although I am GenX, not boomer) - if I am in the hospital and have a low chance of healthy survival and it will cost 1million to try - ***** IT. From a social point of view, I am probably just going to be a big drain on a younger generation that has much more pressing problems than keeping me alive.

        The slippery slope flows both ways: We could easily see a massive increase in medical tech that will keep almost anyone alive - at a cost. If we are all paying for it, I can guarantee you that one day, our society will have to set some limit.
        • sodade, on 06/16/2008, -2/+1I should add that "***** IT" really depends on who is paying for it: my family = ***** IT, The dumb masses through taxation = keep me alive at all costs bitch!
    • jayhawken, on 06/16/2008, -2/+4Riiiight. Are we also going to set limits of care on people who eat poorly and have weight related health problems? People who smoke? Drink? Why should you have to pay for that?

      What KineticShampoo said.
      • Tex2002ans, on 06/16/2008, -1/+6You can already see it starting to happen in Europe. It happens mostly in places where socialized medicine is, since everyone pays for everyone else's medical care, everyone gets to decide what the government will pay for.

        Smoking bad? No government help for you, let us just ban smoking everywhere, and if you actually still smoke... stop smoking.

        A little too fat? No government help for you, go exercise fatty.

        Once the government begins paying for this, then you have people saying "there has to be a cut off line, it is becoming too expensive to pay for all these "preemies." This is why the government should never get involved, it is much better when the parents can decide what is too much money to spend trying to keep the baby alive.
    • mustafya, on 06/16/2008, -2/+111) I detest that view, any time we have a chance to save a human life we should take it. To do otherwise is ethically and morally corrupt.

      2) To all you people that are offended by sodade's comment but want universal healthcare. Remember that the universal healthcare will bring with it rationing. Decisions will be made on a cost-effective basis who gets what treatment.
    • blackinthmiddle, on 06/16/2008, -0/+3Okay, what would be those limits?
      • sodade, on 06/16/2008, -1/+3I have no idea and am probably not the right person to answer anyway, but someone will eventually have to (based on the direction we are heading)
    • badgers2000, on 06/16/2008, -2/+2Strong comments when you are 40 years old and can take care of yourself. When you are an 80 year old shut in who can't drive himself to the pharmacy to pick up his happy pills, you will think other people's kids are quit special. Nice short sited comment, just to get attention. Maybe your cats can help you out.
    • joclark, on 06/16/2008, -1/+4So you advocate having neglected care for my daughter, who was born at 24 weeks. She's 8 years now and healthy, smart and the apple of my eye. Walk a mile in someone else's shoe.
      • sodade, on 06/16/2008, -1/+2Did my tax money pay for your daughter's care? When it does, I will advocate the best bang for the buck - regardless of the emotional impact.
  • GordonClass, on 06/16/2008, -3/+5The problem here is the cost not that it shouldn't be done.
    • Jashobeam5, on 06/16/2008, -2/+6The problem is people who set a limit on what a life is worth. If you ever have a premie child, you would quickly realize there is not enough money on earth to trade for the life of that child and it be too much money.
      • Tex2002ans, on 06/16/2008, -3/+1Actually there is a limit on what a life is worth. Let us say this baby dies, and the family sues the hospital and you were the judge. How much money should be given?

        You can choose between $0 and every single piece of money in the world. You will have to find some limit in between there that is "not too much" and "not too little" (according to yourself).
  • GorfTron, on 06/16/2008, -9/+2Preemies are also the most delicious.
  • tanuki0, on 06/16/2008, -2/+412 freaking bills a day? I've got friends who were twins and preemies and their parents never saw a bill. They couldn't have paid one anyway.
    But that's really sad to have kids and see them in pain so early, and constanly in pain. I don't know if I'd want my kid to live with this world of pain.
    • Jashobeam5, on 06/16/2008, -1/+3The kids are thankful their parents and medical staff worked so hard so they could have a chance to make the world a better place.
      • tanuki0, on 06/18/2008, -0/+1Of course...but that's not what I meant.
  • Nintendesert, on 06/16/2008, -4/+5A better discussion is the money being dumped into the medical care of those that choose to live unhealthy and self damaging lifestyles of their own free will. Be it the heavy drinkers, the fatties, the smokers or the druggies. They choose to destroy their lives and we still gladly pay the bill. But these babies have done nothing wrong except be born alive.
    • blackinthmiddle, on 06/16/2008, -0/+2Agreed. My daughter was born 1lb 9 oz and is completely healthy today with no ill effects whatsoever. I couldn't dream of saying, "Man, we could have saved you but it's just so damn expensive!" I think the discussion should really center around eliminating all of the bloat in the system.
      • DooM, on 06/16/2008, -0/+1THAT is right on - I'm not sure how they're cooking the books but when I was looking at what they were charging me every time they gave my 1lbs 11oz daughter a new pacifier or even a drop of sugar water to make her happier during 'procedures' I about fainted. $60 for a pacifier might be ok for a government contract but for a hospital..?
  • judolphin, on 06/16/2008, -3/+12Wow... I don't care how widespread a practice or how socially acceptable it is: whether you're an HMO, a government, a hospital, or anything else, it's beyond messed up to put a price tag on a human life. When you boil it down, life -- ours and the lives of the ones we love -- is all we have.
    • buba1243, on 06/16/2008, -4/+6The problem is that resources aren't infinite. Just like we can't have a world where their are no poor. It just doesn't work with today's technology. Start building the stuff from star trek then you can stop putting prices on these sort of things.
    • harmil, on 06/16/2008, -4/+4So, if a life is involved... what? You want to pay for the equipment? Should the doctors not get paid? Should the parents be stripped of the ability to sue so that insurance can be waived? Ignoring the fact that there are other concerns, here, what do you suggest doing?

  • swei, on 06/16/2008, -0/+11My boy is in the NICU right now (30 weeks) and we pretty much see claims and bills everyday. Just about everything is paid for by BCBS, but some out of network issues have come up and it's a real pain in the ass to get appeals through.
    • blackinthmiddle, on 06/16/2008, -0/+7I pray for the best. My daughter was born at 26 weeks 5 days and 1lb 9oz. Between our coverage and medicaid, pretty much all of our bills were taken care of. In the US, it's imperative that you apply for medicaid in these cases (I believe it was when your kid is going to be in the hospital for more than 30 days). I've read many a story of people going bankrupt just trying to cover what their insurance doesn't. Our kid was in the hospital for three months.
      • swei, on 06/16/2008, -0/+3Yeah, the social worker at the hospital has given us papers to file for instutional medicaid (>30 days). We just haven't had time to go over there between working and hospital visits.
        • blackinthmiddle, on 06/16/2008, -0/+3If I remember correctly, there's a small window of opportunity in which you can apply. Check and make sure what it is and don't apply too late.
        • swei, on 06/16/2008, -0/+1The wife just came back from the office with all the necessary forms. They'll meet her tomorrow before 11. So I guess we're still in the clear.
  • WRXFiles, on 06/16/2008, -8/+8It is a question that has to be faced, if not now, then soon.

    What amount of money is too much to spend on saving/prolonging a life?

    For those that would say there is no amount, just put another zero on the end of that number, and then another. At some point it becomes obvious. There is such an amount. Perhaps it will help to quantify it by asking what other purpose that same money could serve?

    People are the one thing this world has in over abundance. As much as you may 'feel' that the members of your tribe are special and require saving at any cost, that is a 'feeling' derived from the competitive forces of evolution, and no longer relevant in a society when competition for resources is increasingly likely to result in global wars, and further increased population endangers the future of all our families and all of our children.
    • spxiii, on 06/16/2008, -1/+3So we should evolve into sociopaths for our own good? I think if you had a child you would be singing a different tune.
    • DooM, on 06/16/2008, -0/+1Here's the thing - luckily dropping stacks of cash into an incubator or onto a hospital bed does nothing for care. There are certain premies who are going to die no matter what because we don't know enough medically yet to prevent it - but there is nothing that a hospital shouldn't attempt to try to save that life. There are medical limits to what they can actually do, however, which means that the price tag is never infinite - there's a reason that the soap opera doctor cliche' of "There's nothing more we can do" is a cliche' - eventually there's nothing more you can do.
  • amightywind, on 06/16/2008, -11/+6In a society that has grown comfortable slaying the unborn out of convenience, I guess there is such a thing as too young. I would much rather my tax dollars went to support premature infants than the pointless and narcissistic lives of the elderly through Social Security.
    • Jashobeam5, on 06/16/2008, -1/+3How can I digg you up for the first 2 sentences and down for the last one?
      • harmil, on 06/16/2008, -3/+1"How can I digg you up for the first 2 sentences and down for the last one?"

        You have to make a choice: is the cost involved in digging up a comment that you know probably isn't meant to live too great?

        Ok, sarcasm aside, there's an obvious gulf of thought, here. "Slaying the unborn"? We're talking about keeping a miscarriage alive, at tremendous cost to the child in terms of pain and suffering (not all premature children, but MANY, and far more the earlier they are delivered). At some point THAT cost becomes too great, and it's immoral of us to interfere in what the mother's body (and God, if you believe in one) has already decided is not a pregnancy that should be saved.

        I'd be much more comfortable if we just draw a line in the sand and say, "at a certain point, we do what we can with limited resources, and let nature take it's course if that's not enough."

        The actual cash money involved is less of an issue, but obviously you have to decide how much you CAN spend on keeping these fetuses alive. Wealth is nice to have, and some countries can afford quite a bit, but it has limits.

        • msflower97, on 06/16/2008, -0/+1Perhaps to you this will be just semantics, but a miscarriage is defined as a loss at 19 weeks or under...a baby born dead after 20 weeks is considered stillborn, and a baby born alive after 20 weeks is pretty much like any other baby born alive, except that the smaller and less developed they are, there is less anyone can do for them, especially if they already have birth defects.
    • spxiii, on 06/16/2008, -1/+1Your first point is worth digging on its own merit, but your second point is only worth digging for the satirical humor value.
      • amightywind, on 06/16/2008, -1/+2I think my comment suggests an honest debate. Currently tax money in the US is allocated grotesquely in the favor of the old. We can attribute this to the tyranny of the vote which disenfranchises those under the age of 18, ~25% of citizens. We like to think we are doing our best for youth, but are we? Are we a people who value life or just grimly determined to put off our own death until the last possible moment. I'd say it was the later.
        • SwingCorey, on 06/16/2008, -1/+2well put
        • spxiii, on 06/16/2008, -1/+2I understand your point better this time. As with all tax programs, the benefits are greatest to those who exploit the system the best. And look no further than the fossils that hold all the power.
  • wastedthelight, on 06/16/2008, -0/+2Thought it was a story about Alice Cooper...guess I'll let it slide this time...
  • SpaceBass, on 06/16/2008, -0/+5We have to ask one question: If a hospital is lucky they have a 3-4% operating margin (most are not in the black currently) but the CEO of Atena (BSCS) took home $12 Million in 2007 (not to mention bonuses). Why?
    • thawkth, on 06/16/2008, -1/+0Shhh!

      Our healthcare system is second to none!

      Our life expectancy is terrible, overall we're completely reactionary when it comes to medicine and far from proactive.

      We treat symptoms more often than anything else.

      All for the buck - and don't forget to remind the people they need another pill! Spend spend spend!

      Or we can join the rest of the first world...

      No system is perfect, but ours isn't
  • pizpot, on 06/16/2008, -2/+5We've already halted (or reversed) human evolution and replaced it with modern medicine. Sure it is a pickle, but picking on babies is only going to get you hated. I'd wait till we have a proper society to tackle this one.
    • spxiii, on 06/16/2008, -0/+2You speak of evolution in humans as though you would have made the cut. I'm in no position to say either way, but please explain.
    • pinchduck, on 06/16/2008, -0/+4Nope. We may have alleviated some evolutionary pressures through modern medical and infrastructure techniques, but others have taken their place. Furthermore, the gene crossover that happens at fertilization is still going on. The first rule of Evolution Club is you do not stop evolution.
  • vikki77, on 06/16/2008, -0/+3If one of my children was born premature, I honestly don't think I would spare any expense to save their lives. But I have also made it clear that I do not want to be kept alive with machines should that time ever come. I guess when it's a grown person, it's a little more acceptable to say enough is enough.
    I don't know how those parents, doctors, and nurses keep up their spirits when surrounded with such sadness every day.
  • uneasyryder, on 06/16/2008, -0/+7I had twins that were born at 26 weeks. My son weighed 1lb 5oz and my daughter weighed 1lb 3oz. They stayed in the NICU for over 3 months before coming home with us.

    They are now 14 months old and are perfectly normal healthy babies. If you put them side by side with a normal term baby that is 3 months younger, you would never be able to tell the difference.

    All of our bills were paid for by BCBS. The total bill for the 3 month stay in the NICU, twin delivery, and multitude of tests that were run on them... the tab came out to be right at $500,000.
    • fantasticjon, on 06/16/2008, -0/+4The thing is, that these numbers the hospital and the insurance companies throw around are a farce. I am sure the hospital billed the insurance company $500,000, and the insurance company probably negotiated them down to $150,000, but there is no real link between the actual cost of service and the price charge.

      I went the the ER with extreme back pain a few months ago. It turned out just to be muscle spasms and I was given pain killer and sent on my way. While I was there they performed a CAT scan, chest x-ray, and a myriad of blood tests. I spend maybe 10 minutes with a doctor and maybe 40 minutes with a nurse. total cost $6000. (that cat scan was several thousand alone) That sounds reasonable because we are brainwashed by the industry into thinking it sounds reasonable. I realize I am also paying for the hospital to treat uninsured patients too, but $6000? I think the biggest problem with the American healthcare system is the lack of transparency in pricing. The consumer cannot shop their healthcare because the real prices are veiled. The market cannot work.
      • SpaceBass, on 06/16/2008, -0/+2you are correct that there is a huge problem with pricing transparency. Hospitals struggle every day to remain solvent. Its a cat and mouse game where charges are increased where the insurance companies pay more and decreased where the pay less. So while $6,000.00 may not represent the true cost of a CT scan, it is fairly close to the overall cost of the course of treatment (hopefully with 2% left to cover operating expenses, etc, but usually its a loss).

        If we want fair pricing then we need to demand it from the payors. The insurance companies are the ones who need to consent and open their books - hospitals are required to report cost information to the sates already.
  • herbertstrasse, on 06/16/2008, -1/+2I was born at 28 weeks and turned out okay :D
  • jayhawk88, on 06/16/2008, -1/+7What's hilarious about all you "of course there needs to be a limit" people is that it would all change if and when it were your child born at ~28 weeks or whatever. You think that it wouldn't change anything, but take it from all the parents and, like me, soon to be parents here: It would change everything.
    Very easy for people with children born normally, or those without children, to say "Well it's a tragedy" or "You're child is not special", but I promise you every one of you would change your tune 100% if it were your child in this situation. There isn't anything wrong with this thinking either, it's evolution.
    • locke2002, on 06/16/2008, -1/+0"all you 'of course there needs to be a limit' people"

      Excuse me? Who do you think you're talking to here? All I see going down this thread is pro, pro, pro. The few "of course there needs to be a limit" people are getting buried straight to China.

      And of ***** course it changes your mind if the tragedy affects you.
    • opticbit, on 06/16/2008, -1/+0If the odds are good at having a normal healthy life, yes I want my child to survive, but if they are going to have a sever handicap, I would not want that kind of life for my child, nor would I want to have to provide the extra support they would need. With a preemie not much has been invested into their life, start over and this time around carry it closer to full term
  • cacharo, on 06/16/2008, -0/+1I am the proud father of twin 2lb, 26 weekers. We were briefed on all of the percentages and the risks of the many setbacks that can come with prematurity. They each spent over 3 months in the NICU/Special Care Nurseries. They are 6 months old now and have thankfully landed in the favorable side of most the major risk areas. They are still small for their age but will catch up in time. The bills were certainly up there, but our insurance had paid for most of it and you as a taxpayer helped out with what we could not cover. As a result, we are able to pay our taxes spending money taking care of them until they are able to enter the workforce, pay their taxes, and take care of us.
  • muckemuck, on 06/16/2008, -0/+6We're spending 400 Million every day in Iraq.. and we're arguing over saving a life?
  • endus, on 06/16/2008, -3/+0I think probably about 8 years old should be the cutoff. Below that they're really not much good to us anyway. You figure at about 8 you can start them in the shoe factory or at the very least mowing lawns or dying leather.
  • rawg, on 06/16/2008, -1/+4The question really isn't whether or not saving a child is worth a million dollars, of course it's worth it. If a piece of jewelry can be worth a million dollars, than the life of a child most definitely is. The question is, as a society can we use that million dollars that would have been spent to save one child to save even more children? And in this day and age, would we? Tough questions.
  • SwingCorey, on 06/16/2008, -1/+2this is one of the few instances where I am proud to be a taxpayer.

    When my money goes to helping preemies through Medicare and Medicaid, I don't mind paying my taxes. When I hear it's going to pork barrel projects - not so happy.
  • shieldsikebana, on 06/16/2008, -0/+2I love how this articles tone indicates people seem to like to have premature babies.
    • joclark, on 06/16/2008, -3/+2This is such an terrible thing to say. 8 years ago my daughter was born at 24 weeks, weighing 1 lb 10.5 ounces. We were wrecked, but she is happy and healthy now thanks to the amazing people that fought so hard for her and for us. You should be totally ashamed of yourself for such a comment.
      • DooM, on 06/16/2008, -0/+1Your outrage valve is stuck open - he was just saying that the ARTICLE uses an odd tone and I concurred when I read it.

        -Father of a 1lbs 11oz premie with a fully functional outrage valve. :)
      • kpezzy, on 06/16/2008, -0/+1Not too bright huh?
  • saturnx8, on 06/16/2008, -3/+2spartan times, can't survive with out help and constant assistance, chuck em over the cliff... enough said.
  • joclark, on 06/16/2008, -1/+3My daughter just turned 8. She was born at 24 weeks, weighing 1 lb. 10.5 ounces. I love her beyond belief. She's happy and healthy, no major long-term consequences of her prematurity. As a parent, all you want is for your child to be happy and healthy. We as a society should support that. Walk a mile in someone else's shoes before passing any kind of judgment. We can approve spending billions of dollars for war, but have to fight tooth and nail for health care coverage. It's just an insane way to look at the world.
  • cyberdependent, on 06/16/2008, -0/+3I just hate that this was Business Week, so a lot of their slant was "OMG It costs companies so much for workers to have sick kids! If workers had dead kids, they could get back to work sooner!"

    Screw you business week. And screw you, USA. If we're such a damned "pro-family" nation, why the hell don't we provide ANY sort of maternal leave? Before it mattered to me, I assumed we did, but no, we don't. The best we get is FMLA which is "We won't fire you for a month or two, but we sure as hell aren't going to pay you." Makes me sick.
    • korvan504521, on 06/16/2008, -0/+1um, my company provides several weeks of maternity leave. how much are you asking for?
      • msflower97, on 06/16/2008, -0/+1Just because *your* company provides it doesn't mean all companies do. Even FMLA is only required in companies with 50 or more employees.
      • girlpirate, on 06/17/2008, -0/+2my Country gives me a year.
      • cyberdependent, on 06/17/2008, -0/+1I work for the largest University in my state, my wife works for the State government. Both of our employers are considered to be among the most employee-friendly in our area (and indeed in my experience they are several orders of magnitude better than any of the private sector employers I've had) but both provide ZERO days of maternity leave. My employer allows leave for faculty, but I am only staff.
  • opticbit, on 06/16/2008, -1/+2All the problematic people are consuming resources that others could be using. People are becoming desensitized to reality of life. If an animal knows its child will not survive the animal will kill it. With intelligence we are becoming dumber weaker and fatter . I hate to sound like Hitler here but something has to be said and done. Why not start over if the child is going to suffer through out their life. I still say help them if the odds of growing up without any disabilities are good. If something happened to me and I became a vegetable, I would want them to pull the plug, give me a week or month based on the odds of a full recovery. We are headed in the wrong direction, the Hippocratic oath should be up to interpretation, in modern society we are being penny wise and dollar foolish. Do we really need to continue moving in a direction that enslaves us to the mentally or physically challenged that provide nothing in return, other than the wonderful felling of helping someone. That $1 million could go to save 1 life or 1000.
    • badgers2000, on 06/16/2008, -1/+0"hate to sound like Hitler" Then stop sounding like him. Society's benefit is not the purpose of a person's life. One's own life is the purpose one's own life. When a person creates a child, that child becomes an extension of one's own life. Society "should" support (private donations) the effort of individual's protecting and extending their lives. Society should not be held at gun point (taxes) to support an individual's effort to extend their life
      • thecatcantalk, on 06/16/2008, -1/+2"One's own life is the purpose of life"? Really?

        Half the people on Earth are Chinese, and nearly all of them would find that statement of yours to be profoundly immoral and wicked, the precise opposite of Confucian wisdom. Just because OUR society is based on self-obsession and near-total disregard for the social consequences of one's actions, that doesn't mean this is "normal". Most people on this planet wouldn't agree.

        For example, our custom of throwing our kids out of the family home on their 18th birthday is viewed by most Asian parents with horror...as is our custom of ignoring and neglecting our parents, once they're old and sick.

        China's been a nation for 5,000 years. We've been one for 250. Maybe we don't know it all. People aren't "equal", dude, they never were. Saying it doesn't make it true. And meddling with natural selection is not always an unqualified good.
        • kpezzy, on 06/16/2008, -0/+1Natural selection bro? are you kidding? these kids aren't still born, so by your theory if you fall victim to a deadly "treatable" disease we shouldn't intervene with our technology that can save your life because we will be intervening with natural selection? RETARRRRRRRD
        • badgers2000, on 06/17/2008, -0/+0Right you are talking about a state run society and I am living in a free society (in theory). In a state run society the morality is obviously going to lean towards the state's benefit. All public actions are done with the good of society in mind.

          However your view of American culture is obviously influenced heavily by coastal observations or TV. It may be your experience that people throw their kids on the street at 18 and are socially irresponsible at the benefit of their own self interests. That is not the reality that I see.

          The point here is that if everyone maintains an interest in themselves and their offspring as themselves, society will solve its own problems. In a "free" society my neighbor's well being benefits me. The future of world benefits my children which I tend to as myself, so it is in my interest to protect it. My parents cared for me so I will care for them. The problems in America arise from the fact that we are not exactly a free society.

          Where as if everyone lives with the state's interests above their own, you have the bulk of the people working to benefit the few in government positions. And you need a license to procreate in the first place.
  • kpezzy, on 06/16/2008, -0/+1My son Cody is 13 years old when he was born 5 months early in 1995 he wasnt given a huge chance to survive he weighed 1 pound 11 ounces when he was born and the technology then wasnt as good as today , but today he is the *****! perfect health! and one bad MO FO at moto-x, These people that work with preemies are heroes in my eyes, and who is to say weather these kids get to live or die? So if you are in a car wreck should we not use Technology to save you? should we let you die just because that money could be used to save more people? ***** retarrrrrd
  • sps2003, on 06/16/2008, -1/+1Yep, premature babies cost too much, so we should let them die...
    In fact, Down-Syndrome children are really expense too, die...
    Old people in managed care facalities, well they cost to much so should die...
    Crippled ($) Blind ($$) Cancer ($$$) MS ($$$$) ALS ($$$$$) Die$! Die$$!! Die$$$!!!

    By the way, Heil Hitler!!
  • msflower97, on 06/16/2008, -0/+0My daughter was born at 24 weeks weighing 1 lb. 3 oz. There was nothing wrong with her when she was born...it was me who was sick (preeclampsia and HELLP syndrome) and I have no idea what caused it. She lived for only a week -- even with the excellent care and compassion she received in the NICU, she was not one of the lucky ones. We desperately hoped she would live and would not have any serious, lasting problems throughout her life, but there was no way to predict how that would go. At the end, there was nothing else that could be done and I felt I had to let her go rather than telling them to resuscitate her no matter what...but that was so she would not suffer. (She ended up dying on her own before any last minute "rescue" efforts would have needed to be made.)

    As a parent, I would have done anything in my power to keep her healthy so she could grow up and stay with us. Unless you're a parent, you may very well have no understanding of why we should at least try to help these tiny preemies survive, but at least try to empathize with a fellow human being and stop whining about your bottom line. No parent should ever have to lose a child.
  • synik, on 06/16/2008, -1/+2I like living in a 1st world country (Australia) where I don't have to worry about the cost of medical care.
    • Leomarth, on 06/17/2008, -0/+1Do you think the cost is paid for by magic fairy dust lint? It's paid for by your taxes and/or debt spending.
      • girlpirate, on 06/17/2008, -1/+2why is it that everyone seems to think that people living in countries with health care are idiots? we are well aware that we pay for it through taxes. we get that. what we mean when we say " thank goodness i live in _____, I don't have to worry about healthcare costs" is that we do not have to worry about what each little visit will cost us when it happens. if a tragedy occurs we don't get a bill to go along with it.
        I have no damn clue what the MRI cost me. we do not know how much my grandmothers brain surgeries cost. We have no idea how much it cost for my nephews to be in the ICU for a month.
        I just continue to pay my taxes like everyone else. and everyone else receives medical care just like I do. If people want to cross the border for their, then they are welcome to it. I'll take advantage of the healthcare that I can afford.
      • synik, on 06/20/2008, -1/+1I know it's paid for by my taxes... that's why I'm HAPPY to pay my taxes. It's great that my tax dollars also help those who can't work due to illness, age, or disability.

        The US healthcare system seems like something out of the 1800s to me (in terms of access, not quality of care).
        • Leomarth, on 06/22/2008, -0/+1Then you do ultimately have to worry about the cost!

          And actually, in the 1800's almost everybody was able to have access to health care because the government was out of it. People had friendly relations with the medical practitioner.
  • spencerante, on 06/17/2008, -0/+0Hi folks, This is the writer of the story, Spencer Ante. I want to thank everyone for posting such personal and passionate comments. I also want to make one thing clear, if it wasn't clear in the story: I am a big fan of NICUs, and believe they provide a huge benefit to families and society at large. As many of your stories show, a lot of preemies can be helped and go on to live normal or near-normal lives. This is a wonderful thing. As a parent, I would want to do everything in my power to save my child's life if I thought they had any shot at leading a normal life.

    However, I do think it is legitimate to ask the tough questions that I asked in the story--questions that are being asked and addressed every day by health care practicioners across the world. My purpose in the story was to highlight the amazing work being done in these NICUs and to spark a debate about how we should handle these complex ethical and economic quandaries. And thanks to this message board and others, I think we are collectively accomplishing that goal. I look forward to continuing the dialogue.

    Check out my blog Creative Capital for more info and analysis about this story and others:
    http://creativecapital.wordpress.com/
    best,
    Spencer
  • Leomarth, on 06/17/2008, -0/+1Oh noes! Ban all preemie babies! They cost us too much monies!
  • sealink, on 06/17/2008, -1/+2I see a lot of people talking about how they would do anything to keep their child alive no matter how premature or handicapped. I'm going to step up and admit that I'm not capable of managing a special-needs child. Part of being a parent and being responsible for someone else's life is realizing when you're overwhelmed by something. So many in this thread seem to pretend that people like myself, people who are honest about what they are and are not capable of handling, don't exist. It takes a special, wonderful person to take care of children like that. And I'm not one of them.

    Bury away.
  • Ortheos, on 06/17/2008, -0/+1Chick: "Sweetie...I'm pregnant..."

    Dude: *runs away*
  •  

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